Hospital Houston-Pasadena-The Woodlands, TX

St Luke's Patients Medical Center

Listed in its price file as “Pmc Hospital, LLC”.

St Luke's Patients Medical Center in Pasadena, TX publishes cash prices for 275 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 149 of 270 procedures and above it for 118. By typical cash price it ranks #67 of 211 Texas hospitals and #7 of 35 hospitals in the Houston, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.

4600 E. Sam Houston Parkway South, Pasadena, TX 77505 Collected Sep 27, 2026 Source price file (281) 487-0700

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 670031 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3+ VIEWS LEFT	$614.95	$1,757.00	$34.91–$1,317.75	89% above	65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3+ VIEWS LEFT	$614.95	$1,757.00	$1,142.05–$1,317.75	—	65%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 SBP/ABI LOWER U/L	$870.80	$2,488.00	$129.11–$1,866.00	43% above	65%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 SBP/ABI LOWER U/L	$870.80	$2,488.00	$1,617.20–$1,866.00	—	65%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$887.95	$2,537.00	$92.68–$1,902.75	77% above	65%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$887.95	$2,537.00	$1,649.05–$1,902.75	—	65%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE AND/OR JOINT WHOLE BODY	$1,978.99	$5,654.25	$261.88–$4,240.69	9% above	65%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE AND/OR JOINT WHOLE BODY	$1,978.99	$5,654.25	$3,675.27–$4,240.69	—	65%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST COMPLETE BILATERAL	$1,388.45	$3,967.00	$97.76–$2,975.25	—	65%
Breast ultrasound, complete, one breast CPT 76641 US BREAST UNI	$925.75	$2,645.00	$97.76–$1,983.75	109% above	65%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST COMPLETE BILATERAL	$1,388.45	$3,967.00	$2,578.55–$2,975.25	—	65%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST UNI	$925.75	$2,645.00	$1,719.25–$1,983.75	—	65%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED BILATERAL	$1,101.10	$3,146.00	$80.94–$2,359.50	—	65%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT RT LIMITED	$733.95	$2,097.00	$80.94–$1,572.75	112% above	65%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST LIMITED BILATERAL	$1,101.10	$3,146.00	$2,044.90–$2,359.50	—	65%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT RT LIMITED	$733.95	$2,097.00	$1,363.05–$1,572.75	—	65%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PULM VEIN STUDY	$2,087.05	$5,963.00	$166.31–$4,472.25	36% below	65%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST	$3,421.25	$9,775.00	$166.31–$7,331.25	5% above	65%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST PULM VEIN STUDY	$2,087.05	$5,963.00	$3,875.95–$4,472.25	—	65%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST	$3,421.25	$9,775.00	$6,353.75–$7,331.25	—	65%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CORONARY CTA INCL CALCIUM	$1,619.80	$4,628.00	$166.31–$3,471.00	at median	65%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CORONARY CTA INCL CALCIUM	$1,619.80	$4,628.00	$3,008.20–$3,471.00	—	65%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CALCIUM SCORING	$291.90	$834.00	$82.25–$2,156.00	54% above	65%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART CALCIUM SCORING	$291.90	$834.00	$542.10–$625.50	—	65%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O	$4,700.85	$13,431.00	$178.70–$10,073.25	33% above	65%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/O	$4,700.85	$13,431.00	$8,730.15–$10,073.25	—	65%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST	$5,000.58	$14,287.35	$296.48–$10,715.52	28% above	65%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST	$5,000.58	$14,287.35	$9,286.78–$10,715.52	—	65%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS W/WO CONTR	$5,050.85	$14,431.00	$332.67–$10,823.25	15% above	65%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS W/WO CONTR	$5,050.85	$14,431.00	$9,380.15–$10,823.25	—	65%
CT scan of the abdomen with contrast CPT 74160 CT ABD W	$4,032.35	$11,521.00	$166.31–$8,640.75	54% above	65%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$4,032.44	$11,521.24	$166.31–$8,640.93	54% above	65%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W	$4,032.35	$11,521.00	$7,488.65–$8,640.75	—	65%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$4,032.44	$11,521.24	$7,488.81–$8,640.93	—	65%
CT scan of the abdomen without contrast CPT 74150 CT ABD WO	$2,339.05	$6,683.00	$99.51–$5,012.25	7% above	65%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD WO	$2,339.05	$6,683.00	$4,343.95–$5,012.25	—	65%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO	$2,256.63	$6,447.50	$99.51–$4,835.63	32% above	65%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO	$2,256.63	$6,447.50	$4,190.88–$4,835.63	—	65%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN STROKE PROTOCOL	$2,473.10	$7,066.00	$99.51–$5,299.50	22% above	65%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO	$2,473.10	$7,066.00	$99.51–$5,299.50	22% above	65%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO	$2,473.10	$7,066.00	$4,592.90–$5,299.50	—	65%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN STROKE PROTOCOL	$2,473.10	$7,066.00	$4,592.90–$5,299.50	—	65%
CT scan of the head with contrast CPT 70460 CT BRAIN W/CONTRAST	$3,462.20	$9,892.00	$144.74–$7,419.00	60% above	65%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/CONTRAST	$3,462.20	$9,892.00	$6,429.80–$7,419.00	—	65%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO	$4,055.45	$11,587.00	$166.31–$8,690.25	55% above	65%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO	$4,055.45	$11,587.00	$7,531.55–$8,690.25	—	65%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CON	$3,818.85	$10,911.00	$99.51–$8,183.25	65% above	65%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CON	$3,818.85	$10,911.00	$7,092.15–$8,183.25	—	65%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST	$3,200.40	$9,144.00	$99.51–$6,858.00	35% above	65%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE W/O CONTRAST	$3,200.40	$9,144.00	$5,943.60–$6,858.00	—	65%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$4,924.15	$14,069.00	$166.31–$10,551.75	88% above	65%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$4,924.15	$14,069.00	$9,144.85–$10,551.75	—	65%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,661.80	$4,748.00	$181.89–$3,561.00	—	65%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,661.80	$4,748.00	$3,086.20–$3,561.00	—	65%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$514.85	$1,471.00	$32.06–$1,103.25	13% above	65%
Chest X-ray, 2 views CPT 71046 CXR 2 VW	$549.85	$1,571.00	$32.06–$1,178.25	20% above	65%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$514.85	$1,471.00	$956.15–$1,103.25	—	65%
Chest X-ray, 2 views inpatient CPT 71046 CXR 2 VW	$549.85	$1,571.00	$1,021.15–$1,178.25	—	65%
Chest X-ray, single view CPT 71045 CXR 1 VW	$417.90	$1,194.00	$24.44–$895.50	9% above	65%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$466.20	$1,332.00	$24.44–$999.00	22% above	65%
Chest X-ray, single view inpatient CPT 71045 CXR 1 VW	$417.90	$1,194.00	$776.10–$895.50	—	65%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$466.20	$1,332.00	$865.80–$999.00	—	65%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ULTRASOUND RETORPERITONEAL	$1,183.18	$3,380.50	$99.51–$2,535.38	59% above	65%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ABDOMINAL US RETROPERITONEAL	$1,183.35	$3,381.00	$99.51–$2,535.75	59% above	65%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ULTRASOUND RETORPERITONEAL	$1,183.18	$3,380.50	$2,197.33–$2,535.38	—	65%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ABDOMINAL US RETROPERITONEAL	$1,183.35	$3,381.00	$2,197.65–$2,535.75	—	65%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DXA DUAL ENERGY	$405.30	$1,158.00	$37.14–$868.50	3% below	65%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DXA DUAL ENERGY	$405.30	$1,158.00	$752.70–$868.50	—	65%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$2,970.80	$8,488.00	$99.51–$6,366.00	40% above	65%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$2,970.80	$8,488.00	$5,517.20–$6,366.00	—	65%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$3,760.40	$10,744.00	$163.15–$8,058.00	42% above	65%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST	$3,760.40	$10,744.00	$6,983.60–$8,058.00	—	65%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILATERAL WCAD	$771.05	$2,203.00	$148.00–$1,652.25	—	65%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY CAD BI	$771.05	$2,203.00	$140.00–$1,652.25	—	65%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAG BILATERAL WCAD	$771.05	$2,203.00	$1,431.95–$1,652.25	—	65%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY CAD BI	$771.05	$2,203.00	$1,431.95–$1,652.25	—	65%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHYCAD UNI	$393.40	$1,124.00	$132.62–$843.00	15% above	65%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNILAT & CAD LT	$393.40	$1,124.00	$132.62–$843.00	15% above	65%
Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHYCAD UNI	$393.40	$1,124.00	$730.60–$843.00	—	65%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNILAT & CAD LT	$393.40	$1,124.00	$730.60–$843.00	—	65%
Duplex ultrasound of the leg arteries, both legs CPT 93925 ARTERIAL DUPLEX LWR B/L	$1,113.16	$3,180.45	$221.84–$2,385.34	47% below	65%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 ARTERIAL DUPLEX LWR B/L	$1,113.16	$3,180.45	$2,067.30–$2,385.34	—	65%
