Hospital

Black River Memorial Hospital

Listed in its price file as “Black River Health Inc”.

Black River Memorial Hospital in Black River Falls, WI publishes cash prices for 319 common procedures listed here, from its own machine-readable price file updated Jan 8, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Wisconsin median for 240 of 316 procedures and below it for 76. By typical cash price it ranks #91 of 93 Wisconsin hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

711 W Adams St, Black River Falls, WI 54615-9108 Collected Sep 27, 2026 Source price file (715) 284-5361

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 521333 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Comp Min 3 Views Rt	$411.30	$457.00	$233.07–$452.43	143% above	10%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Comp Min 3 Views Lt	$411.30	$457.00	$233.07–$452.43	143% above	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 UPR/L XTREMITY ART 2 LEVELS	$623.70	$693.00	$353.43–$686.07	72% above	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 UPR/L XTREMITY ART 2 LEVELS	$623.70	$693.00	$353.43–$686.07	72% above	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Ankle Brachial Index	$663.30	$737.00	$375.87–$729.63	83% above	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 UPR/L XTREMITY ART 2 LEVELS	$623.70	$693.00	$353.43–$686.07	—	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 UPR/L XTREMITY ART 2 LEVELS	$623.70	$693.00	$353.43–$686.07	—	10%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus (Fluoro)	$558.90	$621.00	$316.71–$614.79	40% above	10%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Whole Body	$1,909.80	$2,122.00	$1,082.22–$2,100.78	37% above	10%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt	$542.70	$603.00	$307.53–$596.97	22% above	10%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt	$542.70	$603.00	$307.53–$596.97	22% above	10%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED RIGHT TC	$605.70	$673.00	$343.23–$666.27	81% above	10%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED LEFT TC	$605.70	$673.00	$343.23–$666.27	81% above	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$3,235.50	$3,595.00	$1,833.45–$3,559.05	83% above	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 BRMH CT Angio Chest PE	$3,235.50	$3,595.00	$1,833.45–$3,559.05	83% above	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE w/ Cont	$3,235.50	$3,595.00	$1,833.45–$3,559.05	83% above	10%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Heart +Coronary Arteries	$2,655.00	$2,950.00	$1,504.50–$2,920.50	59% above	10%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Cardiac Calcium Score	$286.20	$318.00	$162.18–$314.82	566% above	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Enterography w/o Cont	$2,718.90	$3,021.00	$1,540.71–$2,990.79	43% above	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen + Pelvis w/o Contrast	$2,800.80	$3,112.00	$1,587.12–$3,080.88	47% above	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT KUB	$2,800.80	$3,112.00	$1,587.12–$3,080.88	47% above	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen +Pelvis w/o Cont	$2,800.80	$3,112.00	$1,587.12–$3,080.88	47% above	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography w/ Cont	$3,726.00	$4,140.00	$2,111.40–$4,098.60	104% above	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen + Pelvis w/cont	$3,837.60	$4,264.00	$2,174.64–$4,221.36	110% above	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Angio Chest PE+Abdomen+Pelvis w/Cont	$3,837.60	$4,264.00	$2,174.64–$4,221.36	110% above	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen +Pelvis w/ Cont	$3,837.60	$4,264.00	$2,174.64–$4,221.36	110% above	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen + Pelvis w/ + w/o cont	$4,760.10	$5,289.00	$2,697.39–$5,236.11	113% above	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen +Pelvis w/ + w/o Cont	$4,760.10	$5,289.00	$2,697.39–$5,236.11	113% above	10%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Cont	$2,833.20	$3,148.00	$1,605.48–$3,116.52	93% above	10%
CT scan of the abdomen with contrast CPT 74160 CT Chest +Abdomen w/ Cont	$2,833.20	$3,148.00	$1,605.48–$3,116.52	93% above	10%
CT scan of the abdomen without contrast CPT 74150 CT Chest +Abdomen w/o Cont	$1,976.40	$2,196.00	$1,119.96–$2,174.04	90% above	10%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Cont	$1,976.40	$2,196.00	$1,119.96–$2,174.04	90% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Cont	$1,708.20	$1,898.00	$967.98–$1,879.02	73% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus Full	$1,708.20	$1,898.00	$967.98–$1,879.02	73% above	10%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Cont	$1,691.10	$1,879.00	$958.29–$1,860.21	81% above	10%
CT scan of the head or brain, no contrast dye CPT 70450 CT Stroke Study	$1,691.10	$1,879.00	$958.29–$1,860.21	81% above	10%
CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Cont	$2,019.60	$2,244.00	$1,144.44–$2,221.56	74% above	10%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Cont	$2,592.90	$2,881.00	$1,469.31–$2,852.19	93% above	10%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Cont	$2,034.90	$2,261.00	$1,153.11–$2,238.39	87% above	10%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Cont	$2,044.80	$2,272.00	$1,158.72–$2,249.28	88% above	10%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Cont	$2,714.40	$3,016.00	$1,538.16–$2,985.84	84% above	10%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Carotid Duplex Bil	$1,339.20	$1,488.00	$758.88–$1,473.12	36% above	10%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID ULTRASOUND (TC)	$1,701.00	$1,890.00	$963.90–$1,871.10	72% above	10%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID ULTRASOUND (TC)	$1,701.00	$1,890.00	$963.90–$1,871.10	72% above	10%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID ULTRASOUND (TC)	$1,701.00	$1,890.00	$963.90–$1,871.10	—	10%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID ULTRASOUND (TC)	$1,701.00	$1,890.00	$963.90–$1,871.10	—	10%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$300.60	$334.00	$170.34–$330.66	76% above	10%
Chest X-ray, single view CPT 71045 XR Chest 1 View Discount	$150.30	$167.00	$85.17–$165.33	16% above	10%
Chest X-ray, single view CPT 71045 XR Chest 1 View	$414.90	$461.00	$235.11–$456.39	220% above	10%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Comp	$748.80	$832.00	$424.32–$823.68	47% above	10%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY STUDY	$997.20	$1,108.00	$565.08–$1,096.92	268% above	10%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY APPENDICULAR SKELETON	$432.90	$481.00	$245.31–$476.19	180% above	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 BRMH CT Chest w/o Cont	$1,953.90	$2,171.00	$1,107.21–$2,149.29	79% above	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Cont	$1,953.90	$2,171.00	$1,107.21–$2,149.29	79% above	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Cont	$2,362.50	$2,625.00	$1,338.75–$2,598.75	76% above	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 BRMH CT Chest w/ Cont	$2,362.50	$2,625.00	$1,338.75–$2,598.75	76% above	10%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI (TC)	$873.90	$971.00	$495.21–$990.42	—	10%
Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography including CAD when performed (RT) (TC)	$615.60	$684.00	$348.84–$697.68	180% above	10%
Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography including CAD when performed (LT) (TC)	$615.60	$684.00	$348.84–$697.68	180% above	10%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US LE Art Duplex Bil	$1,656.90	$1,841.00	$938.91–$1,822.59	153% above	10%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VASCULAR US BILATERAL EXT (TC)	$1,317.60	$1,464.00	$746.64–$1,449.36	—	10%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VASCULAR US BILATERAL EXT (TC)	$1,317.60	$1,464.00	$746.64–$1,449.36	—	10%
Duplex ultrasound of the leg veins, both legs CPT 93970 US UE Veins Duplex Bil	$1,455.30	$1,617.00	$824.67–$1,600.83	42% above	10%
Duplex ultrasound of the leg veins, both legs CPT 93970 US LE Veins Duplex Bil	$1,455.30	$1,617.00	$824.67–$1,600.83	42% above	10%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VASCULAR US BILATERAL EXT (TC)	$1,317.60	$1,464.00	$746.64–$1,449.36	—	10%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VASCULAR US BILATERAL EXT (TC)	$1,317.60	$1,464.00	$746.64–$1,449.36	—	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY TRANSTHORACIC	$1,717.20	$1,908.00	$973.08–$1,888.92	25% above	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY TRANSTHORACIC	$1,717.20	$1,908.00	$973.08–$1,888.92	25% above	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Comp w/ Color Flow Doppler	$2,681.10	$2,979.00	$1,519.29–$2,949.21	95% above	10%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY TRANSTHORACIC	$1,717.20	$1,908.00	$973.08–$1,888.92	—	10%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY TRANSTHORACIC	$1,717.20	$1,908.00	$973.08–$1,888.92	—	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepa Duct System w/o Pharm	$1,698.30	$1,887.00	$962.37–$1,868.13	49% above	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepa Duct System w/o Pharm	$1,698.30	$1,887.00	$962.37–$1,868.13	49% above	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepa Duct System w/o Pharm	$1,698.30	$1,887.00	$962.37–$1,868.13	—	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepa Duct System w/o Pharm	$1,698.30	$1,887.00	$962.37–$1,868.13	—	10%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Type 3 Home Sleep Study Charge 95806	$1,048.50	$1,165.00	$594.15–$1,153.35	71% above	10%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Type 3 Home Sleep Study Charge 95806	$1,048.50	$1,165.00	$594.15–$1,153.35	71% above	10%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Type 3 Home Sleep Study Charge 95806	$1,048.50	$1,165.00	$594.15–$1,153.35	—	10%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Type 3 Home Sleep Study Charge 95806	$1,048.50	$1,165.00	$594.15–$1,153.35	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 SPLIT POLY STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	87% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 TITRATION STUDY < 6 HRS CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	87% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 TITRATION STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	87% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 TITRATION STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	87% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 SPLIT POLY STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	87% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 TITRATION STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 SPLIT POLY STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 SPLIT POLY STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 TITRATION STUDY CHARGE	$6,328.80	$7,032.00	$3,586.32–$6,961.68	—	10%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Rt	$460.80	$512.00	$261.12–$506.88	114% above	10%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Lt	$460.80	$512.00	$261.12–$506.88	114% above	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd	$640.80	$712.00	$363.12–$704.88	51% above	10%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Chest Low Dose Screen w/o Cont	$467.10	$519.00	$264.69–$513.81	30% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Cont Rt	$3,715.20	$4,128.00	$1,933.76–$4,086.72	122% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Cont Lt	$3,715.20	$4,128.00	$1,933.76–$4,086.72	122% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Cont Lt	$3,715.20	$4,128.00	$1,933.76–$4,086.72	122% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Cont Lt	$3,715.20	$4,128.00	$1,933.76–$4,086.72	122% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Cont Rt	$3,715.20	$4,128.00	$1,933.76–$4,086.72	122% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Cont Rt	$3,715.20	$4,128.00	$1,933.76–$4,086.72	122% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Cont Lt	$5,011.20	$5,568.00	$2,839.68–$5,512.32	63% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Cont Lt	$5,011.20	$5,568.00	$2,839.68–$5,512.32	63% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Cont Rt	$5,011.20	$5,568.00	$2,839.68–$5,512.32	63% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Cont Rt	$5,011.20	$5,568.00	$2,839.68–$5,512.32	63% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Cont Rt	$5,011.20	$5,568.00	$2,839.68–$5,512.32	63% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Cont Lt	$5,011.20	$5,568.00	$2,839.68–$5,512.32	63% above	10%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Cont	$3,358.80	$3,732.00	$1,903.32–$3,694.68	76% above	10%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Cont	$4,719.60	$5,244.00	$2,674.44–$5,191.56	66% above	10%
