Hospital Twin Falls, ID

St Luke's Magic Valley Regional Medical Center

Listed in its price file as “St Luke's Magic Valley Regional Medical Center, LTD”.

St Luke's Magic Valley Regional Medical Center in Twin Falls, ID publishes cash prices for 524 common procedures listed here, from its own machine-readable price file updated Mar 25, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Idaho median for 250 of 524 procedures and below it for 156. By typical cash price it ranks #16 of 33 Idaho hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

801 Pole Line Rd W., Twin Falls, ID 83301-5810 Collected Sep 22, 2026 Source price file Check a bill from this hospital (208) 814-1000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 130002 · CMS hospital register NPI 1932154705

The price file shows no self-pay discount

For 1858 of the 1858 prices listed here, the cash price in St Luke's Magic Valley Regional Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Financial assistance

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

St Luke's Magic Valley Regional Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Abdominal CT scan without and with contrast CPT 74170	$1,093.00	$1,093.00	—	13% below	—
Abdominal CT scan without and with contrast inpatient CPT 74170	$1,816.00	$1,816.00	—	—	—
Abdominal X-ray, 2 views CPT 74019	$441.00	$441.00	—	47% above	—
Abdominal X-ray, 2 views CPT 74019	$441.00	$441.00	—	47% above	—
Abdominal X-ray, 2 views inpatient CPT 74019	$441.00	$441.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019	$441.00	$441.00	—	—	—
Ankle X-ray, complete, 3 or more views CPT 73610	$365.00	$365.00	—	27% above	—
Ankle X-ray, complete, 3 or more views CPT 73610	$365.00	$365.00	—	27% above	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610	$365.00	$365.00	—	—	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610	$365.00	$365.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922	$695.00	$695.00	—	67% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922	$1,158.00	$1,158.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200	$819.00	$819.00	—	20% below	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200	$1,361.00	$1,361.00	—	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220	$589.00	$589.00	—	40% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220	$589.00	$589.00	—	40% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220	$589.00	$589.00	—	—	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220	$589.00	$589.00	—	—	—
Bone scan, whole body (nuclear medicine) CPT 78306	$1,425.00	$1,425.00	—	at median	—
Bone scan, whole body (nuclear medicine) CPT 78306	$1,425.00	$1,425.00	—	at median	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306	$1,425.00	$1,425.00	—	—	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306	$1,425.00	$1,425.00	—	—	—
Breast ultrasound, complete, one breast CPT 76641	$441.00	$441.00	—	7% above	—
Breast ultrasound, complete, one breast CPT 76641	$441.00	$441.00	—	7% above	—
Breast ultrasound, complete, one breast inpatient CPT 76641	$441.00	$441.00	—	—	—
Breast ultrasound, complete, one breast inpatient CPT 76641	$441.00	$441.00	—	—	—
Breast ultrasound, limited (one breast or one area) CPT 76642	$365.00	$365.00	—	14% above	—
Breast ultrasound, limited (one breast or one area) CPT 76642	$365.00	$365.00	—	14% above	—
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642	$365.00	$365.00	—	—	—
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642	$365.00	$365.00	—	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174	$2,263.00	$2,263.00	—	at median	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174	$3,763.00	$3,763.00	—	—	—
CT angiography (CTA) of the head CPT 70496	$1,093.00	$1,093.00	—	25% below	—
CT angiography (CTA) of the head inpatient CPT 70496	$1,816.00	$1,816.00	—	—	—
CT angiography (CTA) of the neck CPT 70498	$1,093.00	$1,093.00	—	26% below	—
CT angiography (CTA) of the neck inpatient CPT 70498	$1,816.00	$1,816.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275	$1,093.00	$1,093.00	—	30% below	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275	$1,816.00	$1,816.00	—	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574	$2,263.00	$2,263.00	—	37% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574	$3,763.00	$3,763.00	—	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571	$677.00	$677.00	—	577% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571	$1,126.00	$1,126.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176	$1,857.00	$1,857.00	—	13% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176	$3,087.00	$3,087.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177	$2,263.00	$2,263.00	—	at median	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177	$3,763.00	$3,763.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178	$2,263.00	$2,263.00	—	2% below	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178	$3,763.00	$3,763.00	—	—	—
CT scan of the abdomen with contrast CPT 74160	$1,093.00	$1,093.00	—	7% below	—
CT scan of the abdomen with contrast inpatient CPT 74160	$1,816.00	$1,816.00	—	—	—
CT scan of the abdomen without contrast CPT 74150	$819.00	$819.00	—	10% below	—
CT scan of the abdomen without contrast inpatient CPT 74150	$1,361.00	$1,361.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486	$819.00	$819.00	—	4% below	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486	$1,361.00	$1,361.00	—	—	—
CT scan of the head or brain, no contrast dye CPT 70450	$819.00	$819.00	—	18% below	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450	$1,361.00	$1,361.00	—	—	—
CT scan of the head with contrast CPT 70460	$1,093.00	$1,093.00	—	at median	—
CT scan of the head with contrast inpatient CPT 70460	$1,816.00	$1,816.00	—	—	—
CT scan of the head without and with contrast CPT 70470	$1,093.00	$1,093.00	—	16% below	—
CT scan of the head without and with contrast inpatient CPT 70470	$1,816.00	$1,816.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131	$819.00	$819.00	—	12% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131	$1,361.00	$1,361.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125	$819.00	$819.00	—	26% below	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125	$1,361.00	$1,361.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193	$1,093.00	$1,093.00	—	9% below	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193	$1,816.00	$1,816.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880	$1,303.00	$1,303.00	—	44% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880	$2,171.00	$2,171.00	—	—	—
Chest CT scan without and with contrast CPT 71270	$1,093.00	$1,093.00	—	30% below	—
Chest CT scan without and with contrast inpatient CPT 71270	$1,816.00	$1,816.00	—	—	—
Chest X-ray, 2 views CPT 71046	$365.00	$365.00	—	41% above	—
Chest X-ray, 2 views CPT 71046	$365.00	$365.00	—	41% above	—
Chest X-ray, 2 views inpatient CPT 71046	$365.00	$365.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046	$365.00	$365.00	—	—	—
Chest X-ray, single view CPT 71045	$365.00	$365.00	—	58% above	—
Chest X-ray, single view CPT 71045	$365.00	$365.00	—	58% above	—
Chest X-ray, single view inpatient CPT 71045	$365.00	$365.00	—	—	—
Chest X-ray, single view inpatient CPT 71045	$365.00	$365.00	—	—	—
Collarbone (clavicle) X-ray, complete CPT 73000	$365.00	$365.00	—	29% above	—
Collarbone (clavicle) X-ray, complete CPT 73000	$365.00	$365.00	—	29% above	—
Collarbone (clavicle) X-ray, complete inpatient CPT 73000	$365.00	$365.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient CPT 73000	$365.00	$365.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770	$441.00	$441.00	—	6% below	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770	$441.00	$441.00	—	6% below	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770	$441.00	$441.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770	$441.00	$441.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080	$441.00	$441.00	—	36% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080	$441.00	$441.00	—	36% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080	$441.00	$441.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080	$441.00	$441.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081	$365.00	$365.00	—	95% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081	$365.00	$365.00	—	95% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081	$365.00	$365.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081	$365.00	$365.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811	$1,001.00	$1,001.00	—	56% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811	$1,001.00	$1,001.00	—	56% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811	$1,001.00	$1,001.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811	$1,001.00	$1,001.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250	$819.00	$819.00	—	9% below	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250	$1,361.00	$1,361.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260	$1,093.00	$1,093.00	—	8% below	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260	$1,816.00	$1,816.00	—	—	—
Diagnostic mammogram, both breasts CPT 77066	$407.00	$407.00	—	at median	—
Diagnostic mammogram, both breasts CPT 77066	$407.00	$407.00	—	at median	—
Diagnostic mammogram, both breasts inpatient CPT 77066	$407.00	$407.00	—	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066	$407.00	$407.00	—	—	—
Diagnostic mammogram, one breast CPT 77065	$319.00	$319.00	—	at median	—
Diagnostic mammogram, one breast CPT 77065	$319.00	$319.00	—	at median	—
Diagnostic mammogram, one breast inpatient CPT 77065	$319.00	$319.00	—	—	—
Diagnostic mammogram, one breast inpatient CPT 77065	$319.00	$319.00	—	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925	$1,303.00	$1,303.00	—	69% above	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925	$2,171.00	$2,171.00	—	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970	$1,303.00	$1,303.00	—	62% above	—
Duplex ultrasound of the leg veins, both legs CPT 93970	$1,628.00	$1,628.00	—	103% above	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970	$1,628.00	$1,628.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970	$2,171.00	$2,171.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306	$2,729.00	$2,729.00	—	50% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306	$2,729.00	$2,729.00	—	50% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306	$2,729.00	$2,729.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306	$2,729.00	$2,729.00	—	—	—
Elbow X-ray, 2 views CPT 73070	$365.00	$365.00	—	51% above	—
Elbow X-ray, 2 views CPT 73070	$365.00	$365.00	—	51% above	—
Elbow X-ray, 2 views inpatient CPT 73070	$365.00	$365.00	—	—	—
Elbow X-ray, 2 views inpatient CPT 73070	$365.00	$365.00	—	—	—
Elbow X-ray, complete, 3 or more views CPT 73080	$365.00	$365.00	—	17% above	—
Elbow X-ray, complete, 3 or more views CPT 73080	$365.00	$365.00	—	17% above	—
Elbow X-ray, complete, 3 or more views inpatient CPT 73080	$365.00	$365.00	—	—	—
Elbow X-ray, complete, 3 or more views inpatient CPT 73080	$365.00	$365.00	—	—	—
Eye socket (orbit) CT scan without contrast CPT 70480	$819.00	$819.00	—	4% below	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480	$1,361.00	$1,361.00	—	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150	$441.00	$441.00	—	45% above	—
Facial bones X-ray, complete, 3 or more views CPT 70150	$441.00	$441.00	—	45% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150	$441.00	$441.00	—	—	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150	$441.00	$441.00	—	—	—
Forearm X-ray (radius and ulna), 2 views CPT 73090	$365.00	$365.00	—	38% above	—
Forearm X-ray (radius and ulna), 2 views CPT 73090	$365.00	$365.00	—	38% above	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090	$365.00	$365.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090	$365.00	$365.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226	$1,425.00	$1,425.00	—	at median	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226	$1,425.00	$1,425.00	—	at median	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226	$1,425.00	$1,425.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226	$1,425.00	$1,425.00	—	—	—
Hand X-ray, 2 views CPT 73120	$441.00	$441.00	—	48% above	—
Hand X-ray, 2 views CPT 73120	$441.00	$441.00	—	48% above	—
Hand X-ray, 2 views inpatient CPT 73120	$441.00	$441.00	—	—	—
Hand X-ray, 2 views inpatient CPT 73120	$441.00	$441.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650	$365.00	$365.00	—	14% above	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650	$365.00	$365.00	—	14% above	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650	$365.00	$365.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650	$365.00	$365.00	—	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806	$743.00	$743.00	—	at median	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806	$743.00	$743.00	—	at median	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806	$743.00	$743.00	—	—	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806	$743.00	$743.00	—	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811	$4,833.00	$4,833.00	—	46% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811	$4,833.00	$4,833.00	—	46% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811	$4,833.00	$4,833.00	—	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811	$4,833.00	$4,833.00	—	—	—
Knee X-ray, 3 views CPT 73562	$365.00	$365.00	—	3% above	—
Knee X-ray, 3 views CPT 73562	$365.00	$365.00	—	3% above	—
Knee X-ray, 3 views inpatient CPT 73562	$365.00	$365.00	—	—	—
Knee X-ray, 3 views inpatient CPT 73562	$365.00	$365.00	—	—	—
Knee X-ray, complete, 4 or more views CPT 73564	$441.00	$441.00	—	23% above	—
Knee X-ray, complete, 4 or more views CPT 73564	$441.00	$441.00	—	23% above	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564	$441.00	$441.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564	$441.00	$441.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700	$819.00	$819.00	—	18% below	—
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700	$1,361.00	$1,361.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705	$441.00	$441.00	—	at median	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705	$441.00	$441.00	—	at median	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705	$441.00	$441.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705	$441.00	$441.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882	$441.00	$441.00	—	12% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882	$441.00	$441.00	—	12% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882	$441.00	$441.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882	$441.00	$441.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271	$819.00	$819.00	—	1% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271	$1,361.00	$1,361.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590	$365.00	$365.00	—	35% above	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590	$365.00	$365.00	—	35% above	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590	$365.00	$365.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590	$365.00	$365.00	—	—	—
MR angiography (MRA) of the head without contrast CPT 70544	$1,857.00	$1,857.00	—	18% above	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544	$3,087.00	$3,087.00	—	—	—
MRI of both breasts, without and then with contrast dye CPT 77049	$2,780.00	$2,780.00	—	at median	—
MRI of both breasts, without and then with contrast dye inpatient CPT 77049	$4,280.00	$4,280.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721	$1,857.00	$1,857.00	—	5% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721	$3,087.00	$3,087.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723	$2,263.00	$2,263.00	—	at median	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723	$3,763.00	$3,763.00	—	—	—
MRI of the abdomen without contrast CPT 74181	$1,857.00	$1,857.00	—	13% above	—
MRI of the abdomen without contrast inpatient CPT 74181	$3,087.00	$3,087.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183	$2,263.00	$2,263.00	—	1% below	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183	$3,763.00	$3,763.00	—	—	—
MRI of the brain, no contrast dye CPT 70551	$1,857.00	$1,857.00	—	10% above	—
MRI of the brain, no contrast dye inpatient CPT 70551	$3,087.00	$3,087.00	—	—	—
MRI of the brain, with and without contrast dye CPT 70553	$2,263.00	$2,263.00	—	at median	—
MRI of the brain, with and without contrast dye inpatient CPT 70553	$3,763.00	$3,763.00	—	—	—
MRI of the lower back, no contrast dye CPT 72148	$1,857.00	$1,857.00	—	19% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148	$3,087.00	$3,087.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158	$2,263.00	$2,263.00	—	1% below	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158	$3,763.00	$3,763.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146	$1,857.00	$1,857.00	—	16% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146	$3,087.00	$3,087.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156	$2,263.00	$2,263.00	—	2% below	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156	$3,763.00	$3,763.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141	$1,857.00	$1,857.00	—	15% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141	$3,087.00	$3,087.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197	$2,263.00	$2,263.00	—	at median	—
MRI of the pelvis without and with contrast inpatient CPT 72197	$3,763.00	$3,763.00	—	—	—
MRI of the pelvis, no contrast dye CPT 72195	$1,857.00	$1,857.00	—	13% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195	$3,087.00	$3,087.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221	$1,857.00	$1,857.00	—	2% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221	$3,087.00	$3,087.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050	$441.00	$441.00	—	20% above	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050	$441.00	$441.00	—	20% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050	$441.00	$441.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050	$441.00	$441.00	—	—	—