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DUPLEX LWR B/L	$1,796.90	$5,134.00	$179.35–$3,850.50	14% below	65%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DUPLEX LWR B/L	$1,796.90	$5,134.00	$3,337.10–$3,850.50	—	65%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TEE ECHO COMPL W/CF & DOPPLER	$3,033.80	$8,668.00	$100.00–$6,501.00	17% above	65%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TEE ECHO COMPL W/CF & DOPPLER	$3,033.80	$8,668.00	$5,634.20–$6,501.00	—	65%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY	$1,752.80	$5,008.00	$287.91–$3,756.00	at median	65%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY	$1,752.80	$5,008.00	$3,255.20–$3,756.00	—	65%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W/CPAP	$3,497.20	$9,992.00	$100.00–$7,494.00	33% below	65%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W/CPAP	$3,497.20	$9,992.00	$6,494.80–$7,494.00	—	65%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VW RT	$595.35	$1,701.00	$39.05–$1,275.75	86% above	65%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VW RT	$595.35	$1,701.00	$1,105.65–$1,275.75	—	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$926.45	$2,647.00	$82.85–$1,985.25	47% above	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$926.45	$2,647.00	$1,720.55–$1,985.25	—	65%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RIGHT HIP W/O	$4,251.10	$12,146.00	$198.40–$9,109.50	92% above	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RIGHT HIP W/O	$4,251.10	$12,146.00	$7,894.90–$9,109.50	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RIGHT KNEE W/WO CONTRAST	$5,673.15	$16,209.00	$348.10–$12,156.75	89% above	65%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI RIGHT KNEE W/WO CONTRAST	$5,673.15	$16,209.00	$10,535.85–$12,156.75	—	65%
MRI of the abdomen without contrast CPT 74181 MRCP WITHOUT CONTRAST	$2,863.00	$8,180.00	$191.72–$6,135.00	20% above	65%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O	$2,863.00	$8,180.00	$191.72–$6,135.00	20% above	65%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O	$2,863.00	$8,180.00	$5,317.00–$6,135.00	—	65%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP WITHOUT CONTRAST	$2,863.00	$8,180.00	$5,317.00–$6,135.00	—	65%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W W/O	$4,935.88	$14,102.50	$331.07–$10,576.88	51% above	65%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRCP W/WO CONTRAST	$4,936.05	$14,103.00	$331.07–$10,577.25	51% above	65%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W W/O	$4,935.88	$14,102.50	$9,166.63–$10,576.88	—	65%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRCP W/WO CONTRAST	$4,936.05	$14,103.00	$9,166.95–$10,577.25	—	65%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$3,000.90	$8,574.00	$192.04–$6,430.50	33% above	65%
MRI of the brain, no contrast dye CPT 70551 MRI OF PITUITARY GLAND W/O	$3,000.90	$8,574.00	$192.04–$6,430.50	33% above	65%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$3,000.90	$8,574.00	$5,573.10–$6,430.50	—	65%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI OF PITUITARY GLAND W/O	$3,000.90	$8,574.00	$5,573.10–$6,430.50	—	65%
MRI of the brain, with and without contrast dye CPT 70553 MRI OF PITUITARY GLAND W/WO	$4,891.25	$13,975.00	$311.70–$10,481.25	55% above	65%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & W/O	$4,891.25	$13,975.00	$311.70–$10,481.25	55% above	65%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & W/O	$4,891.25	$13,975.00	$9,083.75–$10,481.25	—	65%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI OF PITUITARY GLAND W/WO	$4,891.25	$13,975.00	$9,083.75–$10,481.25	—	65%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O	$2,887.45	$8,249.85	$187.28–$6,187.39	21% above	65%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O	$2,887.45	$8,249.85	$5,362.41–$6,187.39	—	65%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMB SPINE W W/O	$4,822.30	$13,778.00	$312.67–$10,333.50	51% above	65%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMB SPINE W W/O	$4,822.30	$13,778.00	$8,955.70–$10,333.50	—	65%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THOR SPINE W/O	$2,391.20	$6,832.00	$186.33–$5,124.00	9% above	65%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THOR SPINE W/O	$2,391.20	$6,832.00	$4,440.80–$5,124.00	—	65%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERV SPINE W W/O	$5,597.90	$15,994.00	$313.30–$11,995.50	53% above	65%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERV SPINE W W/O	$5,597.90	$15,994.00	$10,396.10–$11,995.50	—	65%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERV SPINE W/O	$3,492.65	$9,979.00	$186.66–$7,484.25	46% above	65%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERV SPINE W/O	$3,492.65	$9,979.00	$6,486.35–$7,484.25	—	65%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W W/O	$4,935.88	$14,102.50	$329.80–$10,576.88	42% above	65%
MRI of the pelvis without and with contrast CPT 72197 MRI SI JOINTS W & W/O CONTRAST	$4,936.05	$14,103.00	$329.80–$10,577.25	42% above	65%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W W/O	$4,935.88	$14,102.50	$9,166.63–$10,576.88	—	65%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI SI JOINTS W & W/O CONTRAST	$4,936.05	$14,103.00	$9,166.95–$10,577.25	—	65%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$3,356.50	$9,590.00	$221.80–$7,192.50	23% above	65%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$3,356.50	$9,590.00	$6,233.50–$7,192.50	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RIGHT SHOULDER W/O	$4,105.50	$11,730.00	$198.70–$8,797.50	129% above	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI RIGHT SHOULDER W/O	$4,105.50	$11,730.00	$7,624.50–$8,797.50	—	65%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDI SPECT MULTIPLE STUDY	$5,327.35	$15,221.00	$416.15–$11,415.75	21% above	65%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDI SPECT MULTIPLE STUDY	$5,327.35	$15,221.00	$9,893.65–$11,415.75	—	65%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER (NON OB)	$489.65	$1,399.00	$48.25–$1,049.25	1% above	65%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER (NON OB)	$489.65	$1,399.00	$909.35–$1,049.25	—	65%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS (NON OB)	$1,041.43	$2,975.50	$91.47–$2,231.63	21% above	65%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS (NON OB)	$1,041.43	$2,975.50	$1,934.08–$2,231.63	—	65%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE SINGLE GEST	$1,088.50	$3,110.00	$99.51–$2,332.50	67% above	65%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE SINGLE GEST	$1,088.50	$3,110.00	$2,021.50–$2,332.50	—	65%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB IST TRI SINGLE GEST	$938.22	$2,680.61	$99.51–$2,010.46	53% above	65%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB IS 1ST GEST < 14WEEKS	$938.35	$2,681.00	$99.51–$2,010.75	53% above	65%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB IST TRI SINGLE GEST	$938.22	$2,680.61	$1,742.40–$2,010.46	—	65%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB IS 1ST GEST < 14WEEKS	$938.35	$2,681.00	$1,742.65–$2,010.75	—	65%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIM ONE OR MORE FETUSES	$581.70	$1,662.00	$77.14–$1,246.50	27% above	65%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIM ONE OR MORE FETUSES	$581.70	$1,662.00	$1,080.30–$1,246.50	—	65%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHYBI 2VIEW	$312.55	$893.00	$140.00–$669.75	at median	65%
Screening mammogram, both breasts one side CPT 77067 MAMOGRAM DIGIT SCR UNILATRL LT	$312.55	$893.00	$140.25–$669.75	at median	65%
Screening mammogram, both breasts inpatient CPT 77067 SCREENING MAMMOGRAPHYBI 2VIEW	$312.55	$893.00	$580.45–$669.75	—	65%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMOGRAM DIGIT SCR UNILATRL LT	$312.55	$893.00	$580.45–$669.75	—	65%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 SHOULDER COMPLETE BILATERAL	$634.90	$1,814.00	$33.34–$1,360.50	—	65%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 SHOULDER COMPLETE BILATERAL	$634.90	$1,814.00	$1,179.10–$1,360.50	—	65%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY	$2,838.81	$8,110.86	$100.00–$6,083.15	39% below	65%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY	$2,838.81	$8,110.86	$5,272.06–$6,083.15	—	65%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO	$2,339.82	$6,685.20	$100.00–$5,013.90	14% below	65%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO	$2,339.82	$6,685.20	$4,345.38–$5,013.90	—	65%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$986.30	$2,818.00	$118.71–$2,113.50	59% above	65%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$986.30	$2,818.00	$1,831.70–$2,113.50	—	65%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL U/S	$719.60	$2,056.00	$99.51–$1,542.00	12% above	65%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL U/S	$719.60	$2,056.00	$1,336.40–$1,542.00	—	65%