MRI of the brain, no contrast dye CPT 70551 Mri brain stem w/o dye	$3,489.30	$3,877.00	$1,933.76–$3,838.23	115% above	10%
MRI of the brain, no contrast dye CPT 70551 Mri brain stem w/o dye	$3,489.30	$3,877.00	$1,933.76–$3,838.23	115% above	10%
MRI of the brain, no contrast dye CPT 70551 MRI Pituitary Gland w/o Cont	$3,489.30	$3,877.00	$1,933.76–$3,838.23	115% above	10%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Cont	$3,593.70	$3,993.00	$1,933.76–$3,953.07	122% above	10%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri brain stem w/o dye	$3,489.30	$3,877.00	$1,933.76–$3,838.23	—	10%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri brain stem w/o dye	$3,489.30	$3,877.00	$1,933.76–$3,838.23	—	10%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Cont	$5,618.70	$6,243.00	$2,857.04–$6,180.57	143% above	10%
MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary Gland w/ + w/o Cont	$5,618.70	$6,243.00	$2,857.04–$6,180.57	143% above	10%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Cont	$5,618.70	$6,243.00	$2,857.04–$6,180.57	143% above	10%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Cont	$3,447.90	$3,831.00	$1,933.76–$3,792.69	77% above	10%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Cont	$5,067.00	$5,630.00	$2,857.04–$5,573.70	85% above	10%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Cont	$3,565.80	$3,962.00	$1,933.76–$3,922.38	80% above	10%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Cont	$5,026.50	$5,585.00	$2,848.35–$5,529.15	144% above	10%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Cont	$3,305.70	$3,673.00	$1,873.23–$3,636.27	88% above	10%
MRI of the pelvis without and with contrast CPT 72197 MRI Sacrum w/ + w/o Contrast	$5,040.90	$5,601.00	$2,856.51–$5,544.99	78% above	10%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Cont	$5,040.90	$5,601.00	$2,856.51–$5,544.99	78% above	10%
MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum w/o Contrast	$3,334.50	$3,705.00	$1,889.55–$3,667.95	73% above	10%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Cont	$3,334.50	$3,705.00	$1,889.55–$3,667.95	73% above	10%
MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum + Coccyx	$3,334.50	$3,705.00	$1,889.55–$3,667.95	73% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Fingers w/o Cont Rt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Cont Rt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Cont Lt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Cont Rt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Cont Rt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Cont Lt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Cont Lt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Fingers w/o Cont Lt	$3,775.50	$4,195.00	$1,933.76–$4,153.05	108% above	10%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocard Perf Spect Mult Rest+Stress	$4,175.10	$4,639.00	$2,365.89–$4,592.61	58% above	10%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Skull Base to Midthigh w/ CT Scan	$5,823.90	$6,471.00	$3,300.21–$6,406.29	59% above	10%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Non-OB Ltd	$621.90	$691.00	$352.41–$684.09	102% above	10%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder	$621.90	$691.00	$352.41–$684.09	102% above	10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non-OB Comp	$764.10	$849.00	$432.99–$840.51	78% above	10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Comp Transvaginal	$764.10	$849.00	$432.99–$840.51	78% above	10%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnant > 14 Weeks 1st Gest	$815.40	$906.00	$462.06–$896.94	67% above	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnant < 14 Weeks 1st Gest+Transvag	$724.50	$805.00	$410.55–$796.95	86% above	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnant < 14 Weeks 1st Gest	$724.50	$805.00	$410.55–$796.95	86% above	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnant Ltd	$543.60	$604.00	$308.04–$597.96	48% above	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PORTABLE	$590.40	$656.00	$334.56–$649.44	61% above	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PORTABLE	$590.40	$656.00	$334.56–$649.44	61% above	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PORTABLE	$590.40	$656.00	$334.56–$649.44	—	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PORTABLE	$590.40	$656.00	$334.56–$649.44	—	10%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD (Right Breast) (TC)	$430.20	$478.00	$243.78–$487.56	—	10%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD (Left Breast) (TC)	$430.20	$478.00	$243.78–$487.56	—	10%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD (TC)	$430.20	$478.00	$243.78–$487.56	—	10%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Comp Min 2 Views Rt	$422.10	$469.00	$239.19–$464.31	145% above	10%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Comp Min 2 Views Lt	$422.10	$469.00	$239.19–$464.31	145% above	10%
Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOMNOGRAPHY < 6 HRS CHARGE	$5,721.30	$6,357.00	$3,242.07–$6,293.43	69% above	10%
Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOMNOGRAPHY CHARGE	$5,893.20	$6,548.00	$3,339.48–$6,482.52	74% above	10%
Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOMNOGRAPHY CHARGE	$5,893.20	$6,548.00	$3,339.48–$6,482.52	74% above	10%
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 POLYSOMNOGRAPHY CHARGE	$5,893.20	$6,548.00	$3,339.48–$6,482.52	—	10%
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 POLYSOMNOGRAPHY CHARGE	$5,893.20	$6,548.00	$3,339.48–$6,482.52	—	10%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Fluoro Modified Esophagram	$1,715.40	$1,906.00	$972.06–$1,886.94	391% above	10%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Funct w/ Video (Fluoro)	$1,766.70	$1,963.00	$1,001.13–$1,943.37	406% above	10%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$774.00	$860.00	$438.60–$851.40	94% above	10%
Transvaginal pelvic ultrasound CPT 76830 BRMH Transvaginal US	$774.00	$860.00	$438.60–$851.40	94% above	10%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnant Transvaginal	$640.80	$712.00	$363.12–$704.88	73% above	10%
Transvaginal ultrasound during pregnancy CPT 76817 BRMH OB Transvag US	$640.80	$712.00	$363.12–$704.88	73% above	10%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Comp	$848.70	$943.00	$480.93–$933.57	54% above	10%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum +Contents	$725.40	$806.00	$411.06–$797.94	70% above	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head +Neck Soft Tissue	$722.70	$803.00	$409.53–$794.97	69% above	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI w/o KUB	$946.80	$1,052.00	$536.52–$1,041.48	125% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Veins Duplex Rt	$1,017.90	$1,131.00	$576.81–$1,119.69	69% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Veins Duplex Lt	$1,017.90	$1,131.00	$576.81–$1,119.69	69% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Veins Duplex Rt	$1,017.90	$1,131.00	$576.81–$1,119.69	69% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Veins Duplex Lt	$1,017.90	$1,131.00	$576.81–$1,119.69	69% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VASCULAR US UNILATERAL EXT LT (TC)	$1,045.80	$1,162.00	$592.62–$1,150.38	74% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VASCULAR US UNILATERAL EXT RT (TC)	$1,045.80	$1,162.00	$592.62–$1,150.38	74% above	10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Comp Min 3 Views Lt	$401.40	$446.00	$227.46–$441.54	103% above	10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Comp Min 3 Views Rt	$401.40	$446.00	$227.46–$441.54	103% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Comp Min 2 Views Rt	$424.80	$472.00	$240.72–$467.28	104% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Comp Min 2 Views Lt	$424.80	$472.00	$240.72–$467.28	104% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis	$437.40	$486.00	$247.86–$481.14	110% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis	$437.40	$486.00	$247.86–$481.14	110% above	10%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View	$265.50	$295.00	$150.45–$292.05	46% above	10%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Lt	$334.80	$372.00	$189.72–$368.28	122% above	10%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Rt	$334.80	$372.00	$189.72–$368.28	122% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views Lt Exam	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 5th Digit Rt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 4th Digit Rt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views Rt Exam	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views Thumb Lt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views Thumb Rt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 5th Digit Lt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 3rd Digit Rt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 4th Digit Lt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 2nd Digit Lt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 2nd Digit Rt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 3rd Digit Lt	$329.40	$366.00	$186.66–$362.34	90% above	10%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Rt	$350.10	$389.00	$198.39–$385.11	94% above	10%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Lt	$350.10	$389.00	$198.39–$385.11	94% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Comp Min 3 Views Lt	$415.80	$462.00	$235.62–$457.38	98% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Weight Bearing Lt	$415.80	$462.00	$235.62–$457.38	98% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Comp Min 3 Views Rt	$415.80	$462.00	