Bath Community Hospital
Bath Community Hospital in Hot Springs, VA publishes cash prices for 241 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Virginia median for 187 of 240 procedures and above it for 47. By typical cash price it ranks #9 of 61 Virginia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
106 Park Drive, Hot Springs, VA, 24445 Collected Sep 27, 2026 Source price file (540) 839-7000
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 491300 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABDOMEN W/O | $1,306.05 | $1,865.78 | $532.53–$1,772.49 | 5% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABD/PLVS W/O | $1,306.05 | $1,865.78 | $532.53–$1,772.49 | 5% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST ABD/PLVS W/O | $1,306.05 | $1,865.78 | $532.53–$1,772.49 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST ABDOMEN W/O | $1,306.05 | $1,865.78 | $532.53–$1,772.49 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP TEST HOME | $924.00 | $1,320.00 | $783.48–$1,254.00 | 102% above | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP TEST HOME | $924.00 | $1,320.00 | $783.48–$1,254.00 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIVER SPLEEN or both PRO FEE | $102.69 | $146.70 | $139.36–$146.70 | 84% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 LIVER SPLEEN or both PRO FEE | $102.69 | $146.70 | $139.36–$146.70 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LS LATERAL PRO FEE | $41.58 | $59.40 | $56.43–$59.40 | 89% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LS LATERAL PRO FEE | $41.58 | $59.40 | $56.43–$59.40 | — | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 3 VWS PRO FEE | $30.91 | $44.15 | $41.94–$44.15 | 90% below | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 3 VWS | $171.74 | $245.34 | $191.86–$245.34 | 42% below | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES 3 VWS PRO FEE | $30.91 | $44.15 | $41.94–$44.15 | — | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES 3 VWS | $171.74 | $245.34 | $191.86–$245.34 | — | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT (ALANINE AMINOTRANSFE | $38.91 | $55.59 | $13.25–$52.81 | 22% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LC ALT/SGPT 001545 | $38.91 | $55.59 | $13.25–$52.81 | 22% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT (ALANINE AMINOTRANSFE | $38.91 | $55.59 | $13.25–$52.81 | — | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 LC ALT/SGPT 001545 | $38.91 | $55.59 | $13.25–$52.81 | — | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT ASPARTATE AMINOTRANSF | $38.05 | $54.36 | $12.95–$51.64 | 23% below | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LC AST/SGOT 001123 | $38.05 | $54.36 | $12.95–$51.64 | 23% below | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 LC AST/SGOT 001123 | $38.05 | $54.36 | $12.95–$51.64 | — | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT ASPARTATE AMINOTRANSF | $38.05 | $54.36 | $12.95–$51.64 | — | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE (A B C | $343.36 | $490.51 | $119.08–$465.98 | 19% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE (A B C | $343.36 | $490.51 | $119.08–$465.98 | — | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROF BASIC FOOD | $25.30 | $33.73 | $13.05–$32.04 | 2% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN IGE 602547 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE F013 68445 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GELATIN IGE 602843 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE 602459 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPIRIN ALLERGY 060029 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHOLE IGE 602528 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YEAST IGE F045 602567 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE MINI-PANEL 6 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE 602453 | $25.97 | $37.10 | $13.05–$35.24 | 5% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE MEAT (X3) 602 | $77.92 | $111.31 | $13.05–$105.74 | 215% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE SHELLFISH X6 | $155.83 | $222.62 | $13.05–$211.49 | 530% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHELLFISH ALLERGEN PROFILE 062 | $177.10 | $253.00 | $13.05–$240.35 | 616% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ALLERGY IGE 650390 | $269.89 | $385.55 | $13.05–$366.27 | 991% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD X12 6029 | $311.67 | $445.24 | $13.05–$422.98 | 1160% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE MOLD X12 062 | $311.67 | $445.24 | $13.05–$422.98 | 1160% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROF IGE RESP AREA 3 | $542.07 | $774.39 | $13.05–$735.67 | 2091% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE (24) | $623.33 | $890.47 | $13.05–$845.95 | 2420% above | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROF BASIC FOOD | $25.30 | $33.73 | $13.05–$32.04 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN IGE 602547 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHOLE IGE 602528 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GELATIN IGE 602843 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE 602459 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK IGE 602453 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPIRIN ALLERGY 060029 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE F013 68445 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE MINI-PANEL 6 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST IGE F045 602567 | $25.97 | $37.10 | $13.05–$35.24 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE MEAT (X3) 602 | $77.92 | $111.31 | $13.05–$105.74 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE SHELLFISH X6 | $155.83 | $222.62 | $13.05–$211.49 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHELLFISH ALLERGEN PROFILE 062 | $177.10 | $253.00 | $13.05–$240.35 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX ALLERGY IGE 650390 | $269.89 | $385.55 | $13.05–$366.27 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE MOLD X12 062 | $311.67 | $445.24 | $13.05–$422.98 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD X12 6029 | $311.67 | $445.24 | $13.05–$422.98 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROF IGE RESP AREA 3 | $542.07 | $774.39 | $13.05–$735.67 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE (24) | $623.33 | $890.47 | $13.05–$845.95 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE I | $66.22 | $94.60 | $32.38–$89.87 | 14% below | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE I | $66.22 | $94.60 | $32.38–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA TITER | $60.01 | $85.73 | $30.22–$81.44 | 56% below | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA TITER | $60.01 | $85.73 | $30.22–$81.44 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 LC BASIC METABOLIC 322758 | $49.48 | $70.68 | $21.15–$67.15 | 43% below | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC | $49.48 | $70.68 | $21.15–$67.15 | 43% below | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC | $49.48 | $70.68 | $21.15–$67.15 | — | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LC BASIC METABOLIC 322758 | $49.48 | $70.68 | $21.15–$67.15 | — | 30% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $58.44 | $77.92 | $25.80–$74.02 | 44% below | 25% |
| Blood culture for bacteria CPT 87040 LC CULTURE BLOOD 008300 | $58.44 | $77.92 | $25.80–$74.02 | 44% below | 25% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD | $58.44 | $77.92 | $25.80–$74.02 | — | 25% |
| Blood culture for bacteria inpatient CPT 87040 LC CULTURE BLOOD 008300 | $58.44 | $77.92 | $25.80–$74.02 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $11.55 | $16.50 | $12.90–$16.50 | 34% below | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE | $20.60 | $29.43 | $23.01–$27.96 | 18% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE | $20.60 | $29.43 | $23.01–$27.96 | — | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $28.89 | $41.27 | $9.82–$39.21 | 36% below | 30% |
| Blood glucose (sugar) test CPT 82947 LC GLUCOSE 001032 | $29.11 | $38.81 | $9.82–$36.87 | 35% below | 25% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $29.11 | $38.81 | $9.82–$36.87 | 35% below | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $29.11 | $38.81 | $9.82–$36.87 | — | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 LC GLUCOSE 001032 | $29.11 | $38.81 | $9.82–$36.87 | — | 25% |
| Blood lead test CPT 83655 LEAD LEVEL ADULT TEST 007625 | $58.46 | $77.94 | $30.28–$74.04 | 11% below | 25% |
| Blood lead test CPT 83655 LEAD PEDIATRIC VENOUS 717009 | $58.48 | $77.97 | $30.28–$74.07 | 11% below | 25% |
| Blood lead test CPT 83655 LEAD TEST | $63.14 | $90.20 | $30.28–$85.69 | 3% below | 30% |
| Blood lead test inpatient CPT 83655 LEAD LEVEL ADULT TEST 007625 | $58.46 | $77.94 | $30.28–$74.04 | — | 25% |
| Blood lead test inpatient CPT 83655 LEAD PEDIATRIC VENOUS 717009 | $58.48 | $77.97 | $30.28–$74.07 | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 LC PREGNANCY SERUM 004556 | $88.01 | $125.73 | $18.80–$119.44 | 17% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM QUAL | $88.01 | $125.73 | $18.80–$119.44 | 17% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM QUAL | $88.01 | $125.73 | $18.80–$119.44 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 LC PREGNANCY SERUM 004556 | $88.01 | $125.73 | $18.80–$119.44 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $99.25 | $141.79 | $7.48–$134.70 | 10% above | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LC ABO TYPE | $99.25 | $141.79 | $7.48–$134.70 | 10% above | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE | $99.25 | $141.79 | $7.48–$134.70 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 LC ABO TYPE | $99.25 | $141.79 | $7.48–$134.70 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 15184001 CRP | $25.97 | $37.10 | $12.95–$35.24 | 76% below | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN 006627 QUAN | $38.17 | $50.89 | $12.95–$48.35 | 65% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 15184001 CRP | $25.97 | $37.10 | $12.95–$35.24 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN 006627 QUAN | $38.17 | $50.89 | $12.95–$48.35 | — | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF GENE NAA 183988 | $156.31 | $223.30 | $93.18–$212.14 | at median | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF GENE NAA 183988 | $156.31 | $223.30 | $93.18–$212.14 | — | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9:CANCER ANTIGEN 19-9 00 | $103.01 | $147.15 | $52.02–$139.79 | at median | 30% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9:CANCER ANTIGEN 19-9 00 | $103.01 | $147.15 | $52.02–$139.79 | — | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125: CANCER ANTIGEN 125 002 | $103.01 | $147.15 | $52.02–$139.79 | 16% below | 30% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125: CANCER ANTIGEN 125 002 | $103.01 | $147.15 | $52.02–$139.79 | — | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 ID NOW COVID-19 | $57.75 | $82.50 | $64.52–$82.50 | 24% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NAA | $207.37 | $296.24 | $87.72–$281.43 | 49% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS NAA 1880 | $207.37 | $296.24 | $87.72–$281.43 | 49% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS NAA 1880 | $207.37 | $296.24 | $87.72–$281.43 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NAA | $207.37 | $296.24 | $87.72–$281.43 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LC LIPID PANEL W LDL/HDL RATIO | $66.75 | $89.00 | $33.48–$84.55 | 21% below | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $66.75 | $89.00 | $33.48–$84.55 | 21% below | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LC LIPID PANEL W LDL/HDL RATIO | $66.75 | $89.00 | $33.48–$84.55 | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $66.75 | $89.00 | $33.48–$84.55 | — | 25% |
| Complete blood count (CBC) with differential CPT 85025 LC CBC WITH DIFFERENTIAL 00500 | $44.09 | $58.79 | $19.42–$55.85 | 53% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFFERENTIAL | $44.09 | $58.79 | $19.42–$55.85 | 53% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/DIFF | $45.27 | $64.67 | $19.42–$61.44 | 57% above | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFFERENTIAL | $44.09 | $58.79 | $19.42–$55.85 | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LC CBC WITH DIFFERENTIAL 00500 | $44.09 | $58.79 | $19.42–$55.85 | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/DIFF | $45.27 | $64.67 | $19.42–$61.44 | — | 30% |
| Complete blood count (CBC), no differential CPT 85027 HEALTH FAIR CBC W/O DIFF | $7.50 | $10.00 | $7.82–$10.00 | 91% below | 25% |
| Complete blood count (CBC), no differential CPT 85027 CBC **WITHOUT DIFFERENTIAL | $34.65 | $49.50 | $16.18–$47.02 | 58% below | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEALTH FAIR CBC W/O DIFF | $7.50 | $10.00 | $7.82–$10.00 | — | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC **WITHOUT DIFFERENTIAL | $34.65 | $49.50 | $16.18–$47.02 | — | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PROFIL | $61.05 | $87.22 | $26.40–$82.86 | 64% below | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 LC COMPREHENSIVE METABOLIC PRO | $61.05 | $87.22 | $26.40–$82.86 | 64% below | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LC COMPREHENSIVE METABOLIC PRO | $61.05 | $87.22 | $26.40–$82.86 | — | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PROFIL | $61.05 | $87.22 | $26.40–$82.86 | — | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANTITATIVE | $64.86 | $92.65 | $25.45–$88.02 | 59% below | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER QUANTITATIVE | $64.86 | $92.65 | $25.45–$88.02 | — | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 004020 | $113.19 | $161.70 | $55.58–$153.62 | 20% below | 30% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE 004020 | $113.19 | $161.70 | $55.58–$153.62 | — | 30% |