Neck soft tissue CT scan with contrast CPT 70491	$1,093.00	$1,093.00	—	2% below	—
Neck soft tissue CT scan with contrast inpatient CPT 70491	$1,816.00	$1,816.00	—	—	—
Neck soft tissue CT scan without contrast CPT 70490	$819.00	$819.00	—	6% below	—
Neck soft tissue CT scan without contrast inpatient CPT 70490	$1,361.00	$1,361.00	—	—	—
Neck soft tissue X-ray CPT 70360	$365.00	$365.00	—	61% above	—
Neck soft tissue X-ray CPT 70360	$365.00	$365.00	—	61% above	—
Neck soft tissue X-ray inpatient CPT 70360	$365.00	$365.00	—	—	—
Neck soft tissue X-ray inpatient CPT 70360	$365.00	$365.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452	$4,271.00	$4,271.00	—	3% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452	$4,271.00	$4,271.00	—	3% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452	$4,271.00	$4,271.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452	$4,271.00	$4,271.00	—	—	—
OCT scan of the retina (optical coherence tomography) CPT 92134	$32.00	$32.00	—	at median	—
OCT scan of the retina (optical coherence tomography) CPT 92134	$32.00	$32.00	—	at median	—
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134	$32.00	$32.00	—	—	—
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134	$32.00	$32.00	—	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815	$9,889.00	$9,889.00	—	42% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815	$16,439.00	$16,439.00	—	—	—
Pelvic CT scan without contrast CPT 72192	$819.00	$819.00	—	11% below	—
Pelvic CT scan without contrast inpatient CPT 72192	$1,361.00	$1,361.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857	$441.00	$441.00	—	16% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857	$441.00	$441.00	—	16% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857	$441.00	$441.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857	$441.00	$441.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856	$441.00	$441.00	—	8% below	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856	$441.00	$441.00	—	8% below	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856	$441.00	$441.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856	$441.00	$441.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805	$441.00	$441.00	—	at median	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805	$441.00	$441.00	—	at median	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805	$441.00	$441.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805	$441.00	$441.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801	$441.00	$441.00	—	3% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801	$441.00	$441.00	—	3% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801	$441.00	$441.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801	$441.00	$441.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815	$441.00	$441.00	—	45% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815	$441.00	$441.00	—	45% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815	$441.00	$441.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815	$441.00	$441.00	—	—	—
Rib X-ray, one side, 2 views CPT 71100	$365.00	$365.00	—	37% above	—
Rib X-ray, one side, 2 views CPT 71100	$365.00	$365.00	—	37% above	—
Rib X-ray, one side, 2 views inpatient CPT 71100	$365.00	$365.00	—	—	—
Rib X-ray, one side, 2 views inpatient CPT 71100	$365.00	$365.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101	$441.00	$441.00	—	11% above	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101	$441.00	$441.00	—	11% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101	$441.00	$441.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101	$441.00	$441.00	—	—	—
Screening mammogram, both breasts CPT 77067	$337.00	$337.00	—	3% above	—
Screening mammogram, both breasts CPT 77067	$337.00	$337.00	—	3% above	—
Screening mammogram, both breasts inpatient CPT 77067	$337.00	$337.00	—	—	—
Screening mammogram, both breasts inpatient CPT 77067	$337.00	$337.00	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030	$365.00	$365.00	—	7% above	—
Shoulder X-ray, complete, 2 or more views CPT 73030	$365.00	$365.00	—	7% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030	$365.00	$365.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030	$365.00	$365.00	—	—	—
Sinus X-ray, complete, 3 or more views CPT 70220	$365.00	$365.00	—	16% above	—
Sinus X-ray, complete, 3 or more views CPT 70220	$365.00	$365.00	—	16% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220	$365.00	$365.00	—	—	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220	$365.00	$365.00	—	—	—
Skull X-ray, fewer than 4 views CPT 70250	$441.00	$441.00	—	71% above	—
Skull X-ray, fewer than 4 views CPT 70250	$441.00	$441.00	—	71% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250	$441.00	$441.00	—	—	—
Skull X-ray, fewer than 4 views inpatient CPT 70250	$441.00	$441.00	—	—	—
Sleep study in a lab (polysomnography) CPT 95810	$4,833.00	$4,833.00	—	46% above	—
Sleep study in a lab (polysomnography) CPT 95810	$4,833.00	$4,833.00	—	46% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810	$4,833.00	$4,833.00	—	—	—
Sleep study in a lab (polysomnography) inpatient CPT 95810	$4,833.00	$4,833.00	—	—	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351	$1,910.00	$1,910.00	—	at median	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351	$1,910.00	$1,910.00	—	at median	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351	$1,910.00	$1,910.00	—	—	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351	$1,910.00	$1,910.00	—	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230	$589.00	$589.00	—	46% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230	$589.00	$589.00	—	46% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230	$589.00	$589.00	—	—	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230	$589.00	$589.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552	$365.00	$365.00	—	28% above	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552	$365.00	$365.00	—	28% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552	$365.00	$365.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552	$365.00	$365.00	—	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128	$819.00	$819.00	—	21% below	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128	$1,361.00	$1,361.00	—	—	—
Toe X-ray, 2 or more views CPT 73660	$365.00	$365.00	—	47% above	—
Toe X-ray, 2 or more views CPT 73660	$365.00	$365.00	—	47% above	—
Toe X-ray, 2 or more views inpatient CPT 73660	$365.00	$365.00	—	—	—
Toe X-ray, 2 or more views inpatient CPT 73660	$365.00	$365.00	—	—	—
Transvaginal pelvic ultrasound CPT 76830	$441.00	$441.00	—	1% above	—
Transvaginal pelvic ultrasound CPT 76830	$441.00	$441.00	—	1% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830	$441.00	$441.00	—	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830	$441.00	$441.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817	$441.00	$441.00	—	3% above	—
Transvaginal ultrasound during pregnancy CPT 76817	$441.00	$441.00	—	3% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817	$441.00	$441.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817	$441.00	$441.00	—	—	—
Ultrasound of the abdomen, complete CPT 76700	$441.00	$441.00	—	17% below	—
Ultrasound of the abdomen, complete CPT 76700	$441.00	$441.00	—	17% below	—
Ultrasound of the abdomen, complete inpatient CPT 76700	$441.00	$441.00	—	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700	$441.00	$441.00	—	—	—
Ultrasound of the scrotum and testicles CPT 76870	$441.00	$441.00	—	at median	—
Ultrasound of the scrotum and testicles CPT 76870	$441.00	$441.00	—	at median	—
Ultrasound of the scrotum and testicles inpatient CPT 76870	$441.00	$441.00	—	—	—
Ultrasound of the scrotum and testicles inpatient CPT 76870	$441.00	$441.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536	$441.00	$441.00	—	at median	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536	$441.00	$441.00	—	at median	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536	$441.00	$441.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536	$441.00	$441.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240	$589.00	$589.00	—	19% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240	$589.00	$589.00	—	19% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240	$589.00	$589.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240	$589.00	$589.00	—	—	—
Upper arm X-ray (humerus), 2 views CPT 73060	$365.00	$365.00	—	28% above	—
Upper arm X-ray (humerus), 2 views CPT 73060	$365.00	$365.00	—	28% above	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060	$365.00	$365.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060	$365.00	$365.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971	$574.00	$574.00	—	at median	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971	$957.00	$957.00	—	—	—
Wrist X-ray, 2 views CPT 73100	$365.00	$365.00	—	35% above	—
Wrist X-ray, 2 views CPT 73100	$365.00	$365.00	—	35% above	—
Wrist X-ray, 2 views inpatient CPT 73100	$365.00	$365.00	—	—	—
Wrist X-ray, 2 views inpatient CPT 73100	$365.00	$365.00	—	—	—
Wrist X-ray, complete, 3 or more views CPT 73110	$365.00	$365.00	—	2% above	—
Wrist X-ray, complete, 3 or more views CPT 73110	$365.00	$365.00	—	2% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110	$365.00	$365.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110	$365.00	$365.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502	$365.00	$365.00	—	57% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502	$365.00	$365.00	—	57% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502	$365.00	$365.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502	$365.00	$365.00	—	—	—
X-ray of the abdomen, 1 view CPT 74018	$365.00	$365.00	—	64% above	—
X-ray of the abdomen, 1 view CPT 74018	$365.00	$365.00	—	64% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018	$365.00	$365.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018	$365.00	$365.00	—	—	—
X-ray of the ankle, 2 views CPT 73600	$365.00	$365.00	—	32% above	—
X-ray of the ankle, 2 views CPT 73600	$365.00	$365.00	—	32% above	—
X-ray of the ankle, 2 views inpatient CPT 73600	$365.00	$365.00	—	—	—
X-ray of the ankle, 2 views inpatient CPT 73600	$365.00	$365.00	—	—	—
X-ray of the finger(s), 2 or more views CPT 73140	$365.00	$365.00	—	40% above	—
X-ray of the finger(s), 2 or more views CPT 73140	$365.00	$365.00	—	40% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140	$365.00	$365.00	—	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140	$365.00	$365.00	—	—	—
X-ray of the foot, 2 views CPT 73620	$365.00	$365.00	—	32% above	—
X-ray of the foot, 2 views CPT 73620	$365.00	$365.00	—	32% above	—
X-ray of the foot, 2 views inpatient CPT 73620	$365.00	$365.00	—	—	—
X-ray of the foot, 2 views inpatient CPT 73620	$365.00	$365.00	—	—	—
X-ray of the foot, complete, 3 or more views CPT 73630	$365.00	$365.00	—	3% above	—
X-ray of the foot, complete, 3 or more views CPT 73630	$365.00	$365.00	—	3% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630	$365.00	$365.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630	$365.00	$365.00	—	—	—
X-ray of the hand, 3 or more views CPT 73130	$365.00	$365.00	—	at median	—
X-ray of the hand, 3 or more views CPT 73130	$365.00	$365.00	—	at median	—
X-ray of the hand, 3 or more views inpatient CPT 73130	$365.00	$365.00	—	—	—
X-ray of the hand, 3 or more views inpatient CPT 73130	$365.00	$365.00	—	—	—
X-ray of the knee, 1 or 2 views CPT 73560	$365.00	$365.00	—	49% above	—
X-ray of the knee, 1 or 2 views CPT 73560	$365.00	$365.00	—	49% above	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560	$365.00	$365.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560	$365.00	$365.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100	$441.00	$441.00	—	46% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100	$441.00	$441.00	—	46% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100	$441.00	$441.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100	$441.00	$441.00	—	—	—
X-ray of the lower back, 4 or more views CPT 72110	$441.00	$441.00	—	10% above	—
X-ray of the lower back, 4 or more views CPT 72110	$441.00	$441.00	—	10% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110	$441.00	$441.00	—	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110	$441.00	$441.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070	$441.00	$441.00	—	51% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070	$441.00	$441.00	—	51% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070	$441.00	$441.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070	$441.00	$441.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160	$365.00	$365.00	—	42% above	—
X-ray of the nasal bones, 3 or more views CPT 70160	$365.00	$365.00	—	42% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160	$365.00	$365.00	—	—	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160	$365.00	$365.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040	$365.00	$365.00	—	40% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040	$365.00	$365.00	—	40% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040	$365.00	$365.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040	$365.00	$365.00	—	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170	$441.00	$441.00	—	69% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170	$441.00	$441.00	—	69% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170	$441.00	$441.00	—	—	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170	$441.00	$441.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220	$365.00	$365.00	—	46% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220	$365.00	$365.00	—	46% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220	$365.00	$365.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220	$365.00	$365.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
ACTH blood test CPT 82024	$27.50	$27.50	—	84% below	—
ACTH blood test CPT 82024	$27.50	$27.50	—	84% below	—
ACTH blood test inpatient CPT 82024	$27.50	$27.50	—	—	—
ACTH blood test inpatient CPT 82024	$27.50	$27.50	—	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460	$24.00	$24.00	—	26% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460	$40.00	$40.00	—	24% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460	$40.00	$40.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460	$41.00	$41.00	—	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450	$23.00	$23.00	—	38% below	—
AST (aspartate aminotransferase) enzyme test CPT 84450	$40.00	$40.00	—	8% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450	$40.00	$40.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450	$40.00	$40.00	—	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074	$212.00	$212.00	—	3% below	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074	$367.00	$367.00	—	—	—
Albumin blood test CPT 82040	$16.47	$16.47	—	40% below	—
Albumin blood test CPT 82040	$22.00	$22.00	—	20% below	—
Albumin blood test inpatient CPT 82040	$16.47	$16.47	—	—	—
Albumin blood test inpatient CPT 82040	$38.00	$38.00	—	—	—
Aldosterone blood test CPT 82088	$314.00	$314.00	—	73% above	—
Aldosterone blood test CPT 82088	$314.00	$314.00	—	73% above	—
Aldosterone blood test inpatient CPT 82088	$314.00	$314.00	—	—	—
Aldosterone blood test inpatient CPT 82088	$314.00	$314.00	—	—	—
Alkaline phosphatase (ALP) blood test CPT 84075	$11.84	$11.84	—	66% below	—
Alkaline phosphatase (ALP) blood test CPT 84075	$23.00	$23.00	—	34% below	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075	$11.84	$11.84	—	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075	$40.00	$40.00	—	—	—
Allergy blood test, specific IgE, per allergen CPT 86003	$6.99	$6.99	—	69% below	—
Allergy blood test, specific IgE, per allergen CPT 86003	$23.00	$23.00	—	2% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003	$6.99	$6.99	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003	$40.00	$40.00	—	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105	$13.75	$13.75	—	85% below	—
Alpha-fetoprotein (AFP) blood test CPT 82105	$13.75	$13.75	—	85% below	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105	$13.75	$13.75	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105	$13.75	$13.75	—	—	—
Ammonia blood test CPT 82140	$28.51	$28.51	—	60% below	—
Ammonia blood test CPT 82140	$65.00	$65.00	—	10% below	—
Ammonia blood test inpatient CPT 82140	$28.51	$28.51	—	—	—
Ammonia blood test inpatient CPT 82140	$112.00	$112.00	—	—	—
Amylase blood test CPT 82150	$11.71	$11.71	—	78% below	—
Amylase blood test CPT 82150	$29.00	$29.00	—	45% below	—
Amylase blood test inpatient CPT 82150	$11.71	$11.71	—	—	—
Amylase blood test inpatient CPT 82150	$50.00	$50.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200	$10.00	$10.00	—	86% below	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200	$10.00	$10.00	—	86% below	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200	$10.00	$10.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200	$10.00	$10.00	—	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038	$6.25	$6.25	—	91% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038	$54.00	$54.00	—	22% below	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038	$6.25	$6.25	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038	$93.00	$93.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880	$92.04	$92.04	—	48% below	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880	$175.00	$175.00	—	at median	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880	$92.04	$92.04	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880	$302.00	$302.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070	$38.00	$38.00	—	36% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070	$66.00	$66.00	—	—	—
Basic metabolic panel (blood test) CPT 80048	$38.00	$38.00	—	31% below	—
Basic metabolic panel (blood test) inpatient CPT 80048	$65.00	$65.00	—	—	—
Bilirubin blood test, total CPT 82247	$10.73	$10.73	—	70% below	—
Bilirubin blood test, total CPT 82247	$22.00	$22.00	—	39% below	—
Bilirubin blood test, total inpatient CPT 82247	$10.73	$10.73	—	—	—