Transvaginal ultrasound during pregnancy CPT 76817 US TV OB 1	$668.50	$1,910.00	$88.25–$1,432.50	31% above	65%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TV OB 1	$668.50	$1,910.00	$1,241.50–$1,432.50	—	65%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN	$1,569.75	$4,485.00	$99.51–$3,363.75	82% above	65%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN-COMPLETE	$1,569.78	$4,485.07	$99.51–$3,363.81	82% above	65%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN	$1,569.75	$4,485.00	$2,915.25–$3,363.75	—	65%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN-COMPLETE	$1,569.78	$4,485.07	$2,915.30–$3,363.81	—	65%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$908.17	$2,594.75	$95.23–$1,946.07	33% above	65%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$908.17	$2,594.75	$1,686.59–$1,946.07	—	65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$1,026.13	$2,931.78	$99.51–$2,198.84	63% above	65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US UPPER EXTREM SOFT TISSUE	$1,026.20	$2,932.00	$99.51–$2,199.00	63% above	65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$1,026.13	$2,931.78	$1,905.66–$2,198.84	—	65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US UPPER EXTREM SOFT TISSUE	$1,026.20	$2,932.00	$1,905.80–$2,199.00	—	65%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$446.42	$1,275.48	$116.81–$956.61	37% below	65%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$446.42	$1,275.48	$829.07–$956.61	—	65%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DUPLEX LWR U/L	$1,006.60	$2,876.00	$101.54–$2,157.00	25% above	65%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DUPLEX LWR U/L	$1,006.60	$2,876.00	$1,869.40–$2,157.00	—	65%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPLETE RIGHT 3+ VIEWS	$539.00	$1,540.00	$39.37–$1,155.00	73% above	65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPLETE RIGHT 3+ VIEWS	$539.00	$1,540.00	$1,001.00–$1,155.00	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VW WITH PELVIS RT	$560.70	$1,602.00	$45.39–$1,201.50	39% above	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VW WITH PELVIS RT	$560.70	$1,602.00	$1,041.30–$1,201.50	—	65%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN-1VIEW (KUB)	$470.40	$1,344.00	$28.88–$1,008.00	30% above	65%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW (KUB)	$472.15	$1,349.00	$28.88–$1,011.75	31% above	65%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN-1VIEW (KUB)	$470.40	$1,344.00	$873.60–$1,008.00	—	65%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW (KUB)	$472.15	$1,349.00	$876.85–$1,011.75	—	65%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LIMITED LEFT	$368.90	$1,054.00	$30.79–$790.50	31% above	65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LIMITED LEFT	$368.90	$1,054.00	$685.10–$790.50	—	65%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER LT	$388.50	$1,110.00	$36.51–$832.50	61% above	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER LT	$388.50	$1,110.00	$721.50–$832.50	—	65%
X-ray of the foot, 2 views both sides CPT 73620 FOOT TWO VIEWS BILATERAL	$515.55	$1,473.00	$27.30–$1,104.75	—	65%
X-ray of the foot, 2 views inpatient both sides CPT 73620 FOOT TWO VIEWS BILATERAL	$515.55	$1,473.00	$957.45–$1,104.75	—	65%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS	$620.90	$1,774.00	$32.69–$1,330.50	70% above	65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS	$620.90	$1,774.00	$1,153.10–$1,330.50	—	65%
X-ray of the hand, 3 or more views both sides CPT 73130 HAND 3 VIEW+ BILATERAL	$535.15	$1,529.00	$35.56–$1,146.75	—	65%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND 3 VIEW+ BILATERAL	$535.15	$1,529.00	$993.85–$1,146.75	—	65%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VW RT	$494.20	$1,412.00	$32.69–$1,059.00	78% above	65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VW RT	$494.20	$1,412.00	$917.80–$1,059.00	—	65%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR 2-3 VIEWS	$714.00	$2,040.00	$38.09–$1,530.00	36% above	65%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR 2-3 VIEWS	$714.00	$2,040.00	$1,326.00–$1,530.00	—	65%
X-ray of the lower back, 4 or more views CPT 72110 SP LUM AP/LAT/FLEX/EXT MIN 4VW	$926.80	$2,648.00	$49.52–$1,986.00	42% above	65%
X-ray of the lower back, 4 or more views CPT 72110 L-SPINE 4 OR MORE VIEWS	$926.89	$2,648.25	$49.52–$1,986.19	42% above	65%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SP LUM AP/LAT/FLEX/EXT MIN 4VW	$926.80	$2,648.00	$1,721.20–$1,986.00	—	65%
X-ray of the lower back, 4 or more views inpatient CPT 72110 L-SPINE 4 OR MORE VIEWS	$926.89	$2,648.25	$1,721.37–$1,986.19	—	65%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VW	$424.90	$1,214.00	$31.43–$910.50	5% above	65%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2 VW	$424.90	$1,214.00	$789.10–$910.50	—	65%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONE	$169.16	$483.30	$35.87–$362.48	40% below	65%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONE	$169.16	$483.30	$314.15–$362.48	—	65%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CSPINE 2-3 VWS	$513.10	$1,466.00	$37.77–$1,099.50	36% above	65%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CSPINE 2-3 VWS	$513.10	$1,466.00	$952.90–$1,099.50	—	65%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS	$457.45	$1,307.00	$26.66–$980.25	23% above	65%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP	$457.46	$1,307.02	$26.66–$980.27	23% above	65%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS	$457.45	$1,307.00	$849.55–$980.25	—	65%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP	$457.46	$1,307.02	$849.57–$980.27	—	65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX	$411.95	$1,177.00	$31.11–$882.75	30% above	65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX	$411.95	$1,177.00	$765.05–$882.75	—	65%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE	$26.46	$75.60	$4.23–$56.70	50% below	65%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE	$26.46	$75.60	$49.14–$56.70	—	65%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE	$18.59	$53.10	$4.13–$39.83	64% below	65%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE	$18.59	$53.10	$34.52–$39.83	—	65%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$368.55	$1,053.00	$38.01–$789.75	7% below	65%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$368.55	$1,053.00	$684.45–$789.75	—	65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLEGEN SPECIFIC IGE	$57.33	$163.80	$4.16–$122.85	302% above	65%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TEST FOOD ALLERGY	$57.33	$163.80	$4.16–$122.85	302% above	65%
Allergy blood test, specific IgE, per allergen CPT 86003 IGEPARROT	$57.33	$163.80	$4.16–$122.85	302% above	65%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER	$59.85	$171.00	$4.16–$128.25	320% above	65%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TEST FOOD ALLERGY	$57.33	$163.80	$106.47–$122.85	—	65%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGEPARROT	$57.33	$163.80	$106.47–$122.85	—	65%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLEGEN SPECIFIC IGE	$57.33	$163.80	$106.47–$122.85	—	65%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER	$59.85	$171.00	$111.15–$128.25	—	65%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$74.97	$214.20	$10.34–$160.65	22% above	65%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$74.97	$214.20	$139.23–$160.65	—	65%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$52.29	$149.40	$9.65–$112.05	42% below	65%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$52.29	$149.40	$97.11–$112.05	—	65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$93.10	$266.00	$31.33–$201.40	56% below	65%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$93.10	$266.00	$172.90–$199.50	—	65%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$190.75	$545.00	$6.75–$408.75	25% below	65%
Basic metabolic panel (blood test) CPT 80048 BASIC MET PANEL	$359.45	$1,027.00	$6.75–$770.25	41% above	65%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$190.75	$545.00	$354.25–$408.75	—	65%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC MET PANEL	$359.45	$1,027.00	$667.55–$770.25	—	65%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS AND MICRO LEVEL 4	$415.80	$1,188.00	$53.52–$891.00	40% above	65%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS AND MICRO LEVEL 4	$415.80	$1,188.00	$772.20–$891.00	—	65%
Blood culture for bacteria CPT 87040 CULTURE BLOOD AERO-ANAERO	$293.30	$838.00	$8.24–$628.50	23% above	65%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD AERO-ANAERO	$293.30	$838.00	$544.70–$628.50	—	65%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$18.90	$54.00	$4.50–$2,430.00	21% below	65%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$18.90	$54.00	$35.10–$40.50	—	65%
Blood glucose (sugar) test CPT 82947 R GLUCOSE	$44.42	$126.90	$3.13–$95.18	14% below	65%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$72.40	$206.85	$3.13–$155.14	40% above	65%
Blood glucose (sugar) test inpatient CPT 82947 R GLUCOSE	$44.42	$126.90	$82.49–$95.18	—	65%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$72.40	$206.85	$134.46–$155.14	—	65%
Blood lead test CPT 83655 LEAD	$41.58	$118.80	$9.66–$89.10	at median	65%
Blood lead test inpatient CPT 83655 LEAD	$41.58	$118.80	$77.22–$89.10	—	65%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH TYPING	$189.66	$541.88	$2.38–$541.88	106% above	65%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/RH TYPING	$189.66	$541.88	$352.23–$406.41	—	65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$127.16	$363.30	$4.13–$272.48	149% above	65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$127.16	$363.30	$236.15–$272.48	—	65%