$235.62–$457.38	98% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Weight Bearing Rt	$415.80	$462.00	$235.62–$457.38	98% above	10%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Min 3 Views Rt	$398.70	$443.00	$225.93–$438.57	106% above	10%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MIN 3 VIEWES LT	$398.70	$443.00	$225.93–$438.57	106% above	10%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Rt	$346.50	$385.00	$196.35–$381.15	110% above	10%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Lt	$346.50	$385.00	$196.35–$381.15	110% above	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral Min 4 Views	$374.40	$416.00	$212.16–$411.84	63% above	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$374.40	$416.00	$212.16–$411.84	63% above	10%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Min 4 Views w/ Obl	$727.20	$808.00	$412.08–$799.92	148% above	10%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$324.90	$361.00	$184.11–$357.39	60% above	10%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Min 3 Views	$352.80	$392.00	$199.92–$388.08	78% above	10%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cerv 2 or 3 Views	$364.50	$405.00	$206.55–$400.95	69% above	10%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 View	$307.80	$342.00	$174.42–$338.58	68% above	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum +Coccyx Min 2 Views	$321.30	$357.00	$182.07–$353.43	76% above	10%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$69.30	$77.00	$3.92–$76.23	64% above	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT-SGPT	$69.30	$77.00	$3.92–$76.23	64% above	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT-SGPT	$69.30	$77.00	$3.92–$76.23	64% above	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$69.30	$77.00	$3.92–$76.23	64% above	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT-SGPT	$69.30	$77.00	$3.92–$76.23	—	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$69.30	$77.00	$3.92–$76.23	—	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$69.30	$77.00	$3.92–$76.23	—	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT-SGPT	$69.30	$77.00	$3.92–$76.23	—	10%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST-SGOT	$70.20	$78.00	$3.83–$77.22	48% above	10%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST-SGOT	$70.20	$78.00	$3.83–$77.22	48% above	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST-SGOT	$70.20	$78.00	$3.83–$77.22	—	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST-SGOT	$70.20	$78.00	$3.83–$77.22	—	10%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$680.40	$756.00	$23.52–$748.44	124% above	10%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$680.40	$756.00	$23.52–$748.44	124% above	10%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$680.40	$756.00	$23.52–$748.44	—	10%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$680.40	$756.00	$23.52–$748.44	—	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Panel, MOLD, KC	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Turkey IgE Serum	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Amoxicillin IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Amoxicillin IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Banana IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Banana IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Beef IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Beef IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Epithelium IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Epithelium IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chicken IgE (CHIC)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chicken IgE (CHIC)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Codfish IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Codfish IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Corn-Food IgE CORN	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Corn-Food IgE CORN	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Crab IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Crab IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg White (ALEWSO)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg White (ALEWSO)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Yolk (ALEYSO)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Yolk (ALEYSO)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Grain Panel (FOOD4)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Grain Panel (FOOD4)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hazelnut IgE (NUTH)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hazelnut IgE (NUTH)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lamb IgE Serum	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lamb IgE Serum	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lobster IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lobster IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Milk IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Milk IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Panel FOOD #6 (ALFODSO)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Panel FOOD #6 (ALFODSO)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Panel Nut #1 (FOOD8)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Panel Nut #1 (FOOD8)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Peanut IgE (PEANT)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Peanut IgE (PEANT)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pork IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pork IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shrimp IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shrimp IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Single	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Single	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean IgE SOY	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean IgE SOY	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat IgE (WHT)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat IgE (WHT)	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 AllergenTuna IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 AllergenTuna IgE	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Specific Panel	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Specific Panel	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 Turkey IgE Serum	$244.80	$272.00	$2.96–$269.28	879% above	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean IgE SOY	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg Yolk (ALEYSO)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg Yolk (ALEYSO)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Peanut IgE (PEANT)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean IgE SOY	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Grain Panel (FOOD4)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Grain Panel (FOOD4)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AllergenTuna IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pork IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hazelnut IgE (NUTH)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hazelnut IgE (NUTH)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pork IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex Specific Panel	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lamb IgE Serum	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lamb IgE Serum	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat IgE (WHT)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shrimp IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lobster IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lobster IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Beef IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Beef IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shrimp IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat IgE (WHT)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Epithelium IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Epithelium IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Milk IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Milk IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chicken IgE (CHIC)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chicken IgE (CHIC)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Turkey IgE Serum	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Single	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Codfish IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Codfish IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Single	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex Specific Panel	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Crab IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Crab IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Panel Nut #1 (FOOD8)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Panel Nut #1 (FOOD8)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AllergenTuna IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Turkey IgE Serum	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg White (ALEWSO)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg White (ALEWSO)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Peanut IgE (PEANT)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Banana IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Banana IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Amoxicillin IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Amoxicillin IgE	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Panel FOOD #6 (ALFODSO)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Panel FOOD #6 (ALFODSO)	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Corn-Food IgE CORN	$244.80	$272.00	$2.96–$269.28	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Corn-Food IgE CORN	$244.80	$272.00	$2.96–$269.28	—	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citryllinated Peptide	$131.40	$146.00	$6.39–$144.54	64% above	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citryllinated Peptide	$131.40	$146.00	$6.39–$144.54	64% above	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide MFL	$135.00	$150.00	$6.39–$148.50	69% above	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide MFL	$135.00	$150.00	$6.39–$148.50	69% above	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citryllinated Peptide	$131.40	$146.00	$6.39–$144.54	—	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citryllinated Peptide	$131.40	$146.00	$6.39–$144.54	—	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide MFL	$135.00	$150.00	$6.39–$148.50	—	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide MFL	$135.00	$150.00	$6.39–$148.50	—	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ENA Screen MFL	$151.20	$168.00	$5.97–$166.32	120% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUALITATIVE-OUT	$151.20	$168.00	$5.97–$166.32	120% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUALITATIVE-OUT	$151.20	$168.00	$5.97–$166.32	120% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ENA Screen MFL	$151.20	$168.00	$5.97–$166.32	120% above	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ENA Screen MFL	$151.20	$168.00	$5.97–$166.32	