Hospital

Baraga County Memorial Hospital

Baraga County Memorial Hospital in Lanse, MI publishes cash prices for 307 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 above the Michigan median for 223 of 305 procedures and below it for 78. By typical cash price it ranks #66 of 86 Michigan hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

18341 US HIGHWAY 41, LANSE, MI, 49946 Collected Sep 27, 2026 Source price file (906) 524-3300

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 231307 · CMS hospital register

The price file shows no self-pay discount

For 1288 of the 1288 prices listed here, the cash price in Baraga County Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Baraga County Memorial Hospital in Lanse, MI:

Apr 28, 2025 Warning notice
Aug 4, 2025 Case closed
Jun 3, 2026 Warning notice
Jul 15, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US ANKLE/BRACHIAL INDICES BILATERAL	$404.00	$404.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 US ANKLE/BRACHIAL INDICES UNILATERAL	$404.00	$404.00	—	36% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US ANKLE/BRACHIAL INDICES BILATERAL	$404.00	$404.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 US ANKLE/BRACHIAL INDICES UNILATERAL	$404.00	$404.00	—	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL ESOPHAGRAM	$290.00	$290.00	—	15% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL ESOPHAGRAM	$290.00	$290.00	—	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN - MULTIPLE AREA	$1,662.00	$1,662.00	—	109% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN - MULTIPLE AREA	$1,662.00	$1,662.00	—	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT LIMITED	$449.00	$449.00	—	107% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT LIMITED	$449.00	$449.00	—	107% above	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT LIMITED	$449.00	$449.00	—	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT LIMITED	$449.00	$449.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST AORTA W OR W/WO	$2,060.00	$2,060.00	—	51% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST WITH PE PROTOCOL	$2,060.00	$2,060.00	—	51% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST AORTA W OR W/WO	$2,060.00	$2,060.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHEST WITH PE PROTOCOL	$2,060.00	$2,060.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS W/O	$2,644.00	$2,644.00	—	54% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS W/O STONE PROTOCOL	$2,644.00	$2,644.00	—	54% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS W/O	$2,644.00	$2,644.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS W/O STONE PROTOCOL	$2,644.00	$2,644.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS WITH	$2,976.00	$2,976.00	—	27% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS WITH APPY PROTOCOL	$2,976.00	$2,976.00	—	27% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS WITH APPY PROTOCOL	$2,976.00	$2,976.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN AND PELVIS WITH	$2,976.00	$2,976.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 COMPUTED TOMOGRAPHY, ABD & PELVIS	$2,228.00	$2,228.00	—	4% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W/WO PELVIS W	$4,033.00	$4,033.00	—	74% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS WITH HEMATURIA PROTOCO	$4,693.00	$4,693.00	—	103% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W/WO PELVIS W/WO	$4,693.00	$4,693.00	—	103% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 COMPUTED TOMOGRAPHY, ABD & PELVIS	$2,228.00	$2,228.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W/WO PELVIS W	$4,033.00	$4,033.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W/WO PELVIS W/WO	$4,693.00	$4,693.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS WITH HEMATURIA PROTOCO	$4,693.00	$4,693.00	—	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH	$1,636.00	$1,636.00	—	26% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH	$1,636.00	$1,636.00	—	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O	$1,462.00	$1,462.00	—	64% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O	$1,462.00	$1,462.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS FACIAL/MAXILLA W/O	$910.00	$910.00	—	6% below	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS FACIAL/MAXILLA W/O	$910.00	$910.00	—	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O	$1,158.00	$1,158.00	—	42% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O	$1,158.00	$1,158.00	—	—	—
CT scan of the head with contrast CPT 70460 CT HEAD WITH	$1,222.00	$1,222.00	—	at median	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH	$1,222.00	$1,222.00	—	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD W AND W/O	$1,290.00	$1,290.00	—	1% below	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W AND W/O	$1,290.00	$1,290.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR W/O	$1,336.00	$1,336.00	—	39% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR W/O	$1,336.00	$1,336.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL W/O	$1,217.00	$1,217.00	—	27% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL W/O	$1,217.00	$1,217.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH	$1,336.00	$1,336.00	—	9% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH	$1,336.00	$1,336.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER	$1,225.00	$1,225.00	—	42% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DOPPLER	$1,225.00	$1,225.00	—	—	—
Chest X-ray, 2 views CPT 71046 DG CHEST - DUCUBITUS OR OBLIQUE VIEWS	$248.00	$248.00	—	56% above	—
Chest X-ray, 2 views CPT 71046 DG CHEST - 2 VIEWS	$248.00	$248.00	—	56% above	—
Chest X-ray, 2 views inpatient CPT 71046 DG CHEST - 2 VIEWS	$248.00	$248.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 DG CHEST - DUCUBITUS OR OBLIQUE VIEWS	$248.00	$248.00	—	—	—
Chest X-ray, single view CPT 71045 DG CHEST - 1 VIEW	$189.00	$189.00	—	35% above	—
Chest X-ray, single view CPT 71045 DG CHEST - 1 VIEW EAGLE MINE	$243.00	$243.00	—	73% above	—
Chest X-ray, single view inpatient CPT 71045 DG CHEST - 1 VIEW	$189.00	$189.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 DG CHEST - 1 VIEW EAGLE MINE	$243.00	$243.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL AND BLADDER	$756.00	$756.00	—	38% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL AND BLADDER	$756.00	$756.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITOMETRY	$355.00	$355.00	—	17% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITOMETRY	$355.00	$355.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB COMPLETE	$823.00	$823.00	—	42% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB COMPLETE	$823.00	$823.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O	$1,461.00	$1,461.00	—	64% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O	$1,461.00	$1,461.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH ROUTINE	$1,584.00	$1,584.00	—	29% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH ROUTINE	$1,584.00	$1,584.00	—	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG BILAT DIAGNOSTIC MAMMO WITH CAD	$361.00	$361.00	—	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG BILAT DIAGNOSTIC MAMMO WITH CAD	$361.00	$361.00	—	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 US ARTERY DOPPLER BIL LOWER EXT	$795.00	$795.00	—	11% above	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ARTERY DOPPLER BIL LOWER EXT	$795.00	$795.00	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DOPPLER VENOUS UP/LOW BILAT	$795.00	$795.00	—	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS INSUFFICIENCY STUDY	$795.00	$795.00	—	29% above	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DOPPLER VENOUS UP/LOW BILAT	$795.00	$795.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS INSUFFICIENCY STUDY	$795.00	$795.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO COMPLETE	$2,504.00	$2,504.00	—	92% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO COMPLETE	$2,504.00	$2,504.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SCAN	$1,161.00	$1,161.00	—	39% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SCAN	$1,161.00	$1,161.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOM REAL TIME W/IMAGE DOCUMENTATION	$149.00	$149.00	—	64% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US RETROPERITONEAL W/IMAGE LIMITED	$382.00	$382.00	—	7% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED	$404.00	$404.00	—	1% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN SPLEEN	$704.00	$704.00	—	72% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN GALLBLADDER	$704.00	$704.00	—	72% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN PANCREAS	$704.00	$704.00	—	72% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN 1 ORGAN	$704.00	$704.00	—	72% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN PARTIAL QUAD	$704.00	$704.00	—	72% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOM REAL TIME W/IMAGE DOCUMENTATION	$149.00	$149.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US RETROPERITONEAL W/IMAGE LIMITED	$382.00	$382.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED	$404.00	$404.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN PARTIAL QUAD	$704.00	$704.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN 1 ORGAN	$704.00	$704.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN GALLBLADDER	$704.00	$704.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN PANCREAS	$704.00	$704.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN SPLEEN	$704.00	$704.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST W/O LUNG SCREENING***	$369.00	$369.00	—	35% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST W/O LUNG SCREENING***	$369.00	$369.00	—	—	—
MRI of both breasts, without and then with contrast dye CPT 77049 MR BREAST BILATATERAL W OR W AND W/O	$4,976.00	$4,976.00	—	115% above	—
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MR BREAST BILATATERAL W OR W AND W/O	$4,976.00	$4,976.00	—	—	—
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN W/O	$3,072.00	$3,072.00	—	106% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN W/O	$3,072.00	$3,072.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W/WO	$4,763.00	$4,763.00	—	68% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W/WO	$4,763.00	$4,763.00	—	—	—
MRI of the brain, no contrast dye CPT 70551 MR BRAIN, IAC's OR PITUITARY W/0	$3,106.00	$3,106.00	—	110% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN, IAC's OR PITUITARY W/0	$3,106.00	$3,106.00	—	—	—
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN, IAC's OR PITUITARY W/WO	$4,545.00	$4,545.00	—	104% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN, IAC's OR PITUITARY W/WO	$4,545.00	$4,545.00	—	—	—
MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR SPINE W/O	$2,922.00	$2,922.00	—	91% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MR LUMBAR SPINE W/O	$2,922.00	$2,922.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MR LUMBAR SPINE W/WO	$5,192.00	$5,192.00	—	97% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR LUMBAR SPINE W/WO	$5,192.00	$5,192.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC SPINE W/O	$3,238.00	$3,238.00	—	109% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC SPINE W/O	$3,238.00	$3,238.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL SPIN W/WO	$4,763.00	$4,763.00	—	89% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR CERVICAL SPIN W/WO	$4,763.00	$4,763.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL SPINE W/O	$3,060.00	$3,060.00	—	100% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR CERVICAL SPINE W/O	$3,060.00	$3,060.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W/WO	$4,763.00	$4,763.00	—	81% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W/WO	$4,763.00	$4,763.00	—	—	—
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS W/O	$3,148.00	$3,148.00	—	132% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS W/O	$3,148.00	$3,148.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM *MYOCARDIAL PERFUSION IMAG MULTIPLE	$3,470.00	$3,470.00	—	39% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM *MYOCARDIAL PERFUSION IMAG MULTIPLE	$3,470.00	$3,470.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED	$155.00	$155.00	—	37% below	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED	$155.00	$155.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON-OB	$539.00	$539.00	—	9% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON-OB	$539.00	$539.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB 2ND & 3RD TRIMESTER	$823.00	$823.00	—	79% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB 2ND & 3RD TRIMESTER	$823.00	$823.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMESTER	$823.00	$823.00	—	106% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMESTER	$823.00	$823.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB PARTIAL	$314.00	$314.00	$33.63	2% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB PARTIAL/LIMITED	$400.00	$400.00	—	30% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB PARTIAL	$314.00	$314.00	$33.63	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB PARTIAL/LIMITED	$400.00	$400.00	—	—	—
Screening mammogram, both breasts both sides CPT 77067 MG BILAT SCREENING MAMMO WITH CAD	$223.00	$223.00	—	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 MG BILAT SCREENING MAMMO WITH CAD	$223.00	$223.00	—	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL MODIFIED BARIUM SWALLOW (FUNCTION)	$339.00	$339.00	—	at median	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL MODIFIED BARIUM SWALLOW (FUNCTION)	$339.00	$339.00	—	—	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$289.00	$289.00	—	20% below	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$289.00	$289.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL STUDY	$289.00	$289.00	—	6% below	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL STUDY	$289.00	$289.00	—	—	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMP 2 ORGANS	$1,131.00	$1,131.00	—	100% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMP 2 ORGANS	$1,131.00	$1,131.00	—	—	—
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$539.00	$539.00	—	9% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$539.00	$539.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE THYROID	$591.00	$591.00	—	36% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$591.00	$591.00	—	36% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$591.00	$591.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE THYROID	$591.00	$591.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UGI REGULAR	$524.00	$524.00	—	46% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UGI REGULAR	$524.00	$524.00	—	—	—