C. difficile toxin gene test (stool PCR) CPT 87493 C.DIFF AMPLIFIED PROBE	$64.84	$185.23	$29.74–$185.23	70% below	65%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C.DIFF AMPLIFIED PROBE	$64.84	$185.23	$120.40–$138.93	—	65%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9	$90.04	$257.25	$16.61–$192.94	46% below	65%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9	$90.04	$257.25	$167.22–$192.94	—	65%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA125	$101.85	$291.00	$16.61–$218.25	37% below	65%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125	$101.85	$291.00	$189.15–$218.25	—	65%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$82.85	$236.70	$40.95–$236.70	10% above	65%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$82.85	$236.70	$153.86–$177.53	—	65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$107.10	$306.00	$28.01–$229.50	12% below	65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFICATION	$146.27	$417.90	$28.01–$313.43	20% above	65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$107.10	$306.00	$198.90–$229.50	—	65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFICATION	$146.27	$417.90	$271.64–$313.43	—	65%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$94.15	$269.00	$10.69–$201.75	50% below	65%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$94.15	$269.00	$174.85–$201.75	—	65%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$76.30	$218.00	$6.20–$163.50	22% below	65%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$76.30	$218.00	$141.70–$163.50	—	65%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$168.70	$482.00	$5.16–$361.50	48% above	65%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$168.70	$482.00	$313.30–$361.50	—	65%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$286.65	$819.00	$8.43–$614.25	27% below	65%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE MET PANEL	$469.70	$1,342.00	$8.43–$1,006.50	20% above	65%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$286.65	$819.00	$532.35–$614.25	—	65%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE MET PANEL	$469.70	$1,342.00	$872.30–$1,006.50	—	65%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$117.95	$337.00	$8.12–$252.75	35% below	65%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$184.10	$526.00	$8.12–$394.50	2% above	65%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$117.95	$337.00	$219.05–$252.75	—	65%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$184.10	$526.00	$341.90–$394.50	—	65%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$38.67	$110.48	$17.74–$110.48	75% below	65%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$38.67	$110.48	$71.82–$82.86	—	65%
Estradiol blood test CPT 82670 ESTRADIOL SERUM	$140.18	$400.50	$22.30–$300.38	6% above	65%
Estradiol blood test inpatient CPT 82670 ESTRADIOL SERUM	$140.18	$400.50	$260.33–$300.38	—	65%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$147.35	$421.00	$14.83–$315.75	8% below	65%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$147.35	$421.00	$273.65–$315.75	—	65%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTINSTOOL	$106.58	$304.50	$15.67–$228.38	52% below	65%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTINSTOOL	$106.58	$304.50	$197.93–$228.38	—	65%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$103.27	$295.05	$10.88–$221.29	31% above	65%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$103.27	$295.05	$191.79–$221.29	—	65%
Folate (folic acid) blood test CPT 82746 FOLATE	$63.95	$182.70	$11.73–$137.03	39% below	65%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$63.95	$182.70	$118.76–$137.03	—	65%
Free T3 thyroid hormone test CPT 84481 FREE T3	$44.61	$127.44	$13.52–$95.58	72% below	65%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$44.61	$127.44	$82.84–$95.58	—	65%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$74.55	$213.00	$7.20–$159.75	40% below	65%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$74.55	$213.00	$138.45–$159.75	—	65%
Free testosterone test CPT 84402 FREE TESTOSTERONE	$89.85	$256.71	$20.32–$192.54	9% below	65%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE	$89.85	$256.71	$166.87–$192.54	—	65%
Glucose tolerance test, 3 samples CPT 82951 TOLERANCE TEST	$114.98	$328.50	$10.27–$246.38	24% below	65%
Glucose tolerance test, 3 samples inpatient CPT 82951 TOLERANCE TEST	$114.98	$328.50	$213.53–$246.38	—	65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHEA AMPLIFICATION	$148.11	$423.15	$28.01–$317.37	16% above	65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHEA AMPLIFICATION	$148.11	$423.15	$275.05–$317.37	—	65%
H. pylori antibody blood test CPT 86677 H.PYLORI IGM AB	$66.15	$189.00	$13.44–$141.75	49% below	65%
H. pylori antibody blood test CPT 86677 H PYLORI IGM	$70.25	$200.70	$13.44–$150.53	46% below	65%
H. pylori antibody blood test CPT 86677 H PYLORI IGG QN	$70.25	$200.70	$13.44–$150.53	46% below	65%
H. pylori antibody blood test CPT 86677 H PYLORI AB IGA	$80.14	$228.96	$13.44–$171.72	39% below	65%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$80.91	$231.15	$13.44–$173.37	38% below	65%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI IGM AB	$66.15	$189.00	$122.85–$141.75	—	65%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM	$70.25	$200.70	$130.46–$150.53	—	65%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG QN	$70.25	$200.70	$130.46–$150.53	—	65%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB IGA	$80.14	$228.96	$148.83–$171.72	—	65%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODY	$80.91	$231.15	$150.25–$173.37	—	65%
H. pylori stool antigen test CPT 87338 HELICOBACTER PY ANTIGEN STOOL	$34.34	$98.10	$11.48–$73.77	72% below	65%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PY ANTIGEN STOOL	$34.34	$98.10	$63.77–$73.58	—	65%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNAQUANT PCR	$163.49	$467.10	$67.91–$436.56	56% below	65%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNAQUANT PCR	$163.49	$467.10	$303.62–$350.33	—	65%
HIV-1 and HIV-2 antibody test CPT 86703 HIV SCREEN	$114.66	$327.60	$10.94–$245.70	7% below	65%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV SCREEN	$114.66	$327.60	$212.94–$245.70	—	65%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$54.95	$157.00	$7.75–$117.75	40% below	65%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$54.95	$157.00	$102.05–$117.75	—	65%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B ABQNT	$87.89	$251.10	$8.57–$188.33	at median	65%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QL	$143.70	$410.55	$8.57–$307.92	63% above	65%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B ABQNT	$87.89	$251.10	$163.22–$188.33	—	65%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB QL	$143.70	$410.55	$266.86–$307.92	—	65%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG	$101.80	$290.85	$8.25–$218.14	28% below	65%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG	$101.80	$290.85	$189.06–$218.14	—	65%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$77.69	$221.95	$11.39–$166.47	11% below	65%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB	$77.69	$221.95	$144.27–$166.47	—	65%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY PCR QT	$278.15	$794.70	$34.19–$596.03	32% above	65%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT	$313.74	$896.40	$34.19–$672.30	49% above	65%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA BY PCR QT	$278.15	$794.70	$516.56–$596.03	—	65%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANT	$313.74	$896.40	$582.66–$672.30	—	65%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG ANTIBODY	$204.40	$584.00	$10.53–$438.00	184% above	65%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGG ANTIBODY	$204.40	$584.00	$379.60–$438.00	—	65%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2	$67.20	$192.00	$15.44–$144.00	21% below	65%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2	$67.20	$192.00	$124.80–$144.00	—	65%
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP	$42.63	$121.80	$10.34–$91.35	57% below	65%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO CRP	$42.63	$121.80	$79.17–$91.35	—	65%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$86.80	$248.00	$14.30–$186.00	42% below	65%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$86.80	$248.00	$161.20–$186.00	—	65%
Insulin blood test CPT 83525 INSULIN TOTAL	$51.10	$146.00	$9.12–$109.50	26% below	65%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$51.10	$146.00	$94.90–$109.50	—	65%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$56.07	$160.20	$5.16–$120.15	39% below	65%
Iron blood test (serum iron) CPT 83540 IRON	$91.51	$261.45	$5.16–$196.09	at median	65%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$56.07	$160.20	$104.13–$120.15	—	65%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$91.51	$261.45	$169.95–$196.09	—	65%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING	$55.76	$159.30	$6.97–$119.48	45% below	65%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING	$55.76	$159.30	$103.55–$119.48	—	65%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$105.21	$300.60	$14.78–$225.45	30% below	65%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$105.21	$300.60	$195.39–$225.45	—	65%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$97.65	$279.00	$5.50–$209.25	44% above	65%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$97.65	$279.00	$181.35–$209.25	—	65%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$208.95	$597.00	$6.52–$447.75	34% below	65%
Liver function blood test panel CPT 80076 HEPATIC PANEL	$326.55	$933.00	$6.52–$699.75	3% above	65%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$208.95	$597.00	$388.05–$447.75	—	65%