—	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ENA Screen MFL	$151.20	$168.00	$5.97–$166.32	—	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA QUALITATIVE-OUT	$151.20	$168.00	$5.97–$166.32	—	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA QUALITATIVE-OUT	$151.20	$168.00	$5.97–$166.32	—	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT Pro-BNP MFL	$234.00	$260.00	$25.14–$257.40	69% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT Pro-BNP MFL	$234.00	$260.00	$25.14–$257.40	69% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$266.40	$296.00	$25.14–$293.04	93% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP II	$266.40	$296.00	$25.14–$293.04	93% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP II	$266.40	$296.00	$25.14–$293.04	93% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$266.40	$296.00	$25.14–$293.04	93% above	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT Pro-BNP MFL	$234.00	$260.00	$25.14–$257.40	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT Pro-BNP MFL	$234.00	$260.00	$25.14–$257.40	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP II	$266.40	$296.00	$25.14–$293.04	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$266.40	$296.00	$25.14–$293.04	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$266.40	$296.00	$25.14–$293.04	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP II	$266.40	$296.00	$25.14–$293.04	—	10%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel	$176.40	$196.00	$6.26–$194.04	106% above	10%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel	$176.40	$196.00	$6.26–$194.04	106% above	10%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic metabolic panel	$176.40	$196.00	$6.26–$194.04	—	10%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic metabolic panel	$176.40	$196.00	$6.26–$194.04	—	10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology Level IV PROF	$464.40	$516.00	$25.76–$510.84	130% above	10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology Level IV PROF	$464.40	$516.00	$25.76–$510.84	130% above	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pathology Level IV PROF	$464.40	$516.00	$25.76–$510.84	—	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pathology Level IV PROF	$464.40	$516.00	$25.76–$510.84	—	10%
Blood culture for bacteria CPT 87040 Blood Culture MFL	$116.10	$129.00	$5.10–$127.71	41% above	10%
Blood culture for bacteria CPT 87040 Blood Culture MFL	$116.10	$129.00	$5.10–$127.71	41% above	10%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$167.40	$186.00	$5.10–$184.14	103% above	10%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$167.40	$186.00	$5.10–$184.14	103% above	10%
Blood culture for bacteria inpatient CPT 87040 Blood Culture MFL	$116.10	$129.00	$5.10–$127.71	—	10%
Blood culture for bacteria inpatient CPT 87040 Blood Culture MFL	$116.10	$129.00	$5.10–$127.71	—	10%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$167.40	$186.00	$5.10–$184.14	—	10%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$167.40	$186.00	$5.10–$184.14	—	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$14.40	$16.00	$2.14–$15.84	10% above	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$14.40	$16.00	$2.14–$15.84	10% above	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LEGAL ETOH	$72.90	$81.00	$2.14–$80.19	456% above	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LEGAL ETOH	$72.90	$81.00	$2.14–$80.19	456% above	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$14.40	$16.00	$2.14–$15.84	—	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$14.40	$16.00	$2.14–$15.84	—	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LEGAL ETOH	$72.90	$81.00	$2.14–$80.19	—	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LEGAL ETOH	$72.90	$81.00	$2.14–$80.19	—	10%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$52.20	$58.00	$1.94–$57.42	132% above	10%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$52.20	$58.00	$1.94–$57.42	132% above	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$52.20	$58.00	$1.94–$57.42	—	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$52.20	$58.00	$1.94–$57.42	—	10%
Blood lead test CPT 83655 Lead MFL	$104.40	$116.00	$8.97–$114.84	112% above	10%
Blood lead test CPT 83655 LEAD-BLOOD	$104.40	$116.00	$8.97–$114.84	112% above	10%
Blood lead test CPT 83655 LEAD-BLOOD	$104.40	$116.00	$8.97–$114.84	112% above	10%
Blood lead test CPT 83655 Lead MFL	$104.40	$116.00	$8.97–$114.84	112% above	10%
Blood lead test inpatient CPT 83655 LEAD-BLOOD	$104.40	$116.00	$8.97–$114.84	—	10%
Blood lead test inpatient CPT 83655 Lead MFL	$104.40	$116.00	$8.97–$114.84	—	10%
Blood lead test inpatient CPT 83655 Lead MFL	$104.40	$116.00	$8.97–$114.84	—	10%
Blood lead test inpatient CPT 83655 LEAD-BLOOD	$104.40	$116.00	$8.97–$114.84	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qualitative Urine POC	$122.40	$136.00	$5.57–$134.64	151% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qualitative Urine POC	$122.40	$136.00	$5.57–$134.64	151% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum 1	$126.00	$140.00	$5.57–$138.60	158% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum 1	$126.00	$140.00	$5.57–$138.60	158% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic gonadotropin assay	$166.50	$185.00	$5.57–$183.15	241% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic gonadotropin assay	$166.50	$185.00	$5.57–$183.15	241% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qualitative Urine POC	$122.40	$136.00	$5.57–$134.64	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qualitative Urine POC	$122.40	$136.00	$5.57–$134.64	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum 1	$126.00	$140.00	$5.57–$138.60	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum 1	$126.00	$140.00	$5.57–$138.60	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic gonadotropin assay	$166.50	$185.00	$5.57–$183.15	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic gonadotropin assay	$166.50	$185.00	$5.57–$183.15	—	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh 7	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh Retype	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 RX - ABO	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh 7	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh Retype	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 RX - ABO	$70.20	$78.00	$1.48–$77.22	76% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 EXTENSIVE ABO	$72.00	$80.00	$1.48–$79.20	80% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh 7 Interp	$72.00	$80.00	$1.48–$79.20	80% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 EXTENSIVE ABO	$72.00	$80.00	$1.48–$79.20	80% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh 7 Interp	$72.00	$80.00	$1.48–$79.20	80% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$72.90	$81.00	$1.48–$80.19	82% above	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$72.90	$81.00	$1.48–$80.19	82% above	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 RX - ABO	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 RX - ABO	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh Retype	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh Retype	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh 7	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh 7	$70.20	$78.00	$1.48–$77.22	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh 7 Interp	$72.00	$80.00	$1.48–$79.20	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 EXTENSIVE ABO	$72.00	$80.00	$1.48–$79.20	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 EXTENSIVE ABO	$72.00	$80.00	$1.48–$79.20	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh 7 Interp	$72.00	$80.00	$1.48–$79.20	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO	$72.90	$81.00	$1.48–$80.19	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO	$72.90	$81.00	$1.48–$80.19	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$96.30	$107.00	$3.83–$105.93	76% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$96.30	$107.00	$3.83–$105.93	76% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$96.30	$107.00	$3.83–$105.93	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$96.30	$107.00	$3.83–$105.93	—	10%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridum Difficile Toxin B gene	$224.10	$249.00	$17.33–$246.51	57% above	10%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF/ EPI PCR	$260.10	$289.00	$17.33–$286.11	82% above	10%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF/ EPI PCR	$260.10	$289.00	$17.33–$286.11	82% above	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF/ EPI PCR	$260.10	$289.00	$17.33–$286.11	—	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF/ EPI PCR	$260.10	$289.00	$17.33–$286.11	—	10%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 MFL	$101.70	$113.00	$10.28–$111.87	8% below	10%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 MFL	$101.70	$113.00	$10.28–$111.87	8% below	10%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 MFL	$101.70	$113.00	$10.28–$111.87	—	10%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 MFL	$101.70	$113.00	$10.28–$111.87	—	10%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$221.40	$246.00	$10.28–$243.54	88% above	10%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$221.40	$246.00	$10.28–$243.54	88% above	10%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$221.40	$246.00	$10.28–$243.54	—	10%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$221.40	$246.00	$10.28–$243.54	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CoVID-19 Rapid (SARS-CoV-2-RNA) CR	$196.20	$218.00	$20.52–$215.82	47% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CoVID-19 Rapid (SARS-CoV-2-RNA) CR	$196.20	$218.00	$20.52–$215.82	47% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS-CoV-2 (Covid) RT-PCR	$196.20	$218.00	$20.52–$215.82	47% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS-CoV-2 (Covid) RT-PCR	$196.20	$218.00	$20.52–$215.82	47% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CoVID-19 Rapid (SARS-CoV-2-RNA) CR	$196.20	$218.00	$20.52–$215.82	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CoVID-19 Rapid (SARS-CoV-2-RNA) CR	$196.20	$218.00	$20.52–$215.82	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS-CoV-2 (Covid) RT-PCR	$196.20	$218.00	$20.52–$215.82	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS-CoV-2 (Covid) RT-PCR	$196.20	$218.00	$20.52–$215.82	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$76.50	$85.00	$19.88–$84.15	47% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trach Nucleic Acid MFL	$76.50	$85.00	$19.88–$84.15	47% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trach Nucleic Acid MFL	$76.50	$85.00	$19.88–$84.15	47% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$76.50	$85.00	$19.88–$84.15	47% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA - PCR	$234.00	$260.00	$19.88–$257.40	64% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA - PCR	$234.00	$260.00	$19.88–$257.40	64% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$76.50	$85.00	$19.88–$84.15	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trach Nucleic Acid MFL	$76.50	$85.00	$19.88–$84.15	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trach Nucleic Acid MFL	$76.50	$85.00	$19.88–$84.15	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$76.50	$85.00	$19.88–$84.15	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA - PCR	$234.00	$260.00	$19.88–$257.40	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA - PCR	$234.00	$260.00	$19.88–$257.40	—	10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$193.50	$215.00	$9.92–$212.85	109% above	10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$193.50	$215.00	$9.92–$212.85	109% above	10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$193.50	$215.00	$9.92–$212.85	—	10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$193.50	$215.00	$9.92–$212.85	—	10%