X-ray of the abdomen, 1 view CPT 74018 DG ABDOMEN ONE VIEW SUPINE OR UPRIGHT	$159.00	$159.00	—	13% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 DG ABDOMEN ONE VIEW SUPINE OR UPRIGHT	$159.00	$159.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DG LUMBAR SPINE FLEXION,EXTENSION ONLY	$273.00	$273.00	—	36% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DG LUMBAR SPINE OBLIQUES ONLY	$273.00	$273.00	—	36% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DG LUMBAR - ROUTINE 3 VIEW	$273.00	$273.00	—	36% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DG LUMBAR SPINE OBLIQUES ONLY	$273.00	$273.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DG LUMBAR SPINE FLEXION,EXTENSION ONLY	$273.00	$273.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DG LUMBAR - ROUTINE 3 VIEW	$273.00	$273.00	—	—	—
X-ray of the lower back, 4 or more views CPT 72110 DG LUMBAR MIN 4 VIEW	$322.00	$322.00	—	9% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 DG LUMBAR MIN 4 VIEW	$322.00	$322.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 DG THORACIC SPINE	$232.00	$232.00	—	35% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DG THORACIC SPINE	$232.00	$232.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 DG NASAL BONES - COMPLETE	$175.00	$175.00	—	12% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 DG NASAL BONES - COMPLETE	$175.00	$175.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DG C-SPINE 2 OR 3 VIEWS	$250.00	$250.00	—	34% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DG C-SPINE 2 OR 3 VIEWS	$250.00	$250.00	—	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 DG PELVIS ROUTINE	$156.00	$156.00	—	2% below	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 DG PELVIS ROUTINE	$156.00	$156.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 DG SACRUM - COCCYX	$189.00	$189.00	—	20% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 DG SACRUM - COCCYX	$189.00	$189.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 **NASH SGPT	$26.00	$26.00	—	16% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 **FIBRO SGPT	$46.00	$46.00	—	105% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$83.00	$83.00	—	271% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 **NASH SGPT	$26.00	$26.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 **FIBRO SGPT	$46.00	$46.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$83.00	$83.00	—	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 **NASH AST	$26.00	$26.00	—	18% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$83.00	$83.00	—	277% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 **NASH AST	$26.00	$26.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$83.00	$83.00	—	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 **BEEF	$16.50	$16.50	—	171% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 **PORK	$16.50	$16.50	—	171% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 **LAMB	$16.50	$16.50	—	171% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 **LATEX ALLERGY SERUM DO NOT USE	$47.00	$47.00	—	673% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 **MGH WHEAT IGE	$126.00	$126.00	—	1972% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 **BASOFUNCTION HRT IBUPROFEN	$150.00	$150.00	—	2367% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 BASOFUNCTION HRT TETRACYCLINE	$150.00	$150.00	—	2367% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 **BEEF	$16.50	$16.50	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 **LAMB	$16.50	$16.50	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 **PORK	$16.50	$16.50	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 **LATEX ALLERGY SERUM DO NOT USE	$47.00	$47.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 **MGH WHEAT IGE	$126.00	$126.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BASOFUNCTION HRT TETRACYCLINE	$150.00	$150.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 **BASOFUNCTION HRT IBUPROFEN	$150.00	$150.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 **CCP IgG	$147.00	$147.00	—	184% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBOD	$151.00	$151.00	—	192% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 **CCP IgG	$147.00	$147.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBOD	$151.00	$151.00	—	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 **MOUSE KIDNEY SUBSTRATES - ANA PROF	$88.00	$88.00	—	52% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 **MAYOS ANTINUCLEAR ANTIBODY	$96.00	$96.00	—	66% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 **ANA TITER	$100.00	$100.00	—	73% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 IFANA	$124.00	$124.00	—	114% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI NUCLEAR AB W/REFELX IFANA	$129.00	$129.00	—	123% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 **MOUSE KIDNEY SUBSTRATES - ANA PROF	$88.00	$88.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 **MAYOS ANTINUCLEAR ANTIBODY	$96.00	$96.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 **ANA TITER	$100.00	$100.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 IFANA	$124.00	$124.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI NUCLEAR AB W/REFELX IFANA	$129.00	$129.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 **BNP NOT PRO ARCH	$191.00	$191.00	—	173% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 **BNP-PRO	$191.00	$191.00	—	173% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 **Z-BNP	$191.00	$191.00	—	173% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP NOT PRO	$198.00	$198.00	—	183% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NTBNP MGH	$198.00	$198.00	—	183% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 **Z-BNP	$191.00	$191.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 **BNP NOT PRO ARCH	$191.00	$191.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 **BNP-PRO	$191.00	$191.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP NOT PRO	$198.00	$198.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NTBNP MGH	$198.00	$198.00	—	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$82.00	$82.00	—	39% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$82.00	$82.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL SPECIMEN LEVEL IV 88305	$202.00	$202.00	—	116% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY EXAM	$332.00	$332.00	—	256% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SPEC REFERRED OUT	$370.00	$370.00	—	296% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL SPECIMEN LEVEL IV 88305	$202.00	$202.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY EXAM	$332.00	$332.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SPEC REFERRED OUT	$370.00	$370.00	—	—	—
Blood culture for bacteria CPT 87040 **MGH DON'T USEBLOOD CULT POS	$20.00	$20.00	—	68% below	—
Blood culture for bacteria CPT 87040 CULT BLOOD 1 BTL	$113.00	$113.00	—	82% above	—
Blood culture for bacteria CPT 87040 **MGH BLOOD CULTURE	$115.00	$115.00	—	85% above	—
Blood culture for bacteria inpatient CPT 87040 **MGH DON'T USEBLOOD CULT POS	$20.00	$20.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD 1 BTL	$113.00	$113.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 **MGH BLOOD CULTURE	$115.00	$115.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ***VENIPUNCTURE	$18.00	$18.00	—	40% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LEGAL BLOOD DRAW	$53.00	$53.00	—	311% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ***VENIPUNCTURE	$18.00	$18.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LEGAL BLOOD DRAW	$53.00	$53.00	—	—	—
Blood glucose (sugar) test CPT 82947 **NASH GLUC	$26.00	$26.00	—	8% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE MONITOR-BLOOD	$37.00	$37.00	—	54% above	—
Blood glucose (sugar) test CPT 82947 **GLUCOSE 1HR PP	$69.00	$69.00	—	188% above	—
Blood glucose (sugar) test CPT 82947 **GLUCOSE OB BASELINE	$69.00	$69.00	—	188% above	—
Blood glucose (sugar) test CPT 82947 **GLUCOSE 2HR PP	$69.00	$69.00	—	188% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE	$69.00	$69.00	—	188% above	—
Blood glucose (sugar) test inpatient CPT 82947 **NASH GLUC	$26.00	$26.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE MONITOR-BLOOD	$37.00	$37.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 **GLUCOSE 1HR PP	$69.00	$69.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$69.00	$69.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 **GLUCOSE OB BASELINE	$69.00	$69.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 **GLUCOSE 2HR PP	$69.00	$69.00	—	—	—
Blood lead test CPT 83655 LEAD PEDIATRIC 15 YEARS & YOUNGER	$79.00	$79.00	—	464% above	—
Blood lead test CPT 83655 LEAD ADULT 16 YEARS & OLDER	$79.00	$79.00	—	464% above	—
Blood lead test CPT 83655 LEAD-INDUSTRIAL	$82.00	$82.00	—	486% above	—
Blood lead test CPT 83655 **LEAD	$82.00	$82.00	—	486% above	—
Blood lead test CPT 83655 URINE 24HR LEAD	$88.00	$88.00	—	529% above	—
Blood lead test inpatient CPT 83655 LEAD ADULT 16 YEARS & OLDER	$79.00	$79.00	—	—	—
Blood lead test inpatient CPT 83655 LEAD PEDIATRIC 15 YEARS & YOUNGER	$79.00	$79.00	—	—	—
Blood lead test inpatient CPT 83655 LEAD-INDUSTRIAL	$82.00	$82.00	—	—	—
Blood lead test inpatient CPT 83655 **LEAD	$82.00	$82.00	—	—	—
Blood lead test inpatient CPT 83655 URINE 24HR LEAD	$88.00	$88.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM	$77.00	$77.00	—	108% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM	$77.00	$77.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPING	$56.00	$56.00	—	63% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BBMGH ABO/RH TYPING	$163.00	$163.00	—	375% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPING	$56.00	$56.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BBMGH ABO/RH TYPING	$163.00	$163.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 **CRP	$33.00	$33.00	—	3% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$86.00	$86.00	—	153% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 **CRP WIDE RANGE	$86.00	$86.00	—	153% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 **CRP	$33.00	$33.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$86.00	$86.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 **CRP WIDE RANGE	$86.00	$86.00	—	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF	$180.00	$180.00	—	72% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF	$180.00	$180.00	—	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 SERUM	$196.00	$196.00	—	167% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 SERUM	$196.00	$196.00	—	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 SERUM	$151.00	$151.00	—	83% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 SERUM	$151.00	$151.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 CEPHEID	$67.00	$67.00	—	24% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 **	$163.00	$163.00	—	85% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 CEPHEID	$67.00	$67.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 **	$163.00	$163.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 **APTIMAHCAM	$150.00	$150.00	—	103% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DONT USECHLAMYDIA DNA PROBE	$183.00	$183.00	—	147% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE	$183.00	$183.00	—	147% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PRC PROBE	$183.00	$183.00	—	147% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 **AMPLIFIED CHLAMYDIA PROBE	$188.00	$188.00	—	154% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 **CHLAMYDIA TMA CONFIRM	$286.00	$286.00	—	286% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 **APTIMAHCAM	$150.00	$150.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PRC PROBE	$183.00	$183.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 DONT USECHLAMYDIA DNA PROBE	$183.00	$183.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE	$183.00	$183.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 **AMPLIFIED CHLAMYDIA PROBE	$188.00	$188.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 **CHLAMYDIA TMA CONFIRM	$286.00	$286.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 **MGH LIPID PROFILE	$118.00	$118.00	—	132% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CRE PROFILE-PANEL (LIPID)	$160.00	$160.00	—	214% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 **MGH LIPID PROFILE	$118.00	$118.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CRE PROFILE-PANEL (LIPID)	$160.00	$160.00	—	—	—
Complete blood count (CBC) with differential CPT 85025 **CBC/AUTOMATED DIFFERENTIAL CHARGE ONLY	$90.00	$90.00	—	114% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 **CBC/AUTOMATED DIFFERENTIAL CHARGE ONLY	$90.00	$90.00	—	—	—
Complete blood count (CBC), no differential CPT 85027 **HEMOGRAM CHARGE ONLY	$71.00	$71.00	—	145% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 **HEMOGRAM CHARGE ONLY	$71.00	$71.00	—	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$121.00	$121.00	—	54% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$121.00	$121.00	—	—	—
D-dimer blood test (blood clot marker) CPT 85379 **DDIMER QUANT MGH	$126.00	$126.00	—	268% above	—
D-dimer blood test (blood clot marker) CPT 85379 **DDIMER	$131.00	$131.00	—	283% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT BCMH	$162.00	$162.00	—	374% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 **DDIMER QUANT MGH	$126.00	$126.00	—	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 **DDIMER	$131.00	$131.00	—	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT BCMH	$162.00	$162.00	—	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$199.00	$199.00	—	209% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$199.00	$199.00	—	—	—
Estradiol blood test CPT 82670 ESTRADIOL	$17.00	$17.00	—	76% below	—
Estradiol blood test CPT 82670 **E1	$22.00	$22.00	—	69% below	—
Estradiol blood test CPT 82670 **E1FRAC	$22.00	$22.00	—	69% below	—
Estradiol blood test CPT 82670 ESTRADIOL ENHANCED	$189.00	$189.00	—	166% above	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$17.00	$17.00	—	—	—
Estradiol blood test inpatient CPT 82670 **E1FRAC	$22.00	$22.00	—	—	—
Estradiol blood test inpatient CPT 82670 **E1	$22.00	$22.00	—	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL ENHANCED	$189.00	$189.00	—	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE SERUM	$113.00	$113.00	—	43% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE SERUM	$113.00	$113.00	—	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN	$409.00	$409.00	—	570% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN	$409.00	$409.00	—	—	—