| Estradiol blood test CPT 82670 ESTRADIOL TOTAL 004515 | $141.68 | $202.40 | $69.85–$192.28 | 16% above | 30% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL 004515 | $141.68 | $202.40 | $69.85–$192.28 | — | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH (FOLLICLE STIMULATING HORM | $94.71 | $135.30 | $46.45–$128.54 | 11% below | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (FOLLICLE STIMULATING HORM | $94.71 | $135.30 | $46.45–$128.54 | — | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL 123255 | $281.05 | $401.50 | $49.08–$381.42 | 93% above | 30% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL 123255 | $281.05 | $401.50 | $49.08–$381.42 | — | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $69.30 | $99.00 | $34.08–$94.05 | 46% below | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN 004598 | $77.03 | $102.70 | $34.08–$97.56 | 40% below | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $69.30 | $99.00 | $34.08–$94.05 | — | 30% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN 004598 | $77.03 | $102.70 | $34.08–$97.56 | — | 25% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $74.69 | $106.70 | $36.75–$101.36 | 21% below | 30% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID (FOLATES) SERUM 002 | $74.69 | $106.70 | $36.75–$101.36 | 21% below | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID (FOLATES) SERUM 002 | $74.69 | $106.70 | $36.75–$101.36 | — | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $74.69 | $106.70 | $36.75–$101.36 | — | 30% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE 010389 (TRI-IODOTHYRON | $136.37 | $194.82 | $42.35–$185.08 | 32% above | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE 010389 (TRI-IODOTHYRON | $136.37 | $194.82 | $42.35–$185.08 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 LC T4 THYROXINE FREE 001974 | $58.96 | $84.23 | $22.55–$80.02 | 24% below | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 THYROXINE FREE | $58.96 | $84.23 | $22.55–$80.02 | 24% below | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 LC T4 THYROXINE FREE 001974 | $58.96 | $84.23 | $22.55–$80.02 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 THYROXINE FREE | $58.96 | $84.23 | $22.55–$80.02 | — | 30% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE 144980 (DIRE | $130.13 | $185.90 | $63.68–$176.60 | 34% below | 30% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE 144980 (DIRE | $130.13 | $185.90 | $63.68–$176.60 | — | 30% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL(CMP TSH C | $119.35 | $170.50 | $133.33–$161.98 | at median | 30% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL(CMP TSH C | $119.35 | $170.50 | $133.33–$161.98 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 LC GLUCOSE TOL PRENATAL SCRN | $34.50 | $46.00 | $11.88–$43.70 | 16% below | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE PRENATAL SCR | $34.50 | $46.00 | $11.88–$43.70 | 16% below | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 LC GLUCOSE TOL PRENATAL SCRN | $34.50 | $46.00 | $11.88–$43.70 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE PRENATAL SCR | $34.50 | $46.00 | $11.88–$43.70 | — | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 2-HR ONE-STEP PREN | $87.75 | $117.00 | $32.18–$111.15 | 7% above | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 2-HR ONE-STEP PREN | $87.75 | $117.00 | $32.18–$111.15 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORR QUANT DNA RNA | $167.86 | $239.80 | $87.72–$227.81 | 27% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORR QUANT DNA RNA | $167.86 | $239.80 | $87.72–$227.81 | — | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI IgM ANTIBODY 163204 | $73.92 | $105.60 | $42.12–$100.32 | 2% above | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI IgG ANTIBODY 162289 | $73.92 | $105.60 | $42.12–$100.32 | 2% above | 30% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IgG ANTIBODY 162289 | $73.92 | $105.60 | $42.12–$100.32 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IgM ANTIBODY 163204 | $73.92 | $105.60 | $42.12–$100.32 | — | 30% |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL ANTIGEN 180764 | $196.35 | $280.50 | $35.95–$266.48 | 82% above | 30% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL ANTIGEN 180764 | $196.35 | $280.50 | $35.95–$266.48 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 VIRAL LOAD (RNA QUANT)55 | $421.66 | $602.37 | $212.75–$572.25 | 35% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 VIRAL LOAD (RNA QUANT)55 | $421.66 | $602.37 | $212.75–$572.25 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ABS IMMUNOASSAY 083935 | $113.19 | $161.70 | $60.20–$153.62 | 5% below | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ABS IMMUNOASSAY 083935 | $113.19 | $161.70 | $60.20–$153.62 | — | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES | $140.91 | $201.30 | $87.72–$191.24 | 22% above | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV NAA APTIMA | $140.91 | $201.30 | $87.72–$191.24 | 22% above | 30% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV NAA APTIMA | $140.91 | $201.30 | $87.72–$191.24 | — | 30% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES | $140.91 | $201.30 | $87.72–$191.24 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEALTH FAIR HEMOGLOBIN A1C | $7.70 | $11.00 | $8.60–$11.00 | 93% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $52.81 | $75.44 | $24.28–$71.67 | 52% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEALTH FAIR HEMOGLOBIN A1C | $7.70 | $11.00 | $8.60–$11.00 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $52.81 | $75.44 | $24.28–$71.67 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB 006395 | $38.51 | $55.02 | $26.85–$52.27 | 54% below | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB 006395 | $38.51 | $55.02 | $26.85–$52.27 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG | $51.06 | $72.94 | $25.82–$69.29 | 19% below | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG #6510 | $51.06 | $72.94 | $25.82–$69.29 | 19% below | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF AG | $51.06 | $72.94 | $25.82–$69.29 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF AG #6510 | $51.06 | $72.94 | $25.82–$69.29 | — | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS AB W/REFLEX | $70.76 | $101.09 | $35.68–$96.04 | 10% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY 140659 | $73.15 | $104.50 | $35.68–$99.28 | 7% below | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS AB W/REFLEX | $70.76 | $101.09 | $35.68–$96.04 | — | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY 140659 | $73.15 | $104.50 | $35.68–$99.28 | — | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA DIAGNOSIS NAA | $341.11 | $487.30 | $107.10–$462.94 | 35% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANTITATIVE PCR 5 | $379.23 | $541.75 | $107.10–$514.66 | 50% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT W/REFLEX 550090 | $438.06 | $625.80 | $107.10–$594.51 | 73% above | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA DIAGNOSIS NAA | $341.11 | $487.30 | $107.10–$462.94 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANTITATIVE PCR 5 | $379.23 | $541.75 | $107.10–$514.66 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT W/REFLEX 550090 | $438.06 | $625.80 | $107.10–$594.51 | — | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 ANTIBODY 1648 | $67.94 | $97.06 | $32.98–$92.21 | 19% below | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX 1 ANTIBODY 1648 | $67.94 | $97.06 | $32.98–$92.21 | — | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 ANTIBODY | $99.59 | $142.27 | $48.38–$135.16 | at median | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 ANTIBODY | $99.59 | $142.27 | $48.38–$135.16 | — | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY 120766 | $66.22 | $94.60 | $32.38–$89.87 | 10% above | 30% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY 120766 | $66.22 | $94.60 | $32.38–$89.87 | — | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $287.21 | $410.30 | $44.80–$389.78 | 159% above | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $287.21 | $410.30 | $44.80–$389.78 | — | 30% |
| Insulin blood test CPT 83525 INSULIN LEVEL 004333 | $74.89 | $99.85 | $28.58–$94.86 | at median | 25% |
| Insulin blood test inpatient CPT 83525 INSULIN LEVEL 004333 | $74.89 | $99.85 | $28.58–$94.86 | — | 25% |
| Iron blood test (serum iron) CPT 83540 IRON SERUM | $32.25 | $46.07 | $16.18–$43.77 | 60% below | 30% |
| Iron blood test (serum iron) CPT 83540 IRON SERUM 001339 | $33.11 | $47.30 | $16.18–$44.94 | 59% below | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM | $32.25 | $46.07 | $16.18–$43.77 | — | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM 001339 | $33.11 | $47.30 | $16.18–$44.94 | — | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC | $42.99 | $61.42 | $21.85–$58.35 | 36% below | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC | $42.99 | $61.42 | $21.85–$58.35 | — | 30% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL LABCORP 3 | $63.88 | $91.25 | $21.70–$86.69 | 39% below | 30% |
| Kidney function blood test panel CPT 80069 LC RENAL FUNCTION PANEL (10) # | $66.37 | $94.81 | $21.70–$90.07 | 37% below | 30% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $66.37 | $94.81 | $21.70–$90.07 | 37% below | 30% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL LABCORP 3 | $63.88 | $91.25 | $21.70–$86.69 | — | 30% |
| Kidney function blood test panel inpatient CPT 80069 LC RENAL FUNCTION PANEL (10) # | $66.37 | $94.81 | $21.70–$90.07 | — | 30% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $66.37 | $94.81 | $21.70–$90.07 | — | 30% |
| LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORMONE)004283 | $93.94 | $134.20 | $46.30–$127.49 | 30% below | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH (LUTEINIZING HORMONE)004283 | $93.94 | $134.20 | $46.30–$127.49 | — | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $52.65 | $75.21 | $17.22–$71.45 | 51% below | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LC LIPASE 001404 | $52.65 | $75.21 | $17.22–$71.45 | 51% below | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LC LIPASE 001404 | $52.65 | $75.21 | $17.22–$71.45 | — | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $52.65 | $75.21 | $17.22–$71.45 | — | 30% |
| Liver function blood test panel CPT 80076 HEPATIC PANEL | $62.39 | $89.13 | $20.42–$84.67 | 25% below | 30% |
| Liver function blood test panel CPT 80076 LC HEPATIC PANEL 322755 | $62.39 | $89.13 | $20.42–$84.67 | 25% below | 30% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC PANEL | $62.39 | $89.13 | $20.42–$84.67 | — | 30% |
| Liver function blood test panel inpatient CPT 80076 LC HEPATIC PANEL 322755 | $62.39 | $89.13 | $20.42–$84.67 | — | 30% |
| Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB REFLEX I | $87.01 | $124.30 | $42.58–$118.08 | 1% below | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB REFLEX I | $87.01 | $124.30 | $42.58–$118.08 | — | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM | $36.75 | $49.00 | $16.75–$46.55 | 33% below | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 003400 | $49.27 | $70.38 | $16.75–$66.86 | 10% below | 30% |
| Magnesium blood test CPT 83735 LC MAGNESIUM 001537 | $49.27 | $70.38 | $16.75–$66.86 | 10% below | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM RBC 80283 | $90.09 | $128.70 | $16.75–$122.26 | 64% above | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $36.75 | $49.00 | $16.75–$46.55 | — | 25% |
| Magnesium blood test inpatient CPT 83735 LC MAGNESIUM 001537 | $49.27 | $70.38 | $16.75–$66.86 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE 003400 | $49.27 | $70.38 | $16.75–$66.86 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC 80283 | $90.09 | $128.70 | $16.75–$122.26 | — | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODIES IGG 096560 | $63.60 | $90.85 | $32.20–$86.31 | 15% below | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM ACUTE TEST 160218 | $65.45 | $93.50 | $32.20–$88.82 | 13% below | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODIES IGG 096560 | $63.60 | $90.85 | $32.20–$86.31 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM ACUTE TEST 160218 | $65.45 | $93.50 | $32.20–$88.82 | — | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 RAPID MONO SCREEN WHOLE BLOOD | $34.13 | $48.76 | $12.95–$46.32 | 64% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $93.94 | $134.20 | $45.98–$127.49 | 14% below | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $93.94 | $134.20 | $45.98–$127.49 | — | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (NOT SCREENING) | $110.02 | $157.17 | $45.98–$149.31 | 8% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE 140731 | $110.02 | $157.17 | $45.98–$149.31 | 8% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LC PSA TOTAL 010322 | $110.02 | $157.17 | $45.98–$149.31 | 8% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (LABCORP) | $110.02 | $157.17 | $45.98–$149.31 | 8% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $110.02 | $157.17 | $45.98–$149.31 | 8% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA FREE:TOTAL RATIO REFLEX 48 | $140.53 | $200.75 | $45.98–$190.71 | 38% above | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (NOT SCREENING) | $110.02 | $157.17 | $45.98–$149.31 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (LABCORP) | $110.02 | $157.17 | $45.98–$149.31 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LC PSA TOTAL 010322 | $110.02 | $157.17 | $45.98–$149.31 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASENSITIVE 140731 | $110.02 | $157.17 | $45.98–$149.31 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING | $110.02 | $157.17 | $45.98–$149.31 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA FREE:TOTAL RATIO REFLEX 48 | $140.53 | $200.75 | $45.98–$190.71 | — | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP W/RFX TO HR HPV ASC-U 1993 | $132.60 | $189.43 | $66.52–$179.96 | 35% above | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH CERVICAL/VAGINAL SCRN | $136.29 | $194.70 | $66.52–$184.96 | 39% above | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUIDED REFLEX HPV AS | $136.29 | $194.70 | $66.52–$184.96 | 39% above | 30% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP W/RFX TO HR HPV ASC-U 1993 | $132.60 | $189.43 | $66.52–$179.96 | — | 30% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IMAGE GUIDED REFLEX HPV AS | $136.29 | $194.70 | $66.52–$184.96 | — | 30% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH CERVICAL/VAGINAL SCRN | $136.29 | $194.70 | $66.52–$184.96 | — | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP W/RFX HPV ASCU 199300 | $103.95 | $148.50 | $50.65–$141.08 | 56% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP W/RFX HPV ALL PATH 199345 | $103.95 | $148.50 | $50.65–$141.08 | 56% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Thin Prep Pap Test | $148.98 | $212.83 | $50.65–$202.19 | 123% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP W/RFX HPV ASCU 199300 | $103.95 | $148.50 | $50.65–$141.08 | — | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP W/RFX HPV ALL PATH 199345 | $103.95 | $148.50 | $50.65–$141.08 | — | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT 015 | $255.93 | $365.61 | $103.20–$347.33 | 10% above | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT 015 | $255.93 | $365.61 | $103.20–$347.33 | — | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LC PARTIAL THROMBOPLASTIN TIME | $34.98 | $49.97 | $15.02–$47.47 | 32% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $34.98 | $49.97 | $15.02–$47.47 | 32% below | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LC PARTIAL THROMBOPLASTIN TIME | $34.98 | $49.97 | $15.02–$47.47 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $34.98 | $49.97 | $15.02–$47.47 | — | 30% |