Bilirubin blood test, total inpatient CPT 82247	$39.00	$39.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305	$237.00	$237.00	—	8% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305	$410.00	$410.00	—	—	—
Blood culture for bacteria CPT 87040	$44.66	$44.66	—	61% below	—
Blood culture for bacteria CPT 87040	$46.00	$46.00	—	59% below	—
Blood culture for bacteria inpatient CPT 87040	$44.66	$44.66	—	—	—
Blood culture for bacteria inpatient CPT 87040	$79.00	$79.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415	$32.00	$32.00	—	43% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415	$36.00	$36.00	—	—	—
Blood glucose (sugar) test CPT 82947	$17.00	$17.00	—	36% below	—
Blood glucose (sugar) test CPT 82947	$43.75	$43.75	—	64% above	—
Blood glucose (sugar) test inpatient CPT 82947	$30.00	$30.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947	$43.75	$43.75	—	—	—
Blood lead test CPT 83655	$17.16	$17.16	—	70% below	—
Blood lead test CPT 83655	$54.00	$54.00	—	5% below	—
Blood lead test inpatient CPT 83655	$17.16	$17.16	—	—	—
Blood lead test inpatient CPT 83655	$93.00	$93.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703	$33.00	$33.00	—	49% below	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703	$58.00	$58.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900	$13.00	$13.00	—	77% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900	$118.36	$118.36	—	108% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900	$23.00	$23.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900	$118.36	$118.36	—	—	—
Blood urea nitrogen (BUN) test CPT 84520	$18.00	$18.00	—	52% below	—
Blood urea nitrogen (BUN) test CPT 84520	$40.00	$40.00	—	7% above	—
Blood urea nitrogen (BUN) test inpatient CPT 84520	$30.00	$30.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520	$40.00	$40.00	—	—	—
C-peptide blood test CPT 84681	$12.50	$12.50	—	88% below	—
C-peptide blood test CPT 84681	$12.50	$12.50	—	88% below	—
C-peptide blood test inpatient CPT 84681	$12.50	$12.50	—	—	—
C-peptide blood test inpatient CPT 84681	$12.50	$12.50	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140	$23.00	$23.00	—	61% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140	$37.38	$37.38	—	37% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140	$37.38	$37.38	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140	$40.00	$40.00	—	—	—
C. difficile toxin gene test (stool PCR) CPT 87493	$166.00	$166.00	—	at median	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493	$287.00	$287.00	—	—	—
CA 19-9 blood test (tumor marker) CPT 86301	$19.18	$19.18	—	80% below	—
CA 19-9 blood test (tumor marker) CPT 86301	$19.18	$19.18	—	80% below	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301	$19.18	$19.18	—	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301	$19.18	$19.18	—	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304	$93.00	$93.00	—	9% below	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304	$160.00	$160.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635	$93.75	$93.75	—	at median	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635	$93.75	$93.75	—	at median	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635	$93.75	$93.75	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635	$93.75	$93.75	—	—	—
Calcium blood test, total CPT 82310	$23.00	$23.00	—	29% below	—
Calcium blood test, total inpatient CPT 82310	$40.00	$40.00	—	—	—
Carcinoembryonic antigen (CEA) test CPT 82378	$22.88	$22.88	—	79% below	—
Carcinoembryonic antigen (CEA) test CPT 82378	$84.00	$84.00	—	23% below	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378	$22.88	$22.88	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378	$146.00	$146.00	—	—	—
Chickenpox (varicella) immunity blood test CPT 86787	$13.99	$13.99	—	80% below	—
Chickenpox (varicella) immunity blood test CPT 86787	$57.00	$57.00	—	19% below	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787	$13.99	$13.99	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787	$99.00	$99.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491	$18.49	$18.49	—	83% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491	$156.00	$156.00	—	41% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491	$18.49	$18.49	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491	$270.00	$270.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061	$21.25	$21.25	—	62% below	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061	$60.00	$60.00	—	7% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061	$21.25	$21.25	—	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061	$103.00	$103.00	—	—	—
Complete blood count (CBC) with differential CPT 85025	$35.00	$35.00	—	31% below	—
Complete blood count (CBC) with differential inpatient CPT 85025	$60.00	$60.00	—	—	—
Complete blood count (CBC), no differential CPT 85027	$29.00	$29.00	—	32% below	—
Complete blood count (CBC), no differential inpatient CPT 85027	$50.00	$50.00	—	—	—
Comprehensive metabolic panel (blood test) CPT 80053	$47.00	$47.00	—	37% below	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053	$81.00	$81.00	—	—	—
Cortisol blood test, total CPT 82533	$54.40	$54.40	—	31% below	—
Cortisol blood test, total CPT 82533	$73.00	$73.00	—	7% below	—
Cortisol blood test, total inpatient CPT 82533	$54.40	$54.40	—	—	—
Cortisol blood test, total inpatient CPT 82533	$126.00	$126.00	—	—	—
Creatine kinase (CK) blood test, total CPT 82550	$14.70	$14.70	—	71% below	—
Creatine kinase (CK) blood test, total CPT 82550	$29.00	$29.00	—	44% below	—
Creatine kinase (CK) blood test, total inpatient CPT 82550	$14.70	$14.70	—	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550	$50.00	$50.00	—	—	—
Creatinine blood test CPT 82565	$23.00	$23.00	—	21% below	—
Creatinine blood test inpatient CPT 82565	$39.00	$39.00	—	—	—
Cytomegalovirus (CMV) antibody test CPT 86644	$75.94	$75.94	—	at median	—
Cytomegalovirus (CMV) antibody test CPT 86644	$75.94	$75.94	—	at median	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644	$75.94	$75.94	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644	$75.94	$75.94	—	—	—
D-dimer blood test (blood clot marker) CPT 85379	$45.00	$45.00	—	55% below	—
D-dimer blood test (blood clot marker) inpatient CPT 85379	$78.00	$78.00	—	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627	$13.75	$13.75	—	86% below	—
DHEA sulfate (DHEA-S) blood test CPT 82627	$13.75	$13.75	—	86% below	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627	$13.75	$13.75	—	—	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627	$13.75	$13.75	—	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307	$62.50	$62.50	—	62% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307	$62.50	$62.50	—	62% below	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307	$62.50	$62.50	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307	$62.50	$62.50	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051	$31.00	$31.00	—	46% below	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051	$54.00	$54.00	—	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665	$13.94	$13.94	—	84% below	—
Epstein-Barr virus (EBV) antibody test CPT 86665	$81.00	$81.00	—	5% below	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665	$13.94	$13.94	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665	$140.00	$140.00	—	—	—
Estradiol blood test CPT 82670	$33.75	$33.75	—	75% below	—
Estradiol blood test CPT 82670	$124.00	$124.00	—	8% below	—
Estradiol blood test inpatient CPT 82670	$33.75	$33.75	—	—	—
Estradiol blood test inpatient CPT 82670	$215.00	$215.00	—	—	—
FSH (follicle-stimulating hormone) test CPT 83001	$18.75	$18.75	—	83% below	—
FSH (follicle-stimulating hormone) test CPT 83001	$83.00	$83.00	—	25% below	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001	$18.75	$18.75	—	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001	$143.00	$143.00	—	—	—
Fecal calprotectin (stool inflammation test) CPT 83993	$87.00	$87.00	—	56% below	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993	$151.00	$151.00	—	—	—
Ferritin blood test (iron stores) CPT 82728	$43.75	$43.75	—	45% below	—
Ferritin blood test (iron stores) CPT 82728	$61.00	$61.00	—	24% below	—
Ferritin blood test (iron stores) inpatient CPT 82728	$43.75	$43.75	—	—	—
Ferritin blood test (iron stores) inpatient CPT 82728	$105.00	$105.00	—	—	—
Fibrinogen blood test CPT 85384	$43.00	$43.00	—	40% below	—
Fibrinogen blood test inpatient CPT 85384	$75.00	$75.00	—	—	—
Folate (folic acid) blood test CPT 82746	$65.00	$65.00	—	23% below	—
Folate (folic acid) blood test inpatient CPT 82746	$113.00	$113.00	—	—	—
Free T3 thyroid hormone test CPT 84481	$11.84	$11.84	—	86% below	—
Free T3 thyroid hormone test CPT 84481	$75.00	$75.00	—	9% below	—
Free T3 thyroid hormone test inpatient CPT 84481	$11.84	$11.84	—	—	—
Free T3 thyroid hormone test inpatient CPT 84481	$130.00	$130.00	—	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439	$40.00	$40.00	—	18% below	—
Free T4 (free thyroxine) thyroid blood test CPT 84439	$40.05	$40.05	—	18% below	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439	$40.05	$40.05	—	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439	$69.00	$69.00	—	—	—
Free testosterone test CPT 84402	$56.93	$56.93	—	46% below	—
Free testosterone test CPT 84402	$56.93	$56.93	—	46% below	—
Free testosterone test inpatient CPT 84402	$56.93	$56.93	—	—	—
Free testosterone test inpatient CPT 84402	$56.93	$56.93	—	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977	$32.00	$32.00	—	24% below	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977	$40.00	$40.00	—	5% below	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977	$40.00	$40.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977	$55.00	$55.00	—	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050	$184.00	$184.00	—	at median	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050	$227.00	$227.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950	$21.00	$21.00	—	47% below	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950	$37.00	$37.00	—	—	—
Glucose tolerance test, 3 samples CPT 82951	$57.00	$57.00	—	29% below	—
Glucose tolerance test, 3 samples inpatient CPT 82951	$99.00	$99.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591	$42.50	$42.50	—	64% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591	$156.00	$156.00	—	33% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591	$42.50	$42.50	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591	$270.00	$270.00	—	—	—
H. pylori antibody blood test CPT 86677	$130.00	$130.00	—	34% above	—
H. pylori antibody blood test CPT 86677	$130.00	$130.00	—	34% above	—
H. pylori antibody blood test inpatient CPT 86677	$130.00	$130.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677	$130.00	$130.00	—	—	—
H. pylori stool antigen test CPT 87338	$64.00	$64.00	—	36% below	—
H. pylori stool antigen test inpatient CPT 87338	$111.00	$111.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536	$379.00	$379.00	—	at median	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536	$655.00	$655.00	—	—	—
HIV-1 and HIV-2 antibody test CPT 86703	$106.00	$106.00	—	7% above	—
HIV-1 and HIV-2 antibody test CPT 86703	$106.00	$106.00	—	7% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703	$106.00	$106.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703	$106.00	$106.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389	$31.55	$31.55	—	66% below	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389	$107.00	$107.00	—	15% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389	$31.55	$31.55	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389	$185.00	$185.00	—	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624	$52.50	$52.50	—	56% below	—
HPV test for high-risk types, one combined (pooled) result CPT 87624	$156.00	$156.00	—	32% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624	$52.50	$52.50	—	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624	$270.00	$270.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036	$43.00	$43.00	—	7% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036	$75.00	$75.00	—	—	—
Hemoglobin blood test CPT 85018	$11.00	$11.00	—	45% below	—
Hemoglobin blood test inpatient CPT 85018	$18.00	$18.00	—	—	—
Hepatitis B core antibody test (total) CPT 86704	$54.00	$54.00	—	16% below	—
Hepatitis B core antibody test (total) CPT 86704	$180.55	$180.55	—	181% above	—
Hepatitis B core antibody test (total) inpatient CPT 86704	$93.00	$93.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704	$180.55	$180.55	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706	$48.00	$48.00	—	14% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706	$83.00	$83.00	—	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340	$46.00	$46.00	—	24% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340	$180.56	$180.56	—	197% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340	$80.00	$80.00	—	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340	$180.56	$180.56	—	—	—
Hepatitis C antibody blood test (screening) CPT 86803	$18.73	$18.73	—	73% below	—
Hepatitis C antibody blood test (screening) CPT 86803	$64.00	$64.00	—	7% below	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803	$18.73	$18.73	—	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803	$110.00	$110.00	—	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522	$87.50	$87.50	—	65% below	—
Hepatitis C viral load (HCV RNA) test CPT 87522	$191.00	$191.00	—	23% below	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522	$87.50	$87.50	—	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522	$330.00	$330.00	—	—	—
Herpes blood test, HSV-1 antibody CPT 86695	$10.00	$10.00	—	79% below	—
Herpes blood test, HSV-1 antibody CPT 86695	$59.00	$59.00	—	23% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695	$10.00	$10.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695	$102.00	$102.00	—	—	—
Herpes blood test, HSV-2 antibody CPT 86696	$10.00	$10.00	—	86% below	—
Herpes blood test, HSV-2 antibody CPT 86696	$86.00	$86.00	—	23% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696	$10.00	$10.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696	$149.00	$149.00	—	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141	$58.00	$58.00	—	16% below	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141	$100.00	$100.00	—	—	—
Homocysteine blood test CPT 83090	$80.00	$80.00	—	at median	—
Homocysteine blood test inpatient CPT 83090	$138.00	$138.00	—	—	—
Insulin blood test CPT 83525	$11.86	$11.86	—	82% below	—
Insulin blood test CPT 83525	$51.00	$51.00	—	24% below	—
Insulin blood test inpatient CPT 83525	$11.86	$11.86	—	—	—
Insulin blood test inpatient CPT 83525	$88.00	$88.00	—	—	—
Iron blood test (serum iron) CPT 83540	$29.00	$29.00	—	34% below	—
Iron blood test (serum iron) CPT 83540	$133.75	$133.75	—	204% above	—
Iron blood test (serum iron) inpatient CPT 83540	$50.00	$50.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540	$133.75	$133.75	—	—	—
Iron-binding capacity (TIBC) test CPT 83550	$7.01	$7.01	—	87% below	—
Iron-binding capacity (TIBC) test CPT 83550	$39.00	$39.00	—	29% below	—
Iron-binding capacity (TIBC) test inpatient CPT 83550	$7.01	$7.01	—	—	—
Iron-binding capacity (TIBC) test inpatient CPT 83550	$67.00	$67.00	—	—	—
Kidney function blood test panel CPT 80069	$39.00	$39.00	—	45% below	—
Kidney function blood test panel inpatient CPT 80069	$67.00	$67.00	—	—	—
LH (luteinizing hormone) test CPT 83002	$9.19	$9.19	—	89% below	—
LH (luteinizing hormone) test CPT 83002	$82.00	$82.00	—	4% below	—
LH (luteinizing hormone) test inpatient CPT 83002	$9.19	$9.19	—	—	—
LH (luteinizing hormone) test inpatient CPT 83002	$143.00	$143.00	—	—	—
Lactate (lactic acid) blood test CPT 83605	$51.00	$51.00	—	33% below	—
Lactate (lactic acid) blood test CPT 83605	$89.00	$89.00	—	17% above	—
Lactate (lactic acid) blood test inpatient CPT 83605	$89.00	$89.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605	$89.00	$89.00	—	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615	$13.23	$13.23	—	58% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615	$27.00	$27.00	—	15% below	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615	$13.23	$13.23	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615	$47.00	$47.00	—	—	—
Lipase blood test (pancreas enzyme) CPT 83690	$10.00	$10.00	—	86% below	—
Lipase blood test (pancreas enzyme) CPT 83690	$31.00	$31.00	—	56% below	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690	$10.00	$10.00	—	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690	$53.00	$53.00	—	—	—
Liver function blood test panel CPT 80076	$36.00	$36.00	—	51% below	—
Liver function blood test panel inpatient CPT 80076	$63.00	$63.00	—	—	—
Lyme disease antibody test CPT 86618	$71.03	$71.03	—	16% below	—
Lyme disease antibody test CPT 86618	$71.03	$71.03	—	16% below	—
Lyme disease antibody test inpatient CPT 86618	$71.03	$71.03	—	—	—
Lyme disease antibody test inpatient CPT 86618	$71.03	$71.03	—	—	—
Magnesium blood test CPT 83735	$30.00	$30.00	—	35% below	—
Magnesium blood test CPT 83735	$49.61	$49.61	—	7% above	—
Magnesium blood test inpatient CPT 83735	$49.61	$49.61	—	—	—
Magnesium blood test inpatient CPT 83735	$52.00	$52.00	—	—	—
Measles (rubeola) antibody test CPT 86765	$15.46	$15.46	—	76% below	—
Measles (rubeola) antibody test CPT 86765	$57.00	$57.00	—	12% below	—
Measles (rubeola) antibody test inpatient CPT 86765	$15.46	$15.46	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765	$99.00	$99.00	—	—	—
Mono test (heterophile antibody, Monospot) CPT 86308	$23.00	$23.00	—	55% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308	$40.00	$40.00	—	—	—
Mumps immunity blood test CPT 86735	$16.23	$16.23	—	75% below	—
Mumps immunity blood test CPT 86735	$58.00	$58.00	—	11% below	—
Mumps immunity blood test inpatient CPT 86735	$16.23	$16.23	—	—	—
Mumps immunity blood test inpatient CPT 86735	$100.00	$100.00	—	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154	$82.00	$82.00	—	at median	—