Ferritin blood test (iron stores) CPT 82728 **FERRITIN	$88.00	$88.00	—	47% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$91.00	$91.00	—	52% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 **FERRITIN	$88.00	$88.00	—	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$91.00	$91.00	—	—	—
Folate (folic acid) blood test CPT 82746 **FOLIC ACID (FOLATE)	$131.00	$131.00	—	67% above	—
Folate (folic acid) blood test CPT 82746 FOLATE	$131.00	$131.00	—	67% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$131.00	$131.00	—	—	—
Folate (folic acid) blood test inpatient CPT 82746 **FOLIC ACID (FOLATE)	$131.00	$131.00	—	—	—
Free T3 thyroid hormone test CPT 84481 FT3	$250.00	$250.00	—	293% above	—
Free T3 thyroid hormone test CPT 84481 **NOT3 FREE	$250.00	$250.00	—	293% above	—
Free T3 thyroid hormone test CPT 84481 **T3 FREE DIALYSIS	$250.00	$250.00	—	293% above	—
Free T3 thyroid hormone test inpatient CPT 84481 **NOT3 FREE	$250.00	$250.00	—	—	—
Free T3 thyroid hormone test inpatient CPT 84481 FT3	$250.00	$250.00	—	—	—
Free T3 thyroid hormone test inpatient CPT 84481 **T3 FREE DIALYSIS	$250.00	$250.00	—	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$107.00	$107.00	—	235% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE DIALYSIS	$163.00	$163.00	—	410% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$107.00	$107.00	—	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE DIALYSIS	$163.00	$163.00	—	—	—
Free testosterone test CPT 84402 **TEST FREE	$213.00	$213.00	—	440% above	—
Free testosterone test CPT 84402 TESTOSTERONE FREE (ONLY)	$213.00	$213.00	—	440% above	—
Free testosterone test CPT 84402 **TESTOSTERONE FREE	$213.00	$213.00	—	440% above	—
Free testosterone test CPT 84402 **TESTOSTERONE FREE, DIALYSIS	$228.00	$228.00	—	478% above	—
Free testosterone test CPT 84402 **TESTOSTERONE PEDIATRIC FREE & TOTAL	$228.00	$228.00	—	478% above	—
Free testosterone test inpatient CPT 84402 **TESTOSTERONE FREE	$213.00	$213.00	—	—	—
Free testosterone test inpatient CPT 84402 **TEST FREE	$213.00	$213.00	—	—	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE (ONLY)	$213.00	$213.00	—	—	—
Free testosterone test inpatient CPT 84402 **TESTOSTERONE FREE, DIALYSIS	$228.00	$228.00	—	—	—
Free testosterone test inpatient CPT 84402 **TESTOSTERONE PEDIATRIC FREE & TOTAL	$228.00	$228.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 **GLUCOSE OB 2HR	$79.00	$79.00	—	255% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE OB 2HR TOLERANCE	$163.00	$163.00	—	632% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 **GLUCOSE OB 2HR	$79.00	$79.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE OB 2HR TOLERANCE	$163.00	$163.00	—	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE POST GLUCOLA	$69.00	$69.00	—	21% above	—
Glucose tolerance test, 3 samples CPT 82951 **GTT2NP75	$109.00	$109.00	—	91% above	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE OB 1HR TOLERANCE	$109.00	$109.00	—	91% above	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE OB 3HR TOLERANCE	$157.00	$157.00	—	175% above	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE NONOB 2HR TOLERANCE	$163.00	$163.00	—	186% above	—
Glucose tolerance test, 3 samples CPT 82951 **GTT3PG100	$163.00	$163.00	—	186% above	—
Glucose tolerance test, 3 samples CPT 82951 **GTT5	$163.00	$163.00	—	186% above	—
Glucose tolerance test, 3 samples CPT 82951 **GTT2PG75	$163.00	$163.00	—	186% above	—
Glucose tolerance test, 3 samples CPT 82951 **GTT4	$163.00	$163.00	—	186% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE POST GLUCOLA	$69.00	$69.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE OB 1HR TOLERANCE	$109.00	$109.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 **GTT2NP75	$109.00	$109.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE OB 3HR TOLERANCE	$157.00	$157.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 **GTT5	$163.00	$163.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 **GTT3PG100	$163.00	$163.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 **GTT2PG75	$163.00	$163.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 **GTT4	$163.00	$163.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE NONOB 2HR TOLERANCE	$163.00	$163.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 **APTIMAGC	$153.00	$153.00	—	67% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONNOREAHE DNA PROBE	$161.00	$161.00	—	75% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONNOREAH DNA PROBE	$167.00	$167.00	—	82% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE PCR PROBE	$183.00	$183.00	—	99% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 **AMPLIFIED GC PROBE	$198.00	$198.00	—	116% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 **GC TMA CONFIRM	$286.00	$286.00	—	211% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 **APTIMAGC	$153.00	$153.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONNOREAHE DNA PROBE	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONNOREAH DNA PROBE	$167.00	$167.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE PCR PROBE	$183.00	$183.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 **AMPLIFIED GC PROBE	$198.00	$198.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 **GC TMA CONFIRM	$286.00	$286.00	—	—	—
H. pylori antibody blood test CPT 86677 H PYLORI QUAL (HERE)	$55.00	$55.00	—	3% below	—
H. pylori antibody blood test CPT 86677 **HELICO PYLORI IGG AB	$162.00	$162.00	—	186% above	—
H. pylori antibody blood test CPT 86677 **HELICO PYLORI IGM AB	$162.00	$162.00	—	186% above	—
H. pylori antibody blood test CPT 86677 **HELICO PYLORI IGA AB	$162.00	$162.00	—	186% above	—
H. pylori antibody blood test inpatient CPT 86677 H PYLORI QUAL (HERE)	$55.00	$55.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 **HELICO PYLORI IGM AB	$162.00	$162.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 **HELICO PYLORI IGG AB	$162.00	$162.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 **HELICO PYLORI IGA AB	$162.00	$162.00	—	—	—
H. pylori stool antigen test CPT 87338 HELICOBACTER ANTIGEN	$128.00	$128.00	—	106% above	—
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER ANTIGEN	$128.00	$128.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 VIRUS RNA QUANT REAL TIME PCR	$406.00	$406.00	—	133% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 **HIV-ULTRA QUANTITATIVE	$406.00	$406.00	—	133% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 VIRUS RNA QUANT REAL TIME PCR	$406.00	$406.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 **HIV-ULTRA QUANTITATIVE	$406.00	$406.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1&2	$117.00	$117.00	—	171% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1&2	$117.00	$117.00	—	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HR	$201.00	$201.00	—	172% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV (HR HPV)	$201.00	$201.00	—	172% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV (HR HPV)	$201.00	$201.00	—	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HR	$201.00	$201.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCATED HEMOGLOBIN	$80.00	$80.00	—	90% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCATED HEMOGLOBIN	$80.00	$80.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB QUANT	$121.00	$121.00	—	200% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB	$121.00	$121.00	—	200% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB	$121.00	$121.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB QUANT	$121.00	$121.00	—	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG	$91.00	$91.00	—	136% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG	$91.00	$91.00	—	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB REFLEX HCVRT	$235.00	$235.00	—	390% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB REFLEX HCVRT	$235.00	$235.00	—	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 **HCV RNA QUANT TMA HCVQN	$336.00	$336.00	—	295% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 **HCV-RNA QUANT BDNA HCVUL	$336.00	$336.00	—	295% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT REAL TIME PCR	$336.00	$336.00	—	295% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCVQU	$445.00	$445.00	—	424% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 **HCV-RNA QUANT BDNA HCVUL	$336.00	$336.00	—	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT REAL TIME PCR	$336.00	$336.00	—	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 **HCV RNA QUANT TMA HCVQN	$336.00	$336.00	—	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCVQU	$445.00	$445.00	—	—	—
Herpes blood test, HSV-1 antibody CPT 86695 **HERPES SIMPLEX 1 IGG	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-1 antibody CPT 86695 **HSV 1 IGG AB	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-1 antibody CPT 86695 **HERPES SIMPEX 1 IGM	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-1 antibody CPT 86695 **ANTIBODY HERPES SIMPEX 1	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 **ANTIBODY HERPES SIMPEX 1	$98.00	$98.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 **HERPES SIMPEX 1 IGM	$98.00	$98.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 **HSV 1 IGG AB	$98.00	$98.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 **HERPES SIMPLEX 1 IGG	$98.00	$98.00	—	—	—
Herpes blood test, HSV-2 antibody CPT 86696 **HERPES SIMPLEX 2 IGM	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-2 antibody CPT 86696 **HERPES SIMPLEX 2 IGG	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-2 antibody CPT 86696 **ANTIBODY HERPES SIMPLEX 2	$98.00	$98.00	—	136% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 **ANTIBODY HERPES SIMPLEX 2	$98.00	$98.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 **HERPES SIMPLEX 2 IGM	$98.00	$98.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 **HERPES SIMPLEX 2 IGG	$98.00	$98.00	—	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 **MGH HSCRP	$88.00	$88.00	—	93% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 **CRP HIGH SENSITIVITY ARCH	$112.00	$112.00	—	146% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HS MGH	$116.00	$116.00	—	155% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 **CRP HIGH SENSITIVITY	$116.00	$116.00	—	155% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 **MGH HSCRP	$88.00	$88.00	—	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 **CRP HIGH SENSITIVITY ARCH	$112.00	$112.00	—	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HS MGH	$116.00	$116.00	—	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 **CRP HIGH SENSITIVITY	$116.00	$116.00	—	—	—
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$151.00	$151.00	—	128% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$151.00	$151.00	—	—	—
Insulin blood test CPT 83525 INSULIN	$103.00	$103.00	—	155% above	—
Insulin blood test inpatient CPT 83525 INSULIN	$103.00	$103.00	—	—	—
Iron blood test (serum iron) CPT 83540 **MGH IRON SERUM	$69.00	$69.00	—	136% above	—
Iron blood test (serum iron) CPT 83540 IRON	$69.00	$69.00	—	136% above	—
Iron blood test (serum iron) CPT 83540 **URINE 24HR IRON	$69.00	$69.00	—	136% above	—
Iron blood test (serum iron) inpatient CPT 83540 **MGH IRON SERUM	$69.00	$69.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540 **URINE 24HR IRON	$69.00	$69.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON	$69.00	$69.00	—	—	—
Iron-binding capacity (TIBC) test CPT 83550 **IRON BINDING CAPACITY	$76.00	$76.00	—	90% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 **IRON BINDING CAPACITY	$76.00	$76.00	—	—	—
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE SERUM/PLASMA	$150.00	$150.00	—	97% above	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE SERUM/PLASMA	$150.00	$150.00	—	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE SERUM	$33.00	$33.00	—	18% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE SERUM	$33.00	$33.00	—	—	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$127.00	$127.00	—	155% above	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$127.00	$127.00	—	—	—
Lyme disease antibody test CPT 86618 LYMES AB W/REFLEX	$160.00	$160.00	—	510% above	—
Lyme disease antibody test CPT 86618 **BORRELIA BURGDORFERI IGG0	$177.00	$177.00	—	574% above	—
Lyme disease antibody test CPT 86618 **LYME DISEASE	$177.00	$177.00	—	574% above	—
Lyme disease antibody test CPT 86618 **BORRELIA BURGDORFERI IGM	$177.00	$177.00	—	574% above	—
Lyme disease antibody test CPT 86618 CSF LYMES	$181.00	$181.00	—	590% above	—
Lyme disease antibody test CPT 86618 **ANTIBODY BORRELIA BURGDORFERI	$188.00	$188.00	—	616% above	—
Lyme disease antibody test inpatient CPT 86618 LYMES AB W/REFLEX	$160.00	$160.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 **BORRELIA BURGDORFERI IGM	$177.00	$177.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 **LYME DISEASE	$177.00	$177.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 **BORRELIA BURGDORFERI IGG0	$177.00	$177.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 CSF LYMES	$181.00	$181.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 **ANTIBODY BORRELIA BURGDORFERI	$188.00	$188.00	—	—	—
Magnesium blood test CPT 83735 URINE RANDOM MAGNESIUM	$54.00	$54.00	—	170% above	—
Magnesium blood test CPT 83735 URINE 24HR MAGNESIUM	$54.00	$54.00	—	170% above	—
Magnesium blood test CPT 83735 **KS MAG	$57.00	$57.00	—	185% above	—
Magnesium blood test CPT 83735 MAGNESIUM RBC	$72.00	$72.00	—	260% above	—
Magnesium blood test CPT 83735 MAGNESIUM	$72.00	$72.00	—	260% above	—
Magnesium blood test inpatient CPT 83735 URINE RANDOM MAGNESIUM	$54.00	$54.00	—	—	—
Magnesium blood test inpatient CPT 83735 URINE 24HR MAGNESIUM	$54.00	$54.00	—	—	—
Magnesium blood test inpatient CPT 83735 **KS MAG	$57.00	$57.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$72.00	$72.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$72.00	$72.00	—	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG (MEASLES IGG)	$276.00	$276.00	—	1072% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM (MEASLES IGM)	$276.00	$276.00	—	1072% above	—