Complete blood count (CBC) with differential CPT 85025 CBC-AUTODIFF	$104.40	$116.00	$5.75–$114.84	49% above	10%
Complete blood count (CBC) with differential CPT 85025 Complete blood count reg/charge	$104.40	$116.00	$5.75–$114.84	49% above	10%
Complete blood count (CBC) with differential CPT 85025 CBC-AUTODIFF	$104.40	$116.00	$5.75–$114.84	49% above	10%
Complete blood count (CBC) with differential CPT 85025 CBC wAuto Diff	$110.70	$123.00	$5.75–$121.77	58% above	10%
Complete blood count (CBC) with differential CPT 85025 CBC wAuto Diff	$110.70	$123.00	$5.75–$121.77	58% above	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-AUTODIFF	$104.40	$116.00	$5.75–$114.84	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-AUTODIFF	$104.40	$116.00	$5.75–$114.84	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC wAuto Diff	$110.70	$123.00	$5.75–$121.77	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC wAuto Diff	$110.70	$123.00	$5.75–$121.77	—	10%
Complete blood count (CBC), no differential CPT 85027 CBC-NO DIFF	$91.80	$102.00	$4.79–$100.98	84% above	10%
Complete blood count (CBC), no differential CPT 85027 CBC-NO DIFF	$91.80	$102.00	$4.79–$100.98	84% above	10%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count, No Diff	$94.50	$105.00	$4.79–$103.95	89% above	10%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count, No Diff	$94.50	$105.00	$4.79–$103.95	89% above	10%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC-NO DIFF	$91.80	$102.00	$4.79–$100.98	—	10%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC-NO DIFF	$91.80	$102.00	$4.79–$100.98	—	10%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count, No Diff	$94.50	$105.00	$4.79–$103.95	—	10%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count, No Diff	$94.50	$105.00	$4.79–$103.95	—	10%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel	$239.40	$266.00	$5.99–$263.34	110% above	10%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel	$239.40	$266.00	$5.99–$263.34	110% above	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive metabolic panel	$239.40	$266.00	$5.99–$263.34	—	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive metabolic panel	$239.40	$266.00	$5.99–$263.34	—	10%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$227.70	$253.00	$5.02–$250.47	232% above	10%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$227.70	$253.00	$5.02–$250.47	232% above	10%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$227.70	$253.00	$5.02–$250.47	—	10%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$227.70	$253.00	$5.02–$250.47	—	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SO4	$90.90	$101.00	$10.98–$99.99	34% below	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SO4	$90.90	$101.00	$10.98–$99.99	34% below	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate	$207.90	$231.00	$10.98–$228.69	51% above	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate	$207.90	$231.00	$10.98–$228.69	51% above	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SO4	$90.90	$101.00	$10.98–$99.99	—	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SO4	$90.90	$101.00	$10.98–$99.99	—	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate	$207.90	$231.00	$10.98–$228.69	—	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate	$207.90	$231.00	$10.98–$228.69	—	10%
Estradiol blood test CPT 82670 Estradiol	$124.20	$138.00	$13.80–$136.62	3% above	10%
Estradiol blood test CPT 82670 Estradiol	$124.20	$138.00	$13.80–$136.62	3% above	10%
Estradiol blood test CPT 82670 Estradiol SENSE2	$221.40	$246.00	$13.80–$243.54	83% above	10%
Estradiol blood test CPT 82670 Estradiol SENSE2	$221.40	$246.00	$13.80–$243.54	83% above	10%
Estradiol blood test CPT 82670 Estradiol Level	$221.40	$246.00	$13.80–$243.54	83% above	10%
Estradiol blood test CPT 82670 Estradiol Level	$221.40	$246.00	$13.80–$243.54	83% above	10%
Estradiol blood test inpatient CPT 82670 Estradiol	$124.20	$138.00	$13.80–$136.62	—	10%
Estradiol blood test inpatient CPT 82670 Estradiol	$124.20	$138.00	$13.80–$136.62	—	10%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$221.40	$246.00	$13.80–$243.54	—	10%
Estradiol blood test inpatient CPT 82670 Estradiol SENSE2	$221.40	$246.00	$13.80–$243.54	—	10%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$221.40	$246.00	$13.80–$243.54	—	10%
Estradiol blood test inpatient CPT 82670 Estradiol SENSE2	$221.40	$246.00	$13.80–$243.54	—	10%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$103.50	$115.00	$13.76–$113.85	11% below	10%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$103.50	$115.00	$13.76–$113.85	11% below	10%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone	$221.40	$246.00	$13.76–$243.54	91% above	10%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone	$221.40	$246.00	$13.76–$243.54	91% above	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$103.50	$115.00	$13.76–$113.85	—	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$103.50	$115.00	$13.76–$113.85	—	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone	$221.40	$246.00	$13.76–$243.54	—	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone	$221.40	$246.00	$13.76–$243.54	—	10%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Stool MFL	$286.20	$318.00	$9.70–$314.82	54% above	10%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Stool MFL	$286.20	$318.00	$9.70–$314.82	54% above	10%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Stool MFL	$286.20	$318.00	$9.70–$314.82	—	10%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Stool MFL	$286.20	$318.00	$9.70–$314.82	—	10%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$161.10	$179.00	$6.73–$177.21	79% above	10%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$161.10	$179.00	$6.73–$177.21	79% above	10%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$161.10	$179.00	$6.73–$177.21	—	10%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$161.10	$179.00	$6.73–$177.21	—	10%
Folate (folic acid) blood test CPT 82746 FOLATE-SERUM	$91.80	$102.00	$7.26–$100.98	7% below	10%
Folate (folic acid) blood test CPT 82746 FOLATE-SERUM	$91.80	$102.00	$7.26–$100.98	7% below	10%
Folate (folic acid) blood test CPT 82746 Folate Level	$149.40	$166.00	$7.26–$164.34	51% above	10%
Folate (folic acid) blood test CPT 82746 Folate Level	$149.40	$166.00	$7.26–$164.34	51% above	10%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE-SERUM	$91.80	$102.00	$7.26–$100.98	—	10%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE-SERUM	$91.80	$102.00	$7.26–$100.98	—	10%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$149.40	$166.00	$7.26–$164.34	—	10%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$149.40	$166.00	$7.26–$164.34	—	10%
Free T3 thyroid hormone test CPT 84481 T3, Free MFL	$90.90	$101.00	$8.37–$99.99	4% below	10%
Free T3 thyroid hormone test CPT 84481 T3, Free MFL	$90.90	$101.00	$8.37–$99.99	4% below	10%
Free T3 thyroid hormone test CPT 84481 T3 Free	$183.60	$204.00	$8.37–$201.96	93% above	10%
Free T3 thyroid hormone test CPT 84481 T3 Free	$183.60	$204.00	$8.37–$201.96	93% above	10%
Free T3 thyroid hormone test inpatient CPT 84481 T3, Free MFL	$90.90	$101.00	$8.37–$99.99	—	10%
Free T3 thyroid hormone test inpatient CPT 84481 T3, Free MFL	$90.90	$101.00	$8.37–$99.99	—	10%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$183.60	$204.00	$8.37–$201.96	—	10%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$183.60	$204.00	$8.37–$201.96	—	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Assay of free thyroxine	$146.70	$163.00	$5.11–$161.37	82% above	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Assay of free thyroxine	$146.70	$163.00	$5.11–$161.37	82% above	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Assay of free thyroxine	$146.70	$163.00	$5.11–$161.37	—	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Assay of free thyroxine	$146.70	$163.00	$5.11–$161.37	—	10%
Free testosterone test CPT 84402 Testosterone, Free	$158.40	$176.00	$12.58–$174.24	38% above	10%
Free testosterone test CPT 84402 Testosterone, Free	$158.40	$176.00	$12.58–$174.24	38% above	10%
Free testosterone test CPT 84402 Testosterone Free	$181.80	$202.00	$12.58–$199.98	58% above	10%
Free testosterone test CPT 84402 Testosterone Free	$181.80	$202.00	$12.58–$199.98	58% above	10%
Free testosterone test inpatient CPT 84402 Testosterone, Free	$158.40	$176.00	$12.58–$174.24	—	10%
Free testosterone test inpatient CPT 84402 Testosterone, Free	$158.40	$176.00	$12.58–$174.24	—	10%
Free testosterone test inpatient CPT 84402 Testosterone Free	$181.80	$202.00	$12.58–$199.98	—	10%
Free testosterone test inpatient CPT 84402 Testosterone Free	$181.80	$202.00	$12.58–$199.98	—	10%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel BRMH	$337.50	$375.00	$17.36–$371.25	32% above	10%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel BRMH	$337.50	$375.00	$17.36–$371.25	32% above	10%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel BRMH	$337.50	$375.00	$17.36–$371.25	—	10%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel BRMH	$337.50	$375.00	$17.36–$371.25	—	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, 2 HR GTT 2	$83.70	$93.00	$3.52–$92.07	79% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, 2 HR GTT 2	$83.70	$93.00	$3.52–$92.07	79% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance Test 1 Hr	$87.30	$97.00	$3.52–$96.03	87% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance Test 1 Hr	$87.30	$97.00	$3.52–$96.03	87% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, 2 HR GTT 2	$83.70	$93.00	$3.52–$92.07	—	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, 2 HR GTT 2	$83.70	$93.00	$3.52–$92.07	—	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance Test 1 Hr	$87.30	$97.00	$3.52–$96.03	—	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance Test 1 Hr	$87.30	$97.00	$3.52–$96.03	—	10%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECIMENS	$229.50	$255.00	$9.53–$252.45	167% above	10%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECIMENS	$229.50	$255.00	$9.53–$252.45	167% above	10%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECIMENS	$229.50	$255.00	$9.53–$252.45	—	10%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECIMENS	$229.50	$255.00	$9.53–$252.45	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae (GC) in-house	$74.70	$83.00	$19.88–$82.17	48% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC by NAM	$74.70	$83.00	$19.88–$82.17	48% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae (GC) in-house	$74.70	$83.00	$19.88–$82.17	48% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC by NAM	$74.70	$83.00	$19.88–$82.17	48% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC by NAM	$74.70	$83.00	$19.88–$82.17	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae (GC) in-house	$74.70	$83.00	$19.88–$82.17	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC by NAM	$74.70	$83.00	$19.88–$82.17	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae (GC) in-house	$74.70	$83.00	$19.88–$82.17	—	10%