PSA (prostate-specific antigen) blood test, free CPT 84154	$178.13	$178.13	—	117% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154	$142.00	$142.00	—	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154	$178.13	$178.13	—	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153	$25.65	$25.65	—	73% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153	$82.00	$82.00	—	13% below	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153	$25.65	$25.65	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153	$142.00	$142.00	—	—	—
Pap test (liquid-based, automated screening with review) CPT 88175	$118.00	$118.00	—	15% above	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175	$205.00	$205.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142	$90.00	$90.00	—	at median	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142	$156.00	$156.00	—	—	—
Parathyroid hormone (PTH) blood test CPT 83970	$184.00	$184.00	—	1% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970	$318.00	$318.00	—	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730	$15.03	$15.03	—	70% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730	$27.00	$27.00	—	46% below	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730	$15.03	$15.03	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730	$46.00	$46.00	—	—	—
Phosphorus (phosphate) blood test CPT 84100	$21.00	$21.00	—	40% below	—
Phosphorus (phosphate) blood test inpatient CPT 84100	$36.00	$36.00	—	—	—
Potassium blood test CPT 84132	$21.00	$21.00	—	41% below	—
Potassium blood test CPT 84132	$37.00	$37.00	—	4% above	—
Potassium blood test inpatient CPT 84132	$37.00	$37.00	—	—	—
Potassium blood test inpatient CPT 84132	$37.00	$37.00	—	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420	$468.75	$468.75	—	33% below	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420	$468.75	$468.75	—	33% below	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420	$468.75	$468.75	—	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420	$468.75	$468.75	—	—	—
Progesterone blood test CPT 84144	$35.16	$35.16	—	63% below	—
Progesterone blood test CPT 84144	$93.00	$93.00	—	3% below	—
Progesterone blood test inpatient CPT 84144	$35.16	$35.16	—	—	—
Progesterone blood test inpatient CPT 84144	$161.00	$161.00	—	—	—
Prolactin blood test CPT 84146	$56.72	$56.72	—	41% below	—
Prolactin blood test CPT 84146	$86.00	$86.00	—	10% below	—
Prolactin blood test inpatient CPT 84146	$56.72	$56.72	—	—	—
Prolactin blood test inpatient CPT 84146	$149.00	$149.00	—	—	—
Prothrombin time (PT/INR) clotting test CPT 85610	$15.03	$15.03	—	54% below	—
Prothrombin time (PT/INR) clotting test CPT 85610	$19.00	$19.00	—	42% below	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610	$15.03	$15.03	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610	$33.00	$33.00	—	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305	$56.00	$56.00	—	7% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305	$97.00	$97.00	—	—	—
Rapid flu test (influenza antigen) CPT 87804	$74.00	$74.00	—	7% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804	$127.00	$127.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880	$74.00	$74.00	—	20% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880	$127.00	$127.00	—	—	—
Renin blood test CPT 84244	$169.00	$169.00	—	48% above	—
Renin blood test CPT 84244	$169.00	$169.00	—	48% above	—
Renin blood test inpatient CPT 84244	$169.00	$169.00	—	—	—
Renin blood test inpatient CPT 84244	$169.00	$169.00	—	—	—
Rh blood typing CPT 86901	$13.00	$13.00	—	72% below	—
Rh blood typing CPT 86901	$34.38	$34.38	—	25% below	—
Rh blood typing inpatient CPT 86901	$23.00	$23.00	—	—	—
Rh blood typing inpatient CPT 86901	$34.38	$34.38	—	—	—
Rheumatoid factor (RF) test CPT 86431	$13.84	$13.84	—	55% below	—
Rheumatoid factor (RF) test CPT 86431	$25.00	$25.00	—	19% below	—
Rheumatoid factor (RF) test inpatient CPT 86431	$13.84	$13.84	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431	$44.00	$44.00	—	—	—
Rubella antibody test (immunity check) CPT 86762	$13.99	$13.99	—	76% below	—
Rubella antibody test (immunity check) CPT 86762	$64.00	$64.00	—	8% above	—
Rubella antibody test (immunity check) inpatient CPT 86762	$13.99	$13.99	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762	$111.00	$111.00	—	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652	$12.00	$12.00	—	40% below	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652	$21.00	$21.00	—	—	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320	$55.00	$55.00	—	36% below	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320	$95.00	$95.00	—	—	—
Sodium blood test CPT 84295	$21.00	$21.00	—	36% below	—
Sodium blood test CPT 84295	$37.00	$37.00	—	13% above	—
Sodium blood test inpatient CPT 84295	$37.00	$37.00	—	—	—
Sodium blood test inpatient CPT 84295	$37.00	$37.00	—	—	—
Stool ova and parasites exam CPT 87177	$18.75	$18.75	—	62% below	—
Stool ova and parasites exam CPT 87177	$18.75	$18.75	—	62% below	—
Stool ova and parasites exam inpatient CPT 87177	$18.75	$18.75	—	—	—
Stool ova and parasites exam inpatient CPT 87177	$18.75	$18.75	—	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270	$19.00	$19.00	—	24% below	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270	$34.00	$34.00	—	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274	$71.00	$71.00	—	at median	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274	$123.00	$123.00	—	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780	$77.00	$77.00	—	13% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780	$77.00	$77.00	—	13% above	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780	$77.00	$77.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780	$77.00	$77.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592	$6.25	$6.25	—	85% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592	$19.00	$19.00	—	56% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592	$6.25	$6.25	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592	$33.00	$33.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480	$276.00	$276.00	—	25% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480	$477.00	$477.00	—	—	—
Testosterone blood test, total (not free testosterone) CPT 84403	$9.05	$9.05	—	91% below	—
Testosterone blood test, total (not free testosterone) CPT 84403	$115.00	$115.00	—	8% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403	$9.05	$9.05	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403	$199.00	$199.00	—	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376	$16.25	$16.25	—	79% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376	$65.00	$65.00	—	17% below	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376	$16.25	$16.25	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376	$112.00	$112.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443	$75.00	$75.00	—	7% below	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443	$129.00	$129.00	—	—	—
Total IgE blood test CPT 82785	$7.01	$7.01	—	92% below	—
Total IgE blood test CPT 82785	$73.00	$73.00	—	19% below	—
Total IgE blood test inpatient CPT 82785	$7.01	$7.01	—	—	—
Total IgE blood test inpatient CPT 82785	$127.00	$127.00	—	—	—
Total cholesterol blood test CPT 82465	$19.00	$19.00	—	41% below	—
Total cholesterol blood test inpatient CPT 82465	$33.00	$33.00	—	—	—
Total thyroxine (T4) blood test CPT 84436	$31.00	$31.00	—	18% below	—
Total thyroxine (T4) blood test inpatient CPT 84436	$53.00	$53.00	—	—	—
Total triiodothyronine (T3) blood test CPT 84480	$63.00	$63.00	—	28% below	—
Total triiodothyronine (T3) blood test inpatient CPT 84480	$109.00	$109.00	—	—	—
Transferrin blood test CPT 84466	$10.00	$10.00	—	88% below	—
Transferrin blood test CPT 84466	$10.00	$10.00	—	88% below	—
Transferrin blood test inpatient CPT 84466	$10.00	$10.00	—	—	—
Transferrin blood test inpatient CPT 84466	$10.00	$10.00	—	—	—
Trichomonas test (NAAT) CPT 87661	$77.50	$77.50	—	38% below	—
Trichomonas test (NAAT) CPT 87661	$156.00	$156.00	—	25% above	—
Trichomonas test (NAAT) inpatient CPT 87661	$77.50	$77.50	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661	$270.00	$270.00	—	—	—
Triglycerides blood test CPT 84478	$11.44	$11.44	—	69% below	—
Triglycerides blood test CPT 84478	$26.00	$26.00	—	30% below	—
Triglycerides blood test inpatient CPT 84478	$11.44	$11.44	—	—	—
Triglycerides blood test inpatient CPT 84478	$44.00	$44.00	—	—	—
Troponin test, quantitative CPT 84484	$45.49	$45.49	—	54% below	—
Troponin test, quantitative CPT 84484	$55.00	$55.00	—	45% below	—
Troponin test, quantitative inpatient CPT 84484	$45.49	$45.49	—	—	—
Troponin test, quantitative inpatient CPT 84484	$96.00	$96.00	—	—	—
Uric acid blood test CPT 84550	$20.00	$20.00	—	42% below	—
Uric acid blood test inpatient CPT 84550	$35.00	$35.00	—	—	—
Urinalysis with microscope exam, automated CPT 81001	$14.00	$14.00	—	33% below	—
Urinalysis with microscope exam, automated inpatient CPT 81001	$24.00	$24.00	—	—	—
Urinalysis with microscope exam, manual CPT 81000	$31.00	$31.00	—	14% above	—
Urinalysis with microscope exam, manual CPT 81000	$31.00	$31.00	—	14% above	—
Urinalysis with microscope exam, manual inpatient CPT 81000	$31.00	$31.00	—	—	—
Urinalysis with microscope exam, manual inpatient CPT 81000	$31.00	$31.00	—	—	—
Urinalysis without microscope exam, automated CPT 81003	$10.00	$10.00	—	23% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003	$17.00	$17.00	—	—	—
Urinalysis without microscope exam, manual CPT 81002	$15.00	$15.00	—	11% below	—
Urinalysis without microscope exam, manual inpatient CPT 81002	$27.00	$27.00	—	—	—
Urine culture for bacteria, with colony count CPT 87086	$36.00	$36.00	—	40% below	—
Urine culture for bacteria, with colony count inpatient CPT 87086	$62.00	$62.00	—	—	—
Urine microalbumin (albumin) test CPT 82043	$26.00	$26.00	—	38% below	—
Urine microalbumin (albumin) test inpatient CPT 82043	$45.00	$45.00	—	—	—
Urine pregnancy test, read by color change CPT 81025	$38.00	$38.00	—	at median	—
Urine pregnancy test, read by color change inpatient CPT 81025	$66.00	$66.00	—	—	—
Vitamin B12 (cobalamin) blood test CPT 82607	$67.00	$67.00	—	19% below	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607	$116.00	$116.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306	$32.81	$32.81	—	73% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306	$132.00	$132.00	—	8% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306	$32.81	$32.81	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306	$228.00	$228.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652	$31.44	$31.44	—	81% below	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652	$171.00	$171.00	—	3% above	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652	$31.44	$31.44	—	—	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652	$296.00	$296.00	—	—	—
Zinc blood test CPT 84630	$17.16	$17.16	—	74% below	—
Zinc blood test CPT 84630	$17.16	$17.16	—	74% below	—
Zinc blood test inpatient CPT 84630	$17.16	$17.16	—	—	—
Zinc blood test inpatient CPT 84630	$17.16	$17.16	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702	$17.50	$17.50	—	80% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702	$67.00	$67.00	—	24% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702	$17.50	$17.50	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702	$116.00	$116.00	—	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830	$7,224.00	$7,224.00	—	at median	—
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830	$8,795.00	$8,795.00	—	—	—
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551	$15,889.00	$15,889.00	—	at median	—
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551	$19,343.00	$19,343.00	—	—	—
Appendectomy, open surgery CPT 44950	$14,664.00	$14,664.00	—	292% above	—
Appendectomy, open surgery CPT 44950	$14,664.00	$14,664.00	—	292% above	—
Appendectomy, open surgery inpatient CPT 44950	$14,664.00	$14,664.00	—	—	—
Appendectomy, open surgery inpatient CPT 44950	$14,664.00	$14,664.00	—	—	—
Arthroscopic ACL reconstruction or repair of the knee CPT 29888	$12,106.00	$12,106.00	—	at median	—
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888	$14,738.00	$14,738.00	—	—	—
Arthroscopic rotator cuff repair of the shoulder CPT 29827	$12,106.00	$12,106.00	—	8% above	—
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827	$14,738.00	$14,738.00	—	—	—
Balloon dilation of the maxillary sinus opening, one side CPT 31295	$17,730.00	$17,730.00	—	98% above	—
Balloon dilation of the maxillary sinus opening, one side CPT 31295	$17,730.00	$17,730.00	—	98% above	—
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295	$17,730.00	$17,730.00	—	—	—
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295	$17,730.00	$17,730.00	—	—	—
Botox injections for chronic migraine CPT 64615	$818.00	$818.00	—	107% above	—
Botox injections for chronic migraine CPT 64615	$818.00	$818.00	—	107% above	—
Botox injections for chronic migraine inpatient CPT 64615	$818.00	$818.00	—	—	—
Botox injections for chronic migraine inpatient CPT 64615	$818.00	$818.00	—	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081	$4,347.00	$4,347.00	—	25% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081	$4,347.00	$4,347.00	—	25% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081	$4,347.00	$4,347.00	—	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081	$4,347.00	$4,347.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786	$670.00	$670.00	—	74% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786	$670.00	$670.00	—	74% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786	$670.00	$670.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786	$670.00	$670.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470	$670.00	$670.00	—	48% above	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470	$670.00	$670.00	—	48% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470	$670.00	$670.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470	$670.00	$670.00	—	—	—
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296	$6,877.00	$6,877.00	—	6% above	—
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296	$8,372.00	$8,372.00	—	—	—
Bunion correction with removal of part of the big toe joint CPT 28292	$8,372.00	$8,372.00	—	57% above	—
Bunion correction with removal of part of the big toe joint CPT 28292	$8,372.00	$8,372.00	—	57% above	—
Bunion correction with removal of part of the big toe joint inpatient CPT 28292	$8,372.00	$8,372.00	—	—	—
Bunion correction with removal of part of the big toe joint inpatient CPT 28292	$8,372.00	$8,372.00	—	—	—
Cardiac catheterization with coronary angiogram CPT 93458	$19,903.00	$19,903.00	—	32% above	—
Cardiac catheterization with coronary angiogram CPT 93458	$19,903.00	$19,903.00	—	32% above	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458	$19,903.00	$19,903.00	—	—	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458	$19,903.00	$19,903.00	—	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960	$2,582.00	$2,582.00	—	74% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960	$2,582.00	$2,582.00	—	74% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960	$2,582.00	$2,582.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960	$2,582.00	$2,582.00	—	—	—
Carpal tunnel release, open surgery CPT 64721	$5,383.00	$5,383.00	—	96% above	—
Carpal tunnel release, open surgery CPT 64721	$5,383.00	$5,383.00	—	96% above	—
Carpal tunnel release, open surgery inpatient CPT 64721	$5,383.00	$5,383.00	—	—	—
Carpal tunnel release, open surgery inpatient CPT 64721	$5,383.00	$5,383.00	—	—	—
Cataract surgery with lens implant CPT 66984	$5,599.00	$5,599.00	—	30% above	—
Cataract surgery with lens implant CPT 66984	$5,599.00	$5,599.00	—	30% above	—
Cataract surgery with lens implant inpatient CPT 66984	$5,599.00	$5,599.00	—	—	—
Cataract surgery with lens implant inpatient CPT 66984	$5,599.00	$5,599.00	—	—	—
Catheter ablation for atrial fibrillation CPT 93656	$62,005.00	$62,005.00	—	at median	—
Catheter ablation for atrial fibrillation CPT 93656	$62,005.00	$62,005.00	—	at median	—
Catheter ablation for atrial fibrillation inpatient CPT 93656	$62,005.00	$62,005.00	—	—	—
Catheter ablation for atrial fibrillation inpatient CPT 93656	$62,005.00	$62,005.00	—	—	—
Cervical biopsy CPT 57500	$2,423.00	$2,423.00	—	174% above	—
Cervical biopsy CPT 57500	$2,423.00	$2,423.00	—	174% above	—
Cervical biopsy inpatient CPT 57500	$2,423.00	$2,423.00	—	—	—
Cervical biopsy inpatient CPT 57500	$2,423.00	$2,423.00	—	—	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161	$5,304.00	$5,304.00	—	at median	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161	$5,304.00	$5,304.00	—	at median	—
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161	$5,304.00	$5,304.00	—	—	—
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161	$5,304.00	$5,304.00	—	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150	$122.00	$122.00	—	59% below	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150	$122.00	$122.00	—	59% below	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150	$122.00	$122.00	—	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150	$122.00	$122.00	—	—	—
Circumcision, surgical, older than a newborn CPT 54160	$1,858.00	$1,858.00	—	at median	—
Circumcision, surgical, older than a newborn CPT 54160	$1,858.00	$1,858.00	—	at median	—
Circumcision, surgical, older than a newborn inpatient CPT 54160	$1,858.00	$1,858.00	—	—	—
Circumcision, surgical, older than a newborn inpatient CPT 54160	$1,858.00	$1,858.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600	$551.00	$551.00	—	61% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600	$670.00	$670.00	—	—	—
Colonoscopy with endoscopic ultrasound CPT 45391	$3,234.00	$3,234.00	—	at median	—
Colonoscopy with endoscopic ultrasound CPT 45391	$3,234.00	$3,234.00	—	at median	—
Colonoscopy with endoscopic ultrasound inpatient CPT 45391	$3,234.00	$3,234.00	—	—	—
Colonoscopy with endoscopic ultrasound inpatient CPT 45391	$3,234.00	$3,234.00	—	—	—
Colonoscopy with polyp removal CPT 45385	$3,234.00	$3,234.00	—	40% above	—
Colonoscopy with polyp removal CPT 45385	$3,234.00	$3,234.00	—	40% above	—
Colonoscopy with polyp removal inpatient CPT 45385	$3,234.00	$3,234.00	—	—	—
Colonoscopy with polyp removal inpatient CPT 45385	$3,234.00	$3,234.00	—	—	—