Measles (rubeola) antibody test CPT 86765 **ANTIBODY RUBEOLA	$276.00	$276.00	—	1072% above	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG (MEASLES IGG)	$276.00	$276.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 **ANTIBODY RUBEOLA	$276.00	$276.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM (MEASLES IGM)	$276.00	$276.00	—	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 **MONO HETEROPHILE AB	$49.00	$49.00	—	22% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SPOT	$72.00	$72.00	—	79% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 **MONO HETEROPHILE AB	$49.00	$49.00	—	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SPOT	$72.00	$72.00	—	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 **PSA FREE	$60.00	$60.00	—	5% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 **FREEPSA	$60.00	$60.00	—	5% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 **PSA FREE	$60.00	$60.00	—	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 **FREEPSA	$60.00	$60.00	—	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX PHI	$148.00	$148.00	—	206% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 **PSA TOTAL	$148.00	$148.00	—	206% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 **PSA-MGH	$220.00	$220.00	—	356% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$220.00	$220.00	—	356% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRA SENSITIVE	$234.00	$234.00	—	385% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 **PSA TOTAL	$148.00	$148.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE HEALTH INDEX PHI	$148.00	$148.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$220.00	$220.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 **PSA-MGH	$220.00	$220.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRA SENSITIVE	$234.00	$234.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 **OMH CYTOLOGY V/C THIN PREP	$58.00	$58.00	—	16% below	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY THIN LAYER SCREEN	$123.00	$123.00	—	79% above	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY VAG/CERV THIN LAYER-DIAGNOSTIC	$123.00	$123.00	—	79% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 **OMH CYTOLOGY V/C THIN PREP	$58.00	$58.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY VAG/CERV THIN LAYER-DIAGNOSTIC	$123.00	$123.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY THIN LAYER SCREEN	$123.00	$123.00	—	—	—
Parathyroid hormone (PTH) blood test CPT 83970 **REF LAB- PTH HORMONE INTACT ICMA SER	$334.00	$334.00	—	165% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 **REF LAB- PTH HORMONE INTACT ICMA SER	$334.00	$334.00	—	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 **MGH APTT	$72.00	$72.00	—	132% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$72.00	$72.00	—	132% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$72.00	$72.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 **MGH APTT	$72.00	$72.00	—	—	—
Progesterone blood test CPT 84144 PROGESTERONE	$116.00	$116.00	—	92% above	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$116.00	$116.00	—	—	—
Prolactin blood test CPT 84146 PROLACTIN SERUM	$157.00	$157.00	—	121% above	—
Prolactin blood test inpatient CPT 84146 PROLACTIN SERUM	$157.00	$157.00	—	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 OFFICE PROTIME	$35.00	$35.00	—	154% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 **MGH PROTHROMBIN TIME	$42.00	$42.00	—	204% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$71.00	$71.00	—	414% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 OFFICE PROTIME	$35.00	$35.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 **MGH PROTHROMBIN TIME	$42.00	$42.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$71.00	$71.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN	$36.00	$36.00	—	26% below	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 OFFICE STREP SCREEN	$36.00	$36.00	—	26% below	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN	$36.00	$36.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 OFFICE STREP SCREEN	$36.00	$36.00	—	—	—
Rheumatoid factor (RF) test CPT 86431 **MAYOS RF	$71.00	$71.00	—	114% above	—
Rheumatoid factor (RF) test CPT 86431 **MGH RF CONF NEPH	$71.00	$71.00	—	114% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$113.00	$113.00	—	241% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 **MGH RF CONF NEPH	$71.00	$71.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 **MAYOS RF	$71.00	$71.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$113.00	$113.00	—	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM ANTIBODY	$8.00	$8.00	—	81% below	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG ANTIBODY	$91.00	$91.00	—	119% above	—
Rubella antibody test (immunity check) CPT 86762 MUMPS IGG	$143.00	$143.00	—	244% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM ANTIBODY	$8.00	$8.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG ANTIBODY	$91.00	$91.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 MUMPS IGG	$143.00	$143.00	—	—	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SPERM CHECK POST VAS	$92.00	$92.00	—	16% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 **SEMEN ANALYSIS	$132.00	$132.00	—	66% above	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SPERM CHECK POST VAS	$92.00	$92.00	—	—	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 **SEMEN ANALYSIS	$132.00	$132.00	—	—	—
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$101.00	$101.00	—	163% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$101.00	$101.00	—	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREENING #1	$44.00	$44.00	—	151% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREENING #1	$44.00	$44.00	—	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD MGH IMMUNOASSAY	$99.00	$99.00	—	168% above	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD MGH IMMUNOASSAY	$99.00	$99.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 **VDRL SERUM	$54.00	$54.00	—	211% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 **SYPHILIS AB IGG	$54.00	$54.00	—	211% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 **RPR	$54.00	$54.00	—	211% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$54.00	$54.00	—	211% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 **RRPR	$243.00	$243.00	—	1298% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF	$54.00	$54.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 **SYPHILIS AB IGG	$54.00	$54.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 **VDRL SERUM	$54.00	$54.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 **RPR	$54.00	$54.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 **RRPR	$243.00	$243.00	—	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 **TESTOSTERONE TOTAL PEDIATRIC	$164.00	$164.00	—	150% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 **TESTOSTERONE FREE AND TOTAL	$164.00	$164.00	—	150% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL (ONLY)	$213.00	$213.00	—	225% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 **TESTOSTERONE TOTAL PEDIATRIC	$164.00	$164.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 **TESTOSTERONE FREE AND TOTAL	$164.00	$164.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL (ONLY)	$213.00	$213.00	—	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 **THYROID MICROSOMAL AB	$89.00	$89.00	—	101% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL AB	$99.00	$99.00	—	124% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AUTOANTIBODIES	$116.00	$116.00	—	162% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 **ANTI TPO	$127.00	$127.00	—	187% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER CYTOSOL AUTO AB	$178.00	$178.00	—	303% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 **THYROID MICROSOMAL AB	$89.00	$89.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI MICROSOMAL AB	$99.00	$99.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AUTOANTIBODIES	$116.00	$116.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 **ANTI TPO	$127.00	$127.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER CYTOSOL AUTO AB	$178.00	$178.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 **TSH MAYO	$127.00	$127.00	—	97% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH SPECIAL METHOD	$131.00	$131.00	—	104% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$178.00	$178.00	—	177% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 **TSH (MGH)	$178.00	$178.00	—	177% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH REFLEX FT4	$178.00	$178.00	—	177% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH SENSITIVE	$178.00	$178.00	—	177% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE PROFILE	$178.00	$178.00	—	177% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 **TSH MAYO	$127.00	$127.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH SPECIAL METHOD	$131.00	$131.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 **TSH (MGH)	$178.00	$178.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH SENSITIVE	$178.00	$178.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$178.00	$178.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH REFLEX FT4	$178.00	$178.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADE PROFILE	$178.00	$178.00	—	—	—
Trichomonas test (NAAT) CPT 87661 **TV	$23.00	$23.00	—	64% below	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS	$183.00	$183.00	—	187% above	—
Trichomonas test (NAAT) inpatient CPT 87661 **TV	$23.00	$23.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS	$183.00	$183.00	—	—	—
Uric acid blood test CPT 84550 URIC ACID BLOOD	$83.00	$83.00	—	261% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$83.00	$83.00	—	—	—
Urinalysis with microscope exam, automated CPT 81001 UA	$57.00	$57.00	—	172% above	—
Urinalysis with microscope exam, automated CPT 81001 UA REFLEX CX	$59.00	$59.00	—	182% above	—
Urinalysis with microscope exam, automated CPT 81001 **TEST URINALYSIS	$59.00	$59.00	—	182% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 UA	$57.00	$57.00	—	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 UA REFLEX CX	$59.00	$59.00	—	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 **TEST URINALYSIS	$59.00	$59.00	—	—	—
Urinalysis with microscope exam, manual CPT 81000 **SPECIFIC GRAVITY URINE ONLY	$26.00	$26.00	—	122% above	—
Urinalysis with microscope exam, manual CPT 81000 **URINE BILE	$33.00	$33.00	—	182% above	—
Urinalysis with microscope exam, manual inpatient CPT 81000 **SPECIFIC GRAVITY URINE ONLY	$26.00	$26.00	—	—	—
Urinalysis with microscope exam, manual inpatient CPT 81000 **URINE BILE	$33.00	$33.00	—	—	—
Urinalysis without microscope exam, automated CPT 81003 HEMOGLOBIN FREE URINE	$4.00	$4.00	—	69% below	—
Urinalysis without microscope exam, automated CPT 81003 **DIPSTICK URINALYSIS	$12.00	$12.00	—	8% below	—
Urinalysis without microscope exam, automated CPT 81003 OFFICE UA DIPSTICK	$12.00	$12.00	—	8% below	—
Urinalysis without microscope exam, automated CPT 81003 **KSUVOL	$23.00	$23.00	—	77% above	—
Urinalysis without microscope exam, automated CPT 81003 **UROBILINOGEN	$25.00	$25.00	—	92% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 HEMOGLOBIN FREE URINE	$4.00	$4.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 OFFICE UA DIPSTICK	$12.00	$12.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 **DIPSTICK URINALYSIS	$12.00	$12.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 **KSUVOL	$23.00	$23.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 **UROBILINOGEN	$25.00	$25.00	—	—	—
Urinalysis without microscope exam, manual CPT 81002 **URINE PH	$31.00	$31.00	—	129% above	—
Urinalysis without microscope exam, manual CPT 81002 **URINE RANDOM GLUCOSE DIP	$31.00	$31.00	—	129% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE SPECIFIC GRAVITY	$31.00	$31.00	—	129% above	—
Urinalysis without microscope exam, manual CPT 81002 **BF SPECIFIC GRAVITY	$31.00	$31.00	—	129% above	—
Urinalysis without microscope exam, manual CPT 81002 **URINALYSIS BY DIPSTICK OR TAB REAG	$31.00	$31.00	—	129% above	—
Urinalysis without microscope exam, manual CPT 81002 **URINE RANDOM KETONES DIP	$31.00	$31.00	—	129% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE SPECIFIC GRAVITY	$31.00	$31.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 **URINE PH	$31.00	$31.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 **URINALYSIS BY DIPSTICK OR TAB REAG	$31.00	$31.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 **BF SPECIFIC GRAVITY	$31.00	$31.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 **URINE RANDOM GLUCOSE DIP	$31.00	$31.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 **URINE RANDOM KETONES DIP	$31.00	$31.00	—	—	—
Urine culture for bacteria, with colony count CPT 87086 UA CULTURE	$106.00	$106.00	—	93% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 UA CULTURE	$106.00	$106.00	—	—	—
Urine pregnancy test, read by color change CPT 81025 OFFICE UA PREGNANCY	$42.00	$42.00	—	91% above	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY	$77.00	$77.00	—	251% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 OFFICE UA PREGNANCY	$42.00	$42.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY	$77.00	$77.00	—	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 **VITAMIN B12	$106.00	$106.00	—	83% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 B12	$124.00	$124.00	—	114% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 **VITAMIN B12	$106.00	$106.00	—	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12	$124.00	$124.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 **VITAMIN D 25-HYDROXY (OHD)	$242.00	$242.00	—	174% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 **CALCIFEDIOL	$260.00	$260.00	—	194% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 OHD (VITAMIN D, 25-HYDROXY, TOTAL)	$269.00	$269.00	—	204% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 D3 25HYDROXY	$269.00	$269.00	—	204% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 **VITAMIN D 25-HYDROXY (OHD)	$242.00	$242.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 **CALCIFEDIOL	$260.00	$260.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 OHD (VITAMIN D, 25-HYDROXY, TOTAL)	$269.00	$269.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 D3 25HYDROXY	$269.00	$269.00	—	—	—
Zinc blood test CPT 84630 ZINC RBC	$32.00	$32.00	—	104% above	—
Zinc blood test CPT 84630 ZINC SERUM	$180.00	$180.00	—	1045% above	—
Zinc blood test inpatient CPT 84630 ZINC RBC	$32.00	$32.00	—	—	—
Zinc blood test inpatient CPT 84630 ZINC SERUM	$180.00	$180.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER	$142.00	$142.00	—	143% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 **BHCG QUANT (MGH)	$142.00	$142.00	—	143% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE SERUM	$148.00	$148.00	—	153% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 **GONADOTROPIN, CHORIONIC QUANTITATIVE	$151.00	$151.00	—	158% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER	$142.00	$142.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 **BHCG QUANT (MGH)	$142.00	$142.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE SERUM	$148.00	$148.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 **GONADOTROPIN, CHORIONIC QUANTITATIVE	$151.00	$151.00	—	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDEDTOMY (RUPTURED)	$2,537.00	$2,537.00	—	45% above	—
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDEDTOMY (RUPTURED)	$2,537.00	$2,537.00	—	—	—