Liver function blood test panel inpatient CPT 80076 HEPATIC PANEL	$326.55	$933.00	$606.45–$699.75	—	65%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$34.65	$99.00	$13.59–$87.36	58% below	65%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODYTOTA EIA	$34.65	$99.00	$13.59–$87.36	58% below	65%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$34.65	$99.00	$64.35–$74.25	—	65%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODYTOTA EIA	$34.65	$99.00	$64.35–$74.25	—	65%
Magnesium blood test CPT 83735 POC MG	$97.30	$278.00	$5.35–$208.50	69% above	65%
Magnesium blood test CPT 83735 MAGNESIUM	$159.25	$455.00	$5.35–$341.25	177% above	65%
Magnesium blood test inpatient CPT 83735 POC MG	$97.30	$278.00	$180.70–$208.50	—	65%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$159.25	$455.00	$295.75–$341.25	—	65%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG AB CSF	$29.93	$85.50	$10.28–$66.07	7% above	65%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG AB CSF	$29.93	$85.50	$55.58–$64.13	—	65%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$121.45	$347.00	$4.13–$260.25	26% above	65%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$121.45	$347.00	$225.55–$260.25	—	65%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA FREE AND TOTAL	$108.11	$308.88	$14.68–$231.66	7% above	65%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA FREE AND TOTAL	$108.11	$308.88	$200.78–$231.66	—	65%
Parathyroid hormone (PTH) blood test CPT 83970 PTH (C-TERMINAL)	$97.65	$279.00	$32.95–$211.77	58% below	65%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$160.30	$458.00	$32.95–$343.50	31% below	65%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH (C-TERMINAL)	$97.65	$279.00	$181.35–$209.25	—	65%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$160.30	$458.00	$297.70–$343.50	—	65%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$131.60	$376.00	$4.80–$282.00	124% above	65%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$131.60	$376.00	$244.40–$282.00	—	65%
Progesterone blood test CPT 84144 PROGESTERONE	$75.60	$216.00	$16.64–$162.00	29% below	65%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$75.60	$216.00	$140.40–$162.00	—	65%
Prolactin blood test CPT 84146 PROLACTIN	$153.65	$439.00	$15.47–$329.25	51% above	65%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$153.65	$439.00	$285.35–$329.25	—	65%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME(PT)	$108.50	$310.00	$3.42–$232.50	62% above	65%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$177.80	$508.00	$3.42–$381.00	165% above	65%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME(PT)	$108.50	$310.00	$201.50–$232.50	—	65%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$177.80	$508.00	$330.20–$381.00	—	65%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRESUMP ANY NUMB DRU	$154.67	$441.90	$10.05–$331.43	at median	65%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRESUMP ANY NUMB DRU	$154.67	$441.90	$287.24–$331.43	—	65%
Rapid flu test (influenza antigen) CPT 87804 IMMUNOASAY W/OPTICAL OBS INFLU	$40.95	$117.00	$13.21–$87.75	63% below	65%
Rapid flu test (influenza antigen) inpatient CPT 87804 IMMUNOASAY W/OPTICAL OBS INFLU	$40.95	$117.00	$76.05–$87.75	—	65%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$94.15	$269.00	$4.52–$201.75	112% above	65%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$94.15	$269.00	$174.85–$201.75	—	65%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG&IGM AB	$55.76	$159.30	$11.49–$119.48	14% above	65%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG&IGM AB	$55.76	$159.30	$103.55–$119.48	—	65%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS	$44.42	$126.90	$12.31–$95.18	73% below	65%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS	$44.42	$126.90	$82.49–$95.18	—	65%
Stool ova and parasites exam CPT 87177 PARASITE EXAM FORM.	$144.20	$412.00	$7.11–$309.00	41% above	65%
Stool ova and parasites exam CPT 87177 OVA&PARASITES DIR SMRCONC&ID	$197.35	$563.85	$7.11–$422.89	92% above	65%
Stool ova and parasites exam inpatient CPT 87177 PARASITE EXAM FORM.	$144.20	$412.00	$267.80–$309.00	—	65%
Stool ova and parasites exam inpatient CPT 87177 OVA&PARASITES DIR SMRCONC&ID	$197.35	$563.85	$366.51–$422.89	—	65%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL 1-3	$16.54	$47.25	$3.50–$35.44	67% below	65%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL 1-3	$16.54	$47.25	$30.72–$35.44	—	65%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTR	$41.27	$117.90	$12.70–$88.43	45% below	65%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTR	$41.27	$117.90	$76.64–$88.43	—	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$71.40	$204.00	$3.41–$153.00	67% above	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM	$113.05	$323.00	$3.41–$242.25	165% above	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF	$71.40	$204.00	$132.60–$153.00	—	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SERUM	$113.05	$323.00	$209.95–$242.25	—	65%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON	$32.76	$93.60	$49.46–$223.10	85% below	65%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON	$32.76	$93.60	$60.84–$70.20	—	65%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONETOTAL	$96.08	$274.50	$20.60–$205.88	6% above	65%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONETOTAL	$96.08	$274.50	$178.43–$205.88	—	65%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$51.98	$148.50	$11.61–$111.38	50% below	65%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXDASE ANTIBODIES	$66.15	$189.00	$11.61–$141.75	36% below	65%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB	$51.98	$148.50	$96.53–$111.38	—	65%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXDASE ANTIBODIES	$66.15	$189.00	$122.85–$141.75	—	65%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$110.60	$316.00	$13.40–$237.00	15% below	65%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$110.60	$316.00	$205.40–$237.00	—	65%
Uric acid blood test CPT 84550 URIC ACID	$126.06	$360.15	$3.61–$270.12	4% above	65%
Uric acid blood test inpatient CPT 84550 URIC ACID	$126.06	$360.15	$234.10–$270.12	—	65%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO	$86.80	$248.00	$2.53–$186.00	20% below	65%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO	$86.80	$248.00	$161.20–$186.00	—	65%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/OUT MICRO	$39.55	$113.00	$1.80–$84.75	21% below	65%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/OUT MICRO	$39.55	$113.00	$73.45–$84.75	—	65%
Urinalysis without microscope exam, manual CPT 81002 ICTOTEST	$13.23	$37.80	$2.77–$28.35	63% below	65%
Urinalysis without microscope exam, manual CPT 81002 NON AUTOMATED URINALYSIS	$13.23	$37.80	$2.77–$28.35	63% below	65%
Urinalysis without microscope exam, manual inpatient CPT 81002 NON AUTOMATED URINALYSIS	$13.23	$37.80	$24.57–$28.35	—	65%
Urinalysis without microscope exam, manual inpatient CPT 81002 ICTOTEST	$13.23	$37.80	$24.57–$28.35	—	65%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$188.90	$539.70	$6.44–$404.78	9% above	65%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT	$188.90	$539.70	$350.81–$404.78	—	65%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST VISUAL COLOR-V	$114.10	$326.00	$6.87–$244.50	5% below	65%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$114.10	$326.00	$6.87–$244.50	5% below	65%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$167.65	$479.00	$6.87–$359.25	40% above	65%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$114.10	$326.00	$211.90–$244.50	—	65%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST VISUAL COLOR-V	$114.10	$326.00	$211.90–$244.50	—	65%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST	$167.65	$479.00	$311.35–$359.25	—	65%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$70.93	$202.65	$12.04–$151.99	29% below	65%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$70.93	$202.65	$131.73–$151.99	—	65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH	$95.80	$273.70	$23.62–$205.28	22% below	65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-OH	$95.80	$273.70	$177.91–$205.28	—	65%
Zinc blood test CPT 84630 ZINC SERUM	$21.11	$60.30	$9.09–$58.43	72% below	65%
Zinc blood test CPT 84630 ZINC RBC	$22.37	$63.90	$9.09–$58.43	70% below	65%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$21.11	$60.30	$39.20–$45.23	—	65%
Zinc blood test inpatient CPT 84630 ZINC RBC	$22.37	$63.90	$41.54–$47.93	—	65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TOTAL HCG	$134.40	$384.00	$12.01–$288.00	51% above	65%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 TOTAL HCG	$134.40	$384.00	$249.60–$288.00	—	65%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BRE 1ST LESION STRTCTC-RT	$2,745.23	$7,843.50	$462.13–$9,029.00	27% below	65%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BRE 1ST LESION STRTCTC-RT	$2,745.23	$7,843.50	$5,098.28–$5,882.63	—	65%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX LAT MALLEOLUS WO MA	$138.29	$395.10	$81.05–$5,160.00	70% below	65%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX LAT MALLEOLUS WO MA	$138.29	$395.10	$256.82–$296.33	—	65%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL W/O MAN	$75.29	$215.10	$81.05–$4,000.00	73% below	65%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL W/O MAN	$75.29	$215.10	$139.82–$161.33	—	65%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION OF BUNION	$1,795.50	$5,130.00	$1,033.86–$9,029.00	55% below	65%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION OF BUNION	$1,795.50	$5,130.00	$3,334.50–$3,847.50	—	65%