Colonoscopy with tissue sample CPT 45380	$3,234.00	$3,234.00	—	20% above	—
Colonoscopy with tissue sample CPT 45380	$3,234.00	$3,234.00	—	20% above	—
Colonoscopy with tissue sample inpatient CPT 45380	$3,234.00	$3,234.00	—	—	—
Colonoscopy with tissue sample inpatient CPT 45380	$3,234.00	$3,234.00	—	—	—
Colonoscopy, diagnostic CPT 45378	$2,509.00	$2,509.00	—	at median	—
Colonoscopy, diagnostic CPT 45378	$2,509.00	$2,509.00	—	at median	—
Colonoscopy, diagnostic inpatient CPT 45378	$2,509.00	$2,509.00	—	—	—
Colonoscopy, diagnostic inpatient CPT 45378	$2,509.00	$2,509.00	—	—	—
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460	$8,592.00	$8,592.00	—	314% above	—
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460	$8,592.00	$8,592.00	—	314% above	—
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460	$8,592.00	$8,592.00	—	—	—
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460	$8,592.00	$8,592.00	—	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454	$851.00	$851.00	—	121% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454	$851.00	$851.00	—	121% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454	$851.00	$851.00	—	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454	$851.00	$851.00	—	—	—
Complex cataract surgery with lens implant CPT 66982	$5,599.00	$5,599.00	—	at median	—
Complex cataract surgery with lens implant CPT 66982	$5,599.00	$5,599.00	—	at median	—
Complex cataract surgery with lens implant inpatient CPT 66982	$5,599.00	$5,599.00	—	—	—
Complex cataract surgery with lens implant inpatient CPT 66982	$5,599.00	$5,599.00	—	—	—
Coronary stent placement, one artery CPT 92928	$28,020.00	$28,020.00	—	49% above	—
Coronary stent placement, one artery CPT 92928	$28,020.00	$28,020.00	—	49% above	—
Coronary stent placement, one artery inpatient CPT 92928	$28,020.00	$28,020.00	—	—	—
Coronary stent placement, one artery inpatient CPT 92928	$28,020.00	$28,020.00	—	—	—
Cystoscopy with ureteral stent placement CPT 52332	$8,773.00	$8,773.00	—	11% above	—
Cystoscopy with ureteral stent placement CPT 52332	$8,773.00	$8,773.00	—	11% above	—
Cystoscopy with ureteral stent placement inpatient CPT 52332	$8,773.00	$8,773.00	—	—	—
Cystoscopy with ureteral stent placement inpatient CPT 52332	$8,773.00	$8,773.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000	$1,858.00	$1,858.00	—	67% above	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000	$1,858.00	$1,858.00	—	67% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000	$1,858.00	$1,858.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000	$1,858.00	$1,858.00	—	—	—
D&C (dilation and curettage), not related to pregnancy CPT 58120	$8,592.00	$8,592.00	—	75% above	—
D&C (dilation and curettage), not related to pregnancy CPT 58120	$8,592.00	$8,592.00	—	75% above	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120	$8,592.00	$8,592.00	—	—	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120	$8,592.00	$8,592.00	—	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000	$556.00	$556.00	—	387% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000	$556.00	$556.00	—	387% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000	$556.00	$556.00	—	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000	$556.00	$556.00	—	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436	$3,330.00	$3,330.00	—	at median	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436	$4,054.00	$4,054.00	—	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433	$1,169.00	$1,169.00	—	65% above	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433	$1,423.00	$1,423.00	—	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209	$166.00	$166.00	—	48% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209	$166.00	$166.00	—	48% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209	$166.00	$166.00	—	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209	$166.00	$166.00	—	—	—
Earwax removal with instruments, one ear CPT 69210	$166.00	$166.00	—	60% above	—
Earwax removal with instruments, one ear CPT 69210	$166.00	$166.00	—	60% above	—
Earwax removal with instruments, one ear inpatient CPT 69210	$166.00	$166.00	—	—	—
Earwax removal with instruments, one ear inpatient CPT 69210	$166.00	$166.00	—	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100	$562.00	$562.00	—	101% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100	$562.00	$562.00	—	101% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100	$562.00	$562.00	—	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100	$562.00	$562.00	—	—	—
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255	$17,730.00	$17,730.00	—	55% above	—
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255	$17,730.00	$17,730.00	—	55% above	—
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255	$17,730.00	$17,730.00	—	—	—
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255	$17,730.00	$17,730.00	—	—	—
Endoscopic sinus surgery: opening the frontal sinus CPT 31276	$17,730.00	$17,730.00	—	36% above	—
Endoscopic sinus surgery: opening the frontal sinus CPT 31276	$17,730.00	$17,730.00	—	36% above	—
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276	$17,730.00	$17,730.00	—	—	—
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276	$17,730.00	$17,730.00	—	—	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256	$9,904.00	$9,904.00	—	29% above	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256	$9,904.00	$9,904.00	—	29% above	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256	$9,904.00	$9,904.00	—	—	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256	$9,904.00	$9,904.00	—	—	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267	$17,730.00	$17,730.00	—	26% above	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267	$17,730.00	$17,730.00	—	26% above	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267	$17,730.00	$17,730.00	—	—	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267	$17,730.00	$17,730.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321	$1,886.00	$1,886.00	—	16% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321	$1,886.00	$1,886.00	—	16% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321	$1,886.00	$1,886.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321	$1,886.00	$1,886.00	—	—	—
Eye injection into the vitreous (intravitreal injection) CPT 67028	$927.00	$927.00	—	at median	—
Eye injection into the vitreous (intravitreal injection) CPT 67028	$927.00	$927.00	—	at median	—
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028	$927.00	$927.00	—	—	—
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028	$927.00	$927.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493	$2,430.00	$2,430.00	—	67% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493	$2,430.00	$2,430.00	—	67% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493	$2,430.00	$2,430.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493	$2,430.00	$2,430.00	—	—	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593	$14,664.00	$14,664.00	—	24% above	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593	$14,664.00	$14,664.00	—	24% above	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593	$14,664.00	$14,664.00	—	—	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593	$14,664.00	$14,664.00	—	—	—
First repair of a front abdominal hernia larger than 10 cm CPT 49595	$14,664.00	$14,664.00	—	42% above	—
First repair of a front abdominal hernia larger than 10 cm CPT 49595	$14,664.00	$14,664.00	—	42% above	—
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595	$14,664.00	$14,664.00	—	—	—
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595	$14,664.00	$14,664.00	—	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591	$8,630.00	$8,630.00	—	3% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591	$8,630.00	$8,630.00	—	3% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591	$8,630.00	$8,630.00	—	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591	$8,630.00	$8,630.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330	$2,509.00	$2,509.00	—	132% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330	$2,509.00	$2,509.00	—	132% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330	$2,509.00	$2,509.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330	$2,509.00	$2,509.00	—	—	—
Gallbladder removal, laparoscopic CPT 47562	$15,131.00	$15,131.00	—	17% above	—
Gallbladder removal, laparoscopic CPT 47562	$15,131.00	$15,131.00	—	17% above	—
Gallbladder removal, laparoscopic inpatient CPT 47562	$15,131.00	$15,131.00	—	—	—
Gallbladder removal, laparoscopic inpatient CPT 47562	$15,131.00	$15,131.00	—	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563	$15,131.00	$15,131.00	—	22% above	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563	$15,131.00	$15,131.00	—	22% above	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563	$15,131.00	$15,131.00	—	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563	$15,131.00	$15,131.00	—	—	—
Hammertoe correction surgery CPT 28285	$6,877.00	$6,877.00	—	73% above	—
Hammertoe correction surgery inpatient CPT 28285	$8,372.00	$8,372.00	—	—	—
Hemorrhoid banding (rubber band ligation) CPT 46221	$2,509.00	$2,509.00	—	129% above	—
Hemorrhoid banding (rubber band ligation) CPT 46221	$2,509.00	$2,509.00	—	129% above	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221	$2,509.00	$2,509.00	—	—	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221	$2,509.00	$2,509.00	—	—	—
Hemorrhoidectomy (internal and external), one area CPT 46255	$7,189.00	$7,189.00	—	71% above	—
Hemorrhoidectomy (internal and external), one area CPT 46255	$7,189.00	$7,189.00	—	71% above	—
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255	$7,189.00	$7,189.00	—	—	—
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255	$7,189.00	$7,189.00	—	—	—
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132	$15,889.00	$15,889.00	—	at median	—
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132	$19,343.00	$19,343.00	—	—	—
Hysterectomy through an abdominal incision (total) CPT 58150	$32,839.00	$32,839.00	—	145% above	—
Hysterectomy through an abdominal incision (total) CPT 58150	$32,839.00	$32,839.00	—	145% above	—
Hysterectomy through an abdominal incision (total) inpatient CPT 58150	$32,839.00	$32,839.00	—	—	—
Hysterectomy through an abdominal incision (total) inpatient CPT 58150	$32,839.00	$32,839.00	—	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340	$653.00	$653.00	—	92% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340	$653.00	$653.00	—	92% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340	$653.00	$653.00	—	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340	$653.00	$653.00	—	—	—
Hysteroscopy with endometrial ablation CPT 58563	$11,723.00	$11,723.00	—	7% above	—
Hysteroscopy with endometrial ablation CPT 58563	$11,723.00	$11,723.00	—	7% above	—
Hysteroscopy with endometrial ablation inpatient CPT 58563	$11,723.00	$11,723.00	—	—	—
Hysteroscopy with endometrial ablation inpatient CPT 58563	$11,723.00	$11,723.00	—	—	—
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558	$8,592.00	$8,592.00	—	100% above	—
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558	$8,592.00	$8,592.00	—	100% above	—
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558	$8,592.00	$8,592.00	—	—	—
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558	$8,592.00	$8,592.00	—	—	—
IUD insertion (the device itself billed separately) CPT 58300	$1,682.00	$1,682.00	—	460% above	—
IUD insertion (the device itself billed separately) CPT 58300	$1,682.00	$1,682.00	—	460% above	—
IUD insertion (the device itself billed separately) inpatient CPT 58300	$1,682.00	$1,682.00	—	—	—
IUD insertion (the device itself billed separately) inpatient CPT 58300	$1,682.00	$1,682.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060	$556.00	$556.00	—	96% above	—
Incision and drainage of a simple or single skin abscess CPT 10060	$556.00	$556.00	—	96% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060	$556.00	$556.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060	$556.00	$556.00	—	—	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505	$8,630.00	$8,630.00	—	at median	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505	$8,630.00	$8,630.00	—	at median	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505	$8,630.00	$8,630.00	—	—	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505	$8,630.00	$8,630.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550	$672.00	$672.00	—	173% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550	$818.00	$818.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610	$672.00	$672.00	—	120% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610	$818.00	$818.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981	$360.00	$360.00	—	91% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981	$360.00	$360.00	—	91% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981	$360.00	$360.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981	$360.00	$360.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605	$672.00	$672.00	—	157% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605	$818.00	$818.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600	$672.00	$672.00	—	125% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600	$818.00	$818.00	—	—	—
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882	$6,877.00	$6,877.00	—	at median	—
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882	$8,372.00	$8,372.00	—	—	—
Knee arthroscopy with meniscus trim CPT 29881	$6,877.00	$6,877.00	—	at median	—
Knee arthroscopy with meniscus trim inpatient CPT 29881	$8,372.00	$8,372.00	—	—	—
Knee arthroscopy with removal of both torn meniscus parts CPT 29880	$6,877.00	$6,877.00	—	at median	—
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880	$8,372.00	$8,372.00	—	—	—
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877	$6,877.00	$6,877.00	—	at median	—
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877	$8,372.00	$8,372.00	—	—	—
Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770	$26,271.00	$26,271.00	—	at median	—
Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770	$26,271.00	$26,271.00	—	at median	—
Laparoscopic adjustable gastric band placement (Lap-Band) inpatient CPT 43770	$26,271.00	$26,271.00	—	—	—
Laparoscopic adjustable gastric band placement (Lap-Band) inpatient CPT 43770	$26,271.00	$26,271.00	—	—	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970	$15,131.00	$15,131.00	—	87% above	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970	$15,131.00	$15,131.00	—	87% above	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970	$15,131.00	$15,131.00	—	—	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970	$15,131.00	$15,131.00	—	—	—
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280	$26,271.00	$26,271.00	—	at median	—
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280	$26,271.00	$26,271.00	—	at median	—
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280	$26,271.00	$26,271.00	—	—	—
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280	$26,271.00	$26,271.00	—	—	—
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570	$26,271.00	$26,271.00	—	60% above	—
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570	$26,271.00	$26,271.00	—	60% above	—
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570	$26,271.00	$26,271.00	—	—	—
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570	$26,271.00	$26,271.00	—	—	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571	$26,271.00	$26,271.00	—	81% above	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571	$26,271.00	$26,271.00	—	81% above	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571	$26,271.00	$26,271.00	—	—	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571	$26,271.00	$26,271.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650	$15,131.00	$15,131.00	—	at median	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650	$15,131.00	$15,131.00	—	at median	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650	$15,131.00	$15,131.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650	$15,131.00	$15,131.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651	$15,131.00	$15,131.00	—	at median	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651	$15,131.00	$15,131.00	—	at median	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651	$15,131.00	$15,131.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651	$15,131.00	$15,131.00	—	—	—
Laparoscopic removal of an adjustable gastric band and its port CPT 43774	$8,663.00	$8,663.00	—	at median	—
Laparoscopic removal of an adjustable gastric band and its port CPT 43774	$8,663.00	$8,663.00	—	at median	—
Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774	$8,663.00	$8,663.00	—	—	—
Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774	$8,663.00	$8,663.00	—	—	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661	$15,131.00	$15,131.00	—	32% above	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661	$15,131.00	$15,131.00	—	32% above	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661	$15,131.00	$15,131.00	—	—	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661	$15,131.00	$15,131.00	—	—	—
Laparoscopic sleeve gastrectomy for weight loss CPT 43775	$32,839.00	$32,839.00	—	at median	—
Laparoscopic sleeve gastrectomy for weight loss CPT 43775	$32,839.00	$32,839.00	—	at median	—
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775	$32,839.00	$32,839.00	—	—	—
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775	$32,839.00	$32,839.00	—	—	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$1,535.00	$1,535.00	—	at median	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$1,535.00	$1,535.00	—	at median	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821	$1,535.00	$1,535.00	—	—	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821	$1,535.00	$1,535.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031	$1,117.00	$1,117.00	—	201% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031	$1,117.00	$1,117.00	—	201% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031	$1,117.00	$1,117.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031	$1,117.00	$1,117.00	—	—	—