Appendectomy, open surgery CPT 44950 APPENDECTOMY (INCIDENTAL)	$1,831.00	$1,831.00	—	24% above	—
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY (INCIDENTAL)	$1,831.00	$1,831.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX-DISTAL FIBULA	$678.00	$678.00	$321.17	94% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX-DISTAL FIBULA	$678.00	$678.00	$321.17	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FRACTURE-METARSAL W/O MANIPULATION	$458.00	$458.00	$227.34	35% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FRACTURE-METARSAL W/O MANIPULATION	$458.00	$458.00	$227.34	—	—
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORR HLX VLGS W/BUNIONECTOMY	$4,680.00	$4,680.00	—	140% above	—
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORR HLX VLGS W/BUNIONECTOMY	$4,680.00	$4,680.00	—	—	—
Bunion correction with removal of part of the big toe joint CPT 28292 BUNIONECTOMY W/WO HAMMERTOE	$2,199.00	$2,199.00	—	74% above	—
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 BUNIONECTOMY W/WO HAMMERTOE	$2,199.00	$2,199.00	—	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE	$641.00	$641.00	—	29% below	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE	$641.00	$641.00	—	—	—
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE	$1,185.00	$1,185.00	—	36% below	—
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE; OPEN	$2,841.00	$2,841.00	—	53% above	—
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE,MEDIAN NERVE	$2,879.00	$2,879.00	—	55% above	—
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE	$1,185.00	$1,185.00	—	—	—
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE; OPEN	$2,841.00	$2,841.00	—	—	—
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE,MEDIAN NERVE	$2,879.00	$2,879.00	—	—	—
Cataract surgery with lens implant CPT 66984 PHACO	$1,340.00	$1,340.00	—	4% below	—
Cataract surgery with lens implant inpatient CPT 66984 PHACO	$1,340.00	$1,340.00	—	—	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$724.00	$724.00	—	at median	—
Cervical biopsy CPT 57500 BIOPSY CERVICAL	$1,152.00	$1,152.00	—	59% above	—
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$724.00	$724.00	—	—	—
Cervical biopsy inpatient CPT 57500 BIOPSY CERVICAL	$1,152.00	$1,152.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX-DISTAL RADIUS W/OUT MANIPULATION	$602.00	$602.00	$364.44	66% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 FX-DISTAL RADIUS W/OUT MANIPULATION	$602.00	$602.00	$364.44	—	—
Colonoscopy with polyp removal CPT 45385 COLONSCOPY WITH LESION REMOVAL	$1,691.00	$1,691.00	—	49% above	—
Colonoscopy with polyp removal inpatient CPT 45385 COLONSCOPY WITH LESION REMOVAL	$1,691.00	$1,691.00	—	—	—
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY	$1,272.00	$1,272.00	—	12% above	—
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY	$1,272.00	$1,272.00	—	—	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY (SPLENIC FLEXURE)	$1,160.00	$1,160.00	—	33% above	—
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY (SPLENIC FLEXURE)	$1,160.00	$1,160.00	—	—	—
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 LEEP PROCEDURE	$1,828.00	$1,828.00	—	32% below	—
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 LEEP PROCEDURE	$1,828.00	$1,828.00	—	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY WITH BX	$389.00	$389.00	—	21% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY WITH BX	$389.00	$389.00	—	—	—
Complex cataract surgery with lens implant CPT 66982 COMPLEX PHACO	$1,838.00	$1,838.00	—	31% above	—
Complex cataract surgery with lens implant CPT 66982 COMPLEX CATARACT	$1,955.00	$1,955.00	—	40% above	—
Complex cataract surgery with lens implant inpatient CPT 66982 COMPLEX PHACO	$1,838.00	$1,838.00	—	—	—
Complex cataract surgery with lens implant inpatient CPT 66982 COMPLEX CATARACT	$1,955.00	$1,955.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$860.00	$860.00	—	15% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$860.00	$860.00	—	—	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C (DIAG AND THERAPUTIC)	$929.00	$929.00	—	at median	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILITATION & CURRETAGE ALL	$981.00	$981.00	—	6% above	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D & C (DIAG AND THERAPUTIC)	$929.00	$929.00	—	—	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILITATION & CURRETAGE ALL	$981.00	$981.00	—	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PROC DESTROY LESION FIRST	$191.00	$191.00	—	110% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PROC DESTROY LESION FIRST	$191.00	$191.00	—	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN/IRRIGATION LAVA	$43.00	$43.00	$16.02	42% below	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN/IRRIGATION LAVA	$43.00	$43.00	$16.02	—	—
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN	$104.00	$104.00	—	24% above	—
Earwax removal with instruments, one ear CPT 69210 EAR REMOVAL IMPACTED CERUMEN	$139.00	$139.00	$35.24	66% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN	$104.00	$104.00	—	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 EAR REMOVAL IMPACTED CERUMEN	$139.00	$139.00	$35.24	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL SAMPLING BX W/WOUT ENDOCERV	$258.00	$258.00	—	13% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING BX W/WOUT ENDOCERV	$258.00	$258.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ CERVICAL OR THORACIC INTERLAMINAR	$304.00	$304.00	—	61% below	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ INTERLAMINAR EPIDURAL CERV OR THOR	$1,030.00	$1,030.00	—	33% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ CERVICAL OR THORACIC INTERLAMINAR	$304.00	$304.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ INTERLAMINAR EPIDURAL CERV OR THOR	$1,030.00	$1,030.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT LUMBAR -FACET JOINT INJ SINGLE LEVEL	$884.00	$884.00	—	18% below	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THER AFT PVRT FACET JT LUM/SAC 1L	$1,246.00	$1,246.00	—	15% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THER AGT PVRT FACET JF LUM/SAC 1L	$1,295.00	$1,295.00	—	20% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT LUMBAR -FACET JOINT INJ SINGLE LEVEL	$884.00	$884.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THER AFT PVRT FACET JT LUM/SAC 1L	$1,246.00	$1,246.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THER AGT PVRT FACET JF LUM/SAC 1L	$1,295.00	$1,295.00	—	—	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 VENTRAL HERNIA REPAIR 3-10CM	$5,358.00	$5,358.00	—	291% above	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 VENTRAL HERNIA REPAIR 3-10CM	$5,358.00	$5,358.00	—	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REP ANTERIOR ABDOMINAL HERNIA <3CM	$834.00	$834.00	—	44% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 ROBO PROF ANT ABD HERNIA REPAIR <3CM	$1,126.00	$1,126.00	—	94% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 ANTERIOR ABDOMINAL HERNIA REPAIR >3CM	$4,987.00	$4,987.00	—	761% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 ROBO ANT ABDOMINAL HERNIA REPAIR >3CM	$6,732.00	$6,732.00	—	1063% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REP ANTERIOR ABDOMINAL HERNIA <3CM	$834.00	$834.00	—	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 ROBO PROF ANT ABD HERNIA REPAIR <3CM	$1,126.00	$1,126.00	—	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 ANTERIOR ABDOMINAL HERNIA REPAIR >3CM	$4,987.00	$4,987.00	—	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 ROBO ANT ABDOMINAL HERNIA REPAIR >3CM	$6,732.00	$6,732.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$371.00	$371.00	—	45% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$540.00	$540.00	—	19% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,257.00	$1,257.00	—	88% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY	$371.00	$371.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$540.00	$540.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,257.00	$1,257.00	—	—	—
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLECYSTECTOMY	$3,256.00	$3,256.00	—	19% above	—
Gallbladder removal, laparoscopic CPT 47562 ROBO PROF LAP CHOLECYSTECTOMY	$4,396.00	$4,396.00	—	61% above	—
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$8,487.00	$8,487.00	—	210% above	—
Gallbladder removal, laparoscopic CPT 47562 ROBO LAP CHOLECYSTECTOMY	$11,457.00	$11,457.00	—	319% above	—
Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLECYSTECTOMY	$3,256.00	$3,256.00	—	—	—
Gallbladder removal, laparoscopic inpatient CPT 47562 ROBO PROF LAP CHOLECYSTECTOMY	$4,396.00	$4,396.00	—	—	—
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$8,487.00	$8,487.00	—	—	—
Gallbladder removal, laparoscopic inpatient CPT 47562 ROBO LAP CHOLECYSTECTOMY	$11,457.00	$11,457.00	—	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE(WITH OPER CHOLANGIOGRAM)	$3,713.00	$3,713.00	—	87% above	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE(WITH OPER CHOLANGIOGRAM)	$3,713.00	$3,713.00	—	—	—
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLE (CHOLECYSTECTOMY)	$2,716.00	$2,716.00	—	41% above	—
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY OPEN	$2,911.00	$2,911.00	—	51% above	—
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLE (CHOLECYSTECTOMY)	$2,716.00	$2,716.00	—	—	—
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY OPEN	$2,911.00	$2,911.00	—	—	—
Hammertoe correction surgery CPT 28285 CORRECTION, HAMMERTOE	$4,486.00	$4,486.00	—	436% above	—
Hammertoe correction surgery inpatient CPT 28285 CORRECTION, HAMMERTOE	$4,486.00	$4,486.00	—	—	—
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOIDS	$423.00	$423.00	—	38% below	—
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID/BANDING OF HEMORR	$1,402.00	$1,402.00	—	105% above	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOIDS	$423.00	$423.00	—	—	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID/BANDING OF HEMORR	$1,402.00	$1,402.00	—	—	—
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL& EXTERNAL	$1,540.00	$1,540.00	—	34% above	—
Hemorrhoidectomy (internal and external), one area CPT 46255 EXCISION OF HEMORRHOIDECTOMY INTERNAL &	$3,891.00	$3,891.00	—	239% above	—
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL& EXTERNAL	$1,540.00	$1,540.00	—	—	—
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 EXCISION OF HEMORRHOIDECTOMY INTERNAL &	$3,891.00	$3,891.00	—	—	—
Hysterectomy through an abdominal incision (total) CPT 58150 HYSTERECTOMY (TAVH BSO)	$3,381.00	$3,381.00	—	29% above	—
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 HYSTERECTOMY (TAVH BSO)	$3,381.00	$3,381.00	—	—	—
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY/SURG W/BX OF ENDO W/O D&C	$2,941.00	$2,941.00	—	5% above	—
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY,SURG W/BX OF ENDO W/O D&C	$4,630.00	$4,630.00	—	65% above	—
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY/SURG W/BX OF ENDO W/O D&C	$2,941.00	$2,941.00	—	—	—
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY,SURG W/BX OF ENDO W/O D&C	$4,630.00	$4,630.00	—	—	—
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD	$220.00	$220.00	—	14% below	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF IUD	$220.00	$220.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABCESS, SIMPLE	$169.00	$169.00	$115.10	34% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS	$271.00	$271.00	$115.10	6% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS; SIMPLE OR SINGLE	$278.00	$278.00	—	9% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABCESS SIMPLE	$282.00	$282.00	—	10% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE OR SINGLE	$282.00	$282.00	$115.10	10% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE OF ABCESS	$1,295.00	$1,295.00	—	406% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABCESS, SIMPLE	$169.00	$169.00	$115.10	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS	$271.00	$271.00	$115.10	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS; SIMPLE OR SINGLE	$278.00	$278.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE OR SINGLE	$282.00	$282.00	$115.10	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABCESS SIMPLE	$282.00	$282.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE OF ABCESS	$1,295.00	$1,295.00	—	—	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA REPAIR INGUINIAL REDUCIBLE>5	$1,677.00	$1,677.00	—	38% above	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA (INGUINAL 5 YR & OVER)	$1,678.00	$1,678.00	—	38% above	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA REPAIR INGUINIAL REDUCIBLE>5	$1,677.00	$1,677.00	—	—	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA (INGUINAL 5 YR & OVER)	$1,678.00	$1,678.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH OR LIG	$410.00	$410.00	—	10% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH OR LIG	$410.00	$410.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS JOINT	$129.00	$129.00	—	66% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS-MAJOR JOINT OR BURSA	$257.00	$257.00	—	33% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS INJ MAJOR JOINT	$269.00	$269.00	$49.97	29% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS	$269.00	$269.00	—	29% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FL ARTHROCENTESIS INJECT MAJOR JOINT**	$272.00	$272.00	—	29% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT	$320.00	$320.00	—	16% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS JOINT	$129.00	$129.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS-MAJOR JOINT OR BURSA	$257.00	$257.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS INJ MAJOR JOINT	$269.00	$269.00	$49.97	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS	$269.00	$269.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 FL ARTHROCENTESIS INJECT MAJOR JOINT**	$272.00	$272.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JOINT	$320.00	$320.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INJ INTERMED JOINT	$213.00	$213.00	$40.31	33% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION LEFT WRIST MASS	$191.00	$191.00	—	40% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INJ INTERMED JOINT	$213.00	$213.00	$40.31	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ASPIRATION LEFT WRIST MASS	$191.00	$191.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS INJECTION SMALL JOINT	$204.00	$204.00	$39.23	41% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT	$396.00	$396.00	—	15% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS INJECTION SMALL JOINT	$204.00	$204.00	$39.23	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT	$396.00	$396.00	—	—	—
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE MENISCECTOMY MEDIAL & LATERAL	$5,031.00	$5,031.00	—	133% above	—