| Progesterone blood test CPT 84144 PROGESTERONE SERUM TEST 004317 | $123.49 | $176.41 | $52.15–$167.59 | 32% below | 30% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE SERUM TEST 004317 | $123.49 | $176.41 | $52.15–$167.59 | — | 30% |
| Prolactin blood test CPT 84146 PROLACTIN 004465 | $108.41 | $154.87 | $48.45–$147.13 | 10% below | 30% |
| Prolactin blood test CPT 84146 MACROPROLACTIN 500324 (2) | $216.82 | $309.74 | $48.45–$294.25 | 80% above | 30% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN 004465 | $108.41 | $154.87 | $48.45–$147.13 | — | 30% |
| Prolactin blood test inpatient CPT 84146 MACROPROLACTIN 500324 (2) | $216.82 | $309.74 | $48.45–$294.25 | — | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN | $19.71 | $28.15 | $10.72–$26.74 | 24% below | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $27.72 | $39.60 | $10.72–$37.62 | 7% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LC PROTHROMBIN TIME 005199 | $28.06 | $37.41 | $10.72–$35.54 | 8% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $28.06 | $37.41 | $10.72–$35.54 | 8% above | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN | $19.71 | $28.15 | $10.72–$26.74 | — | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LC PROTHROMBIN TIME 005199 | $28.06 | $37.41 | $10.72–$35.54 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $28.06 | $37.41 | $10.72–$35.54 | — | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN 5 DRUG PANEL | $42.35 | $60.50 | $31.50–$57.48 | 2% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 RAPID FLU AB | $88.18 | $125.97 | $41.38–$119.67 | 5% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 RAPID FLU AB - CLINIC ONLY | $88.18 | $125.97 | $41.38–$119.67 | 5% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A&B LABCORP186064 | $138.99 | $198.55 | $41.38–$188.62 | 65% above | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID FLU AB | $88.18 | $125.97 | $41.38–$119.67 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID FLU AB - CLINIC ONLY | $88.18 | $125.97 | $41.38–$119.67 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A&B LABCORP186064 | $138.99 | $198.55 | $41.38–$188.62 | — | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID (RA) FACTOR 006502 | $27.77 | $39.67 | $14.18–$37.69 | 23% below | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID (RA) FACTOR 006502 | $27.77 | $39.67 | $14.18–$37.69 | — | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA-IMMUNE STATUS 006197 ( | $73.92 | $105.60 | $35.98–$100.32 | 24% below | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA-IMMUNE STATUS 006197 ( | $73.92 | $105.60 | $35.98–$100.32 | — | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTOMATED | $20.66 | $29.52 | $6.75–$28.04 | 64% below | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 LC SED RATE WESTERGREN 005215 | $20.66 | $29.52 | $6.75–$28.04 | 64% below | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTOMATED | $20.66 | $29.52 | $6.75–$28.04 | — | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 LC SED RATE WESTERGREN 005215 | $20.66 | $29.52 | $6.75–$28.04 | — | 30% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES SMEAR | $52.77 | $75.39 | $22.25–$71.62 | 2% below | 30% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES SMEAR | $52.77 | $75.39 | $22.25–$71.62 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREENING (3 CARD | $24.87 | $35.53 | $10.95–$33.75 | 8% above | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREENING (3 CARD | $24.87 | $35.53 | $10.95–$33.75 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD IA LABCORP 182949 | $113.77 | $151.69 | $39.80–$144.11 | 55% above | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD IA LABCORP 182949 | $113.77 | $151.69 | $39.80–$144.11 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX 012005 | $19.71 | $28.15 | $10.68–$26.74 | 22% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGIN(RPR)QUAL 0 | $35.42 | $50.60 | $10.68–$48.07 | 41% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF 6445 | $74.69 | $106.70 | $10.68–$101.36 | 196% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX 012005 | $19.71 | $28.15 | $10.68–$26.74 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN(RPR)QUAL 0 | $35.42 | $50.60 | $10.68–$48.07 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF 6445 | $74.69 | $106.70 | $10.68–$101.36 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD INCUBATED | $473.60 | $676.57 | $154.95–$642.74 | 115% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD+ NOT INCUB | $473.60 | $676.57 | $154.95–$642.74 | 115% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD+ NOT INCUB | $473.60 | $676.57 | $154.95–$642.74 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD INCUBATED | $473.60 | $676.57 | $154.95–$642.74 | — | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE 004226 | $211.55 | $302.21 | $64.52–$287.10 | 41% above | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE 004226 | $211.55 | $302.21 | $64.52–$287.10 | — | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB 163 | $71.66 | $102.37 | $36.38–$97.25 | 11% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE TPO ANTIBOD | $73.92 | $105.60 | $36.38–$100.32 | 8% below | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL AB 163 | $71.66 | $102.37 | $36.38–$97.25 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE TPO ANTIBOD | $73.92 | $105.60 | $36.38–$100.32 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LC THYROID CASCADE PANEL 33001 | $12.94 | $18.48 | $14.45–$18.48 | 87% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LC TSH 004259 | $97.90 | $139.85 | $42.00–$132.86 | at median | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $97.90 | $139.85 | $42.00–$132.86 | at median | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LC THYROID CASCADE PANEL 33001 | $12.94 | $18.48 | $14.45–$18.48 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $97.90 | $139.85 | $42.00–$132.86 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LC TSH 004259 | $97.90 | $139.85 | $42.00–$132.86 | — | 30% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS NAA 1880 | $132.44 | $189.20 | $87.72–$179.74 | 20% above | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS NAA 1880 | $132.44 | $189.20 | $87.72–$179.74 | — | 30% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $22.39 | $31.99 | $11.30–$30.39 | 68% below | 30% |
| Uric acid blood test CPT 84550 URIC ACID | $30.42 | $43.45 | $11.30–$41.28 | 57% below | 30% |
| Uric acid blood test CPT 84550 LC URIC ACID 001057 | $30.42 | $43.45 | $11.30–$41.28 | 57% below | 30% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD | $22.39 | $31.99 | $11.30–$30.39 | — | 30% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $30.42 | $43.45 | $11.30–$41.28 | — | 30% |
| Uric acid blood test inpatient CPT 84550 LC URIC ACID 001057 | $30.42 | $43.45 | $11.30–$41.28 | — | 30% |
| Urinalysis with microscope exam, manual CPT 81000 UA, NONAUTO, W/MICRO | $23.10 | $33.00 | $10.05–$31.35 | 124% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA Speyside Only (PRE-EMPLOYME | $3.85 | $5.50 | $4.30–$5.50 | 88% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/REFLEX CULTURE | $25.41 | $36.30 | $5.62–$34.48 | 23% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 LC URINALYSIS REFLEX CULTURE 3 | $25.41 | $36.30 | $5.62–$34.48 | 23% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 LC URINALYSIS REFLEX MICRO 003 | $25.41 | $36.30 | $5.62–$34.48 | 23% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O REFLEX CULTURE | $25.41 | $36.30 | $5.62–$34.48 | 23% below | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Speyside Only (PRE-EMPLOYME | $3.85 | $5.50 | $4.30–$5.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LC URINALYSIS REFLEX MICRO 003 | $25.41 | $36.30 | $5.62–$34.48 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O REFLEX CULTURE | $25.41 | $36.30 | $5.62–$34.48 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LC URINALYSIS REFLEX CULTURE 3 | $25.41 | $36.30 | $5.62–$34.48 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/REFLEX CULTURE | $25.41 | $36.30 | $5.62–$34.48 | — | 30% |
| Urine culture for bacteria, with colony count CPT 87086 LC CULTURE URINE 008847 | $56.12 | $74.82 | $20.18–$71.08 | 27% below | 25% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE | $56.12 | $74.82 | $20.18–$71.08 | 27% below | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 LC CULTURE URINE 008847 | $56.12 | $74.82 | $20.18–$71.08 | — | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE | $56.12 | $74.82 | $20.18–$71.08 | — | 25% |
| Urine pregnancy test, read by color change CPT 81025 LC PREGNANCY URINE 004036 | $56.21 | $80.30 | $21.52–$76.28 | 39% below | 30% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY URINE QUAL | $56.21 | $80.30 | $21.52–$76.28 | 39% below | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY URINE QUAL | $56.21 | $80.30 | $21.52–$76.28 | — | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 LC PREGNANCY URINE 004036 | $56.21 | $80.30 | $21.52–$76.28 | — | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 001503 | $76.72 | $109.60 | $37.70–$104.12 | 9% below | 30% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 001503 | $76.72 | $109.60 | $37.70–$104.12 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY 081950 | $166.35 | $237.64 | $74.00–$225.76 | 18% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY 081950 | $166.35 | $237.64 | $74.00–$225.76 | — | 30% |
| Zinc blood test CPT 84630 ZINC | $56.43 | $80.61 | $28.48–$76.58 | 21% below | 30% |
| Zinc blood test inpatient CPT 84630 ZINC | $56.43 | $80.61 | $28.48–$76.58 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE 004416 | $74.25 | $99.00 | $37.62–$94.05 | 39% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE 004416 | $74.25 | $99.00 | $37.62–$94.05 | — | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Appendectomy, open surgery CPT 44950 SURGN APPENDECTOMY | $1,474.05 | $1,965.40 | $1,867.13–$1,965.40 | 85% below | 25% |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY | $4,298.18 | $5,730.90 | $4,481.56–$5,730.90 | 56% below | 25% |
| Appendectomy, open surgery inpatient CPT 44950 SURGN APPENDECTOMY | $1,474.05 | $1,965.40 | $1,867.13–$1,965.40 | — | 25% |
| Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY | $4,298.18 | $5,730.90 | $4,481.56–$5,730.90 | — | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLD TX METATARSAL FRACTURE | $488.26 | $697.51 | $545.45–$697.51 | 68% above | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 PRO FEE CARDIOVERSION EXTERNAL | $456.71 | $608.95 | $578.50–$608.95 | 62% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ER DEPT ONLY | $1,023.02 | $1,364.02 | $1,066.66–$1,364.02 | 15% below | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PRO FEE CARDIOVERSION EXTERNAL | $456.71 | $608.95 | $578.50–$608.95 | — | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ER DEPT ONLY | $1,023.02 | $1,364.02 | $1,066.66–$1,364.02 | — | 25% |
| Carpal tunnel release, open surgery CPT 64721 SURGN CARPAL TUNNEL NEUROPLAST | $637.50 | $850.00 | $807.50–$850.00 | 89% below | 25% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL NEUROPLASTY/TRAN | $3,178.17 | $4,237.56 | $3,313.77–$4,237.56 | 44% below | 25% |
| Carpal tunnel release, open surgery inpatient CPT 64721 SURGN CARPAL TUNNEL NEUROPLAST | $637.50 | $850.00 | $807.50–$850.00 | — | 25% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL NEUROPLASTY/TRAN | $3,178.17 | $4,237.56 | $3,313.77–$4,237.56 | — | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 P CLD TX-ULNA /RAD FX-W/O MNP | $441.47 | $630.67 | $599.14–$630.67 | 31% above | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 F CLD TX-ULNA /RAD FX-W/O MNP | $494.03 | $658.71 | $515.11–$658.71 | 46% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLD TX RADIAL FX EPIPHYSEAL | $727.85 | $1,039.79 | $813.12–$1,039.79 | 115% above | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PRO FEE CLOSDISTAL RADIAL | $1,181.58 | $1,575.44 | $1,201.26–$1,496.67 | 250% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 P CLD TX-ULNA /RAD FX-W/O MNP | $441.47 | $630.67 | $599.14–$630.67 | — | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 F CLD TX-ULNA /RAD FX-W/O MNP | $494.03 | $658.71 | $515.11–$658.71 | — | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PRO FEE CLOSDISTAL RADIAL | $1,181.58 | $1,575.44 | $1,201.26–$1,496.67 | — | 25% |