Cardiac catheterization with coronary angiogram CPT 93458 LH LV CA INJANGSUP	$7,570.50	$21,630.00	$1,438.40–$28,954.00	51% below	65%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LH LV CA INJANGSUP	$7,570.50	$21,630.00	$14,059.50–$16,222.50	—	65%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSIONEXTERNAL	$864.36	$2,469.60	$100.00–$2,749.00	56% below	65%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSIONEXTERNAL	$864.36	$2,469.60	$1,605.24–$1,852.20	—	65%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$1,465.70	$4,187.70	$626.94–$7,221.00	62% below	65%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$1,465.70	$4,187.70	$2,722.01–$3,140.78	—	65%
Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL W/O ECP	$2,734.57	$7,813.05	$807.44–$12,381.00	6% below	65%
Cataract surgery with lens implant inpatient CPT 66984 XCAPSL CTRC RMVL W/O ECP	$2,734.57	$7,813.05	$5,078.49–$5,859.79	—	65%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX COLLES FX W/O MANIP	$153.41	$438.30	$81.05–$4,000.00	70% below	65%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX COLLES FX W/O MANIP	$153.41	$438.30	$284.90–$328.73	—	65%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPYLESION REMVL/SNARE	$1,460.82	$4,173.75	$407.80–$7,221.00	46% above	65%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPYLESION REMVL/SNARE	$1,460.82	$4,173.75	$2,712.94–$3,130.32	—	65%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY	$1,521.45	$4,347.00	$407.80–$7,221.00	70% above	65%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY	$1,521.45	$4,347.00	$2,825.55–$3,260.25	—	65%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPYDXW/WOUT BRS/WASH	$1,375.92	$3,931.20	$312.07–$7,221.00	24% below	65%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPYDXW/WOUT BRS/WASH	$1,375.92	$3,931.20	$2,555.28–$2,948.40	—	65%
Complex cataract surgery with lens implant CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$2,816.80	$8,048.00	$807.44–$12,381.00	36% below	65%
Complex cataract surgery with lens implant inpatient CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$2,816.80	$8,048.00	$5,231.20–$6,036.00	—	65%
Coronary stent placement, one artery CPT 92928 CORONARY STENT	$5,628.35	$16,081.00	$1,069.39–$48,650.64	54% below	65%
Coronary stent placement, one artery inpatient CPT 92928 CORONARY STENT	$5,628.35	$16,081.00	$10,452.65–$12,060.75	—	65%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C NON-OBSTETRICAL	$1,145.66	$3,273.30	$1,010.34–$7,221.00	72% below	65%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D&C NON-OBSTETRICAL	$1,145.66	$3,273.30	$2,127.65–$2,454.98	—	65%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED CERUMEN	$68.99	$197.10	$13.11–$2,749.00	56% below	65%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL OF IMPACTED CERUMEN	$68.99	$197.10	$128.12–$147.83	—	65%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$1,028.92	$2,939.76	$1,033.86–$9,029.00	71% below	65%
Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE	$1,028.92	$2,939.76	$1,910.85–$2,204.82	—	65%
Hemorrhoid banding (rubber band ligation) CPT 46221 SIMPLE LIGATION HEMORRHOID	$327.92	$936.90	$139.67–$5,160.00	63% below	65%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 SIMPLE LIGATION HEMORRHOID	$327.92	$936.90	$608.99–$702.68	—	65%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH INTRO SALINE/CONT HYSTERO	$266.49	$761.40	$50.64–$2,749.00	33% below	65%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH INTRO SALINE/CONT HYSTERO	$266.49	$761.40	$494.91–$571.05	—	65%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE SKIN ABCESS	$167.30	$478.00	$56.57–$2,749.00	64% below	65%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$167.30	$478.00	$56.57–$2,749.00	64% below	65%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$167.30	$478.00	$310.70–$358.50	—	65%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE SKIN ABCESS	$167.30	$478.00	$310.70–$358.50	—	65%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TENDON SHEATH/LIGAMENT INJECT	$168.84	$482.40	$19.49–$5,160.00	62% below	65%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TENDON/SHEATH/LIG INJECT	$168.84	$482.40	$19.49–$5,160.00	62% below	65%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TENDON/SHEATH/LIG INJECT	$168.84	$482.40	$313.56–$361.80	—	65%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TENDON SHEATH/LIGAMENT INJECT	$168.84	$482.40	$313.56–$361.80	—	65%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHOCENTESIS MAJOR JT	$334.85	$956.70	$23.28–$5,160.00	43% below	65%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHOCENTESIS-MAJOR JOINT	$334.95	$957.00	$23.28–$5,160.00	43% below	65%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHOCENTESIS MAJOR JT	$334.85	$956.70	$621.86–$717.53	—	65%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHOCENTESIS-MAJOR JOINT	$334.95	$957.00	$622.05–$717.75	—	65%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMED JT	$295.47	$844.20	$19.49–$5,160.00	50% below	65%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHCENTESIS-INTERMEDIATE JOIN	$295.47	$844.20	$19.49–$5,160.00	50% below	65%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMED JT	$295.47	$844.20	$548.73–$633.15	—	65%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHCENTESIS-INTERMEDIATE JOIN	$295.47	$844.20	$548.73–$633.15	—	65%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT	$277.83	$793.80	$18.68–$5,160.00	22% below	65%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT	$277.83	$793.80	$515.97–$595.35	—	65%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY;W/MENISCUS REPAIR	$1,393.25	$3,980.70	$1,033.86–$9,029.00	76% below	65%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY;W/MENISCUS REPAIR	$1,393.25	$3,980.70	$2,587.46–$2,985.53	—	65%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY W/MENISCECTOM	$1,865.75	$5,330.70	$1,033.86–$10,059.00	68% below	65%
Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY W/MENISCECTOM	$1,865.75	$5,330.70	$3,464.96–$3,998.03	—	65%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$1,946.07	$5,560.20	$1,033.86–$10,059.00	66% below	65%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY/SURGERY	$1,946.07	$5,560.20	$3,614.13–$4,170.15	—	65%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$2,524.41	$7,212.60	$479.64–$10,059.00	81% below	65%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$2,524.41	$7,212.60	$4,688.19–$5,409.45	—	65%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY ADD-ON	$1,800.01	$5,142.86	$342.01–$30,120.00	81% below	65%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAP SLEEVE GASTRECTOMY ADD-ON	$1,800.01	$5,142.86	$3,342.86–$3,857.15	—	65%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPRINTWNDS EXC HNDS/FT<2.5	$332.85	$951.00	$121.09–$2,749.00	42% below	65%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPRINTWNDS EXC HNDS/FT<2.5	$332.85	$951.00	$618.15–$713.25	—	65%
Left heart catheterization, diagnostic CPT 93452 LH LV INJ	$3,621.24	$10,346.40	$688.04–$28,954.00	68% below	65%
Left heart catheterization, diagnostic inpatient CPT 93452 LH LV INJ	$3,621.24	$10,346.40	$6,725.16–$7,759.80	—	65%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ SPINE LUMB/SACRAL W IMAGE	$2,127.20	$6,077.70	$249.72–$5,160.00	34% above	65%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$2,127.30	$6,078.00	$249.72–$5,160.00	34% above	65%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ SPINE LUMB/SACRAL W IMAGE	$2,127.20	$6,077.70	$3,950.51–$4,558.28	—	65%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$2,127.30	$6,078.00	$3,950.70–$4,558.50	—	65%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ SPINE LUMB/SACRAL W/O IMAG	$1,234.17	$3,526.20	$249.72–$5,160.00	1% above	65%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ SPINE LUMB/SACRAL W/O IMAG	$1,234.17	$3,526.20	$2,292.03–$2,644.65	—	65%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S	$624.33	$1,783.80	$323.73–$5,160.00	58% below	65%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S	$624.33	$1,783.80	$1,159.47–$1,337.85	—	65%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$1,707.62	$4,878.90	$915.48–$9,029.00	60% below	65%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY	$1,707.62	$4,878.90	$3,171.29–$3,659.18	—	65%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 BENIGN LES EXC TR/A/L/0.5CM	$407.61	$1,164.60	$69.29–$5,160.00	50% below	65%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 BENIGN LES EXC TR/A/L/0.5CM	$407.61	$1,164.60	$756.99–$873.45	—	65%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE	$120.96	$345.60	$22.99–$2,749.00	57% below	65%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF SINGLE NAIL PLATE	$121.10	$346.00	$23.01–$2,749.00	57% below	65%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE	$120.96	$345.60	$224.64–$259.20	—	65%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF SINGLE NAIL PLATE	$121.10	$346.00	$224.90–$259.50	—	65%
Pacemaker implant (dual chamber) CPT 33208 INSERT DUAL PPM & LEADS	$5,896.10	$16,846.00	$2,403.00–$20,126.81	69% below	65%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT DUAL PPM & LEADS	$5,896.10	$16,846.00	$10,949.90–$12,634.50	—	65%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$2,239.30	$6,398.00	$318.20–$5,160.00	38% above	65%