Left heart catheterization, diagnostic CPT 93452	$19,903.00	$19,903.00	—	42% above	—
Left heart catheterization, diagnostic CPT 93452	$19,903.00	$19,903.00	—	42% above	—
Left heart catheterization, diagnostic inpatient CPT 93452	$19,903.00	$19,903.00	—	—	—
Left heart catheterization, diagnostic inpatient CPT 93452	$19,903.00	$19,903.00	—	—	—
Lower-back epidural injection, with imaging guidance CPT 62323	$1,886.00	$1,886.00	—	35% above	—
Lower-back epidural injection, with imaging guidance CPT 62323	$1,886.00	$1,886.00	—	35% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323	$1,886.00	$1,886.00	—	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323	$1,886.00	$1,886.00	—	—	—
Lower-back epidural injection, without imaging guidance CPT 62322	$2,430.00	$2,430.00	—	89% above	—
Lower-back epidural injection, without imaging guidance CPT 62322	$2,430.00	$2,430.00	—	89% above	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322	$2,430.00	$2,430.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322	$2,430.00	$2,430.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483	$2,430.00	$2,430.00	—	39% above	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483	$2,430.00	$2,430.00	—	39% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483	$2,430.00	$2,430.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483	$2,430.00	$2,430.00	—	—	—
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030	$14,738.00	$14,738.00	—	at median	—
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030	$14,738.00	$14,738.00	—	at median	—
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030	$14,738.00	$14,738.00	—	—	—
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030	$14,738.00	$14,738.00	—	—	—
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633	$17,113.00	$17,113.00	—	at median	—
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633	$20,834.00	$20,834.00	—	—	—
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630	$20,834.00	$20,834.00	—	at median	—
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630	$20,834.00	$20,834.00	—	at median	—
Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630	$20,834.00	$20,834.00	—	—	—
Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630	$20,834.00	$20,834.00	—	—	—
Lumbar laminectomy (spinal decompression), one level CPT 63047	$14,738.00	$14,738.00	—	17% above	—
Lumbar laminectomy (spinal decompression), one level CPT 63047	$14,738.00	$14,738.00	—	17% above	—
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047	$14,738.00	$14,738.00	—	—	—
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047	$14,738.00	$14,738.00	—	—	—
Lumbar spinal fusion (posterior), one level CPT 22612	$17,113.00	$17,113.00	—	1% above	—
Lumbar spinal fusion (posterior), one level inpatient CPT 22612	$20,834.00	$20,834.00	—	—	—
Lumpectomy (partial mastectomy) CPT 19301	$10,392.00	$10,392.00	—	69% above	—
Lumpectomy (partial mastectomy) CPT 19301	$10,392.00	$10,392.00	—	69% above	—
Lumpectomy (partial mastectomy) inpatient CPT 19301	$10,392.00	$10,392.00	—	—	—
Lumpectomy (partial mastectomy) inpatient CPT 19301	$10,392.00	$10,392.00	—	—	—
Mastectomy (total removal of the breast) CPT 19303	$17,300.00	$17,300.00	—	59% above	—
Mastectomy (total removal of the breast) CPT 19303	$17,300.00	$17,300.00	—	59% above	—
Mastectomy (total removal of the breast) inpatient CPT 19303	$17,300.00	$17,300.00	—	—	—
Mastectomy (total removal of the breast) inpatient CPT 19303	$17,300.00	$17,300.00	—	—	—
Miscarriage treatment with D&C, first trimester CPT 59820	$8,592.00	$8,592.00	—	5% above	—
Miscarriage treatment with D&C, first trimester CPT 59820	$8,592.00	$8,592.00	—	5% above	—
Miscarriage treatment with D&C, first trimester inpatient CPT 59820	$8,592.00	$8,592.00	—	—	—
Miscarriage treatment with D&C, first trimester inpatient CPT 59820	$8,592.00	$8,592.00	—	—	—
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311	$1,686.00	$1,686.00	—	at median	—
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311	$1,686.00	$1,686.00	—	at median	—
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311	$1,686.00	$1,686.00	—	—	—
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311	$1,686.00	$1,686.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400	$1,783.00	$1,783.00	—	432% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400	$1,783.00	$1,783.00	—	432% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400	$1,783.00	$1,783.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400	$1,783.00	$1,783.00	—	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440	$1,783.00	$1,783.00	—	420% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440	$1,783.00	$1,783.00	—	420% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440	$1,783.00	$1,783.00	—	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440	$1,783.00	$1,783.00	—	—	—
Nail removal (partial or complete), one nail CPT 11730	$556.00	$556.00	—	170% above	—
Nail removal (partial or complete), one nail CPT 11730	$556.00	$556.00	—	170% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730	$556.00	$556.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730	$556.00	$556.00	—	—	—
Occipital nerve block (injection for headaches) CPT 64405	$818.00	$818.00	—	101% above	—
Occipital nerve block (injection for headaches) CPT 64405	$818.00	$818.00	—	101% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405	$818.00	$818.00	—	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405	$818.00	$818.00	—	—	—
Pacemaker implant (dual chamber) CPT 33208	$12,726.00	$12,726.00	—	at median	—
Pacemaker implant (dual chamber) CPT 33208	$12,726.00	$12,726.00	—	at median	—
Pacemaker implant (dual chamber) inpatient CPT 33208	$12,726.00	$12,726.00	—	—	—
Pacemaker implant (dual chamber) inpatient CPT 33208	$12,726.00	$12,726.00	—	—	—
Paracentesis with imaging guidance CPT 49083	$2,526.00	$2,526.00	—	86% above	—
Paracentesis with imaging guidance CPT 49083	$2,526.00	$2,526.00	—	86% above	—
Paracentesis with imaging guidance inpatient CPT 49083	$2,526.00	$2,526.00	—	—	—
Paracentesis with imaging guidance inpatient CPT 49083	$2,526.00	$2,526.00	—	—	—
Partial knee replacement (one compartment) CPT 27446	$15,889.00	$15,889.00	—	at median	—
Partial knee replacement (one compartment) inpatient CPT 27446	$19,343.00	$19,343.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750	$1,117.00	$1,117.00	—	119% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750	$1,117.00	$1,117.00	—	119% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750	$1,117.00	$1,117.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750	$1,117.00	$1,117.00	—	—	—
Prostate removal (prostatectomy), laparoscopic CPT 55866	$26,271.00	$26,271.00	—	at median	—
Prostate removal (prostatectomy), laparoscopic CPT 55866	$26,271.00	$26,271.00	—	at median	—
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866	$26,271.00	$26,271.00	—	—	—
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866	$26,271.00	$26,271.00	—	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635	$5,383.00	$5,383.00	—	123% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635	$5,383.00	$5,383.00	—	123% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635	$5,383.00	$5,383.00	—	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635	$5,383.00	$5,383.00	—	—	—
Removal of a breast lump, open surgery CPT 19120	$10,392.00	$10,392.00	—	163% above	—
Removal of a breast lump, open surgery CPT 19120	$10,392.00	$10,392.00	—	163% above	—
Removal of a breast lump, open surgery inpatient CPT 19120	$10,392.00	$10,392.00	—	—	—
Removal of a breast lump, open surgery inpatient CPT 19120	$10,392.00	$10,392.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120	$1,117.00	$1,117.00	—	226% above	—
Removal of a foreign object under the skin, simple CPT 10120	$1,117.00	$1,117.00	—	226% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120	$1,117.00	$1,117.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120	$1,117.00	$1,117.00	—	—	—
Removal of one lobe of the thyroid (lobectomy) CPT 60220	$15,131.00	$15,131.00	—	5% above	—
Removal of one lobe of the thyroid (lobectomy) CPT 60220	$15,131.00	$15,131.00	—	5% above	—
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220	$15,131.00	$15,131.00	—	—	—
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220	$15,131.00	$15,131.00	—	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121	$2,509.00	$2,509.00	—	at median	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121	$2,509.00	$2,509.00	—	at median	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121	$2,509.00	$2,509.00	—	—	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121	$2,509.00	$2,509.00	—	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105	$2,509.00	$2,509.00	—	3% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105	$2,509.00	$2,509.00	—	3% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105	$2,509.00	$2,509.00	—	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105	$2,509.00	$2,509.00	—	—	—
Septoplasty to straighten the nasal septum CPT 30520	$7,224.00	$7,224.00	—	18% above	—
Septoplasty to straighten the nasal septum inpatient CPT 30520	$8,795.00	$8,795.00	—	—	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590	$8,773.00	$8,773.00	—	at median	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590	$8,773.00	$8,773.00	—	at median	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590	$8,773.00	$8,773.00	—	—	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590	$8,773.00	$8,773.00	—	—	—
Short arm cast (elbow to hand) CPT 29075	$611.00	$611.00	—	180% above	—
Short arm cast (elbow to hand) inpatient CPT 29075	$743.00	$743.00	—	—	—
Short arm splint (forearm and hand) CPT 29125	$296.00	$296.00	—	47% above	—
Short arm splint (forearm and hand) inpatient CPT 29125	$360.00	$360.00	—	—	—
Short leg cast (below the knee) CPT 29405	$743.00	$743.00	—	213% above	—
Short leg cast (below the knee) CPT 29405	$743.00	$743.00	—	213% above	—
Short leg cast (below the knee) inpatient CPT 29405	$743.00	$743.00	—	—	—
Short leg cast (below the knee) inpatient CPT 29405	$743.00	$743.00	—	—	—
Short leg splint (calf to foot) CPT 29515	$363.00	$363.00	—	64% above	—
Short leg splint (calf to foot) inpatient CPT 29515	$442.00	$442.00	—	—	—
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824	$6,877.00	$6,877.00	—	26% above	—
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824	$8,372.00	$8,372.00	—	—	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826	$2,859.00	$2,859.00	—	at median	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826	$2,859.00	$2,859.00	—	at median	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826	$2,859.00	$2,859.00	—	—	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826	$2,859.00	$2,859.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001	$556.00	$556.00	—	118% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001	$556.00	$556.00	—	118% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001	$556.00	$556.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001	$556.00	$556.00	—	—	—
Skin biopsy, punch, one lesion CPT 11104	$1,117.00	$1,117.00	—	389% above	—
Skin biopsy, punch, one lesion CPT 11104	$1,117.00	$1,117.00	—	389% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104	$1,117.00	$1,117.00	—	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104	$1,117.00	$1,117.00	—	—	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600	$1,783.00	$1,783.00	—	235% above	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600	$1,783.00	$1,783.00	—	235% above	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600	$1,783.00	$1,783.00	—	—	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600	$1,783.00	$1,783.00	—	—	—
Skin tag removal, up to 15 tags CPT 11200	$556.00	$556.00	—	228% above	—
Skin tag removal, up to 15 tags CPT 11200	$556.00	$556.00	—	228% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200	$556.00	$556.00	—	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200	$556.00	$556.00	—	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270	$1,886.00	$1,886.00	—	124% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270	$1,886.00	$1,886.00	—	124% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270	$1,886.00	$1,886.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270	$1,886.00	$1,886.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002	$556.00	$556.00	—	86% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002	$556.00	$556.00	—	86% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002	$556.00	$556.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002	$556.00	$556.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011	$556.00	$556.00	—	94% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011	$556.00	$556.00	—	94% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011	$556.00	$556.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011	$556.00	$556.00	—	—	—
TURP (transurethral resection of the prostate) CPT 52601	$12,489.00	$12,489.00	—	42% above	—
TURP (transurethral resection of the prostate) CPT 52601	$12,489.00	$12,489.00	—	42% above	—
TURP (transurethral resection of the prostate) inpatient CPT 52601	$12,489.00	$12,489.00	—	—	—
TURP (transurethral resection of the prostate) inpatient CPT 52601	$12,489.00	$12,489.00	—	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102	$556.00	$556.00	—	166% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102	$556.00	$556.00	—	166% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102	$556.00	$556.00	—	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102	$556.00	$556.00	—	—	—
Thoracentesis with imaging guidance CPT 32555	$1,672.00	$1,672.00	—	45% above	—
Thoracentesis with imaging guidance CPT 32555	$1,672.00	$1,672.00	—	45% above	—
Thoracentesis with imaging guidance inpatient CPT 32555	$1,672.00	$1,672.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555	$1,672.00	$1,672.00	—	—	—
Tonsil and adenoid removal, age 12 or older CPT 42821	$7,224.00	$7,224.00	—	40% above	—
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821	$8,795.00	$8,795.00	—	—	—
Tonsil and adenoid removal, child under 12 CPT 42820	$12,747.00	$12,747.00	—	55% above	—
Tonsil and adenoid removal, child under 12 inpatient CPT 42820	$15,519.00	$15,519.00	—	—	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826	$7,224.00	$7,224.00	—	15% above	—
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826	$8,795.00	$8,795.00	—	—	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825	$12,747.00	$12,747.00	—	19% above	—
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825	$15,519.00	$15,519.00	—	—	—
Total hip replacement CPT 27130	$15,889.00	$15,889.00	—	at median	—
Total hip replacement CPT 27130	$15,889.00	$15,889.00	—	at median	—
Total hip replacement inpatient CPT 27130	$15,889.00	$15,889.00	—	—	—
Total hip replacement inpatient CPT 27130	$15,889.00	$15,889.00	—	—	—
Total knee replacement CPT 27447	$15,889.00	$15,889.00	—	at median	—
Total knee replacement CPT 27447	$15,889.00	$15,889.00	—	at median	—
Total knee replacement inpatient CPT 27447	$15,889.00	$15,889.00	—	—	—
Total knee replacement inpatient CPT 27447	$15,889.00	$15,889.00	—	—	—
Total shoulder replacement CPT 23472	$17,113.00	$17,113.00	—	at median	—
Total shoulder replacement inpatient CPT 23472	$20,834.00	$20,834.00	—	—	—
Total thyroid removal (thyroidectomy) CPT 60240	$15,131.00	$15,131.00	—	at median	—
Total thyroid removal (thyroidectomy) CPT 60240	$15,131.00	$15,131.00	—	at median	—
Total thyroid removal (thyroidectomy) inpatient CPT 60240	$15,131.00	$15,131.00	—	—	—
Total thyroid removal (thyroidectomy) inpatient CPT 60240	$15,131.00	$15,131.00	—	—	—
Trigger finger release surgery CPT 26055	$3,644.00	$3,644.00	—	77% above	—
Trigger finger release surgery inpatient CPT 26055	$4,436.00	$4,436.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552	$672.00	$672.00	—	274% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552	$818.00	$818.00	—	—	—
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670	$15,131.00	$15,131.00	—	at median	—
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670	$15,131.00	$15,131.00	—	at median	—
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670	$15,131.00	$15,131.00	—	—	—
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670	$15,131.00	$15,131.00	—	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083	$4,347.00	$4,347.00	—	74% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083	$4,347.00	$4,347.00	—	74% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083	$4,347.00	$4,347.00	—	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083	$4,347.00	$4,347.00	—	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249	$4,686.00	$4,686.00	—	78% above	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249	$4,686.00	$4,686.00	—	78% above	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249	$4,686.00	$4,686.00	—	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249	$4,686.00	$4,686.00	—	—	—
Upper endoscopy (EGD) with biopsy CPT 43239	$2,526.00	$2,526.00	—	8% above	—
Upper endoscopy (EGD) with biopsy CPT 43239	$2,526.00	$2,526.00	—	8% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD) with injection into the lining CPT 43236	$2,526.00	$2,526.00	—	8% above	—
Upper endoscopy (EGD) with injection into the lining CPT 43236	$2,526.00	$2,526.00	—	8% above	—
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251	$4,686.00	$4,686.00	—	92% above	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251	$4,686.00	$4,686.00	—	92% above	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251	$4,686.00	$4,686.00	—	—	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251	$4,686.00	$4,686.00	—	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248	$2,526.00	$2,526.00	—	6% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248	$2,526.00	$2,526.00	—	6% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD), diagnostic CPT 43235	$2,526.00	$2,526.00	—	18% above	—