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE MENISCECTOMY MEDIAL & LATERAL	$5,031.00	$5,031.00	—	—	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 ROBO PROF LAP APPENDECTOMY	$1,976.00	$1,976.00	—	47% above	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPARASCOPIC APPENDECTOMY	$8,168.00	$8,168.00	—	509% above	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 ROBO APPENDECTOMY	$11,027.00	$11,027.00	—	722% above	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 ROBO PROF LAP APPENDECTOMY	$1,976.00	$1,976.00	—	—	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPARASCOPIC APPENDECTOMY	$8,168.00	$8,168.00	—	—	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 ROBO APPENDECTOMY	$11,027.00	$11,027.00	—	—	—
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 ROBO TLH UTERUS 250 G OR LESS PROF	$2,429.00	$2,429.00	—	39% above	—
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 ROBO TLH UTERUS 250 G OR LESS	$20,526.00	$20,526.00	—	1078% above	—
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 ROBO TLH UTERUS 250 G OR LESS PROF	$2,429.00	$2,429.00	—	—	—
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 ROBO TLH UTERUS 250 G OR LESS	$20,526.00	$20,526.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPSCPC REPAIR INITIAL INGUINAL HERNIA	$1,053.00	$1,053.00	—	1% above	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 ROBO PROF LAP INIT INGUINAL HERNIA	$1,422.00	$1,422.00	—	36% above	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPSCPY SURG REP INITIAL INGUINAL HERNIA	$8,168.00	$8,168.00	—	681% above	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 ROBO INIT INGUINAL HERNIA	$11,027.00	$11,027.00	—	955% above	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPSCPC REPAIR INITIAL INGUINAL HERNIA	$1,053.00	$1,053.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 ROBO PROF LAP INIT INGUINAL HERNIA	$1,422.00	$1,422.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPSCPY SURG REP INITIAL INGUINAL HERNIA	$8,168.00	$8,168.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 ROBO INIT INGUINAL HERNIA	$11,027.00	$11,027.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 ROBO PROF LAP REP RECURRENT INGNAL HRNIA	$1,856.00	$1,856.00	—	67% above	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP REPAIR RECURRENT INGUINAL HERNIA	$8,648.00	$8,648.00	—	678% above	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 ROBO LAP REP RECURRENT ING HERNIA	$11,675.00	$11,675.00	—	951% above	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 ROBO PROF LAP REP RECURRENT INGNAL HRNIA	$1,856.00	$1,856.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP REPAIR RECURRENT INGUINAL HERNIA	$8,648.00	$8,648.00	—	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 ROBO LAP REP RECURRENT ING HERNIA	$11,675.00	$11,675.00	—	—	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 ROBO LAPAROSCOPY REMOVE ADNEXA PROF	$1,967.00	$1,967.00	—	24% below	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP REMOVAL OF OVARY	$2,969.00	$2,969.00	—	14% above	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 ROBO LAPAROSCOPY REMOVE ADNEXA	$11,674.00	$11,674.00	—	349% above	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 ROBO LAPAROSCOPY REMOVE ADNEXA PROF	$1,967.00	$1,967.00	—	—	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP REMOVAL OF OVARY	$2,969.00	$2,969.00	—	—	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 ROBO LAPAROSCOPY REMOVE ADNEXA	$11,674.00	$11,674.00	—	—	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 CLOUDY AFTER-CATARACT MEMBRANE	$818.00	$818.00	—	30% below	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 CLOUDY AFTER-CATARACT MEMBRANE	$818.00	$818.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR 2.5 OR LESS	$296.00	$296.00	—	23% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACERATION TRUNK 2.5CM LESS LAYERED	$460.00	$460.00	$167.65	20% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$581.00	$581.00	—	52% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE REPAIR 2.5 OR LESS	$296.00	$296.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LACERATION TRUNK 2.5CM LESS LAYERED	$460.00	$460.00	$167.65	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$581.00	$581.00	—	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR/SACRAL ILESI WITH FLUORO	$963.00	$963.00	—	32% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJ INTERLAMINAR EPIDURAL LUMB OR SACRAL	$1,030.00	$1,030.00	—	41% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR/SACRAL ILESI WITH FLUORO	$963.00	$963.00	—	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ INTERLAMINAR EPIDURAL LUMB OR SACRAL	$1,030.00	$1,030.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ LUMBAR OR SACRAL TRANSFORAMINAL	$314.00	$314.00	—	70% below	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSFORAMINAL EPIDURAL LUMB OR SAC	$1,335.00	$1,335.00	—	26% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ LUMBAR OR SACRAL TRANSFORAMINAL	$314.00	$314.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRANSFORAMINAL EPIDURAL LUMB OR SAC	$1,335.00	$1,335.00	—	—	—
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$5,361.00	$5,361.00	—	436% above	—
Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY	$5,361.00	$5,361.00	—	—	—
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY, SIMPLE COMPLETE	$3,033.00	$3,033.00	—	64% above	—
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY, SIMPLE, COMPLETE	$9,130.00	$9,130.00	—	394% above	—
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY, SIMPLE COMPLETE	$3,033.00	$3,033.00	—	—	—
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY, SIMPLE, COMPLETE	$9,130.00	$9,130.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 LESION BENIGN EXCISION TRUNK 0.5 OR LESS	$219.00	$219.00	$91.33	60% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 LESION (BENIGN EXCISION 0.5 OR LESS)	$275.00	$275.00	—	50% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 LESION BENIGN EXCISION TRUNK 0.5 OR LESS	$219.00	$219.00	$91.33	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 LESION (BENIGN EXCISION 0.5 OR LESS)	$275.00	$275.00	—	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 LESION (BENIGN H/F 0.5 OR LESS)	$298.00	$298.00	—	47% below	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 LESION (BENIGN H/F 0.5 OR LESS)	$298.00	$298.00	—	—	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION , NAIL PLATE SIMPLE	$199.00	$199.00	$58.81	2% below	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, PART OR COMPLETE	$201.00	$201.00	$58.81	1% below	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE, SIMPLE, SINGLE	$278.00	$278.00	—	38% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION , NAIL PLATE SIMPLE	$199.00	$199.00	$58.81	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, PART OR COMPLETE	$201.00	$201.00	$58.81	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE, SIMPLE, SINGLE	$278.00	$278.00	—	—	—
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$190.00	$190.00	—	56% below	—
Occipital nerve block (injection for headaches) CPT 64405 INJ AA&/STRD GR OCPL NRV	$439.00	$439.00	—	1% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$190.00	$190.00	—	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ AA&/STRD GR OCPL NRV	$439.00	$439.00	—	—	—
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/ULTRASOUND	$282.00	$282.00	$115.32	76% below	—
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENESIS WITH IMAGING	$594.00	$594.00	—	49% below	—
Paracentesis with imaging guidance CPT 49083 US PARACENTHESIS W N/G	$594.00	$594.00	—	49% below	—
Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS W/IMAGING GUIDANCE	$667.00	$667.00	—	43% below	—
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PERICENTESIS W/IMAGING	$670.00	$670.00	—	43% below	—
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/ULTRASOUND	$282.00	$282.00	$115.32	—	—
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENESIS WITH IMAGING	$594.00	$594.00	—	—	—
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTHESIS W N/G	$594.00	$594.00	—	—	—
Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS W/IMAGING GUIDANCE	$667.00	$667.00	—	—	—
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PERICENTESIS W/IMAGING	$670.00	$670.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL PART/COMPL	$502.00	$502.00	$110.54	1% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EX OF NAIL & NAIL MATRIX PARTIAL/COMPLET	$553.00	$553.00	—	11% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX	$582.00	$582.00	—	17% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAILBED	$582.00	$582.00	—	17% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 MATRIXECTOMY	$844.00	$844.00	—	70% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL PART/COMPL	$502.00	$502.00	$110.54	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EX OF NAIL & NAIL MATRIX PARTIAL/COMPLET	$553.00	$553.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX	$582.00	$582.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAILBED	$582.00	$582.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 MATRIXECTOMY	$844.00	$844.00	—	—	—
Prostate biopsy CPT 55700 BIOPSY PROSTATE	$330.00	$330.00	—	76% below	—
Prostate biopsy CPT 55700 US PROSTATE BIOPSY	$398.00	$398.00	—	71% below	—
Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE	$330.00	$330.00	—	—	—
Prostate biopsy inpatient CPT 55700 US PROSTATE BIOPSY	$398.00	$398.00	—	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST BY NEUR AGNT PARAVRTBRL FAC JNT	$988.00	$988.00	—	44% below	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST OF PARAVERTEBRAL FACET JOINT NERVE	$2,467.00	$2,467.00	—	40% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST BY NEUR AGNT PARAVRTBRL FAC JNT	$988.00	$988.00	—	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST OF PARAVERTEBRAL FACET JOINT NERVE	$2,467.00	$2,467.00	—	—	—
Removal of a breast lump, open surgery CPT 19120 BIOPSY (BREAST EXCISIONAL)	$1,108.00	$1,108.00	—	61% below	—
Removal of a breast lump, open surgery CPT 19120 BREAST LUMPECTOMY ALL	$1,349.00	$1,349.00	—	53% below	—
Removal of a breast lump, open surgery inpatient CPT 19120 BIOPSY (BREAST EXCISIONAL)	$1,108.00	$1,108.00	—	—	—
Removal of a breast lump, open surgery inpatient CPT 19120 BREAST LUMPECTOMY ALL	$1,349.00	$1,349.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION-REMOVAL FOREIGN BODY SUB Q	$267.00	$267.00	—	25% below	—
Removal of a foreign object under the skin, simple CPT 10120 INCSIN/REMOVL FOREGN BODY/SUB TISS SIMP	$267.00	$267.00	$113.94	25% below	—
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FB SUBCUTANEOUS SIMPLE	$423.00	$423.00	$113.94	18% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISN/REMOVL FOREGN BODY/SUBQ TISS SIMP	$553.00	$553.00	—	55% above	—
Removal of a foreign object under the skin, simple CPT 10120 I & R OF FOREIGN BODY SIMPLE	$581.00	$581.00	—	63% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCSIN/REMOVL FOREGN BODY/SUB TISS SIMP	$267.00	$267.00	$113.94	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION-REMOVAL FOREIGN BODY SUB Q	$267.00	$267.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FB SUBCUTANEOUS SIMPLE	$423.00	$423.00	$113.94	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISN/REMOVL FOREGN BODY/SUBQ TISS SIMP	$553.00	$553.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 I & R OF FOREIGN BODY SIMPLE	$581.00	$581.00	—	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCREENING COLONOSCOPY - NOT HIGH RISK	$1,062.00	$1,062.00	—	22% above	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCREENING COLONOSCOPY - NOT HIGH RISK	$1,062.00	$1,062.00	—	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONOSCOPY - HIGH RISK	$1,062.00	$1,062.00	—	22% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCREENING COLONOSCOPY - HIGH RISK	$1,062.00	$1,062.00	—	—	—
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM	$193.00	$193.00	$69.52	11% below	—
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM	$193.00	$193.00	$69.52	—	—
Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM APPLICATION OF	$142.00	$142.00	$44.11	19% below	—
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT SHORT ARM APPLICATION OF	$142.00	$142.00	$44.11	—	—
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG	$224.00	$224.00	$64.57	18% below	—
Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG	$224.00	$224.00	$64.57	—	—
Short leg splint (calf to foot) CPT 29515 SPLINT, SHORT LEG APPLICATION OF	$129.00	$129.00	$55.10	19% below	—
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT, SHORT LEG APPLICATION OF	$129.00	$129.00	$55.10	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACERATION TRUNK 2.5 LESS SIMPLE	$285.00	$285.00	$51.20	36% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< SIMPLE	$287.00	$287.00	—	37% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SNT & EXT REPAIR WD (SIMPLE 2.5)	$309.00	$309.00	—	47% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACERATION TRUNK 2.5 LESS SIMPLE	$285.00	$285.00	$51.20	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< SIMPLE	$287.00	$287.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SNT & EXT REPAIR WD (SIMPLE 2.5)	$309.00	$309.00	—	—	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN	$564.00	$564.00	—	78% above	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOP OF SKIN(SIMP CLOURE)SINGL LES	$564.00	$564.00	$51.16	78% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN	$564.00	$564.00	—	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOP OF SKIN(SIMP CLOURE)SINGL LES	$564.00	$564.00	$51.16	—	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS	$196.00	$196.00	—	7% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO 15 LESIONS	$196.00	$196.00	$82.46	7% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS	$196.00	$196.00	—	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UP TO 15 LESIONS	$196.00	$196.00	$82.46	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$490.00	$490.00	$72.17	39% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$1,010.00	$1,010.00	—	27% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$490.00	$490.00	$72.17	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$1,010.00	$1,010.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK 2.6-7.5CM SIMPLE	$287.00	$287.00	—	19% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SNT & EXT REPAIR WD 2.6-7.5	$307.00	$307.00	—	27% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LACERATION TRUNK 2.6-7.5CM SI	$346.00	$346.00	$65.56	44% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK 2.6-7.5CM SIMPLE	$287.00	$287.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SNT & EXT REPAIR WD 2.6-7.5	$307.00	$307.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LACERATION TRUNK 2.6-7.5CM SI	$346.00	$346.00	$65.56	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 FEENL/REPAIR WD SIMPLE 2.5	$223.00	$223.00	—	6% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5CM/< SIMPLE	$287.00	$287.00	—	22% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACERATION FACE/MOUTH 2.5CM SIMPLE	$345.00	$345.00	$62.18	46% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 FEENL/REPAIR WD SIMPLE 2.5	$223.00	$223.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5CM/< SIMPLE	$287.00	$287.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LACERATION FACE/MOUTH 2.5CM SIMPLE	$345.00	$345.00	$62.18	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN	$273.00	$273.00	—	16% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$273.00	$273.00	—	16% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN	$273.00	$273.00	—	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$273.00	$273.00	—	—	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING GUIDANCE	$297.00	$297.00	$118.35	72% below	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ULTRASOUND GUIDANCE	$698.00	$698.00	—	33% below	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WITH IMAGING GUIDANCE	$938.00	$938.00	—	10% below	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WITH IMAGING	$938.00	$938.00	$118.35	10% below	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING GUIDANCE	$297.00	$297.00	$118.35	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ULTRASOUND GUIDANCE	$698.00	$698.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WITH IMAGING GUIDANCE	$938.00	$938.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WITH IMAGING	$938.00	$938.00	$118.35	—	—