H. pylori antibody blood test CPT 86677 H. Pylori Screen, Blood	$129.60	$144.00	$7.16–$142.56	53% above	10%
H. pylori antibody blood test CPT 86677 H. Pylori Screen, Blood	$129.60	$144.00	$7.16–$142.56	53% above	10%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI	$219.60	$244.00	$7.16–$241.56	159% above	10%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI	$219.60	$244.00	$7.16–$241.56	159% above	10%
H. pylori antibody blood test inpatient CPT 86677 H. Pylori Screen, Blood	$129.60	$144.00	$7.16–$142.56	—	10%
H. pylori antibody blood test inpatient CPT 86677 H. Pylori Screen, Blood	$129.60	$144.00	$7.16–$142.56	—	10%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI	$219.60	$244.00	$7.16–$241.56	—	10%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI	$219.60	$244.00	$7.16–$241.56	—	10%
H. pylori stool antigen test CPT 87338 H Pylori Antigen, Feces	$153.90	$171.00	$7.10–$169.29	23% above	10%
H. pylori stool antigen test CPT 87338 H Pylori Antigen, Feces	$153.90	$171.00	$7.10–$169.29	23% above	10%
H. pylori stool antigen test CPT 87338 H. Pylori Antigen-Stool MFL	$158.40	$176.00	$7.10–$174.24	27% above	10%
H. pylori stool antigen test CPT 87338 H. Pylori Antigen-Stool MFL	$158.40	$176.00	$7.10–$174.24	27% above	10%
H. pylori stool antigen test inpatient CPT 87338 H Pylori Antigen, Feces	$153.90	$171.00	$7.10–$169.29	—	10%
H. pylori stool antigen test inpatient CPT 87338 H Pylori Antigen, Feces	$153.90	$171.00	$7.10–$169.29	—	10%
H. pylori stool antigen test inpatient CPT 87338 H. Pylori Antigen-Stool MFL	$158.40	$176.00	$7.10–$174.24	—	10%
H. pylori stool antigen test inpatient CPT 87338 H. Pylori Antigen-Stool MFL	$158.40	$176.00	$7.10–$174.24	—	10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 VIRAL LOAD	$927.90	$1,031.00	$42.02–$1,020.69	147% above	10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 VIRAL LOAD	$927.90	$1,031.00	$42.02–$1,020.69	147% above	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 VIRAL LOAD	$927.90	$1,031.00	$42.02–$1,020.69	—	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 VIRAL LOAD	$927.90	$1,031.00	$42.02–$1,020.69	—	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 AB SCREEN	$134.10	$149.00	$6.77–$147.51	79% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 AB SCREEN	$134.10	$149.00	$6.77–$147.51	79% above	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 AB SCREEN	$134.10	$149.00	$6.77–$147.51	—	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 AB SCREEN	$134.10	$149.00	$6.77–$147.51	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AND HIV1 ANTIGEN AND ANTIBODY	$189.90	$211.00	$11.89–$208.89	90% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AND HIV1 ANTIGEN AND ANTIBODY	$189.90	$211.00	$11.89–$208.89	90% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 and HIV-2 AB	$201.60	$224.00	$11.89–$221.76	102% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 and HIV-2 AB	$201.60	$224.00	$11.89–$221.76	102% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AND HIV1 ANTIGEN AND ANTIBODY	$189.90	$211.00	$11.89–$208.89	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AND HIV1 ANTIGEN AND ANTIBODY	$189.90	$211.00	$11.89–$208.89	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 and HIV-2 AB	$201.60	$224.00	$11.89–$221.76	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 and HIV-2 AB	$201.60	$224.00	$11.89–$221.76	—	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Cytology-HPV Only	$129.60	$144.00	$19.10–$142.56	9% below	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Cytology-HPV Only PROF	$148.50	$165.00	$19.10–$163.35	4% above	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Cytology-HPV Only PROF	$148.50	$165.00	$19.10–$163.35	4% above	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS HIGH RISK TYPES	$222.30	$247.00	$19.10–$244.53	55% above	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS HIGH RISK TYPES	$222.30	$247.00	$19.10–$244.53	55% above	10%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Cytology-HPV Only PROF	$148.50	$165.00	$19.10–$163.35	—	10%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Cytology-HPV Only PROF	$148.50	$165.00	$19.10–$163.35	—	10%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMAVIRUS HIGH RISK TYPES	$222.30	$247.00	$19.10–$244.53	—	10%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMAVIRUS HIGH RISK TYPES	$222.30	$247.00	$19.10–$244.53	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c w/ Avg. Glucose	$120.60	$134.00	$7.19–$132.66	141% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C W/AVG GLUC	$120.60	$134.00	$7.19–$132.66	141% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C W/AVG GLUC	$120.60	$134.00	$7.19–$132.66	141% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c w/ Avg. Glucose	$120.60	$134.00	$7.19–$132.66	141% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C W/AVG GLUC	$120.60	$134.00	$7.19–$132.66	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c w/ Avg. Glucose	$120.60	$134.00	$7.19–$132.66	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c w/ Avg. Glucose	$120.60	$134.00	$7.19–$132.66	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C W/AVG GLUC	$120.60	$134.00	$7.19–$132.66	—	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep. B Surface Ab(Immune) MFL	$132.30	$147.00	$5.30–$145.53	79% above	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep. B Surface Ab(Immune) MFL	$132.30	$147.00	$5.30–$145.53	79% above	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep BsAby( IMM )STAT- MMC	$132.30	$147.00	$5.30–$145.53	79% above	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep BsAby( IMM )STAT- MMC	$132.30	$147.00	$5.30–$145.53	79% above	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep BsAby( IMM )STAT- MMC	$132.30	$147.00	$5.30–$145.53	—	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep. B Surface Ab(Immune) MFL	$132.30	$147.00	$5.30–$145.53	—	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep. B Surface Ab(Immune) MFL	$132.30	$147.00	$5.30–$145.53	—	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep BsAby( IMM )STAT- MMC	$132.30	$147.00	$5.30–$145.53	—	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Profile	$118.80	$132.00	$5.10–$130.68	82% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Profile	$118.80	$132.00	$5.10–$130.68	82% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$120.60	$134.00	$5.10–$132.66	85% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HepBsAg- MMC	$120.60	$134.00	$5.10–$132.66	85% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HepBsAg- MMC	$120.60	$134.00	$5.10–$132.66	85% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$120.60	$134.00	$5.10–$132.66	85% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep Panel Comprehensive	$145.80	$162.00	$5.10–$160.38	123% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep Panel Comprehensive	$145.80	$162.00	$5.10–$160.38	123% above	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Profile	$118.80	$132.00	$5.10–$130.68	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Profile	$118.80	$132.00	$5.10–$130.68	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$120.60	$134.00	$5.10–$132.66	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$120.60	$134.00	$5.10–$132.66	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HepBsAg- MMC	$120.60	$134.00	$5.10–$132.66	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HepBsAg- MMC	$120.60	$134.00	$5.10–$132.66	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep Panel Comprehensive	$145.80	$162.00	$5.10–$160.38	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep Panel Comprehensive	$145.80	$162.00	$5.10–$160.38	—	10%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$182.70	$203.00	$10.57–$200.97	121% above	10%
Hepatitis C antibody blood test (screening) CPT 86803 HepCAby-MMC	$182.70	$203.00	$10.57–$200.97	121% above	10%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$182.70	$203.00	$10.57–$200.97	121% above	10%
Hepatitis C antibody blood test (screening) CPT 86803 HepCAby-MMC	$182.70	$203.00	$10.57–$200.97	121% above	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$182.70	$203.00	$10.57–$200.97	—	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HepCAby-MMC	$182.70	$203.00	$10.57–$200.97	—	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HepCAby-MMC	$182.70	$203.00	$10.57–$200.97	—	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$182.70	$203.00	$10.57–$200.97	—	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep. C Vir (PCR-Qt) MFL	$492.30	$547.00	$21.15–$541.53	122% above	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep. C Vir (PCR-Qt) MFL	$492.30	$547.00	$21.15–$541.53	122% above	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep. C Vir (PCR-Qt) MFL	$492.30	$547.00	$21.15–$541.53	—	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep. C Vir (PCR-Qt) MFL	$492.30	$547.00	$21.15–$541.53	—	10%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY HERPES SIMPLES TYPE 1	$180.00	$200.00	$6.51–$198.00	177% above	10%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY HERPES SIMPLES TYPE 1	$180.00	$200.00	$6.51–$198.00	177% above	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY HERPES SIMPLES TYPE 1	$180.00	$200.00	$6.51–$198.00	—	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY HERPES SIMPLES TYPE 1	$180.00	$200.00	$6.51–$198.00	—	10%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 IMMUN	$191.70	$213.00	$9.56–$210.87	143% above	10%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 IMMUN	$191.70	$213.00	$9.56–$210.87	143% above	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 IMMUN	$191.70	$213.00	$9.56–$210.87	—	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 IMMUN	$191.70	$213.00	$9.56–$210.87	—	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Highly Sensitive	$123.30	$137.00	$6.39–$135.63	59% above	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Highly Sensitive	$123.30	$137.00	$6.39–$135.63	59% above	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HIGH SENS	$131.40	$146.00	$6.39–$144.54	70% above	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HIGH SENS	$131.40	$146.00	$6.39–$144.54	70% above	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Highly Sensitive	$123.30	$137.00	$6.39–$135.63	—	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Highly Sensitive	$123.30	$137.00	$6.39–$135.63	—	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HIGH SENS	$131.40	$146.00	$6.39–$144.54	—	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HIGH SENS	$131.40	$146.00	$6.39–$144.54	—	10%
Homocysteine blood test CPT 83090 Homocysteine, Total	$98.10	$109.00	$8.33–$107.91	17% below	10%
Homocysteine blood test CPT 83090 Homocysteine, Total	$98.10	$109.00	$8.33–$107.91	17% below	10%
Homocysteine blood test CPT 83090 Homocysteine Level	$183.60	$204.00	$8.33–$201.96	55% above	10%
Homocysteine blood test CPT 83090 Homocysteine Level	$183.60	$204.00	$8.33–$201.96	55% above	10%