| Colonoscopy with polyp removal CPT 45385 SURGN COLNSCPY LESN REMOV SNAR | $488.54 | $651.39 | $618.82–$651.39 | 88% below | 25% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY LESN RMVL SNARE | $1,748.19 | $2,330.92 | $1,822.78–$2,330.92 | 56% below | 25% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY HOT BIOP POLYP SNA | $1,748.19 | $2,330.92 | $1,822.78–$2,330.92 | 56% below | 25% |
| Colonoscopy with polyp removal inpatient CPT 45385 SURGN COLNSCPY LESN REMOV SNAR | $488.54 | $651.39 | $618.82–$651.39 | — | 25% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY HOT BIOP POLYP SNA | $1,748.19 | $2,330.92 | $1,822.78–$2,330.92 | — | 25% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY LESN RMVL SNARE | $1,748.19 | $2,330.92 | $1,822.78–$2,330.92 | — | 25% |
| Colonoscopy with tissue sample CPT 45380 PHY FEE COLONOSCOPY W BX | $368.51 | $491.35 | $466.78–$491.35 | 75% below | 25% |
| Colonoscopy with tissue sample CPT 45380 SURGN COLNSCPY FLEX SPLEN BX | $368.51 | $491.35 | $466.78–$491.35 | 75% below | 25% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEX SPLEN BX | $1,748.19 | $2,330.92 | $1,822.78–$2,330.92 | 20% above | 25% |
| Colonoscopy with tissue sample inpatient CPT 45380 PHY FEE COLONOSCOPY W BX | $368.51 | $491.35 | $466.78–$491.35 | — | 25% |
| Colonoscopy with tissue sample inpatient CPT 45380 SURGN COLNSCPY FLEX SPLEN BX | $368.51 | $491.35 | $466.78–$491.35 | — | 25% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEX SPLEN BX | $1,748.19 | $2,330.92 | $1,822.78–$2,330.92 | — | 25% |
| Colonoscopy, diagnostic CPT 45378 SURGN COLONOSCOPY | $330.47 | $440.63 | $418.60–$440.63 | 74% below | 25% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $1,721.39 | $2,295.18 | $1,794.83–$2,295.18 | 35% above | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 SURGN COLONOSCOPY | $330.47 | $440.63 | $418.60–$440.63 | — | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY | $1,721.39 | $2,295.18 | $1,794.83–$2,295.18 | — | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 SURGN COLPOSCOPY W/LOOP ELEC B | $201.00 | $268.00 | $254.60–$268.00 | 96% below | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY W/LOOP ELEC BX CERV | $2,175.00 | $2,900.00 | $2,267.80–$2,900.00 | 58% below | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 LEEP | $2,448.24 | $3,497.48 | $2,735.03–$3,497.48 | 53% below | 30% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 SURGN COLPOSCOPY W/LOOP ELEC B | $201.00 | $268.00 | $254.60–$268.00 | — | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY W/LOOP ELEC BX CERV | $2,175.00 | $2,900.00 | $2,267.80–$2,900.00 | — | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCPY CERVIX BIOPSY ECC | $343.89 | $491.27 | $384.17–$491.27 | 39% below | 30% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPE WITH SAMPLING | $600.00 | $800.00 | $625.60–$800.00 | 7% above | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPE WITH SAMPLING | $600.00 | $800.00 | $625.60–$800.00 | — | 25% |
| Complex cataract surgery with lens implant CPT 66982 CATARACT REMOVAL AND LENS INSE | $4,650.00 | $6,200.00 | $4,848.40–$6,200.00 | — | 25% |
| Complex cataract surgery with lens implant inpatient CPT 66982 CATARACT REMOVAL AND LENS INSE | $4,650.00 | $6,200.00 | $4,848.40–$6,200.00 | — | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPE | $1,212.77 | $1,617.03 | $1,264.52–$1,617.03 | 39% above | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPE | $1,212.77 | $1,617.03 | $1,264.52–$1,617.03 | — | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 SURGN DESTRUCT MALIGNANT LESIO | $113.25 | $151.00 | $143.45–$151.00 | 6% below | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST PREMALIGN LESION FIRST | $153.00 | $218.57 | $170.92–$218.57 | 28% above | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION MALIGNANT LESION | $192.00 | $256.00 | $200.19–$256.00 | 60% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 SURGN DESTRUCT MALIGNANT LESIO | $113.25 | $151.00 | $143.45–$151.00 | — | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION MALIGNANT LESION | $192.00 | $256.00 | $200.19–$256.00 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 PRO CEREMUN REMOVAL/IRRIGATION | $14.43 | $19.24 | $18.28–$19.24 | 82% below | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 PRO CERUMEN REMOVAL/IRRIGATION | $14.43 | $19.24 | $18.28–$19.24 | 82% below | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 PRO CERUMEN REM/IRRIGATION | $14.43 | $19.24 | $18.28–$19.24 | 82% below | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 FAC IP EAR WAX REM/IRRIGATE | $172.76 | $230.34 | $180.13–$230.34 | 117% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 FAC CERUMEN REMOVAL/IRRIGATION | $172.76 | $230.34 | $180.13–$230.34 | 117% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 FAC ER CERUMEN REMOVAL/IRRIGAT | $177.36 | $253.37 | $198.14–$253.37 | 123% above | 30% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOV IMPACT CERUMEN UNILAT | $63.45 | $90.64 | $70.88–$90.64 | 20% below | 30% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 PRO CERUMEN REMOVAL/IRRIGATION | $14.43 | $19.24 | $18.28–$19.24 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 PRO CEREMUN REMOVAL/IRRIGATION | $14.43 | $19.24 | $18.28–$19.24 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 PRO CERUMEN REM/IRRIGATION | $14.43 | $19.24 | $18.28–$19.24 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 FAC IP EAR WAX REM/IRRIGATE | $172.76 | $230.34 | $180.13–$230.34 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 FAC CERUMEN REMOVAL/IRRIGATION | $172.76 | $230.34 | $180.13–$230.34 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 FAC ER CERUMEN REMOVAL/IRRIGAT | $177.36 | $253.37 | $198.14–$253.37 | — | 30% |
| Earwax removal with instruments, one ear CPT 69210 PRO OR REMOV IMPACT EAR W/TOOL | $33.99 | $45.32 | $43.05–$45.32 | 77% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 PF REMOV IMPACT EAR W/TOOLS | $33.99 | $45.32 | $43.05–$45.32 | 77% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 PF REM CERUMEN IMPACT W/TOOLS | $124.80 | $166.40 | $158.08–$166.40 | 16% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 REMOV IMPACT CERUMEN W TOOL | $158.62 | $226.60 | $177.20–$226.60 | 6% above | 30% |
| Earwax removal with instruments, one ear CPT 69210 FAC REMOV IMPACT EAR | $200.93 | $287.04 | $224.47–$287.04 | 35% above | 30% |
| Earwax removal with instruments, one ear CPT 69210 FAC REMOV IMPACT EAT W/TOOLS | $215.28 | $287.04 | $224.47–$287.04 | 45% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 FAC REMOV IMPACT EAR W/TOOLS | $215.28 | $287.04 | $224.47–$287.04 | 45% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 FAC OR REMOV IMPACT EAR W/TOOL | $215.28 | $287.04 | $224.47–$287.04 | 45% above | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 PF REMOV IMPACT EAR W/TOOLS | $33.99 | $45.32 | $43.05–$45.32 | — | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 PRO OR REMOV IMPACT EAR W/TOOL | $33.99 | $45.32 | $43.05–$45.32 | — | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 PF REM CERUMEN IMPACT W/TOOLS | $124.80 | $166.40 | $158.08–$166.40 | — | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 FAC REMOV IMPACT EAR | $200.93 | $287.04 | $224.47–$287.04 | — | 30% |
| Earwax removal with instruments, one ear inpatient CPT 69210 FAC REMOV IMPACT EAT W/TOOLS | $215.28 | $287.04 | $224.47–$287.04 | — | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 FAC REMOV IMPACT EAR W/TOOLS | $215.28 | $287.04 | $224.47–$287.04 | — | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 FAC OR REMOV IMPACT EAR W/TOOL | $215.28 | $287.04 | $224.47–$287.04 | — | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W/O DILATION | $212.14 | $303.05 | $236.99–$303.05 | 34% below | 30% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 SURG RPR INIT INC VENT HERNIA | $985.26 | $1,313.68 | $1,248.00–$1,313.68 | 94% below | 25% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR INIT INCIS VENT HERNIA | $5,100.00 | $6,800.00 | $5,317.60–$6,800.00 | 68% below | 25% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 SURG RPR INIT INC VENT HERNIA | $985.26 | $1,313.68 | $1,248.00–$1,313.68 | — | 25% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR INIT INCIS VENT HERNIA | $5,100.00 | $6,800.00 | $5,317.60–$6,800.00 | — | 25% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 SURG RPR INIT INC VENT HERNIA | $1,135.26 | $1,513.68 | $1,438.00–$1,513.68 | 96% below | 25% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR INIT INCIS VENT HERNIA | $5,288.25 | $7,051.00 | $5,513.88–$7,051.00 | 81% below | 25% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 SURG RPR INIT INC VENT HERNIA | $1,135.26 | $1,513.68 | $1,438.00–$1,513.68 | — | 25% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 REPAIR INIT INCIS VENT HERNIA | $5,288.25 | $7,051.00 | $5,513.88–$7,051.00 | — | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 SURG REPR INIT INCIS VENT HERN | $835.26 | $1,113.68 | $1,058.00–$1,113.68 | 94% below | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR INIT INCIS VENT HERNIA | $4,913.77 | $6,551.69 | $5,123.42–$6,551.69 | 63% below | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 SURG REPR INIT INCIS VENT HERN | $835.26 | $1,113.68 | $1,058.00–$1,113.68 | — | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR INIT INCIS VENT HERNIA | $4,913.77 | $6,551.69 | $5,123.42–$6,551.69 | — | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SURGN FLEXIBLE SIGMOIDOSCOPY | $97.50 | $130.00 | $123.50–$130.00 | 91% below | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY | $633.75 | $845.00 | $660.79–$845.00 | 44% below | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SURGN FLEXIBLE SIGMOIDOSCOPY | $97.50 | $130.00 | $123.50–$130.00 | — | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY | $633.75 | $845.00 | $660.79–$845.00 | — | 25% |
| Gallbladder removal, laparoscopic CPT 47562 SURGN LAP CHOLECYSTECTOMY | $767.81 | $1,023.75 | $972.56–$1,023.75 | 95% below | 25% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $9,518.58 | $12,691.44 | $9,924.71–$12,691.44 | 44% below | 25% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 SURGN LAP CHOLECYSTECTOMY | $767.81 | $1,023.75 | $972.56–$1,023.75 | — | 25% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $9,518.58 | $12,691.44 | $9,924.71–$12,691.44 | — | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 SURGN LAP SURGICAL CHOLE W/CH | $825.94 | $1,101.25 | $1,046.19–$1,101.25 | 96% below | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP SURGICAL CHOLE W/CHOLANGI | $9,518.58 | $12,691.44 | $9,924.71–$12,691.44 | 54% below | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 SURGN LAP SURGICAL CHOLE W/CH | $825.94 | $1,101.25 | $1,046.19–$1,101.25 | — | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP SURGICAL CHOLE W/CHOLANGI | $9,518.58 | $12,691.44 | $9,924.71–$12,691.44 | — | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 SURGN HEMORRHOIDECTOMY BY SIMP | $240.57 | $320.76 | $304.72–$320.76 | 83% below | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY BY SMPL LIG | $626.25 | $835.00 | $652.97–$835.00 | 57% below | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 EXC 1 EXT PAP OR TAG ANUS | $702.02 | $1,002.88 | $784.25–$1,002.88 | 52% below | 30% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL | $702.02 | $1,002.88 | $784.25–$1,002.88 | 52% below | 30% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 SURGN HEMORRHOIDECTOMY BY SIMP | $240.57 | $320.76 | $304.72–$320.76 | — | 25% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY BY SMPL LIG | $626.25 | $835.00 | $652.97–$835.00 | — | 25% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 SURGN HEMORRHOIDECTOMY SIMPLE | $500.75 | $667.66 | $634.28–$667.66 | 84% below | 25% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOM INT EXT SINGLE | $2,111.64 | $3,016.63 | $2,359.00–$3,016.63 | 33% below | 30% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY SIMPLE | $3,873.18 | $5,164.24 | $4,038.44–$5,164.24 | 23% above | 25% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 SURGN HEMORRHOIDECTOMY SIMPLE | $500.75 | $667.66 | $634.28–$667.66 | — | 25% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY SIMPLE | $3,873.18 | $5,164.24 | $4,038.44–$5,164.24 | — | 25% |
| Hysteroscopy with endometrial ablation CPT 58563 SURGN ENDOMETRIAL ABLATION | $782.85 | $1,043.80 | $991.61–$1,043.80 | 95% below | 25% |