Paracentesis with imaging guidance CPT 49083 US GUIDED PARACENTESIS	$2,239.30	$6,398.00	$318.20–$5,160.00	38% above	65%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$2,239.30	$6,398.00	$4,158.70–$4,798.50	—	65%
Paracentesis with imaging guidance inpatient CPT 49083 US GUIDED PARACENTESIS	$2,239.30	$6,398.00	$4,158.70–$4,798.50	—	65%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL NAILBED AND MATRIX	$372.96	$1,065.60	$74.44–$5,160.00	29% below	65%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 MATRIXECTOMY	$372.96	$1,065.60	$74.44–$5,160.00	29% below	65%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 MATRIXECTOMY	$372.96	$1,065.60	$692.64–$799.20	—	65%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL NAILBED AND MATRIX	$372.96	$1,065.60	$692.64–$799.20	—	65%
Prostate biopsy CPT 55700 BIOPSY PROSTATE NEEDLE	$907.83	$2,593.80	$620.16–$7,221.00	69% below	65%
Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE NEEDLE	$907.83	$2,593.80	$1,685.97–$1,945.35	—	65%
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY REMOVAL TISSUE	$178.92	$511.20	$80.12–$2,749.00	74% below	65%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FOREIGN BODY REMOVAL TISSUE	$178.92	$511.20	$332.28–$383.40	—	65%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY;SCRNG;LOW RISK	$1,376.20	$3,932.00	$312.07–$7,221.00	48% above	65%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY;SCRNG;LOW RISK	$1,376.20	$3,932.00	$2,555.80–$2,949.00	—	65%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY;SCRNG;HIGH RISK	$1,376.20	$3,932.00	$312.07–$7,221.00	39% below	65%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY;SCRNG;HIGH RISK	$1,376.20	$3,932.00	$2,555.80–$2,949.00	—	65%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY (ESWL)	$7,211.82	$20,605.20	$1,085.76–$30,902.00	3% above	65%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY (ESWL)	$7,211.82	$20,605.20	$13,393.38–$15,453.90	—	65%
Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST	$96.08	$274.50	$41.42–$4,000.00	69% below	65%
Short arm cast (elbow to hand) CPT 29075 APP CAST ELBOW TO FING SHORT	$96.25	$275.00	$41.42–$4,000.00	69% below	65%
Short arm cast (elbow to hand) inpatient CPT 29075 SHORT ARM CAST	$96.08	$274.50	$178.43–$205.88	—	65%
Short arm cast (elbow to hand) inpatient CPT 29075 APP CAST ELBOW TO FING SHORT	$96.25	$275.00	$178.75–$206.25	—	65%
Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT	$197.35	$563.85	$37.50–$4,000.00	31% below	65%
Short arm splint (forearm and hand) CPT 29125 APP SHORT ARM SPLINT(STATIC)	$197.35	$563.85	$81.77–$4,000.00	31% below	65%
Short arm splint (forearm and hand) inpatient CPT 29125 APP SHORT ARM SPLINT(STATIC)	$197.35	$563.85	$366.51–$422.89	—	65%
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT	$197.35	$563.85	$366.51–$422.89	—	65%
Short leg cast (below the knee) CPT 29405 SHORT LEG CAST	$204.12	$583.20	$36.27–$4,000.00	40% below	65%
Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG CAST	$204.12	$583.20	$379.08–$437.40	—	65%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT	$163.17	$466.20	$31.67–$4,000.00	40% below	65%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT	$163.17	$466.20	$303.03–$349.65	—	65%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$101.43	$289.80	$19.28–$2,749.00	74% below	65%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$101.43	$289.80	$188.37–$217.35	—	65%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$318.85	$911.00	$66.22–$2,749.00	28% below	65%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$318.85	$911.00	$592.15–$683.25	—	65%
Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REMOVAL 1-15	$74.03	$211.50	$14.07–$2,749.00	71% below	65%
Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REMOVAL 1-15	$74.03	$211.50	$137.48–$158.63	—	65%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNC	$583.10	$1,666.00	$249.72–$5,160.00	49% below	65%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNC	$583.10	$1,666.00	$1,082.90–$1,249.50	—	65%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$96.60	$276.00	$18.36–$2,749.00	80% below	65%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$96.60	$276.00	$179.40–$207.00	—	65%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$86.94	$248.40	$16.52–$2,749.00	81% below	65%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$86.94	$248.40	$161.46–$186.30	—	65%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$286.97	$819.90	$56.84–$2,749.00	7% below	65%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$286.97	$819.90	$532.94–$614.93	—	65%
Thoracentesis with imaging guidance CPT 32555 US GUIDANCE FOR THORACENTESIS	$1,240.75	$3,545.00	$212.56–$5,160.00	12% below	65%
Thoracentesis with imaging guidance CPT 32555 CT THORACENTESIS	$1,240.75	$3,545.00	$212.56–$5,160.00	12% below	65%
Thoracentesis with imaging guidance inpatient CPT 32555 US GUIDANCE FOR THORACENTESIS	$1,240.75	$3,545.00	$2,304.25–$2,658.75	—	65%
Thoracentesis with imaging guidance inpatient CPT 32555 CT THORACENTESIS	$1,240.75	$3,545.00	$2,304.25–$2,658.75	—	65%
Trigger point injections, 1 or 2 muscles CPT 20552 SG/ML TRIG POINT(S)INJ1-2MUSC	$375.17	$1,071.90	$22.10–$5,160.00	22% below	65%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG POINT 1-2 MUSCLE	$375.20	$1,072.00	$22.10–$5,160.00	22% below	65%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 SG/ML TRIG POINT(S)INJ1-2MUSC	$375.17	$1,071.90	$696.74–$803.93	—	65%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG POINT 1-2 MUSCLE	$375.20	$1,072.00	$696.80–$804.00	—	65%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BRST 1ST LESION US IMAG-LT	$2,045.61	$5,844.60	$462.13–$9,029.00	34% below	65%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BRST 1ST LESION US IMAG-LT	$2,045.61	$5,844.60	$3,798.99–$4,383.45	—	65%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$813.33	$2,323.80	$536.72–$7,221.00	29% below	65%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH EGD DILATION <30 MM	$813.33	$2,323.80	$1,510.47–$1,742.85	—	65%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SINGLE/MULTIPLE	$1,326.31	$3,789.45	$318.20–$7,221.00	81% above	65%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SINGLE/MULTIPLE	$1,326.31	$3,789.45	$2,463.15–$2,842.09	—	65%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD/FLEX/TRANSORAL W/INJECTION	$715.05	$2,043.00	$318.20–$7,221.00	2% below	65%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD/FLEX/TRANSORAL W/INJECTION	$715.05	$2,043.00	$1,327.95–$1,532.25	—	65%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$836.80	$2,390.85	$536.72–$7,221.00	26% below	65%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVE LESION SNARE	$836.80	$2,390.85	$1,554.06–$1,793.14	—	65%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION	$727.97	$2,079.90	$318.20–$7,221.00	1% below	65%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION	$727.97	$2,079.90	$1,351.94–$1,559.93	—	65%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD;DX;W/WOUT BRUSH/WASHING	$1,002.54	$2,864.40	$318.20–$5,160.00	6% below	65%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD;DX;W/WOUT BRUSH/WASHING	$1,002.54	$2,864.40	$1,861.86–$2,148.30	—	65%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$4,650.10	$13,286.00	$1,528.00–$30,902.00	38% below	65%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$4,650.10	$13,286.00	$8,635.90–$9,964.50	—	65%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYST/URET/LITHO INDWELL STENT	$9,002.88	$25,722.50	$1,528.00–$30,902.00	77% above	65%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYST/URET/LITHO INDWELL STENT	$9,002.88	$25,722.50	$16,719.63–$19,291.88	—	65%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN/SUB Q TISSUE	$1,138.52	$3,252.90	$135.93–$7,221.00	13% above	65%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRSKIN TO SQ INIT 20SQCM	$1,138.52	$3,252.90	$135.93–$7,221.00	13% above	65%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRSKIN TO SQ INIT 20SQCM	$1,138.52	$3,252.90	$2,114.39–$2,439.68	—	65%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN/SUB Q TISSUE	$1,138.52	$3,252.90	$2,114.39–$2,439.68	—	65%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/BLOOD COMPO	$560.35	$1,601.00	$26.26–$5,160.00	48% below	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/BLOOD COMPO	$560.35	$1,601.00	$1,040.65–$1,200.75	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREAT:DUP SAME DAY DIFF MD	$208.60	$596.00	$100.00–$1,604.00	at median	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREAT:DUP SAME DAY DIFF MD	$208.60	$596.00	$387.40–$447.00	—	65%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN INTRAV INFUS 1 HR	$282.80	$808.00	$90.00–$606.00	58% below	65%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN INTRAV INFUS 1 HR	$282.80	$808.00	$525.20–$606.00	—	65%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE LEVEL W/PROC	$1,560.51	$4,458.60	$296.50–$5,857.00	47% below	65%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER CRITICAL CARE LEVEL W/PROC	$1,560.51	$4,458.60	$2,898.09–$3,343.95	—	65%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AWAKE AND DROWSY	$823.90	$2,354.00	$100.00–$1,765.50	20% below	65%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG REC AWAKE AND DROWSY	$823.90	$2,354.00	$1,530.10–$1,765.50	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD (RESP DEPT)	$469.35	$1,341.00	$59.50–$1,005.75	62% above	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD (RESP DEPT)	$469.35	$1,341.00	$871.65–$1,005.75	—	