Homocysteine blood test inpatient CPT 83090 Homocysteine, Total	$98.10	$109.00	$8.33–$107.91	—	10%
Homocysteine blood test inpatient CPT 83090 Homocysteine, Total	$98.10	$109.00	$8.33–$107.91	—	10%
Homocysteine blood test inpatient CPT 83090 Homocysteine Level	$183.60	$204.00	$8.33–$201.96	—	10%
Homocysteine blood test inpatient CPT 83090 Homocysteine Level	$183.60	$204.00	$8.33–$201.96	—	10%
Insulin blood test CPT 83525 INSULIN ASSAY	$93.60	$104.00	$5.64–$102.96	44% above	10%
Insulin blood test CPT 83525 INSULIN ASSAY	$93.60	$104.00	$5.64–$102.96	44% above	10%
Insulin blood test CPT 83525 Insulin Level	$116.10	$129.00	$5.64–$127.71	79% above	10%
Insulin blood test CPT 83525 Insulin Level	$116.10	$129.00	$5.64–$127.71	79% above	10%
Insulin blood test CPT 83525 Insulin, Free	$162.00	$180.00	$5.64–$178.20	149% above	10%
Insulin blood test CPT 83525 Insulin, Free	$162.00	$180.00	$5.64–$178.20	149% above	10%
Insulin blood test inpatient CPT 83525 INSULIN ASSAY	$93.60	$104.00	$5.64–$102.96	—	10%
Insulin blood test inpatient CPT 83525 INSULIN ASSAY	$93.60	$104.00	$5.64–$102.96	—	10%
Insulin blood test inpatient CPT 83525 Insulin Level	$116.10	$129.00	$5.64–$127.71	—	10%
Insulin blood test inpatient CPT 83525 Insulin Level	$116.10	$129.00	$5.64–$127.71	—	10%
Insulin blood test inpatient CPT 83525 Insulin, Free	$162.00	$180.00	$5.64–$178.20	—	10%
Insulin blood test inpatient CPT 83525 Insulin, Free	$162.00	$180.00	$5.64–$178.20	—	10%
Iron blood test (serum iron) CPT 83540 Iron Level	$75.60	$84.00	$3.20–$83.16	42% above	10%
Iron blood test (serum iron) CPT 83540 Iron Level	$75.60	$84.00	$3.20–$83.16	42% above	10%
Iron blood test (serum iron) CPT 83540 IRON-SERUM	$83.70	$93.00	$3.20–$92.07	57% above	10%
Iron blood test (serum iron) CPT 83540 IRON-SERUM	$83.70	$93.00	$3.20–$92.07	57% above	10%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$75.60	$84.00	$3.20–$83.16	—	10%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$75.60	$84.00	$3.20–$83.16	—	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON-SERUM	$83.70	$93.00	$3.20–$92.07	—	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON-SERUM	$83.70	$93.00	$3.20–$92.07	—	10%
Iron-binding capacity (TIBC) test CPT 83550 TIBC-MFL	$83.70	$93.00	$4.32–$92.07	35% above	10%
Iron-binding capacity (TIBC) test CPT 83550 TIBC-MFL	$83.70	$93.00	$4.32–$92.07	35% above	10%
Iron-binding capacity (TIBC) test CPT 83550 Iron Total Iron Binding Capacity	$90.90	$101.00	$4.32–$99.99	47% above	10%
Iron-binding capacity (TIBC) test CPT 83550 Iron Total Iron Binding Capacity.	$90.90	$101.00	$4.32–$99.99	47% above	10%
Iron-binding capacity (TIBC) test CPT 83550 Iron Total Iron Binding Capacity	$90.90	$101.00	$4.32–$99.99	47% above	10%
Iron-binding capacity (TIBC) test CPT 83550 Iron Total Iron Binding Capacity.	$90.90	$101.00	$4.32–$99.99	47% above	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC-MFL	$83.70	$93.00	$4.32–$92.07	—	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC-MFL	$83.70	$93.00	$4.32–$92.07	—	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Total Iron Binding Capacity	$90.90	$101.00	$4.32–$99.99	—	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Total Iron Binding Capacity.	$90.90	$101.00	$4.32–$99.99	—	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Total Iron Binding Capacity.	$90.90	$101.00	$4.32–$99.99	—	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Total Iron Binding Capacity	$90.90	$101.00	$4.32–$99.99	—	10%
Kidney function blood test panel CPT 80069 Renal Panel Standard	$161.10	$179.00	$6.43–$177.21	57% above	10%
Kidney function blood test panel CPT 80069 Renal Panel Standard	$161.10	$179.00	$6.43–$177.21	57% above	10%
Kidney function blood test panel inpatient CPT 80069 Renal Panel Standard	$161.10	$179.00	$6.43–$177.21	—	10%
Kidney function blood test panel inpatient CPT 80069 Renal Panel Standard	$161.10	$179.00	$6.43–$177.21	—	10%
LH (luteinizing hormone) test CPT 83002 LH-MMC	$101.70	$113.00	$13.72–$111.87	7% above	10%
LH (luteinizing hormone) test CPT 83002 LH-MMC	$101.70	$113.00	$13.72–$111.87	7% above	10%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone MFL	$104.40	$116.00	$13.72–$114.84	10% above	10%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone MFL	$104.40	$116.00	$13.72–$114.84	10% above	10%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$211.50	$235.00	$13.72–$232.65	123% above	10%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$211.50	$235.00	$13.72–$232.65	123% above	10%
LH (luteinizing hormone) test inpatient CPT 83002 LH-MMC	$101.70	$113.00	$13.72–$111.87	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 LH-MMC	$101.70	$113.00	$13.72–$111.87	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone MFL	$104.40	$116.00	$13.72–$114.84	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone MFL	$104.40	$116.00	$13.72–$114.84	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$211.50	$235.00	$13.72–$232.65	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$211.50	$235.00	$13.72–$232.65	—	10%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$117.00	$130.00	$3.40–$128.70	73% above	10%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$117.00	$130.00	$3.40–$128.70	73% above	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$117.00	$130.00	$3.40–$128.70	—	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$117.00	$130.00	$3.40–$128.70	—	10%
Liver function blood test panel CPT 80076 Hepatic function panel	$192.60	$214.00	$4.04–$211.86	101% above	10%
Liver function blood test panel CPT 80076 Hepatic function panel	$192.60	$214.00	$4.04–$211.86	101% above	10%
Liver function blood test panel inpatient CPT 80076 Hepatic function panel	$192.60	$214.00	$4.04–$211.86	—	10%
Liver function blood test panel inpatient CPT 80076 Hepatic function panel	$192.60	$214.00	$4.04–$211.86	—	10%
Lyme disease antibody test CPT 86618 Lyme Antibody Screen IgG/IgM	$197.10	$219.00	$8.41–$216.81	151% above	10%
Lyme disease antibody test CPT 86618 Lyme Antibody Screen IgG/IgM	$197.10	$219.00	$8.41–$216.81	151% above	10%
Lyme disease antibody test inpatient CPT 86618 Lyme Antibody Screen IgG/IgM	$197.10	$219.00	$8.41–$216.81	—	10%
Lyme disease antibody test inpatient CPT 86618 Lyme Antibody Screen IgG/IgM	$197.10	$219.00	$8.41–$216.81	—	10%
Magnesium blood test CPT 83735 MAGNESIUM- OB	$87.30	$97.00	$3.31–$96.03	75% above	10%
Magnesium blood test CPT 83735 MAGNESIUM- OB	$87.30	$97.00	$3.31–$96.03	75% above	10%
Magnesium blood test CPT 83735 Magnesium	$90.00	$100.00	$3.31–$99.00	80% above	10%
Magnesium blood test CPT 83735 Magnesium	$90.00	$100.00	$3.31–$99.00	80% above	10%
Magnesium blood test CPT 83735 Magnesium 24 Hour Urine	$90.00	$100.00	$3.31–$99.00	80% above	10%
Magnesium blood test CPT 83735 Magnesium 24 Hour Urine	$90.00	$100.00	$3.31–$99.00	80% above	10%
Magnesium blood test CPT 83735 Magnesium, RBC	$106.20	$118.00	$3.31–$116.82	112% above	10%
Magnesium blood test CPT 83735 Magnesium, RBC	$106.20	$118.00	$3.31–$116.82	112% above	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM- OB	$87.30	$97.00	$3.31–$96.03	—	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM- OB	$87.30	$97.00	$3.31–$96.03	—	10%
Magnesium blood test inpatient CPT 83735 Magnesium	$90.00	$100.00	$3.31–$99.00	—	10%
Magnesium blood test inpatient CPT 83735 Magnesium	$90.00	$100.00	$3.31–$99.00	—	10%
Magnesium blood test inpatient CPT 83735 Magnesium 24 Hour Urine	$90.00	$100.00	$3.31–$99.00	—	10%
Magnesium blood test inpatient CPT 83735 Magnesium 24 Hour Urine	$90.00	$100.00	$3.31–$99.00	—	10%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC	$106.20	$118.00	$3.31–$116.82	—	10%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC	$106.20	$118.00	$3.31–$116.82	—	10%
Measles (rubeola) antibody test CPT 86765 MEASLES-RUB-MMC	$102.60	$114.00	$6.36–$112.86	28% above	10%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Ab IgM	$102.60	$114.00	$6.36–$112.86	28% above	10%
Measles (rubeola) antibody test CPT 86765 MEASLES-RUB-MMC	$102.60	$114.00	$6.36–$112.86	28% above	10%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Ab IgM	$102.60	$114.00	$6.36–$112.86	28% above	10%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES-RUB-MMC	$102.60	$114.00	$6.36–$112.86	—	10%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Ab IgM	$102.60	$114.00	$6.36–$112.86	—	10%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES-RUB-MMC	$102.60	$114.00	$6.36–$112.86	—	10%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Ab IgM	$102.60	$114.00	$6.36–$112.86	—	10%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen	$104.40	$116.00	$3.83–$114.84	89% above	10%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen	$104.40	$116.00	$3.83–$114.84	89% above	10%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Screen	$104.40	$116.00	$3.83–$114.84	—	10%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Screen	$104.40	$116.00	$3.83–$114.84	—	10%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$601.20	$668.00	$18.84–$661.32	213% above	10%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$601.20	$668.00	$18.84–$661.32	213% above	10%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$601.20	$668.00	$18.84–$661.32	—	10%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$601.20	$668.00	$18.84–$661.32	—	10%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Total Free	$152.10	$169.00	$9.08–$167.31	69% above	10%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Total Free	$152.10	$169.00	$9.08–$167.31	69% above	10%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Total Free	$152.10	$169.00	$9.08–$167.31	—	10%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Total Free	$152.10	$169.00	$9.08–$167.31	—	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen 2	$198.00	$220.00	$10.42–$217.80	120% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen	$198.00	$220.00	$10.42–$217.80	120% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen 2	$198.00	$220.00	$10.42–$217.80	120% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total Diagnostic	$198.00	$220.00	$10.42–$217.80	120% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total Diagnostic	$198.00	$220.00	$10.42–$217.80	120% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen	$198.00	$220.00	$10.42–$217.80	120% above	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen 2	$198.00	$220.00	$10.42–$217.80	—	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen	$198.00	$220.00	$10.42–$217.80	—	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen	$198.00	$220.00	$10.42–$217.80	—	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen 2	$198.00	$220.00	$10.42–$217.80	—	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total Diagnostic	$198.00	$220.00	$10.42–$217.80	—	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total Diagnostic	$198.00	$220.00	$10.42–$217.80	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology-GYN Liquid Prep	$84.60	$94.00	$11.48–$93.06	3% below	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP TEST	$118.80	$132.00	$11.48–$130.68	36% above	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP TEST	$118.80	$132.00	$11.48–$130.68	36% above	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology GYN Liquid Prep PROF	$148.50	$165.00	$11.48–$163.35	70% above	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology GYN Liquid Prep