| Hysteroscopy with endometrial ablation CPT 58563 ENDOMETRIAL ABLATION W/NOVASU | $3,935.93 | $5,247.90 | $4,103.86–$5,247.90 | 74% below | 25% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 SURGN ENDOMETRIAL ABLATION | $782.85 | $1,043.80 | $991.61–$1,043.80 | — | 25% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 ENDOMETRIAL ABLATION W/NOVASU | $3,935.93 | $5,247.90 | $4,103.86–$5,247.90 | — | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 SURGN HYSTEROSCOPY W BIOP/POLP | $600.00 | $800.00 | $760.00–$800.00 | 91% below | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY W BIOP OR POLP WW | $3,935.93 | $5,247.90 | $4,103.86–$5,247.90 | 42% below | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 SURGN HYSTEROSCOPY W BIOP/POLP | $600.00 | $800.00 | $760.00–$800.00 | — | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY W BIOP OR POLP WW | $3,935.93 | $5,247.90 | $4,103.86–$5,247.90 | — | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD | $158.62 | $226.60 | $177.20–$215.27 | 73% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SURGN I & D ABSCESS SGL SIMP | $150.15 | $200.20 | $190.19–$200.20 | 61% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 PRO FEE I AND D ABCESS OF SKIN | $215.03 | $286.71 | $272.37–$286.71 | 44% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SKIN ABSCESS SIMPLE SINGLE | $227.39 | $324.84 | $254.02–$324.84 | 41% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SGL SIMP | $431.25 | $575.00 | $449.65–$575.00 | 11% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 FAC I&D ABSCESS SGL SIMP | $431.25 | $575.00 | $449.65–$575.00 | 11% above | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 SURGN I & D ABSCESS SGL SIMP | $150.15 | $200.20 | $190.19–$200.20 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PRO FEE I AND D ABCESS OF SKIN | $215.03 | $286.71 | $272.37–$286.71 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 FAC I&D ABSCESS SGL SIMP | $431.25 | $575.00 | $449.65–$575.00 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SGL SIMP | $431.25 | $575.00 | $449.65–$575.00 | — | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 SURGN REPAIR INIT ING HERNIA > | $571.66 | $762.21 | $724.10–$762.21 | 96% below | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INIT ING HERNIA >5YRS | $4,913.77 | $6,551.69 | $5,123.42–$6,551.69 | 65% below | 25% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 SURGN REPAIR INIT ING HERNIA > | $571.66 | $762.21 | $724.10–$762.21 | — | 25% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INIT ING HERNIA >5YRS | $4,913.77 | $6,551.69 | $5,123.42–$6,551.69 | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH | $227.30 | $324.71 | $253.92–$324.71 | 38% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 P ARTHRO/ASP/INJ MJR JT-W/O US | $46.92 | $67.03 | $63.68–$67.03 | 88% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PHYS FEE ARTHROCENTESIS MAJOR | $86.80 | $124.00 | $117.80–$124.00 | 77% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PRO FEE ARTHROCENTESIS MAJOR | $93.00 | $124.00 | $117.80–$124.00 | 75% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT | $227.30 | $324.71 | $253.92–$324.71 | 40% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FAC ARTHROCENTESIS MAJOR | $465.26 | $620.34 | $485.11–$620.34 | 23% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 F ARTHRO/ASP/INJ MJR JT-W/O US | $480.38 | $640.50 | $500.87–$640.50 | 27% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 P ARTHRO/ASP/INJ MJR JT-W/O US | $46.92 | $67.03 | $63.68–$67.03 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PHYS FEE ARTHROCENTESIS MAJOR | $86.80 | $124.00 | $117.80–$124.00 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PRO FEE ARTHROCENTESIS MAJOR | $93.00 | $124.00 | $117.80–$124.00 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 FAC ARTHROCENTESIS MAJOR | $465.26 | $620.34 | $485.11–$620.34 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 F ARTHRO/ASP/INJ MJR JT-W/O US | $480.38 | $640.50 | $500.87–$640.50 | — | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT NONBIODEGR DRUG IMPLANT | $200.27 | $286.10 | $223.73–$286.10 | 65% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 P ARTHRO/ASP/INJ MED JT-W/O US | $41.15 | $58.78 | $55.84–$58.78 | 90% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PHY FEE ARTHROCENTESIS INTERM | $140.51 | $187.35 | $177.98–$187.35 | 67% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PRO FEE REMOVAL CYST INTER JOI | $140.51 | $187.35 | $177.98–$187.35 | 67% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMEDI JOINT | $227.30 | $324.71 | $253.92–$324.71 | 46% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 FAC ARTHRCEN/ASP/INJ ITRMD JOI | $436.77 | $582.36 | $455.41–$582.36 | 4% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 F ARTHRO/ASP/INJ MED JT-W/O US | $480.38 | $640.50 | $500.87–$640.50 | 14% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 P ARTHRO/ASP/INJ MED JT-W/O US | $41.15 | $58.78 | $55.84–$58.78 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PHY FEE ARTHROCENTESIS INTERM | $140.51 | $187.35 | $177.98–$187.35 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PRO FEE REMOVAL CYST INTER JOI | $140.51 | $187.35 | $177.98–$187.35 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 FAC ARTHRCEN/ASP/INJ ITRMD JOI | $436.77 | $582.36 | $455.41–$582.36 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 F ARTHRO/ASP/INJ MED JT-W/O US | $480.38 | $640.50 | $500.87–$640.50 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 P ARTHRO/ASP/INJ SM JT-W/O US | $40.19 | $57.41 | $54.54–$57.41 | 89% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 PRO FEE ARTHROCENTESIS SMALL | $134.14 | $178.85 | $169.91–$178.85 | 63% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT | $227.30 | $324.71 | $253.92–$324.71 | 38% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 F ARTHRO/ASP/INJ SM JT-W/O US | $507.21 | $724.58 | $566.62–$724.58 | 38% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 P ARTHRO/ASP/INJ SM JT-W/O US | $40.19 | $57.41 | $54.54–$57.41 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PRO FEE ARTHROCENTESIS SMALL | $134.14 | $178.85 | $169.91–$178.85 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 F ARTHRO/ASP/INJ SM JT-W/O US | $507.21 | $724.58 | $566.62–$724.58 | — | 30% |
| Knee arthroscopy with meniscus trim CPT 29881 SURG ARTHROSCOPY KNEE W/MENISC | $1,090.50 | $1,454.00 | $1,381.30–$1,454.00 | 86% below | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MENISCECTOM | $4,733.11 | $6,310.81 | $4,935.05–$6,310.81 | 41% below | 25% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 SURG ARTHROSCOPY KNEE W/MENISC | $1,090.50 | $1,454.00 | $1,381.30–$1,454.00 | — | 25% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MENISCECTOM | $4,733.11 | $6,310.81 | $4,935.05–$6,310.81 | — | 25% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 SURGN ARTHRO MENISECTOMY MED/L | $889.04 | $1,185.38 | $1,126.11–$1,185.38 | 94% below | 25% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY MENISECTOMY MED/LA | $5,593.67 | $7,458.23 | $5,832.34–$7,458.23 | 62% below | 25% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 SURGN ARTHRO MENISECTOMY MED/L | $889.04 | $1,185.38 | $1,126.11–$1,185.38 | — | 25% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY MENISECTOMY MED/LA | $5,593.67 | $7,458.23 | $5,832.34–$7,458.23 | — | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 SURGN ARTHRO DX KNEE CHONDROPL | $889.04 | $1,185.38 | $1,126.11–$1,185.38 | 94% below | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCOPY DX KNEE CHONDROPLA | $5,593.67 | $7,458.23 | $5,832.34–$7,458.23 | 65% below | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 SURGN ARTHRO DX KNEE CHONDROPL | $889.04 | $1,185.38 | $1,126.11–$1,185.38 | — | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPY DX KNEE CHONDROPLA | $5,593.67 | $7,458.23 | $5,832.34–$7,458.23 | — | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 SURGN LAP APPENDECTOMY | $718.43 | $957.90 | $910.00–$957.90 | 96% below | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY | $5,555.65 | $7,407.53 | $5,792.69–$7,407.53 | 68% below | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 SURGN LAP APPENDECTOMY | $718.43 | $957.90 | $910.00–$957.90 | — | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY | $5,555.65 | $7,407.53 | $5,792.69–$7,407.53 | — | 25% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 SURGN LAP REPAIR INITIAL ING H | $534.00 | $712.00 | $676.40–$712.00 | 96% below | 25% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP REPAIR INITIAL INGL HERNIA | $8,625.00 | $11,500.00 | $8,993.00–$11,500.00 | 37% below | 25% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 SURGN LAP REPAIR INITIAL ING H | $534.00 | $712.00 | $676.40–$712.00 | — | 25% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP REPAIR INITIAL INGL HERNIA | $8,625.00 | $11,500.00 | $8,993.00–$11,500.00 | — | 25% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 SURGN LAP REPAIR RECUR ING HER | $706.80 | $942.40 | $895.28–$942.40 | 95% below | 25% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP REPAIR RECUR INGL HERNIA | $9,159.37 | $12,212.49 | $9,550.17–$12,212.49 | 37% below | 25% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 SURGN LAP REPAIR RECUR ING HER | $706.80 | $942.40 | $895.28–$942.40 | — | 25% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP REPAIR RECUR INGL HERNIA | $9,159.37 | $12,212.49 | $9,550.17–$12,212.49 | — | 25% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 SURGN LAP PART/TOTAL OOPH AND/ | $1,180.88 | $1,574.50 | $1,495.78–$1,574.50 | 95% below | 25% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP PART/TOTAL OOPH AND/OR SAL | $9,219.11 | $12,292.14 | $9,612.45–$12,292.14 | 58% below | 25% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 SURGN LAP PART/TOTAL OOPH AND/ | $1,180.88 | $1,574.50 | $1,495.78–$1,574.50 | — | 25% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP PART/TOTAL OOPH AND/OR SAL | $9,219.11 | $12,292.14 | $9,612.45–$12,292.14 | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 P LAYER SCALP 2.5CM OR LESS | $140.13 | $200.18 | $190.17–$200.18 | 73% below | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SURGN RPR INT WOUND SCLP/TRNK/ | $185.15 | $264.50 | $251.28–$264.50 | 64% below | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPR IN WOUND DSCALP 2.5C | $360.58 | $515.12 | $402.82–$515.12 | 30% below | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 FAC RPR INT WOUND SCLP/TRNK/EX | $503.93 | $671.90 | $525.43–$671.90 | 3% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 F LAYER SCALP 2.5CM OR LESS | $553.23 | $737.64 | $576.83–$737.64 | 7% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PRO FEE LAYER CLOSE SCAL | $568.31 | $757.75 | $719.86–$757.75 | 10% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 P LAYER SCALP 2.5CM OR LESS | $140.13 | $200.18 | $190.17–$200.18 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 SURGN RPR INT WOUND SCLP/TRNK/ | $185.15 | $264.50 | $251.28–$264.50 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 FAC RPR INT WOUND SCLP/TRNK/EX | $503.93 | $671.90 | $525.43–$671.90 | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 F LAYER SCALP 2.5CM OR LESS | $553.23 | $737.64 | $576.83–$737.64 | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PRO FEE LAYER CLOSE SCAL | $568.31 | $757.75 | $719.86–$757.75 | — | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 AA INJ DX/TX LUMBAR SAC W IM | $175.58 | $234.10 | $222.40–$234.10 | 90% below | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 AA INJ DX/TX LUMBAR SAC W IM | $175.58 | $234.10 | $222.40–$234.10 | — | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 SURGN EXC BEN LES TNK EXTRM 0. | $124.32 | $165.76 | $157.47–$165.76 | 78% below | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENGN LESION TRUNK 0.5CM | $541.77 | $773.95 | $605.23–$773.95 | 4% below | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES TNK EXTRM 0.5 CM | $862.50 | $1,150.00 | $899.30–$1,150.00 | 54% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 SURGN EXC BEN LES TNK EXTRM 0. | $124.32 | $165.76 | $157.47–$165.76 | — | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LES TNK EXTRM 0.5 CM | $862.50 | $1,150.00 | $899.30–$1,150.00 | — | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 SURGN EXC BEN LES FACE 0.5CM | $158.03 | $210.70 | $200.16–$210.70 | 86% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PHY FEE EXC BENIGN LES-FACE-.5 | $385.24 | $513.65 | $487.97–$513.65 | 66% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENGN LESION FACE 0.5CM | $541.77 | $773.95 | $605.23–$773.95 | 53% below | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES FACE 0.5 CM | $862.50 | $1,150.00 | $899.30–$1,150.00 | 25% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 SURGN EXC BEN LES FACE 0.5CM | $158.03 | $210.70 | $200.16–$210.70 | — | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 PHY FEE EXC BENIGN LES-FACE-.5 | $385.24 | $513.65 | $487.97–$513.65 | — | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES FACE 0.5 CM | $862.50 | $1,150.00 | $899.30–$1,150.00 | — | 25% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE | $153.00 | $218.57 | $170.92–$218.57 | 28% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 PHY FEE AVULSION NAIL PLATE | $192.98 | $257.30 | $244.44–$257.30 | 9% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 SURGN AVULSION NAIL PLATE PART | $192.98 | $257.30 | $244.44–$257.30 | 9% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE PART/CO | $197.93 | $263.90 | $206.37–$263.90 | 7% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 FAC AVULSION OF NAIL PART/COMP | $197.93 | $263.90 | $206.37–$263.90 | 7% below | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 PHY FEE AVULSION NAIL PLATE | $192.98 | $257.30 | $244.44–$257.30 | — | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 SURGN AVULSION NAIL PLATE PART | $192.98 | $257.30 | $244.44–$257.30 | — | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE PART/CO | $197.93 | $263.90 | $206.37–$263.90 | — | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 FAC AVULSION OF NAIL PART/COMP | $197.93 | $263.90 | $206.37–$263.90 | — | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ NERVE BLK GTR OCCIPITAL | $227.30 | $324.71 | $253.92–$324.71 | 60% below | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 P INJ(S) GTR OCCIPITAL NERVE | $755.84 | $1,007.79 | $788.09–$1,007.79 | 34% above | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 P INJ(S) GTR OCCIPITAL NERVE | $755.84 | $1,007.79 | $788.09–$1,007.79 | — | 25% |
| Paracentesis with imaging guidance CPT 49083 SURGN ABDMNL PARACENTESIS W IM | $172.64 | $230.18 | $218.67–$230.18 | 85% below | 25% |
| Paracentesis with imaging guidance CPT 49083 PF ABD PARACENTESIS W/IMAGE GU | $177.24 | $253.20 | $240.54–$253.20 | 85% below | 30% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGE GUIDE PUR | $777.70 | $1,111.00 | $868.80–$1,111.00 | 33% below | 30% |
| Paracentesis with imaging guidance CPT 49083 ABDMNL PARACENTESIS W IMAGE GU | $1,207.08 | $1,609.44 | $1,258.58–$1,609.44 | 4% above | 25% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS WITH IMAGE GUIDE | $1,207.08 | $1,609.44 | $1,258.58–$1,609.44 | 4% above | 25% |