65%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FSED ER LEVEL I	$236.60	$676.00	$48.79–$1,085.00	18% below	65%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FSED ER LEVEL I	$236.60	$676.00	$439.40–$507.00	—	65%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL II	$508.20	$1,452.00	$48.79–$1,405.00	1% above	65%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL II	$508.20	$1,452.00	$943.80–$1,089.00	—	65%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL III	$891.80	$2,548.00	$48.79–$3,983.00	1% above	65%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL III	$891.80	$2,548.00	$1,656.20–$1,911.00	—	65%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 FSED ER LEVEL IV	$1,351.35	$3,861.00	$256.76–$5,609.00	6% below	65%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 FSED ER LEVEL IV	$1,351.35	$3,861.00	$2,509.65–$2,895.75	—	65%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 FSED ER LEVEL V	$1,753.15	$5,009.00	$333.10–$7,146.00	25% below	65%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 FSED ER LEVEL V	$1,753.15	$5,009.00	$3,255.85–$3,756.75	—	65%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$1,814.75	$5,185.00	$100.00–$3,888.75	26% above	65%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$1,814.75	$5,185.00	$3,370.25–$3,888.75	—	65%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRA INIT 31-60M	$520.80	$1,488.00	$56.30–$1,116.00	7% above	65%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRA INIT 31-60M	$520.80	$1,488.00	$967.20–$1,116.00	—	65%
IV infusion of a medicine, first hour CPT 96365 IV INFUS THERPROPDX INIT HR	$520.80	$1,488.00	$100.00–$1,116.00	2% below	65%
IV infusion of a medicine, first hour CPT 96365 IV INFUS TXPROP DX INITIAL	$520.80	$1,488.00	$100.00–$1,116.00	2% below	65%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS THERPROPDX INIT HR	$520.80	$1,488.00	$967.20–$1,116.00	—	65%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS TXPROP DX INITIAL	$520.80	$1,488.00	$967.20–$1,116.00	—	65%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION	$306.25	$875.00	$71.29–$656.25	78% above	65%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEITC INJ SUBST OR INTRA	$306.25	$875.00	$71.29–$656.25	78% above	65%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEITC INJ SUBST OR INTRA	$306.25	$875.00	$568.75–$656.25	—	65%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION	$306.25	$875.00	$568.75–$656.25	—	65%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION KX	$116.90	$334.00	$52.09–$520.00	3% above	65%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-EDUCATION	$116.90	$334.00	$52.09–$250.50	3% above	65%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED KX	$116.90	$334.00	$52.09–$480.00	3% above	65%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION	$116.90	$334.00	$52.09–$480.00	3% above	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION	$116.90	$334.00	$217.10–$250.50	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED KX	$116.90	$334.00	$217.10–$250.50	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-EDUCATION	$116.90	$334.00	$217.10–$250.50	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION KX	$116.90	$334.00	$217.10–$250.50	—	65%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTR THRPY ASMT &INT EA 15 MIN	$22.68	$64.80	$36.01–$117.00	66% below	65%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTR THRPY ASMT &INT EA 15 MIN	$22.68	$64.80	$42.12–$48.60	—	65%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPATIONAL THERAPY EVAL LOW	$248.50	$710.00	$100.00–$532.50	7% below	65%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$248.50	$710.00	$100.00–$532.50	7% below	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPATIONAL THERAPY EVAL LOW	$248.50	$710.00	$461.50–$532.50	—	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$248.50	$710.00	$461.50–$532.50	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$339.50	$970.00	$100.00–$727.50	11% above	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PHYSICAL THERAPY EVAL KX HIGH	$339.50	$970.00	$100.00–$727.50	11% above	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVAL KX HIGH	$339.50	$970.00	$630.50–$727.50	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$339.50	$970.00	$630.50–$727.50	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVAL KX LOW	$203.70	$582.00	$100.00–$480.00	14% below	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$203.70	$582.00	$100.00–$436.50	14% below	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$203.70	$582.00	$378.30–$436.50	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVAL KX LOW	$203.70	$582.00	$378.30–$436.50	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVAL KX MOD	$271.60	$776.00	$100.00–$582.00	5% below	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$271.60	$776.00	$100.00–$582.00	5% below	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVAL KX MOD	$271.60	$776.00	$504.40–$582.00	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$271.60	$776.00	$504.40–$582.00	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MAN THPY(MOBMANLYM)EA 15KX	$109.90	$314.00	$41.57–$520.00	2% below	65%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15MIN	$109.90	$314.00	$41.57–$480.00	2% below	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15MIN	$109.90	$314.00	$204.10–$235.50	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MAN THPY(MOBMANLYM)EA 15KX	$109.90	$314.00	$204.10–$235.50	—	65%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC 1 OR MR AREA EA 15	$107.45	$307.00	$45.77–$520.00	13% below	65%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES	$107.45	$307.00	$45.77–$230.25	13% below	65%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EA 15MIN	$107.45	$307.00	$45.77–$480.00	13% below	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISES	$107.45	$307.00	$199.55–$230.25	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE EA 15MIN	$107.45	$307.00	$199.55–$230.25	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC 1 OR MR AREA EA 15	$107.45	$307.00	$199.55–$230.25	—	65%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAVRL CHG SMKING CESS3-10MIN	$14.70	$42.00	$18.41–$287.00	70% below	65%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAVRL CHG SMKING CESS3-10MIN	$14.70	$42.00	$27.30–$31.50	—	65%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$297.50	$850.00	$100.00–$637.50	30% below	65%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$297.50	$850.00	$552.50–$637.50	—	65%
Speech therapy session, individual CPT 92507 SLP TREATMENT KX	$256.55	$733.00	$100.00–$623.00	12% above	65%
Speech therapy session, individual CPT 92507 SLP TREATMENT	$256.55	$733.00	$100.00–$623.00	12% above	65%
Speech therapy session, individual inpatient CPT 92507 SLP TREATMENT	$256.55	$733.00	$476.45–$549.75	—	65%
Speech therapy session, individual inpatient CPT 92507 SLP TREATMENT KX	$256.55	$733.00	$476.45–$549.75	—	65%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$224.28	$640.80	$100.00–$979.00	37% below	65%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$224.28	$640.80	$416.52–$480.60	—	65%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION W/SPIROMETRY	$756.00	$2,160.00	$68.93–$1,620.00	20% above	65%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION W/SPIROMETRY	$756.00	$2,160.00	$1,404.00–$1,620.00	—	65%
Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL TRAINING (THERP)	$100.80	$288.00	$59.45–$480.00	14% below	65%
Therapeutic activities (functional training), 15 minutes CPT 97530 OCCUPATIONAL THERAP EXCRS KX	$100.80	$288.00	$59.45–$520.00	14% below	65%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIVITIES (FT)	$100.80	$288.00	$59.45–$216.00	14% below	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OCCUPATIONAL THERAP EXCRS KX	$100.80	$288.00	$187.20–$216.00	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES (FT)	$100.80	$288.00	$187.20–$216.00	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL TRAINING (THERP)	$100.80	$288.00	$187.20–$216.00	—	65%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$205.80	$588.00	$81.77–$446.88	25% below	65%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$205.80	$588.00	$382.20–$441.00	—	65%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE	$176.77	$505.05	$50.51–$407.81	32% below	65%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE	$176.77	$505.05	$50.51–$378.79	—	65%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$210.95	$602.70	$132.60–$704.73	79% below	65%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$210.95	$602.70	$132.60–$452.03	—	65%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET/DIPTH/TOX ADSORB ADULT VL	$30.14	$86.10	$18.95–$86.10	77% below	65%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPTH/TET/PERTUSS0.5ML SYRINGE	$64.32	$183.75	$20.21–$137.82	51% below	65%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET/DIPTH/TOX ADSORB ADULT VL	$30.14	$86.10	$18.95–$64.58	—	65%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPTH/TET/PERTUSS0.5ML SYRINGE	$64.32	$183.75	$40.43–$137.82	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FEE TETANUS/DIPTHERIA TO	$75.25	$215.00	$37.00–$192.29	3% below	65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FEE TETANUS/DIPTHERIA TO	$75.25	$215.00	$139.75–$161.25	—	65%

Source file: https://www.commonspirit.org/content/dam/commonspiritorg/en/stluh/soho/finance/price-transparency/273280598-1407990088_pmc-hospital-llc_standardcharges.json