Tonsil and adenoid removal, child under 12 CPT 42820 T & A (UNDER AGE 12)	$1,003.00	$1,003.00	—	38% above	—
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 T & A (UNDER AGE 12)	$1,003.00	$1,003.00	—	—	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 T & A (OVER AGE 12)	$1,211.00	$1,211.00	—	61% above	—
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 T & A (OVER AGE 12)	$1,211.00	$1,211.00	—	—	—
Total hip replacement CPT 27130 HIP ARTHROPLASTY	$4,298.00	$4,298.00	—	23% below	—
Total hip replacement inpatient CPT 27130 HIP ARTHROPLASTY	$4,298.00	$4,298.00	—	—	—
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$4,232.00	$4,232.00	—	25% below	—
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$4,232.00	$4,232.00	—	—	—
Trigger finger release surgery CPT 26055 TRIGGER FINGER RELEASE	$1,198.00	$1,198.00	—	26% below	—
Trigger finger release surgery inpatient CPT 26055 TRIGGER FINGER RELEASE	$1,198.00	$1,198.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJ ONE OR TWO MUSCLES GRPS	$105.00	$105.00	—	72% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 SINGLE OR MULT TRIGGER POINTS 1 OR 2 MUS	$192.00	$192.00	—	50% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULT TRIGGER PTS 1or 2	$236.00	$236.00	$39.80	38% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL OR MULT TRIGGER POINTS 1/2 MUSCL	$413.00	$413.00	—	8% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJ ONE OR TWO MUSCLES GRPS	$105.00	$105.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 SINGLE OR MULT TRIGGER POINTS 1 OR 2 MUS	$192.00	$192.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULT TRIGGER PTS 1or 2	$236.00	$236.00	$39.80	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SGL OR MULT TRIGGER POINTS 1/2 MUSCL	$413.00	$413.00	—	—	—
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY (FULGARATION)	$1,867.00	$1,867.00	—	88% above	—
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY (FULGARATION)	$1,867.00	$1,867.00	—	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US GUIDED BREAST BIOPSY; FIRST LESION	$1,090.00	$1,090.00	—	35% below	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST WITH US GUIDANCE SINGLE	$1,426.00	$1,426.00	—	15% below	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US GUIDED BREAST BIOPSY; FIRST LESION	$1,090.00	$1,090.00	—	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST WITH US GUIDANCE SINGLE	$1,426.00	$1,426.00	—	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALLOON DILATION LESS THAN 30MM	$918.00	$918.00	—	46% below	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALLOON DILATION LESS THAN 30MM	$918.00	$918.00	—	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD (WITH BX)	$874.00	$874.00	—	1% above	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH AND WITHOUT ANESTHESIA	$1,069.00	$1,069.00	—	23% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD (WITH BX)	$874.00	$874.00	—	—	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH AND WITHOUT ANESTHESIA	$1,069.00	$1,069.00	—	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD WITH SNARE POLYPECTOMY	$1,127.00	$1,127.00	—	at median	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD WITH SNARE POLYPECTOMY	$1,127.00	$1,127.00	—	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD/BRUSHING BIOPSY/ESOPHAGEAL DILAT	$1,003.00	$1,003.00	—	44% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD WITH DILATION OF ESOPHOGUS	$1,576.00	$1,576.00	—	126% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD/BRUSHING BIOPSY/ESOPHAGEAL DILAT	$1,003.00	$1,003.00	—	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD WITH DILATION OF ESOPHOGUS	$1,576.00	$1,576.00	—	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$787.00	$787.00	—	9% below	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$787.00	$787.00	—	—	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$1,020.00	$1,020.00	—	66% below	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$1,020.00	$1,020.00	—	—	—
Wart removal, up to 14 warts CPT 17110 PROC DESTROY FLWARTS 1-14	$174.00	$174.00	—	4% below	—
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF BENIGN LESION (1-14)	$225.00	$225.00	$73.73	24% above	—
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS 1-14	$235.00	$235.00	—	29% above	—
Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESION 1-14	$235.00	$235.00	—	29% above	—
Wart removal, up to 14 warts inpatient CPT 17110 PROC DESTROY FLWARTS 1-14	$174.00	$174.00	—	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF BENIGN LESION (1-14)	$225.00	$225.00	$73.73	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS 1-14	$235.00	$235.00	—	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LESION 1-14	$235.00	$235.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ TISSUE >20 SQCM	$214.00	$214.00	$66.29	53% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ TISSUE <20SQ CM	$343.00	$343.00	—	25% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ 1ST 20 SQ CM	$356.00	$356.00	$66.29	22% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN AND SUB Q TISSUE	$370.00	$370.00	$66.29	19% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ TISSUE FIRST 20 SQ CM	$581.00	$581.00	—	27% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ TISSUE >20 SQCM	$214.00	$214.00	$66.29	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ TISSUE <20SQ CM	$343.00	$343.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ 1ST 20 SQ CM	$356.00	$356.00	$66.29	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN AND SUB Q TISSUE	$370.00	$370.00	$66.29	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ TISSUE FIRST 20 SQ CM	$581.00	$581.00	—	—	—
Wrist fracture surgery (plate and screws), distal radius CPT 25607 ORIF OF DISTAL RADIUS	$2,430.00	$2,430.00	—	115% above	—
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 ORIF OF DISTAL RADIUS	$2,430.00	$2,430.00	—	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN UP TO 2 HOURS	$208.00	$208.00	—	67% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION UP TO 2 HRS	$208.00	$208.00	—	67% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION UP TO 2HRS	$208.00	$208.00	—	67% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION >4 HOURS	$220.00	$220.00	—	65% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 3-4 HOURS	$397.00	$397.00	—	37% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 3-4HRS	$412.00	$412.00	—	34% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN OVER 4 HOURS	$619.00	$619.00	—	1% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION OVER 4 HRS	$619.00	$619.00	—	1% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION >4HRS	$619.00	$619.00	—	1% below	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN UP TO 2 HOURS	$208.00	$208.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION UP TO 2 HRS	$208.00	$208.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION UP TO 2HRS	$208.00	$208.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION >4 HOURS	$220.00	$220.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 3-4 HOURS	$397.00	$397.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 3-4HRS	$412.00	$412.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN OVER 4 HOURS	$619.00	$619.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION OVER 4 HRS	$619.00	$619.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION >4HRS	$619.00	$619.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT	$67.00	$67.00	—	61% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT	$67.00	$67.00	—	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HOUR	$611.00	$611.00	—	31% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HOUR	$611.00	$611.00	—	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE (1ST HR)	$561.00	$561.00	—	66% below	—
Critical care, first 30 to 74 minutes CPT 99291 ER DOCTOR INTENSIVE CARE 1ST HOUR	$622.00	$622.00	$234.72	62% below	—
Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY CRITICAL CARE 30-74	$2,813.00	$2,813.00	—	70% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE (1ST HR)	$561.00	$561.00	—	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER DOCTOR INTENSIVE CARE 1ST HOUR	$622.00	$622.00	$234.72	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY CRITICAL CARE 30-74	$2,813.00	$2,813.00	—	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE	$926.00	$926.00	—	37% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE	$926.00	$926.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 OFFICE EKG	$170.00	$170.00	—	38% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG-ELECTROCARDIOGRAM	$170.00	$170.00	—	38% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG-ELECTROCARDIOGRAM	$170.00	$170.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 OFFICE EKG	$170.00	$170.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER DOCTOR BRIEF SERVICE	$72.00	$72.00	$12.64	45% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL 1	$249.00	$249.00	—	90% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER SERVICES (INTERMEDIATE)	$349.00	$349.00	—	166% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER DOCTOR BRIEF SERVICE	$72.00	$72.00	$12.64	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM LEVEL 1	$249.00	$249.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER SERVICES (INTERMEDIATE)	$349.00	$349.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER DOCTOR LIMITED SERVICE	$142.00	$142.00	$46.41	55% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER SERVICES (EXTENDED)	$152.00	$152.00	—	52% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL 2	$356.00	$356.00	—	12% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER DOCTOR LIMITED SERVICE	$142.00	$142.00	$46.41	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER SERVICES (EXTENDED)	$152.00	$152.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY ROOM LEVEL 2	$356.00	$356.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER SERVICES (COMP LOW)	$216.00	$216.00	—	59% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER DOCTOR INTERMEDIATE SERVICE	$216.00	$216.00	$78.36	59% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL 3	$556.00	$556.00	—	5% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER SERVICES (COMP LOW)	$216.00	$216.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER DOCTOR INTERMEDIATE SERVICE	$216.00	$216.00	$78.36	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM LEVEL 3	$556.00	$556.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER DOCTOR EXTENDED SERVICE	$314.00	$314.00	$133.89	65% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER SERVICES (COMP MOD)	$367.00	$367.00	—	59% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL 4	$997.00	$997.00	—	11% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER DOCTOR EXTENDED SERVICE	$314.00	$314.00	$133.89	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER SERVICES (COMP MOD)	$367.00	$367.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM LEVEL 4	$997.00	$997.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER DOC PATIENT COMPREHENSIVE SERVICE	$443.00	$443.00	$194.33	64% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER SERVICES (COMP HIGH)	$487.00	$487.00	—	61% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL 5	$1,886.00	$1,886.00	—	53% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER DOC PATIENT COMPREHENSIVE SERVICE	$443.00	$443.00	$194.33	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER SERVICES (COMP HIGH)	$487.00	$487.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM LEVEL 5	$1,886.00	$1,886.00	—	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 NM *CARDIOVASCULAR STRESS W/O INTERPRET	$751.00	$751.00	—	3% below	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM *CARDIOVASCULAR STRESS W/O INTERPRET	$751.00	$751.00	—	—	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT PRESENT	$470.00	$470.00	—	256% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT PRESENT	$470.00	$470.00	—	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT	$470.00	$470.00	—	248% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT	$470.00	$470.00	—	—	—
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$416.00	$416.00	—	611% above	—
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY	$416.00	$416.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION 31-60MIN	$106.00	$106.00	—	58% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION 31MIN-1 HR	$106.00	$106.00	—	58% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION-INITIAL	$106.00	$106.00	—	58% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION 31MIN-1 HR	$106.00	$106.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION-INITIAL	$106.00	$106.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION INFUSION 31-60MIN	$106.00	$106.00	—	—	—
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THER/PROPH INIT UP TO 1HR	$254.00	$254.00	—	13% below	—