| Paracentesis with imaging guidance CPT 49083 F ABD PARACENTESIS W/ IMAGE | $1,239.27 | $1,770.38 | $1,384.44–$1,770.38 | 7% above | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 SURGN ABDMNL PARACENTESIS W IM | $172.64 | $230.18 | $218.67–$230.18 | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 PF ABD PARACENTESIS W/IMAGE GU | $177.24 | $253.20 | $240.54–$253.20 | — | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGE GUIDE PUR | $777.70 | $1,111.00 | $868.80–$1,111.00 | — | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS WITH IMAGE GUIDE | $1,207.08 | $1,609.44 | $1,258.58–$1,609.44 | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDMNL PARACENTESIS W IMAGE GU | $1,207.08 | $1,609.44 | $1,258.58–$1,609.44 | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 F ABD PARACENTESIS W/ IMAGE | $1,239.27 | $1,770.38 | $1,384.44–$1,770.38 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PRO FEE EXCISION OF NAIL PART | $317.50 | $423.33 | $402.16–$423.33 | 42% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL NAIL MATRIX FOR REMOV | $413.28 | $590.40 | $461.69–$590.40 | 25% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 SURGN EXCISION OF NAIL PARTIAL | $520.88 | $694.50 | $659.78–$694.50 | 5% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 FAC EXCISION OF NAIL PARTIAL/C | $719.40 | $959.20 | $750.09–$959.20 | 31% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL PARTIAL/COMPL | $2,590.12 | $3,453.49 | $2,000.72–$3,280.82 | 371% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PRO FEE EXCISION OF NAIL PART | $317.50 | $423.33 | $402.16–$423.33 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 SURGN EXCISION OF NAIL PARTIAL | $520.88 | $694.50 | $659.78–$694.50 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 FAC EXCISION OF NAIL PARTIAL/C | $719.40 | $959.20 | $750.09–$959.20 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL PARTIAL/COMPL | $2,590.12 | $3,453.49 | $2,000.72–$3,280.82 | — | 25% |
| Removal of a breast lump, open surgery CPT 19120 SURGN EXCISION CYST/BENIGN TUM | $456.19 | $608.25 | $577.84–$608.25 | 91% below | 25% |
| Removal of a breast lump, open surgery inpatient CPT 19120 SURGN EXCISION CYST/BENIGN TUM | $456.19 | $608.25 | $577.84–$608.25 | — | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 P INCIS REM F/B | $98.55 | $140.78 | $133.74–$140.78 | 82% below | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 SURGN INCIS REMOVE FB SUBQ SIM | $147.56 | $210.80 | $200.26–$210.80 | 74% below | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 PHY FEE INCIS REM FORIEGN BODY | $158.10 | $210.80 | $200.26–$210.80 | 72% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 INCIS REMOV FB SKIN SIMPLE | $307.64 | $439.48 | $343.67–$439.48 | 45% below | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 FAC INCIS REMOV FB SUBQ SIMP | $431.25 | $575.00 | $449.65–$575.00 | 23% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 F INCIS REM F/B | $455.33 | $607.10 | $474.75–$607.10 | 19% below | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 P INCIS REM F/B | $98.55 | $140.78 | $133.74–$140.78 | — | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 SURGN INCIS REMOVE FB SUBQ SIM | $147.56 | $210.80 | $200.26–$210.80 | — | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 PHY FEE INCIS REM FORIEGN BODY | $158.10 | $210.80 | $200.26–$210.80 | — | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 FAC INCIS REMOV FB SUBQ SIMP | $431.25 | $575.00 | $449.65–$575.00 | — | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 F INCIS REM F/B | $455.33 | $607.10 | $474.75–$607.10 | — | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SURGN COLONOSCOPY MEDICARE SCR | $339.28 | $484.69 | $460.46–$484.69 | 89% below | 30% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY MEDICARE SCREENING | $1,721.39 | $2,295.18 | $1,794.83–$2,295.18 | 45% below | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCREENING MEDICA | $1,721.39 | $2,295.18 | $1,794.83–$2,295.18 | 45% below | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SURGN COLONOSCOPY MEDICARE SCR | $339.28 | $484.69 | $460.46–$484.69 | — | 30% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY MEDICARE SCREENING | $1,721.39 | $2,295.18 | $1,794.83–$2,295.18 | — | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY SCREENING MEDICA | $1,721.39 | $2,295.18 | $1,794.83–$2,295.18 | — | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SURGN COLORECTAL SCREEN MEDICA | $480.47 | $640.63 | $608.60–$640.63 | 83% below | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREENING MEDICARE | $2,011.50 | $2,682.00 | $2,097.32–$2,682.00 | 31% below | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SURGN COLORECTAL SCREEN MEDICA | $480.47 | $640.63 | $608.60–$640.63 | — | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREENING MEDICARE | $2,011.50 | $2,682.00 | $2,097.32–$2,682.00 | — | 25% |
| Short arm cast (elbow to hand) CPT 29075 P APPLI CAST SHORT ARM | $57.97 | $82.82 | $78.68–$82.82 | 79% below | 30% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION SHORT ARM CAST | $204.50 | $292.14 | $228.45–$292.14 | 25% below | 30% |
| Short arm cast (elbow to hand) CPT 29075 PRO FEE CAST SHORT ARM ELBOW-F | $232.88 | $310.50 | $294.98–$310.50 | 15% below | 25% |
| Short arm cast (elbow to hand) CPT 29075 F APPLI CAST SHORT ARM | $396.14 | $528.18 | $413.04–$528.18 | 45% above | 25% |
| Short arm cast (elbow to hand) inpatient CPT 29075 P APPLI CAST SHORT ARM | $57.97 | $82.82 | $78.68–$82.82 | — | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 PRO FEE CAST SHORT ARM ELBOW-F | $232.88 | $310.50 | $294.98–$310.50 | — | 25% |
| Short arm cast (elbow to hand) inpatient CPT 29075 F APPLI CAST SHORT ARM | $396.14 | $528.18 | $413.04–$528.18 | — | 25% |
| Short arm splint (forearm and hand) CPT 29125 P APPLI SHORT ARM SPLINT STAT | $37.48 | $53.54 | $50.86–$53.54 | 85% below | 30% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC | $99.25 | $141.79 | $110.88–$141.79 | 59% below | 30% |
| Short arm splint (forearm and hand) CPT 29125 PRO FEE APP SHRT ARM SPLNT 4AR | $182.10 | $242.80 | $230.66–$242.80 | 25% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 FAC APP SHRT ARM SPLNT 4ARM O | $360.00 | $480.00 | $375.36–$480.00 | 48% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 F APPLI SHORT ARM SPLINT STAT | $396.14 | $528.18 | $413.04–$528.18 | 63% above | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 P APPLI SHORT ARM SPLINT STAT | $37.48 | $53.54 | $50.86–$53.54 | — | 30% |
| Short arm splint (forearm and hand) inpatient CPT 29125 PRO FEE APP SHRT ARM SPLNT 4AR | $182.10 | $242.80 | $230.66–$242.80 | — | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 FAC APP SHRT ARM SPLNT 4ARM O | $360.00 | $480.00 | $375.36–$480.00 | — | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 F APPLI SHORT ARM SPLINT STAT | $396.14 | $528.18 | $413.04–$528.18 | — | 25% |
| Short leg cast (below the knee) CPT 29405 P APPLI SHORT LEG CAST | $56.79 | $81.13 | $77.07–$81.13 | 82% below | 30% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST | $204.50 | $292.14 | $228.45–$292.14 | 36% below | 30% |
| Short leg cast (below the knee) CPT 29405 F APPLI SHORT LEG CAST | $396.14 | $528.18 | $413.04–$528.18 | 25% above | 25% |
| Short leg cast (below the knee) inpatient CPT 29405 P APPLI SHORT LEG CAST | $56.79 | $81.13 | $77.07–$81.13 | — | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 F APPLI SHORT LEG CAST | $396.14 | $528.18 | $413.04–$528.18 | — | 25% |
| Short leg splint (calf to foot) CPT 29515 APPL SHORT LEG SPLINT | $121.50 | $173.57 | $135.73–$173.57 | 45% below | 30% |
| Short leg splint (calf to foot) CPT 29515 P APP SHORT LEG SPLINT | $140.29 | $200.42 | $190.40–$200.42 | 36% below | 30% |
| Short leg splint (calf to foot) CPT 29515 PRO FEE APPLY SHORT LEG SPLINT | $187.50 | $250.00 | $237.50–$250.00 | 15% below | 25% |
| Short leg splint (calf to foot) CPT 29515 OT APL MULT LAYER COMP THI/LEG | $187.50 | $250.00 | $195.50–$250.00 | 15% below | 25% |
| Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT ADULT | $224.73 | $321.04 | $251.05–$321.04 | 2% above | 30% |
| Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT PED | $224.73 | $321.04 | $251.05–$321.04 | 2% above | 30% |
| Short leg splint (calf to foot) CPT 29515 FAC APPLY SHORT LEG SPLINT | $225.47 | $300.63 | $235.09–$300.63 | 2% above | 25% |
| Short leg splint (calf to foot) CPT 29515 F APP SHORT LEG SPLINT | $248.16 | $330.88 | $258.75–$330.88 | 13% above | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 P APP SHORT LEG SPLINT | $140.29 | $200.42 | $190.40–$200.42 | — | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 OT APL MULT LAYER COMP THI/LEG | $187.50 | $250.00 | $195.50–$250.00 | — | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 PRO FEE APPLY SHORT LEG SPLINT | $187.50 | $250.00 | $237.50–$250.00 | — | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT ADULT | $224.73 | $321.04 | $251.05–$321.04 | — | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT PED | $224.73 | $321.04 | $251.05–$321.04 | — | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 FAC APPLY SHORT LEG SPLINT | $225.47 | $300.63 | $235.09–$300.63 | — | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 F APP SHORT LEG SPLINT | $248.16 | $330.88 | $258.75–$330.88 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 P SMP RPR 2.5 CM OR LESS | $106.36 | $151.94 | $144.34–$151.94 | 71% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REPAR WOUND, SCALP 2.5CM< | $153.00 | $218.57 | $170.92–$218.57 | 58% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PRO FEE LAC TO 2.5 CM SIMPLE | $168.56 | $224.75 | $213.51–$224.75 | 54% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 FAC RPR SMPL 2.5 CM OR LESS | $503.01 | $670.68 | $524.47–$670.68 | 39% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 F SMP RPR 2.5 CM OR LESS | $553.23 | $737.64 | $576.83–$737.64 | 52% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 P SMP RPR 2.5 CM OR LESS | $106.36 | $151.94 | $144.34–$151.94 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PRO FEE LAC TO 2.5 CM SIMPLE | $168.56 | $224.75 | $213.51–$224.75 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 FAC RPR SMPL 2.5 CM OR LESS | $503.01 | $670.68 | $524.47–$670.68 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 F SMP RPR 2.5 CM OR LESS | $553.23 | $737.64 | $576.83–$737.64 | — | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PHY FEE BIOPSY OF SKIN PUNCH | $182.18 | $242.90 | $230.76–$242.90 | 41% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 SURGN PNCH BX SKIN INC SMPL CL | $182.18 | $242.90 | $230.76–$242.90 | 41% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 BIOPSY PUNCH SKIN | $307.64 | $439.48 | $343.67–$439.48 | 1% below | 30% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN INC SMPL CLOSR S | $388.50 | $518.00 | $405.08–$518.00 | 25% above | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PHY FEE BIOPSY OF SKIN PUNCH | $182.18 | $242.90 | $230.76–$242.90 | — | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 SURGN PNCH BX SKIN INC SMPL CL | $182.18 | $242.90 | $230.76–$242.90 | — | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN INC SMPL CLOSR S | $388.50 | $518.00 | $405.08–$518.00 | — | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MALIGN LESION TRUNK 0.5CM | $541.77 | $773.95 | $605.23–$773.95 | 52% below | 30% |
| Skin tag removal, up to 15 tags CPT 11200 SURGN SKIN TAG REMVAL 1 TO 15 | $112.14 | $149.52 | $142.04–$149.52 | 52% below | 25% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS 1-15 | $172.40 | $246.29 | $192.60–$246.29 | 27% below | 30% |
| Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REMOVAL 1 TO 15 LES | $381.66 | $508.88 | $397.94–$508.88 | 62% above | 25% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 SURGN SKIN TAG REMVAL 1 TO 15 | $112.14 | $149.52 | $142.04–$149.52 | — | 25% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REMOVAL 1 TO 15 LES | $381.66 | $508.88 | $397.94–$508.88 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 PHY FEE SPINAL TAP.LUMBAR | $296.55 | $395.40 | $375.63–$395.40 | 65% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT LUMBAR DIAG | $533.24 | $761.77 | $595.70–$761.77 | 38% below | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 P SPINAL PUNCTURE LUMBAR DIAG | $682.99 | $910.65 | $712.13–$910.65 | 21% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 FAC LUMBAR PUNCTURE | $796.48 | $1,061.97 | $830.46–$1,061.97 | 7% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 F SPINAL PUNCTURE LUMBAR DIAG | $1,808.26 | $2,583.23 | $2,020.09–$2,583.23 | 110% above | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PHY FEE SPINAL TAP.LUMBAR | $296.55 | $395.40 | $375.63–$395.40 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 P SPINAL PUNCTURE LUMBAR DIAG | $682.99 | $910.65 | $712.13–$910.65 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 FAC LUMBAR PUNCTURE | $796.48 | $1,061.97 | $830.46–$1,061.97 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 F SPINAL PUNCTURE LUMBAR DIAG | $1,808.26 | $2,583.23 | $2,020.09–$2,583.23 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 P SIMP RPR 2.6 cm - 7.5 cm | $119.35 | $170.50 | $161.98–$170.50 | 72% below | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP REPAR WOUND SCLP2.6-7.5CM | $153.00 | $218.57 | $170.92–$218.57 | 64% below | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PRO FEE SUTURE OF SKIN SIMPLE | $228.66 | $304.88 | $289.64–$304.88 | 46% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 FAC SIMP RPR 2.6 cm - 7.5 cm | $503.01 | $670.68 | $524.47–$670.68 | 19% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 F SIMP RPR 2.6 cm - 7.5 cm | $553.23 | $737.64 | $576.83–$737.64 | 31% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 P SIMP RPR 2.6 cm - 7.5 cm | $119.35 | $170.50 | $161.98–$170.50 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PRO FEE SUTURE OF SKIN SIMPLE | $228.66 | $304.88 | $289.64–$304.88 | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 FAC SIMP RPR 2.6 cm - 7.5 cm | $503.01 | $670.68 | $524.47–$670.68 | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 F SIMP RPR 2.6 cm - 7.5 cm | $553.23 | $737.64 | $576.83–$737.64 | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 P RPR SIMP FACE 2.5CM OR LESS | $113.10 | $161.57 | $153.49–$161.57 | 70% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP REPR WOUND FACE 2.5CMOR < | $153.00 | $218.57 | $170.92–$218.57 | 59% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PRO FEE REPR SIMPLE SUPR WOUND | $209.96 | $279.95 | $265.95–$279.95 | 44% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 FAC REPR SIMPLE SUPR WOUND 2. | $503.01 | $670.68 | $524.47–$670.68 | 33% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 F RPR SIMP FACE 2.5CM OR LESS | $553.23 | $737.64 | $576.83–$737.64 | 47% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 P RPR SIMP FACE 2.5CM OR LESS | $113.10 | $161.57 | $153.49–$161.57 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PRO FEE REPR SIMPLE SUPR WOUND | $209.96 | $279.95 | $265.95–$279.95 | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 FAC REPR SIMPLE SUPR WOUND 2. | $503.01 | $670.68 | $524.47–$670.68 | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 F RPR SIMP FACE 2.5CM OR LESS | $553.23 | $737.64 | $576.83–$737.64 | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 SURGN TANGENTIAL BX SKIN SNGL | $60.89 | $81.18 | $77.12–$81.18 | 69% below | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN TANGENTIAL | $153.00 | $218.57 | $170.92–$218.57 | 23% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BX SKIN SINGLE LESI | $202.69 | $270.25 | $211.34–$270.25 | 2% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 SURGN TANGENTIAL BX SKIN SNGL | $60.89 | $81.18 | $77.12–$81.18 | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BX SKIN SINGLE LESI | $202.69 | $270.25 | $211.34–$270.25 | — | 25% |