Upper endoscopy (EGD), diagnostic CPT 43235	$2,526.00	$2,526.00	—	18% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235	$2,526.00	$2,526.00	—	—	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235	$2,526.00	$2,526.00	—	—	—
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240	$10,986.00	$10,986.00	—	at median	—
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240	$10,986.00	$10,986.00	—	at median	—
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240	$10,986.00	$10,986.00	—	—	—
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240	$10,986.00	$10,986.00	—	—	—
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353	$12,489.00	$12,489.00	—	100% above	—
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353	$12,489.00	$12,489.00	—	100% above	—
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353	$12,489.00	$12,489.00	—	—	—
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353	$12,489.00	$12,489.00	—	—	—
Ureteroscopy with laser stone breaking and stent placement CPT 52356	$12,489.00	$12,489.00	—	9% above	—
Ureteroscopy with laser stone breaking and stent placement CPT 52356	$12,489.00	$12,489.00	—	9% above	—
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356	$12,489.00	$12,489.00	—	—	—
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356	$12,489.00	$12,489.00	—	—	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250	$5,304.00	$5,304.00	—	112% above	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250	$5,304.00	$5,304.00	—	112% above	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250	$5,304.00	$5,304.00	—	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250	$5,304.00	$5,304.00	—	—	—
Vein ablation, radiofrequency, first vein CPT 36475	$7,280.00	$7,280.00	—	at median	—
Vein ablation, radiofrequency, first vein CPT 36475	$7,280.00	$7,280.00	—	at median	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475	$7,280.00	$7,280.00	—	—	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475	$7,280.00	$7,280.00	—	—	—
Wart removal, up to 14 warts CPT 17110	$556.00	$556.00	—	155% above	—
Wart removal, up to 14 warts CPT 17110	$556.00	$556.00	—	155% above	—
Wart removal, up to 14 warts inpatient CPT 17110	$556.00	$556.00	—	—	—
Wart removal, up to 14 warts inpatient CPT 17110	$556.00	$556.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042	$1,117.00	$1,117.00	—	235% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042	$1,117.00	$1,117.00	—	235% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042	$1,117.00	$1,117.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042	$1,117.00	$1,117.00	—	—	—
Wrist fracture surgery (plate and screws), distal radius CPT 25607	$12,106.00	$12,106.00	—	26% above	—
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607	$14,738.00	$14,738.00	—	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Blood transfusion (giving blood or blood components) CPT 36430	$1,224.00	$1,224.00	—	25% above	—
Blood transfusion (giving blood or blood components) CPT 36430	$1,224.00	$1,224.00	—	25% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430	$1,224.00	$1,224.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430	$1,224.00	$1,224.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640	$463.00	$463.00	—	122% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640	$463.00	$463.00	—	122% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640	$463.00	$463.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640	$463.00	$463.00	—	—	—
Chemotherapy IV infusion, first hour CPT 96413	$1,358.00	$1,358.00	—	94% above	—
Chemotherapy IV infusion, first hour CPT 96413	$1,358.00	$1,358.00	—	94% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413	$1,358.00	$1,358.00	—	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413	$1,358.00	$1,358.00	—	—	—
Comprehensive eye exam by an eye doctor, new patient CPT 92004	$121.00	$121.00	—	at median	—
Comprehensive eye exam by an eye doctor, new patient CPT 92004	$121.00	$121.00	—	at median	—
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004	$121.00	$121.00	—	—	—
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004	$121.00	$121.00	—	—	—
Comprehensive eye exam, returning patient CPT 92014	$612.00	$612.00	—	at median	—
Comprehensive eye exam, returning patient CPT 92014	$612.00	$612.00	—	at median	—
Comprehensive eye exam, returning patient inpatient CPT 92014	$612.00	$612.00	—	—	—
Comprehensive eye exam, returning patient inpatient CPT 92014	$612.00	$612.00	—	—	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557	$414.00	$414.00	—	at median	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557	$414.00	$414.00	—	at median	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557	$414.00	$414.00	—	—	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557	$414.00	$414.00	—	—	—
Critical care, first 30 to 74 minutes CPT 99291	$3,661.00	$3,661.00	—	57% above	—
Critical care, first 30 to 74 minutes CPT 99291	$3,661.00	$3,661.00	—	57% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291	$3,661.00	$3,661.00	—	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291	$3,661.00	$3,661.00	—	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816	$1,464.00	$1,464.00	—	45% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816	$1,464.00	$1,464.00	—	45% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816	$1,464.00	$1,464.00	—	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816	$1,464.00	$1,464.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005	$296.00	$296.00	—	79% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005	$296.00	$296.00	—	79% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005	$296.00	$296.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005	$296.00	$296.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281	$383.00	$383.00	—	71% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281	$383.00	$383.00	—	71% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281	$383.00	$383.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281	$383.00	$383.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282	$688.00	$688.00	—	58% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282	$688.00	$688.00	—	58% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282	$688.00	$688.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282	$688.00	$688.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283	$1,204.00	$1,204.00	—	59% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283	$1,204.00	$1,204.00	—	59% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283	$1,204.00	$1,204.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283	$1,204.00	$1,204.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284	$1,851.00	$1,851.00	—	44% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284	$1,851.00	$1,851.00	—	44% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284	$1,851.00	$1,851.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284	$1,851.00	$1,851.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285	$2,665.00	$2,665.00	—	45% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285	$2,665.00	$2,665.00	—	45% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285	$2,665.00	$2,665.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285	$2,665.00	$2,665.00	—	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017	$1,079.00	$1,079.00	—	30% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017	$1,079.00	$1,079.00	—	30% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017	$1,079.00	$1,079.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017	$1,079.00	$1,079.00	—	—	—
Eye exam, returning patient, intermediate CPT 92012	$612.00	$612.00	—	at median	—
Eye exam, returning patient, intermediate CPT 92012	$612.00	$612.00	—	at median	—
Eye exam, returning patient, intermediate inpatient CPT 92012	$612.00	$612.00	—	—	—
Eye exam, returning patient, intermediate inpatient CPT 92012	$612.00	$612.00	—	—	—
Family therapy with the patient, 50 minutes CPT 90847	$466.00	$466.00	—	141% above	—
Family therapy with the patient, 50 minutes CPT 90847	$466.00	$466.00	—	141% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847	$466.00	$466.00	—	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847	$466.00	$466.00	—	—	—
Family therapy without the patient, 50 minutes CPT 90846	$466.00	$466.00	—	153% above	—
Family therapy without the patient, 50 minutes CPT 90846	$466.00	$466.00	—	153% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846	$466.00	$466.00	—	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846	$466.00	$466.00	—	—	—
Group psychotherapy session CPT 90853	$268.00	$268.00	—	at median	—
Group psychotherapy session CPT 90853	$268.00	$268.00	—	at median	—
Group psychotherapy session inpatient CPT 90853	$268.00	$268.00	—	—	—
Group psychotherapy session inpatient CPT 90853	$268.00	$268.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360	$734.00	$734.00	—	122% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360	$734.00	$734.00	—	122% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360	$734.00	$734.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360	$734.00	$734.00	—	—	—
IV infusion of a medicine, first hour CPT 96365	$734.00	$734.00	—	53% above	—
IV infusion of a medicine, first hour CPT 96365	$734.00	$734.00	—	53% above	—
IV infusion of a medicine, first hour inpatient CPT 96365	$734.00	$734.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365	$734.00	$734.00	—	—	—
IV push of a medicine, first drug CPT 96374	$734.00	$734.00	—	218% above	—
IV push of a medicine, first drug CPT 96374	$734.00	$734.00	—	218% above	—
IV push of a medicine, first drug inpatient CPT 96374	$734.00	$734.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374	$734.00	$734.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372	$249.00	$249.00	—	117% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372	$249.00	$249.00	—	117% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372	$249.00	$249.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372	$249.00	$249.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791	$466.00	$466.00	—	98% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791	$466.00	$466.00	—	98% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791	$466.00	$466.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791	$466.00	$466.00	—	—	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910	$1,464.00	$1,464.00	—	266% above	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910	$1,464.00	$1,464.00	—	266% above	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910	$1,464.00	$1,464.00	—	—	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910	$1,464.00	$1,464.00	—	—	—
Neuromuscular re-education, 15 minutes CPT 97112	$81.00	$81.00	—	at median	—
Neuromuscular re-education, 15 minutes CPT 97112	$81.00	$81.00	—	at median	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112	$81.00	$81.00	—	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112	$81.00	$81.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802	$89.00	$89.00	—	63% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802	$89.00	$89.00	—	63% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802	$89.00	$89.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802	$89.00	$89.00	—	—	—
Occupational therapy evaluation, low complexity CPT 97165	$253.00	$253.00	—	11% above	—
Occupational therapy evaluation, low complexity CPT 97165	$253.00	$253.00	—	11% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165	$253.00	$253.00	—	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165	$253.00	$253.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163	$246.00	$246.00	—	6% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163	$246.00	$246.00	—	6% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163	$246.00	$246.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163	$246.00	$246.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161	$246.00	$246.00	—	23% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161	$246.00	$246.00	—	23% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161	$246.00	$246.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161	$246.00	$246.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162	$246.00	$246.00	—	10% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162	$246.00	$246.00	—	10% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162	$246.00	$246.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162	$246.00	$246.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140	$68.00	$68.00	—	at median	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140	$68.00	$68.00	—	at median	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140	$68.00	$68.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140	$68.00	$68.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110	$72.00	$72.00	—	6% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110	$72.00	$72.00	—	6% below	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110	$72.00	$72.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110	$72.00	$72.00	—	—	—
Preventive checkup, new patient aged 18–39 CPT 99385	$428.00	$428.00	—	65% above	—
Preventive checkup, new patient aged 18–39 CPT 99385	$428.00	$428.00	—	65% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385	$428.00	$428.00	—	—	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385	$428.00	$428.00	—	—	—
Psychiatric evaluation with medical services CPT 90792	$466.00	$466.00	—	74% above	—
Psychiatric evaluation with medical services CPT 90792	$466.00	$466.00	—	74% above	—
Psychiatric evaluation with medical services inpatient CPT 90792	$466.00	$466.00	—	—	—
Psychiatric evaluation with medical services inpatient CPT 90792	$466.00	$466.00	—	—	—
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130	$894.00	$894.00	—	at median	—
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130	$894.00	$894.00	—	at median	—
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130	$894.00	$894.00	—	—	—
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130	$894.00	$894.00	—	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839	$466.00	$466.00	—	97% above	—
Psychotherapy for crisis, first 60 minutes CPT 90839	$466.00	$466.00	—	97% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839	$466.00	$466.00	—	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839	$466.00	$466.00	—	—	—
Psychotherapy session, 30 minutes CPT 90832	$466.00	$466.00	—	283% above	—
Psychotherapy session, 30 minutes CPT 90832	$466.00	$466.00	—	283% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832	$466.00	$466.00	—	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832	$466.00	$466.00	—	—	—
Psychotherapy session, 45 minutes CPT 90834	$466.00	$466.00	—	201% above	—
Psychotherapy session, 45 minutes CPT 90834	$466.00	$466.00	—	201% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834	$466.00	$466.00	—	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834	$466.00	$466.00	—	—	—
Psychotherapy session, 60 minutes CPT 90837	$466.00	$466.00	—	113% above	—
Psychotherapy session, 60 minutes CPT 90837	$466.00	$466.00	—	113% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837	$466.00	$466.00	—	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837	$466.00	$466.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406	$79.00	$79.00	—	126% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406	$79.00	$79.00	—	126% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406	$79.00	$79.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406	$79.00	$79.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215	$386.00	$386.00	—	50% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215	$386.00	$386.00	—	50% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215	$386.00	$386.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215	$386.00	$386.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213	$322.00	$322.00	—	108% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213	$322.00	$322.00	—	108% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213	$322.00	$322.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213	$322.00	$322.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214	$354.00	$354.00	—	110% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214	$354.00	$354.00	—	110% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214	$354.00	$354.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214	$354.00	$354.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212	$290.00	$290.00	—	218% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212	$290.00	$290.00	—	218% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212	$290.00	$290.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212	$290.00	$290.00	—	—	—
Speech and language evaluation CPT 92523	$564.00	$564.00	—	32% above	—
Speech and language evaluation CPT 92523	$564.00	$564.00	—	32% above	—
Speech and language evaluation inpatient CPT 92523	$564.00	$564.00	—	—	—
Speech and language evaluation inpatient CPT 92523	$564.00	$564.00	—	—	—
Speech therapy session, individual CPT 92507	$190.00	$190.00	—	at median	—
Speech therapy session, individual CPT 92507	$190.00	$190.00	—	at median	—
Speech therapy session, individual inpatient CPT 92507	$190.00	$190.00	—	—	—
Speech therapy session, individual inpatient CPT 92507	$190.00	$190.00	—	—	—
Spirometry (breathing test) CPT 94010	$360.00	$360.00	—	47% above	—
Spirometry (breathing test) CPT 94010	$360.00	$360.00	—	47% above	—
Spirometry (breathing test) inpatient CPT 94010	$360.00	$360.00	—	—	—
Spirometry (breathing test) inpatient CPT 94010	$360.00	$360.00	—	—	—
Spirometry before and after a bronchodilator CPT 94060	$709.00	$709.00	—	40% above	—
Spirometry before and after a bronchodilator CPT 94060	$709.00	$709.00	—	40% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060	$709.00	$709.00	—	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060	$709.00	$709.00	—	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530	$86.00	$86.00	—	at median	—