IV infusion of a medicine, first hour CPT 96365 IV INFUSION/PROPH/DX UP TO 1HR	$254.00	$254.00	—	13% below	—
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INFUSION INITIAL	$254.00	$254.00	—	13% below	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION/PROPH/DX UP TO 1HR	$254.00	$254.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INFUSION INITIAL	$254.00	$254.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER/PROPH INIT UP TO 1HR	$254.00	$254.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION,SUB Q OR IM	$43.00	$43.00	—	53% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INTRAMUSCULAR INJECTION	$59.00	$59.00	$15.24	35% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH DIAG INJ SQ/IM	$59.00	$59.00	—	35% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$59.00	$59.00	—	35% below	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION,SUB Q OR IM	$43.00	$43.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INTRAMUSCULAR INJECTION	$59.00	$59.00	$15.24	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$59.00	$59.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH DIAG INJ SQ/IM	$59.00	$59.00	—	—	—
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR REEDUCATION 15 MIN	$108.00	$108.00	—	37% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-ED 15 MIN	$108.00	$108.00	—	37% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-ED 15 MIN	$108.00	$108.00	—	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR REEDUCATION 15 MIN	$108.00	$108.00	—	—	—
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT EVAL NEW PT LEVEL 3	$195.00	$195.00	$89.88	77% above	—
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3	$195.00	$195.00	$89.88	77% above	—
New patient office visit, about 30 minutes CPT 99203 AMBULATORY NEW PT LEVEL 3	$510.00	$510.00	—	364% above	—
New patient office visit, about 30 minutes CPT 99203 NEW PT LEVEL 3	$510.00	$510.00	—	364% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT EVAL NEW PT LEVEL 3	$195.00	$195.00	$89.88	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3	$195.00	$195.00	$89.88	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 AMBULATORY NEW PT LEVEL 3	$510.00	$510.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT LEVEL 3	$510.00	$510.00	—	—	—
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4	$269.00	$269.00	$146.15	128% above	—
New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT EVAL NEW PT LEVEL 4	$269.00	$269.00	$146.15	128% above	—
New patient office visit, about 45 minutes CPT 99204 AMBULATORY NEW PT LEVEL 4	$754.00	$754.00	—	538% above	—
New patient office visit, about 45 minutes CPT 99204 NEW PT LEVEL 4	$754.00	$754.00	—	538% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT EVAL NEW PT LEVEL 4	$269.00	$269.00	$146.15	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4	$269.00	$269.00	$146.15	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT LEVEL 4	$754.00	$754.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 AMBULATORY NEW PT LEVEL 4	$754.00	$754.00	—	—	—
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5	$366.00	$366.00	$198.92	149% above	—
New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT EVAL NEW PT LEVEL 5	$366.00	$366.00	$198.92	149% above	—
New patient office visit, about 60 minutes CPT 99205 AMBULATORY NEW PT LEVEL 5	$1,005.00	$1,005.00	—	582% above	—
New patient office visit, about 60 minutes CPT 99205 NEW PT LEVEL 5	$1,005.00	$1,005.00	—	582% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT EVAL NEW PT LEVEL 5	$366.00	$366.00	$198.92	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5	$366.00	$366.00	$198.92	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 AMBULATORY NEW PT LEVEL 5	$1,005.00	$1,005.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT LEVEL 5	$1,005.00	$1,005.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2	$148.00	$148.00	$51.21	97% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT EVAL NEW PT LEVEL 2	$148.00	$148.00	$51.21	97% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT LEVEL 2	$316.00	$316.00	—	321% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 AMBULATORY NEW PT LEVEL 2	$316.00	$316.00	—	321% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2	$148.00	$148.00	$51.21	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT EVAL NEW PT LEVEL 2	$148.00	$148.00	$51.21	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 AMBULATORY NEW PT LEVEL 2	$316.00	$316.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT LEVEL 2	$316.00	$316.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT-INDIVIDUAL INITIAL EA 15 MIN	$43.00	$43.00	—	2% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INIT ASSESSMT&INTERVENTION, EA 15 MI	$83.00	$83.00	—	97% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TELE MNT INIT ASSESS & INTERV, EA 15 MI	$83.00	$83.00	—	97% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT-INDIVIDUAL INITIAL EA 15 MIN	$43.00	$43.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INIT ASSESSMT&INTERVENTION, EA 15 MI	$83.00	$83.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TELE MNT INIT ASSESS & INTERV, EA 15 MI	$83.00	$83.00	—	—	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION x15 MIN	$214.00	$214.00	—	8% above	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY	$214.00	$214.00	—	8% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION x15 MIN	$214.00	$214.00	—	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY	$214.00	$214.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION X45 MIN	$588.00	$588.00	—	168% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY	$588.00	$588.00	—	168% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY	$588.00	$588.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION X45 MIN	$588.00	$588.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY	$195.00	$195.00	—	2% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION X15 MIN	$195.00	$195.00	—	2% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY	$195.00	$195.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION X15 MIN	$195.00	$195.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION X30 MIN	$393.00	$393.00	—	75% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY	$393.00	$393.00	—	75% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY	$393.00	$393.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION X30 MIN	$393.00	$393.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN	$130.00	$130.00	—	60% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15 MIN	$130.00	$130.00	—	60% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY 15 MIN	$130.00	$130.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15 MIN	$130.00	$130.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER PROCEDURES 15 MIN	$88.00	$88.00	—	7% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER PROCEDURE 15 MIN	$88.00	$88.00	—	7% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THER PROCEDURE 15 MIN	$88.00	$88.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THER PROCEDURES 15 MIN	$88.00	$88.00	—	—	—
Psychotherapy session, 30 minutes CPT 90832 16-37 MINS INDIVIDUAL PSYCHOTHERAPY	$427.00	$427.00	—	201% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 16-37 MINS INDIVIDUAL PSYCHOTHERAPY	$427.00	$427.00	—	—	—
Psychotherapy session, 45 minutes CPT 90834 38-52 MINS INDIVIDUAL PSYCHOTHERAPY	$459.00	$459.00	—	161% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 38-52 MINS INDIVIDUAL PSYCHOTHERAPY	$459.00	$459.00	—	—	—
Psychotherapy session, 60 minutes CPT 90837 53-67 MINS INDIVIDUAL PSYCHOTHERAPY	$470.00	$470.00	—	118% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 53-67 MINS INDIVIDUAL PSYCHOTHERAPY	$470.00	$470.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT LEVEL 5	$282.00	$282.00	$156.70	139% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 FOLLOW UP VISIT LEVEL 5	$318.00	$318.00	$156.70	169% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED LEVEL 5	$916.00	$916.00	$156.70	675% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 AMBULATORY ESTABLISHED PT LEVEL 5	$916.00	$916.00	—	675% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED PATIENT LEVEL 5	$282.00	$282.00	$156.70	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 FOLLOW UP VISIT LEVEL 5	$318.00	$318.00	$156.70	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 AMBULATORY ESTABLISHED PT LEVEL 5	$916.00	$916.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED LEVEL 5	$916.00	$916.00	$156.70	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PT LEVEL 3	$114.00	$114.00	$72.04	23% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT LEVEL 3	$142.00	$142.00	$72.04	53% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 AMBULATORY ESTABLISHED PT LEVEL 3	$461.00	$461.00	—	398% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED LEVEL 3	$461.00	$461.00	$72.04	398% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PT LEVEL 3	$114.00	$114.00	$72.04	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PATIENT LEVEL 3	$142.00	$142.00	$72.04	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 AMBULATORY ESTABLISHED PT LEVEL 3	$461.00	$461.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED LEVEL 3	$461.00	$461.00	$72.04	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT LEVEL 4	$213.00	$213.00	$106.09	80% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PT VISIT LEVEL 4	$238.00	$238.00	$106.09	101% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 AMBULATORY ESTABLISHED PT LEVEL 4	$685.00	$685.00	—	480% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED LEVEL 4	$685.00	$685.00	$106.09	480% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PATIENT LEVEL 4	$213.00	$213.00	$106.09	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PT VISIT LEVEL 4	$238.00	$238.00	$106.09	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED LEVEL 4	$685.00	$685.00	$106.09	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 AMBULATORY ESTABLISHED PT LEVEL 4	$685.00	$685.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT LEVEL 2	$85.00	$85.00	$38.39	91% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 FOLLOW UP VISIST LEVEL 2	$101.00	$101.00	$38.39	127% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 AMBULATORY ESTABLISHED PT LEVEL 2	$289.00	$289.00	—	550% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED LEVEL 2	$289.00	$289.00	$38.39	550% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PATIENT LEVEL 2	$85.00	$85.00	$38.39	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 FOLLOW UP VISIST LEVEL 2	$101.00	$101.00	$38.39	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED LEVEL 2	$289.00	$289.00	$38.39	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 AMBULATORY ESTABLISHED PT LEVEL 2	$289.00	$289.00	—	—	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 OP CONSULT (COMP LOW)	$281.00	$281.00	—	107% above	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OP CONSULT (COMP LOW)	$281.00	$281.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OP CONSULT (COMP MODERATE)	$394.00	$394.00	—	107% above	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OP CONSULT (COMP MODERATE)	$394.00	$394.00	—	—	—
Speech therapy session, individual CPT 92507 ST INDIVIDUAL THERAPY	$180.00	$180.00	—	13% below	—
Speech therapy session, individual inpatient CPT 92507 ST INDIVIDUAL THERAPY	$180.00	$180.00	—	—	—
Spirometry (breathing test) CPT 94010 PFT BASIC SPRIOMETRY	$297.00	$297.00	—	59% above	—
Spirometry (breathing test) inpatient CPT 94010 PFT BASIC SPRIOMETRY	$297.00	$297.00	—	—	—
Spirometry before and after a bronchodilator CPT 94060 PFT BEFORE AND AFTER	$461.00	$461.00	—	17% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT BEFORE AND AFTER	$461.00	$461.00	—	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THER ACTIVITIES 15 MIN	$109.00	$109.00	—	42% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACTIVITIES 15 MIN	$109.00	$109.00	—	42% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THER ACTIVITIES 15 MIN	$109.00	$109.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THER ACTIVITIES 15 MIN	$109.00	$109.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 **BB PHLEBOTOMY THERAPEUTIC	$130.00	$130.00	—	38% below	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 **BB PHLEBOTOMY THERAPEUTIC	$130.00	$130.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFIZER COMIRNATY DOSE COVID 19	$230.00	$230.00	—	15% above	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PFIZER COMIRNATY DOSE COVID 19	$230.00	$230.00	—	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS B VACCINE RECOM 1 ML	$158.00	$158.00	—	5% below	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS B VACCINE RECOM 1 ML	$158.00	$158.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH DOSE VACCINE	$130.00	$130.00	—	92% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH DOSE VACCINE	$130.00	$130.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 23MCG/INJ	$268.00	$268.00	—	86% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 23MCG/INJ	$268.00	$268.00	—	—	—
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES INJ (SERIES 0,3,7,14)	$1,000.00	$1,000.00	—	94% above	—
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES INJ (SERIES 0,3,7,14)	$1,000.00	$1,000.00	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET/DIP ADULT 0.5ML INJ(TENIVAC) Td	$120.00	$120.00	—	129% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET/DIP ADULT 0.5ML INJ(TENIVAC) Td	$120.00	$120.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TET/TOX/DIPHT/PERTUSSIS) Tdap	$150.00	$150.00	—	127% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TET/TOX/DIPHT/PERTUSSIS) Tdap	$150.00	$150.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$50.00	$50.00	—	117% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION SINGLE	$50.00	$50.00	—	117% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$50.00	$50.00	—	117% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION SINGLE	$50.00	$50.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$50.00	$50.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$50.00	$50.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADDL HR	$38.00	$38.00	—	94% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD'L	$38.00	$38.00	—	94% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADDL	$38.00	$38.00	—	94% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADDL HR	$38.00	$38.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD'L	$38.00	$38.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADDL	$38.00	$38.00	—	—	—

Source file: https://bcmh.org/wp-content/uploads/2026/06/382892565_baraga-county-memorial-hospital_standardcharges-1.csv