| Thoracentesis with imaging guidance CPT 32555 SURGN THORACENTESIS ASPIR W/ | $241.88 | $322.50 | $306.38–$322.50 | 82% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 PHY FEE THORACENTESIS W IMAGE | $241.88 | $322.50 | $306.38–$322.50 | 82% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH ASP | $1,113.44 | $1,484.59 | $1,160.95–$1,484.59 | 16% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WITH IMAGE GUIDE | $1,113.44 | $1,484.59 | $1,160.95–$1,484.59 | 16% below | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 SURGN THORACENTESIS ASPIR W/ | $241.88 | $322.50 | $306.38–$322.50 | — | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 PHY FEE THORACENTESIS W IMAGE | $241.88 | $322.50 | $306.38–$322.50 | — | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH ASP | $1,113.44 | $1,484.59 | $1,160.95–$1,484.59 | — | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WITH IMAGE GUIDE | $1,113.44 | $1,484.59 | $1,160.95–$1,484.59 | — | 25% |
| Trigger finger release surgery CPT 26055 SURGN TENDON SHEATH INCISION | $495.00 | $660.00 | $627.00–$660.00 | 84% below | 25% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION | $2,280.00 | $3,040.00 | $2,377.28–$3,040.00 | 28% below | 25% |
| Trigger finger release surgery inpatient CPT 26055 SURGN TENDON SHEATH INCISION | $495.00 | $660.00 | $627.00–$660.00 | — | 25% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION | $2,280.00 | $3,040.00 | $2,377.28–$3,040.00 | — | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 PRO FEE INJECTION TRIGGER POIN | $143.36 | $191.15 | $181.59–$191.15 | 61% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGR PNT | $227.30 | $324.71 | $253.92–$324.71 | 38% below | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 FAC INJECTION TRIGGER POINT 1 | $436.77 | $582.36 | $455.41–$582.36 | 19% above | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PRO FEE INJECTION TRIGGER POIN | $143.36 | $191.15 | $181.59–$191.15 | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 FAC INJECTION TRIGGER POINT 1 | $436.77 | $582.36 | $455.41–$582.36 | — | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 SURGN EGD W/BALLOON DILATION | $264.00 | $352.00 | $334.40–$352.00 | 90% below | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALLOON DIALATION | $1,566.36 | $2,088.48 | $1,633.19–$2,088.48 | 43% below | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 SURGN EGD W/BALLOON DILATION | $264.00 | $352.00 | $334.40–$352.00 | — | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALLOON DIALATION | $1,566.36 | $2,088.48 | $1,633.19–$2,088.48 | — | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 SURGN FLEX TRANSORAL W BX SNGL | $230.29 | $328.99 | $312.54–$328.99 | 84% below | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 PF EGD FLX TRANSORAL W BX SNGL | $246.74 | $328.99 | $312.54–$328.99 | 83% below | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD FLEX TRANSORAL W BX SNGL | $1,566.36 | $2,088.48 | $1,633.19–$2,088.48 | 6% above | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 SURGN FLEX TRANSORAL W BX SNGL | $230.29 | $328.99 | $312.54–$328.99 | — | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PF EGD FLX TRANSORAL W BX SNGL | $246.74 | $328.99 | $312.54–$328.99 | — | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD FLEX TRANSORAL W BX SNGL | $1,566.36 | $2,088.48 | $1,633.19–$2,088.48 | — | 25% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 SURGN EGD FLEX/TRANS DX W RMV | $328.79 | $438.38 | $416.46–$438.38 | 91% below | 25% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD FLEX/TRANS DX W RMVL SNAR | $1,377.36 | $1,836.48 | $1,436.13–$1,836.48 | 63% below | 25% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 SURGN EGD FLEX/TRANS DX W RMV | $328.79 | $438.38 | $416.46–$438.38 | — | 25% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD FLEX/TRANS DX W RMVL SNAR | $1,377.36 | $1,836.48 | $1,436.13–$1,836.48 | — | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 SURGN ESOPHGSTRDUODSCPY FLEX T | $219.42 | $292.56 | $277.93–$292.56 | 85% below | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHGSTRDUODSCPY FLEX TRANS D | $1,713.14 | $2,284.18 | $1,786.23–$2,284.18 | 15% above | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 SURGN ESOPHGSTRDUODSCPY FLEX T | $219.42 | $292.56 | $277.93–$292.56 | — | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHGSTRDUODSCPY FLEX TRANS D | $1,713.14 | $2,284.18 | $1,786.23–$2,284.18 | — | 25% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOM UNI OR BI SEPRTE PROC | $1,577.35 | $2,253.36 | $1,762.13–$2,253.36 | — | 30% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 SUR VASECTOMY | $210.66 | $300.94 | $285.89–$300.94 | 77% below | 30% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY | $4,267.98 | $6,097.11 | $4,767.94–$6,097.11 | 375% above | 30% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 SUR VASECTOMY | $210.66 | $300.94 | $285.89–$300.94 | — | 30% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY | $4,267.98 | $6,097.11 | $4,767.94–$6,097.11 | — | 30% |
| Wart removal, up to 14 warts CPT 17110 PRO FEE DESTRUCT UP TO 14 BENI | $87.80 | $117.06 | $111.21–$117.06 | 36% below | 25% |
| Wart removal, up to 14 warts CPT 17110 FAC DESTRUCT UP TO 14 BENIGN L | $146.25 | $195.00 | $152.49–$195.00 | 7% above | 25% |
| Wart removal, up to 14 warts CPT 17110 DEST BGN LESIONS NO SKIN TAG | $162.69 | $232.42 | $181.75–$232.42 | 19% above | 30% |
| Wart removal, up to 14 warts inpatient CPT 17110 PRO FEE DESTRUCT UP TO 14 BENI | $87.80 | $117.06 | $111.21–$117.06 | — | 25% |
| Wart removal, up to 14 warts inpatient CPT 17110 FAC DESTRUCT UP TO 14 BENIGN L | $146.25 | $195.00 | $152.49–$195.00 | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PRO FEE DEBRIDE SKIN FULL THIC | $238.09 | $317.45 | $301.58–$317.45 | 52% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 SURGN DEBRIDE SKIN FULL THICKN | $238.09 | $317.45 | $301.58–$317.45 | 52% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKI SUBCUTISSUE | $307.64 | $439.48 | $343.67–$439.48 | 38% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 FAC DEBRIDE SKIN FULL THICKNES | $732.75 | $977.00 | $764.01–$977.00 | 48% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN FULL THICKNESS | $732.75 | $977.00 | $764.01–$977.00 | 48% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PRO FEE DEBRIDE SKIN FULL THIC | $238.09 | $317.45 | $301.58–$317.45 | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 SURGN DEBRIDE SKIN FULL THICKN | $238.09 | $317.45 | $301.58–$317.45 | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN FULL THICKNESS | $732.75 | $977.00 | $764.01–$977.00 | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 FAC DEBRIDE SKIN FULL THICKNES | $732.75 | $977.00 | $764.01–$977.00 | — | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN or MONITOR | $1,170.74 | $1,560.98 | $1,220.69–$1,560.98 | 20% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMINISTRATION | $1,201.96 | $1,717.08 | $1,342.76–$1,717.08 | 23% above | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN or MONITOR | $1,170.74 | $1,560.98 | $1,220.69–$1,560.98 | — | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMINISTRATION | $1,201.96 | $1,717.08 | $1,342.76–$1,717.08 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT ADDITIONAL | $144.00 | $192.00 | $150.14–$192.00 | 9% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TX - INITIAL | $144.00 | $192.00 | $150.14–$192.00 | 9% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT | $144.00 | $192.00 | $150.14–$192.00 | 9% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NONPRESSURIZED INHALATION TRX | $156.61 | $223.73 | $174.96–$223.73 | 1% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT | $144.00 | $192.00 | $150.14–$192.00 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TX - INITIAL | $144.00 | $192.00 | $150.14–$192.00 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT ADDITIONAL | $144.00 | $192.00 | $150.14–$192.00 | — | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 PHY FEE CRITICAL CARE | $703.88 | $938.50 | $891.58–$938.50 | 72% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 EMERG DEPT LEVEL 6 CRITICAL | $1,471.47 | $1,961.96 | $1,534.25–$1,961.96 | 42% below | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 PHY FEE CRITICAL CARE | $703.88 | $938.50 | $891.58–$938.50 | — | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERG DEPT LEVEL 6 CRITICAL | $1,471.47 | $1,961.96 | $1,534.25–$1,961.96 | — | 25% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 12 LEAD EKG TRACING AND INTERP | $84.70 | $121.00 | $15.01–$114.95 | 13% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $87.15 | $116.20 | $90.87–$116.20 | 58% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY | $87.15 | $116.20 | $90.87–$116.20 | — | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PRO FEE ROUTINE | $78.08 | $104.10 | $98.90–$104.10 | 60% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERG DEPT LEVEL 1 | $128.97 | $171.96 | $134.47–$171.96 | 35% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PRO FEE ROUTINE | $78.08 | $104.10 | $98.90–$104.10 | — | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERG DEPT LEVEL 1 | $128.97 | $171.96 | $134.47–$171.96 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PRO LOW COMPLEXITY | $157.79 | $210.38 | $199.86–$210.38 | 58% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERG DEPT LEVEL 2 | $233.69 | $311.58 | $243.66–$311.58 | 38% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PRO LOW COMPLEXITY | $157.79 | $210.38 | $199.86–$210.38 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERG DEPT LEVEL 2 | $233.69 | $311.58 | $243.66–$311.58 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PRO LOW TO MODERATE COMPLEX | $235.50 | $314.00 | $298.30–$314.00 | 59% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERG DEPT LEVEL 3 | $385.69 | $514.25 | $402.14–$514.25 | 32% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PRO LOW TO MODERATE COMPLEX | $235.50 | $314.00 | $298.30–$314.00 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERG DEPT LEVEL 3 | $385.69 | $514.25 | $402.14–$514.25 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 SURGN IP CONSULT-MOD MDM | $427.74 | $570.32 | $541.80–$570.32 | 53% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PRO MODERATE COMPLEX | $448.71 | $598.28 | $568.37–$598.28 | 51% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERG DEPT LEVEL 4 | $680.81 | $907.75 | $709.86–$907.75 | 25% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 SURGN IP CONSULT-MOD MDM | $427.74 | $570.32 | $541.80–$570.32 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PRO MODERATE COMPLEX | $448.71 | $598.28 | $568.37–$598.28 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERG DEPT LEVEL 4 | $680.81 | $907.75 | $709.86–$907.75 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PRO FEE HIGH COMPLEX | $660.06 | $880.08 | $836.08–$880.08 | 59% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERG DEPT LEVEL 5 | $1,056.62 | $1,408.82 | $1,101.70–$1,408.82 | 34% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PRO FEE HIGH COMPLEX | $660.06 | $880.08 | $836.08–$880.08 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERG DEPT LEVEL 5 | $1,056.62 | $1,408.82 | $1,101.70–$1,408.82 | — | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 PSYCHOTHERAPY FAMILY w/PATIENT | $138.60 | $198.00 | $154.84–$198.00 | 40% below | 30% |
| Family therapy without the patient, 50 minutes CPT 90846 PSYCHOTHERAPY FAMILY | $138.60 | $198.00 | $154.84–$198.00 | 49% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL | $317.91 | $454.15 | $355.15–$454.15 | 5% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL | $317.91 | $454.15 | $355.15–$454.15 | — | 30% |