Therapeutic activities (functional training), 15 minutes CPT 97530	$86.00	$86.00	—	at median	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530	$86.00	$86.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530	$86.00	$86.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195	$341.00	$341.00	—	52% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195	$341.00	$341.00	—	52% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195	$341.00	$341.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195	$341.00	$341.00	—	—	—
Visual field test, extended CPT 92083	$611.00	$611.00	—	at median	—
Visual field test, extended CPT 92083	$611.00	$611.00	—	at median	—
Visual field test, extended inpatient CPT 92083	$611.00	$611.00	—	—	—
Visual field test, extended inpatient CPT 92083	$611.00	$611.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320	$242.00	$242.00	—	at median	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320	$242.00	$242.00	—	at median	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320	$378.17	$378.17	—	56% above	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320	$378.17	$378.17	—	56% above	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320	$242.00	$242.00	—	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320	$242.00	$242.00	—	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320	$378.17	$378.17	—	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320	$378.17	$378.17	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716	$243.99	$243.99	—	at median	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716	$243.99	$243.99	—	at median	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716	$424.44	$424.44	—	74% above	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716	$424.44	$424.44	—	74% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716	$243.99	$243.99	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716	$243.99	$243.99	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716	$424.44	$424.44	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716	$424.44	$424.44	—	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696	$148.30	$148.30	—	at median	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696	$148.30	$148.30	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700	$42.87	$42.87	—	at median	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700	$42.87	$42.87	—	at median	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700	$75.93	$75.93	—	77% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700	$75.93	$75.93	—	77% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700	$42.87	$42.87	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700	$42.87	$42.87	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700	$75.93	$75.93	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700	$75.93	$75.93	—	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723	$144.31	$144.31	—	at median	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723	$144.31	$144.31	—	at median	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723	$144.31	$144.31	—	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723	$144.31	$144.31	—	—	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698	$148.30	$148.30	—	at median	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698	$285.58	$285.58	—	93% above	—
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698	$148.30	$148.30	—	—	—
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698	$285.58	$285.58	—	—	—
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697	$219.53	$219.53	—	at median	—
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697	$219.53	$219.53	—	at median	—
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697	$219.53	$219.53	—	—	—
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697	$219.53	$219.53	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656	$36.00	$36.00	—	at median	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656	$36.00	$36.00	—	at median	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656	$36.00	$36.00	—	at median	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656	$36.00	$36.00	—	at median	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656	$36.00	$36.00	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656	$36.00	$36.00	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656	$36.00	$36.00	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656	$36.00	$36.00	—	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651	$459.68	$459.68	—	18% above	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651	$459.68	$459.68	—	18% above	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651	$1,424.87	$1,424.87	—	265% above	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651	$1,424.87	$1,424.87	—	265% above	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651	$459.68	$459.68	—	—	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651	$459.68	$459.68	—	—	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651	$1,424.87	$1,424.87	—	—	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651	$1,424.87	$1,424.87	—	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636	$147.30	$147.30	—	at median	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636	$147.30	$147.30	—	—	—
Hepatitis A vaccine, adult dose CPT 90632	$108.89	$108.89	—	at median	—
Hepatitis A vaccine, adult dose CPT 90632	$108.89	$108.89	—	at median	—
Hepatitis A vaccine, adult dose CPT 90632	$203.96	$203.96	—	87% above	—
Hepatitis A vaccine, adult dose CPT 90632	$203.96	$203.96	—	87% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632	$108.89	$108.89	—	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632	$108.89	$108.89	—	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632	$203.96	$203.96	—	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632	$203.96	$203.96	—	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633	$61.98	$61.98	—	at median	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633	$61.98	$61.98	—	at median	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633	$61.98	$61.98	—	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633	$61.98	$61.98	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746	$103.30	$103.30	—	at median	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746	$103.30	$103.30	—	at median	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746	$103.30	$103.30	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746	$103.30	$103.30	—	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739	$198.58	$198.58	—	at median	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739	$198.58	$198.58	—	at median	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739	$198.58	$198.58	—	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739	$198.58	$198.58	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744	$54.18	$54.18	—	at median	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744	$54.18	$54.18	—	at median	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744	$172.86	$172.86	—	219% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744	$172.86	$172.86	—	219% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744	$54.18	$54.18	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744	$54.18	$54.18	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744	$172.86	$172.86	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744	$172.86	$172.86	—	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647	$49.62	$49.62	—	at median	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647	$79.06	$79.06	—	59% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647	$49.62	$49.62	—	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647	$79.06	$79.06	—	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648	$19.75	$19.75	—	24% below	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648	$41.30	$41.30	—	59% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648	$19.75	$19.75	—	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648	$41.30	$41.30	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662	$152.00	$152.00	—	33% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662	$152.00	$152.00	—	33% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662	$152.00	$152.00	—	33% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662	$152.00	$152.00	—	33% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662	$152.00	$152.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662	$152.00	$152.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662	$152.00	$152.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662	$152.00	$152.00	—	—	—
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738	$323.55	$323.55	—	at median	—
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738	$323.55	$323.55	—	at median	—
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738	$323.55	$323.55	—	—	—
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738	$323.55	$323.55	—	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707	$158.02	$158.02	—	at median	—
MMR vaccine (measles, mumps and rubella), live CPT 90707	$218.85	$218.85	—	38% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707	$158.02	$158.02	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707	$218.85	$218.85	—	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710	$412.74	$412.74	—	at median	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710	$412.74	$412.74	—	at median	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710	$412.74	$412.74	—	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710	$412.74	$412.74	—	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734	$188.70	$188.70	—	at median	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734	$188.70	$188.70	—	at median	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734	$188.70	$188.70	—	—	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734	$188.70	$188.70	—	—	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619	$211.17	$211.17	—	at median	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619	$211.17	$211.17	—	at median	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619	$392.17	$392.17	—	86% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619	$392.17	$392.17	—	86% above	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619	$211.17	$211.17	—	—	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619	$211.17	$211.17	—	—	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619	$392.17	$392.17	—	—	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619	$392.17	$392.17	—	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620	$265.92	$265.92	—	at median	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620	$265.92	$265.92	—	at median	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620	$265.92	$265.92	—	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620	$265.92	$265.92	—	—	—
Meningococcal B vaccine (Trumenba) CPT 90621	$309.85	$309.85	—	at median	—
Meningococcal B vaccine (Trumenba) CPT 90621	$309.85	$309.85	—	at median	—
Meningococcal B vaccine (Trumenba) inpatient CPT 90621	$309.85	$309.85	—	—	—
Meningococcal B vaccine (Trumenba) inpatient CPT 90621	$309.85	$309.85	—	—	—
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611	$405.00	$405.00	—	at median	—
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611	$405.00	$405.00	—	at median	—
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611	$405.00	$405.00	—	—	—
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611	$405.00	$405.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670	$287.74	$287.74	—	at median	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670	$287.74	$287.74	—	at median	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670	$287.74	$287.74	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670	$287.74	$287.74	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677	$410.78	$410.78	—	4% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677	$410.78	$410.78	—	4% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677	$674.95	$674.95	—	71% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677	$674.95	$674.95	—	71% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677	$410.78	$410.78	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677	$410.78	$410.78	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677	$674.95	$674.95	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677	$674.95	$674.95	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732	$149.28	$149.28	—	at median	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732	$149.28	$149.28	—	at median	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732	$149.28	$149.28	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732	$149.28	$149.28	—	—	—
Polio vaccine, inactivated (IPV) CPT 90713	$83.57	$83.57	—	at median	—
Polio vaccine, inactivated (IPV) CPT 90713	$83.57	$83.57	—	at median	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713	$83.57	$83.57	—	—	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713	$83.57	$83.57	—	—	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381	$607.13	$607.13	—	at median	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381	$607.13	$607.13	—	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380	$595.98	$595.98	—	at median	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380	$1,292.38	$1,292.38	—	117% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380	$595.98	$595.98	—	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380	$1,292.38	$1,292.38	—	—	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678	$442.50	$442.50	—	at median	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678	$699.01	$699.01	—	58% above	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678	$699.01	$699.01	—	58% above	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678	$442.50	$442.50	—	—	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678	$699.01	$699.01	—	—	—
Rabies vaccine, one dose CPT 90675	$417.89	$417.89	—	at median	—
Rabies vaccine, one dose CPT 90675	$417.89	$417.89	—	at median	—
Rabies vaccine, one dose CPT 90675	$947.42	$947.42	—	127% above	—
Rabies vaccine, one dose CPT 90675	$947.42	$947.42	—	127% above	—
Rabies vaccine, one dose inpatient CPT 90675	$417.89	$417.89	—	—	—
Rabies vaccine, one dose inpatient CPT 90675	$417.89	$417.89	—	—	—
Rabies vaccine, one dose inpatient CPT 90675	$947.42	$947.42	—	—	—
Rabies vaccine, one dose inpatient CPT 90675	$947.42	$947.42	—	—	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681	$141.71	$141.71	—	at median	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681	$141.71	$141.71	—	at median	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681	$141.71	$141.71	—	—	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681	$141.71	$141.71	—	—	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680	$141.71	$141.71	—	at median	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680	$141.71	$141.71	—	at median	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680	$141.71	$141.71	—	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750	$323.26	$323.26	—	11% above	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750	$323.26	$323.26	—	11% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750	$323.26	$323.26	—	—	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750	$323.26	$323.26	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714	$77.42	$77.42	—	at median	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714	$77.42	$77.42	—	at median	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714	$108.49	$108.49	—	40% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714	$108.49	$108.49	—	40% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714	$77.42	$77.42	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714	$77.42	$77.42	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714	$108.49	$108.49	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714	$108.49	$108.49	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715	$75.09	$75.09	—	27% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715	$75.09	$75.09	—	27% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715	$117.99	$117.99	—	14% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715	$117.99	$117.99	—	14% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715	$75.09	$75.09	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715	$75.09	$75.09	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715	$117.99	$117.99	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715	$117.99	$117.99	—	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691	$173.14	$173.14	—	at median	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691	$173.14	$173.14	—	—	—
Typhoid vaccine, oral capsules (Vivotif) CPT 90690	$120.00	$120.00	—	at median	—
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690	$120.00	$120.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471	$110.00	$110.00	—	105% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471	$110.00	$110.00	—	105% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471	$110.00	$110.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471	$110.00	$110.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472	$110.00	$110.00	—	234% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472	$110.00	$110.00	—	234% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472	$110.00	$110.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472	$110.00	$110.00	—	—	—
Yellow fever vaccine, live CPT 90717	$201.75	$201.75	—	at median	—
Yellow fever vaccine, live CPT 90717	$201.75	$201.75	—	at median	—
Yellow fever vaccine, live inpatient CPT 90717	$201.75	$201.75	—	—	—
Yellow fever vaccine, live inpatient CPT 90717	$201.75	$201.75	—	—	—

Dental

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240	$4,585.00	$4,585.00	—	at median	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240	$4,585.00	$4,585.00	—	at median	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240	$4,585.00	$4,585.00	—	—	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240	$4,585.00	$4,585.00	—	—	—

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://assets.slhs.org/download/assets/562570686_St-Lukes-Magic-Valley-Regional-Medical-Center-LTD_standardcharges.csv/c858a3662a2111f192bf16988bbe7db4