| IV infusion of a medicine, first hour CPT 96365 KETAMINE CHR PAIN INF ****ADDL | $187.50 | $250.00 | $195.50–$250.00 | 50% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 KETAMINE DEPRESSION INF / DAY | $281.25 | $375.00 | $293.25–$375.00 | 25% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 KETAMINE CHR PAIN INF ****1st | $281.25 | $375.00 | $293.25–$375.00 | 25% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 KETAMINE DEPRESS INF ****1ST | $288.75 | $412.50 | $322.58–$412.50 | 23% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY INIT-1HR | $388.44 | $554.91 | $433.94–$554.91 | 4% above | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 KETAMINE CHR PAIN INF ****ADDL | $187.50 | $250.00 | $195.50–$250.00 | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 KETAMINE CHR PAIN INF ****1st | $281.25 | $375.00 | $293.25–$375.00 | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 KETAMINE DEPRESSION INF / DAY | $281.25 | $375.00 | $293.25–$375.00 | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 KETAMINE DEPRESS INF ****1ST | $288.75 | $412.50 | $322.58–$412.50 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY INIT-1HR | $388.44 | $554.91 | $433.94–$554.91 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTOC DIAG | $54.80 | $78.29 | $74.38–$78.29 | 50% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PRO FEE SOFT TISSUE INJECTION | $92.33 | $123.10 | $116.94–$123.10 | 15% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION THER/PROP/DIAG I | $93.69 | $133.84 | $104.66–$133.84 | 14% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PRO FEE SOFT TISSUE INJECTION | $92.33 | $123.10 | $116.94–$123.10 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM INJECTION THER/PROP/DIAG I | $93.69 | $133.84 | $104.66–$133.84 | — | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DX EVALUATION | $196.35 | $280.50 | $219.35–$280.50 | 37% below | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DX EVALUATION | $196.35 | $280.50 | $219.35–$280.50 | 37% below | 30% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DX EVALUATION | $196.35 | $280.50 | $219.35–$280.50 | — | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED 15 MIN - PO | $93.10 | $133.00 | $32.37–$126.35 | 15% below | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE ED 15 MIN | $93.10 | $133.00 | $32.37–$126.35 | 15% below | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE ED 15 MIN | $93.10 | $133.00 | $32.37–$126.35 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE-ED 15 MIN - PO | $93.10 | $133.00 | $32.37–$126.35 | — | 30% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT-NEW PT LEVEL 3 H | $111.65 | $159.50 | $115.00–$151.52 | 40% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT NEW PT LEVEL 3 | $115.50 | $165.00 | $115.00–$156.75 | 38% below | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT-NEW PT LEVEL 3 H | $111.65 | $159.50 | $115.00–$151.52 | — | 30% |
| New patient office visit, about 45 minutes CPT 99204 KETAMINE CONSULTATION | $150.00 | $200.00 | $173.60–$190.00 | 5% below | 25% |
| New patient office visit, about 45 minutes CPT 99204 KETAMINE CONSULT-DEPRESS/PAIN | $154.00 | $220.00 | $173.60–$209.00 | 2% below | 30% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT NEW PT LEVEL 4 | $167.09 | $238.70 | $173.60–$226.76 | 6% above | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 KETAMINE CONSULTATION | $150.00 | $200.00 | $173.60–$190.00 | — | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 KETAMINE CONSULT-DEPRESS/PAIN | $154.00 | $220.00 | $173.60–$209.00 | — | 30% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT NEW P LEVEL 5 | $206.36 | $294.80 | $230.53–$280.06 | at median | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT NEW PT LEVEL 2 | $99.33 | $141.90 | $73.75–$134.80 | 6% below | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL ASSESS EA. 15 MIN | $29.25 | $39.00 | $30.50–$37.05 | 12% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL ASSESS EA. 15 MIN | $29.25 | $39.00 | $30.50–$37.05 | — | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY | $342.64 | $489.48 | $99.61–$465.01 | 62% above | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW COMPLEXITY | $342.64 | $489.48 | $99.61–$465.01 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT INITIAL EVAL MODERATE COMPL | $353.47 | $504.95 | $96.98–$479.70 | 55% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT INITIAL EVAL MODERATE COMPL | $353.47 | $504.95 | $96.98–$479.70 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN - POS | $83.24 | $118.92 | $27.40–$112.97 | 5% below | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN | $83.24 | $118.92 | $27.40–$112.97 | 5% below | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY 15 MIN | $83.24 | $118.92 | $27.40–$112.97 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY 15 MIN - POS | $83.24 | $118.92 | $27.40–$112.97 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC PROCEDURE 15 MI | $89.18 | $127.40 | $28.73–$121.03 | 4% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC PROC 15 MIN- PO | $89.18 | $127.40 | $28.73–$121.03 | 4% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC PROC 15 MIN- PO | $89.18 | $127.40 | $28.73–$121.03 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC PROCEDURE 15 MI | $89.18 | $127.40 | $28.73–$121.03 | — | 30% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE NEW PT, 18-39YR | $127.82 | $182.60 | $142.79–$173.47 | at median | 30% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE NEW PT, 40-64YR | $147.84 | $211.20 | $165.16–$200.64 | at median | 30% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE NEW PT, =/+ 65Y | $160.16 | $228.80 | $178.92–$217.36 | 13% below | 30% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE EST PT 18-39Y | $113.96 | $162.80 | $127.31–$154.66 | 17% below | 30% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE EST 40-64Y | $122.43 | $174.90 | $136.77–$166.16 | 43% below | 30% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE EST PT =/+65Y | $131.67 | $188.10 | $147.09–$178.70 | 22% above | 30% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DX EVALUATION W/MED SERV | $219.45 | $313.50 | $297.82–$313.50 | 31% below | 30% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DX EVALUATION W/MED SERV | $219.45 | $313.50 | $297.82–$313.50 | — | 30% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY CRISIS 1ST 30 MI | $204.05 | $291.50 | $227.95–$291.50 | 32% below | 30% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy Crisis 60 min | $204.05 | $291.50 | $227.95–$291.50 | 32% below | 30% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY CRISIS 1ST 30 MI | $204.05 | $291.50 | $227.95–$291.50 | — | 30% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCH TX 30 MIN WITH PATIENT | $123.72 | $176.74 | $138.21–$176.74 | 18% below | 30% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN W/PATIENT | $123.72 | $176.74 | $167.90–$176.74 | 18% below | 30% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN W/PATIENT | $123.72 | $176.74 | $167.90–$176.74 | — | 30% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN W/PATIENT | $130.90 | $187.00 | $177.65–$187.00 | 37% below | 30% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCH TX 45 MIN WITH PATIENT | $130.90 | $187.00 | $146.23–$187.00 | 37% below | 30% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN W/PATIENT | $130.90 | $187.00 | $177.65–$187.00 | — | 30% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCH TX 60 MIN WITH PATIENT | $196.35 | $280.50 | $219.35–$280.50 | 26% below | 30% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN W/PATIENT | $196.35 | $280.50 | $266.48–$280.50 | 26% below | 30% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN W/PATIENT | $196.35 | $280.50 | $266.48–$280.50 | — | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE COUNSEL 3-10 MINS | $28.64 | $40.92 | $32.00–$40.92 | 49% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT EST PT LEVEL 5 | $158.62 | $226.60 | $177.20–$215.27 | 35% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT-ESTAB PT LEVEL 3 | $96.25 | $137.50 | $93.48–$130.62 | 33% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT EST PT LEVEL 3 | $99.33 | $141.90 | $93.48–$134.80 | 30% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT-ESTAB PT LEVEL 3 | $96.25 | $137.50 | $93.48–$130.62 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT EST PT LEVEL 4 | $119.35 | $170.50 | $133.10–$161.98 | 14% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT-ESTAB PT LEVEL 2 | $54.15 | $77.35 | $58.29–$73.48 | 48% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT EST PT LEVEL 2 | $60.06 | $85.80 | $58.29–$81.51 | 43% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT-ESTAB PT LEVEL 2 | $54.15 | $77.35 | $58.29–$73.48 | — | 30% |
| Speech therapy session, individual CPT 92507 ST SPEECH LANG SWALLOW TX | $110.25 | $147.00 | $75.51–$139.65 | 37% below | 25% |
| Speech therapy session, individual CPT 92507 SP SPEECH TREATMENT | $222.35 | $317.64 | $75.51–$301.76 | 28% above | 30% |
| Speech therapy session, individual inpatient CPT 92507 ST SPEECH LANG SWALLOW TX | $110.25 | $147.00 | $75.51–$139.65 | — | 25% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH TREATMENT | $222.35 | $317.64 | $75.51–$301.76 | — | 30% |
| Spirometry (breathing test) CPT 94010 PEAK FLOW METER TX PRE and POS | $112.50 | $150.00 | $117.30–$150.00 | 58% below | 25% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY INCL GRAPHIC RECORD | $120.48 | $172.11 | $134.59–$172.11 | 55% below | 30% |
| Spirometry (breathing test) inpatient CPT 94010 PEAK FLOW METER TX PRE and POS | $112.50 | $150.00 | $117.30–$150.00 | — | 25% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSE | $239.78 | $342.54 | $267.87–$342.54 | 40% below | 30% |
| Spirometry before and after a bronchodilator CPT 94060 PULMONARY TEST WO BRONCHODILAT | $270.75 | $361.00 | $282.30–$361.00 | 32% below | 25% |
| Spirometry before and after a bronchodilator CPT 94060 PULMONARY TEST W BRONCHODILATO | $394.04 | $525.38 | $410.85–$525.38 | 1% below | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PULMONARY TEST WO BRONCHODILAT | $270.75 | $361.00 | $282.30–$361.00 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PULMONARY TEST W BRONCHODILATO | $394.04 | $525.38 | $410.85–$525.38 | — | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT CANOLITH REPOSITIONING | $97.02 | $138.60 | $34.63–$131.67 | 3% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPUTIC ACTIVITIES 1 | $106.72 | $152.46 | $34.63–$144.84 | 7% above | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT CANOLITH REPOSITIONING | $97.02 | $138.60 | $34.63–$131.67 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPUTIC ACTIVITIES 1 | $106.72 | $152.46 | $34.63–$144.84 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $115.50 | $165.00 | $129.03–$165.00 | 54% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY | $115.50 | $165.00 | $129.03–$165.00 | — | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC FLUAD HD 65+ | $70.00 | $100.00 | $78.20–$95.00 | 176% above | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACFOR SUBCU | $227.32 | $324.74 | $177.81–$308.50 | 60% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC FLUARIX | $35.00 | $50.00 | $22.35–$47.50 | 4% above | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC FLUZONE >6 SYR | $35.00 | $50.00 | $22.35–$47.50 | 4% above | 30% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDISIL HPV9 | $685.59 | $979.42 | $290.42–$930.45 | 18% below | 30% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE HAVRIX | $245.00 | $350.00 | $80.55–$332.50 | 23% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VAC ADULT 20MCG | $244.30 | $349.00 | $70.38–$331.55 | 8% above | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACADULT 20MCG/ML | $244.30 | $349.00 | $70.38–$331.55 | 8% above | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE (ENGERIX-B | $244.30 | $349.00 | $70.38–$331.55 | 8% above | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC fluzone HD | $52.49 | $74.99 | $58.64–$74.99 | 76% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC FLUZONE HD SYR | $70.00 | $100.00 | $78.20–$95.00 | 68% below | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS RUBELLA II VIRUS | $131.54 | $187.92 | $94.34–$178.52 | 63% below | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL ACYW 135 VAC | $389.65 | $556.64 | $160.50–$528.81 | 46% above | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VAC INJ | $308.86 | $441.23 | $228.23–$419.17 | 10% below | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCA PREVNAR 20 | $673.16 | $961.65 | $312.90–$913.57 | 98% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 13 VALIANT | $176.24 | $251.77 | $133.47–$239.18 | 55% below | 30% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE ABRYSVO | $245.00 | $350.00 | $273.70–$332.50 | 29% below | 30% |
| Rabies vaccine, one dose CPT 90675 PHY FEE RABIES VACCINE | $895.22 | $1,193.62 | $1,133.94–$1,193.62 | 5% below | 25% |
| Rabies vaccine, one dose inpatient CPT 90675 PHY FEE RABIES VACCINE | $895.22 | $1,193.62 | $1,133.94–$1,193.62 | — | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (SHINGLES) VACCINE | $328.21 | $468.87 | $201.86–$445.43 | 146% above | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD ABSORBED TENIVAC 0.5 ML | $44.80 | $64.00 | $28.55–$60.80 | 66% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP (BOOSTRIX) 0.5ML PFS/VIAL | $121.56 | $173.66 | $48.34–$164.98 | 31% above | 30% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE 25MCG/0.5ML | $112.00 | $160.00 | $125.12–$152.00 | 28% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION PN | $52.50 | $70.00 | $66.50–$70.00 | 1% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION INJ ADMINISTRATIO | $52.50 | $70.00 | $66.50–$70.00 | 1% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION NOT FLU | $52.50 | $70.00 | $66.50–$70.00 | 1% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN VACCINE | $54.80 | $78.29 | $74.38–$78.29 | 4% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION NOT FLU | $52.50 | $70.00 | $66.50–$70.00 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION INJ ADMINISTRATIO | $52.50 | $70.00 | $66.50–$70.00 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION PN | $52.50 | $70.00 | $66.50–$70.00 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION INJ ADMINISTRATIO | $22.50 | $30.00 | $15.75–$28.50 | 44% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EACH ADDITI | $23.10 | $33.00 | $15.75–$31.35 | 43% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION INJ ADMINISTRATIO | $22.50 | $30.00 | $15.75–$28.50 | — | 25% |
Source file: https://bathhospital.org/wp-content/uploads/2026/09/540505913_bath-community-hospital_standardcharges.csv