PROF	$148.50	$165.00	$11.48–$163.35	70% above	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP TEST	$118.80	$132.00	$11.48–$130.68	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP TEST	$118.80	$132.00	$11.48–$130.68	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology GYN Liquid Prep PROF	$148.50	$165.00	$11.48–$163.35	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology GYN Liquid Prep PROF	$148.50	$165.00	$11.48–$163.35	—	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact With Calcium	$344.70	$383.00	$20.38–$379.17	84% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact	$344.70	$383.00	$20.38–$379.17	84% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact With Calcium	$344.70	$383.00	$20.38–$379.17	84% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact	$344.70	$383.00	$20.38–$379.17	84% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH-Intact with Ca MFL	$344.70	$383.00	$20.38–$379.17	84% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH-Intact with Ca MFL	$344.70	$383.00	$20.38–$379.17	84% above	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH-Intact with Ca MFL	$344.70	$383.00	$20.38–$379.17	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact	$344.70	$383.00	$20.38–$379.17	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH-Intact with Ca MFL	$344.70	$383.00	$20.38–$379.17	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact	$344.70	$383.00	$20.38–$379.17	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact With Calcium	$344.70	$383.00	$20.38–$379.17	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact With Calcium	$344.70	$383.00	$20.38–$379.17	—	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated partial thromobplastin time (aPTT)	$95.40	$106.00	$2.97–$104.94	91% above	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$95.40	$106.00	$2.97–$104.94	91% above	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated partial thromobplastin time (aPTT)	$95.40	$106.00	$2.97–$104.94	91% above	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$95.40	$106.00	$2.97–$104.94	91% above	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated partial thromobplastin time (aPTT)	$95.40	$106.00	$2.97–$104.94	—	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated partial thromobplastin time (aPTT)	$95.40	$106.00	$2.97–$104.94	—	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$95.40	$106.00	$2.97–$104.94	—	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$95.40	$106.00	$2.97–$104.94	—	10%
Progesterone blood test CPT 84144 Progesterone	$151.20	$168.00	$10.30–$166.32	26% above	10%
Progesterone blood test CPT 84144 Progesterone	$151.20	$168.00	$10.30–$166.32	26% above	10%
Progesterone blood test inpatient CPT 84144 Progesterone	$151.20	$168.00	$10.30–$166.32	—	10%
Progesterone blood test inpatient CPT 84144 Progesterone	$151.20	$168.00	$10.30–$166.32	—	10%
Prolactin blood test CPT 84146 Prolactin	$206.10	$229.00	$9.57–$226.71	70% above	10%
Prolactin blood test CPT 84146 Prolactin	$206.10	$229.00	$9.57–$226.71	70% above	10%
Prolactin blood test inpatient CPT 84146 Prolactin	$206.10	$229.00	$9.57–$226.71	—	10%
Prolactin blood test inpatient CPT 84146 Prolactin	$206.10	$229.00	$9.57–$226.71	—	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR	$63.00	$70.00	$2.91–$69.30	99% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$63.00	$70.00	$2.91–$69.30	99% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$63.00	$70.00	$2.91–$69.30	99% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR	$63.00	$70.00	$2.91–$69.30	99% above	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR	$63.00	$70.00	$2.91–$69.30	—	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$63.00	$70.00	$2.91–$69.30	—	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$63.00	$70.00	$2.91–$69.30	—	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR	$63.00	$70.00	$2.91–$69.30	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Rapid Drug Screen 14 urine	$104.40	$116.00	$8.08–$114.84	106% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Rapid Drug Screen 14 urine	$104.40	$116.00	$8.08–$114.84	106% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen 10 Panel iScreen	$139.50	$155.00	$8.08–$153.45	175% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen 10 Panel iScreen	$139.50	$155.00	$8.08–$153.45	175% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS - 10 Panel	$245.70	$273.00	$8.08–$270.27	384% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS - 10 Panel	$245.70	$273.00	$8.08–$270.27	384% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Rapid Drug Screen 14 urine	$104.40	$116.00	$8.08–$114.84	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Rapid Drug Screen 14 urine	$104.40	$116.00	$8.08–$114.84	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Urine Drug Screen 10 Panel iScreen	$139.50	$155.00	$8.08–$153.45	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Urine Drug Screen 10 Panel iScreen	$139.50	$155.00	$8.08–$153.45	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS - 10 Panel	$245.70	$273.00	$8.08–$270.27	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS - 10 Panel	$245.70	$273.00	$8.08–$270.27	—	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A POC	$99.90	$111.00	$9.92–$109.89	119% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A POC	$99.90	$111.00	$9.92–$109.89	119% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A-EIA	$135.90	$151.00	$9.92–$149.49	198% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A-EIA	$135.90	$151.00	$9.92–$149.49	198% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Step A Screen	$140.40	$156.00	$9.92–$154.44	208% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Step A Screen	$140.40	$156.00	$9.92–$154.44	208% above	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A POC	$99.90	$111.00	$9.92–$109.89	—	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A POC	$99.90	$111.00	$9.92–$109.89	—	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A-EIA	$135.90	$151.00	$9.92–$149.49	—	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A-EIA	$135.90	$151.00	$9.92–$149.49	—	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Step A Screen	$140.40	$156.00	$9.92–$154.44	—	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Step A Screen	$140.40	$156.00	$9.92–$154.44	—	10%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, IgM MFL	$76.50	$85.00	$2.80–$84.15	33% above	10%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, IgM MFL	$76.50	$85.00	$2.80–$84.15	33% above	10%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor, IgM MFL	$76.50	$85.00	$2.80–$84.15	—	10%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor, IgM MFL	$76.50	$85.00	$2.80–$84.15	—	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA-IGG-MMC	$110.70	$123.00	$7.11–$121.77	38% above	10%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$110.70	$123.00	$7.11–$121.77	38% above	10%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$110.70	$123.00	$7.11–$121.77	38% above	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA-IGG-MMC	$110.70	$123.00	$7.11–$121.77	38% above	10%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$110.70	$123.00	$7.11–$121.77	—	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA-IGG-MMC	$110.70	$123.00	$7.11–$121.77	—	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA-IGG-MMC	$110.70	$123.00	$7.11–$121.77	—	10%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$110.70	$123.00	$7.11–$121.77	—	10%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$271.80	$302.00	$5.95–$298.98	194% above	10%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$271.80	$302.00	$5.95–$298.98	194% above	10%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE	$271.80	$302.00	$5.95–$298.98	—	10%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE	$271.80	$302.00	$5.95–$298.98	—	10%
Stool ova and parasites exam CPT 87177 OVA and PARASITES DIRECT SMEARS	$161.10	$179.00	$4.40–$177.21	158% above	10%
Stool ova and parasites exam CPT 87177 OVA and PARASITES DIRECT SMEARS	$161.10	$179.00	$4.40–$177.21	158% above	10%
Stool ova and parasites exam inpatient CPT 87177 OVA and PARASITES DIRECT SMEARS	$161.10	$179.00	$4.40–$177.21	—	10%
Stool ova and parasites exam inpatient CPT 87177 OVA and PARASITES DIRECT SMEARS	$161.10	$179.00	$4.40–$177.21	—	10%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Diagnostic	$96.30	$107.00	$7.86–$105.93	78% above	10%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Diagnostic	$96.30	$107.00	$7.86–$105.93	78% above	10%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Diagnostic	$96.30	$107.00	$7.86–$105.93	—	10%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Diagnostic	$96.30	$107.00	$7.86–$105.93	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-SER	$59.40	$66.00	$2.11–$65.34	58% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-SER	$59.40	$66.00	$2.11–$65.34	58% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-SER	$59.40	$66.00	$2.11–$65.34	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-SER	$59.40	$66.00	$2.11–$65.34	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Gold TB MFL	$263.70	$293.00	$30.61–$290.07	4% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Gold TB SHH	$263.70	$293.00	$30.61–$290.07	4% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Gold TB MFL	$263.70	$293.00	$30.61–$290.07	4% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Gold TB SHH	$263.70	$293.00	$30.61–$290.07	4% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Gold TB SHH	$263.70	$293.00	$30.61–$290.07	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Gold TB SHH	$263.70	$293.00	$30.61–$290.07	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Gold TB MFL	$263.70	$293.00	$30.61–$290.07	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Gold TB MFL	$263.70	$293.00	$30.61–$290.07	—	10%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$196.20	$218.00	$12.75–$215.82	74% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$196.20	$218.00	$12.75–$215.82	74% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, total	$215.10	$239.00	$12.75–$236.61	91% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, total	$215.10	$239.00	$12.75–$236.61	91% above	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$196.20	$218.00	$12.75–$215.82	—	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$196.20	$218.00	$12.75–$215.82	—	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, total	$215.10	$239.00	$12.75–$236.61	—	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, total	$215.10	$239.00	$12.75–$236.61	—	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO Antibody MFL	$52.20	$58.00	$7.18–$57.42	23% below	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Antibodies Serum (TPO)	$52.20	$58.00	$7.18–$57.42	23% below	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Antibodies Serum (TPO)	$52.20	$58.00	$7.18–$57.42	23% below	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO Antibody MFL	$52.20	$58.00	$7.18–$57.42	23% below	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibody	$144.00	$160.00	$7.18–$158.40	113% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibody	$144.00	$160.00	$7.18–$158.40	113% above	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroperoxidase Antibodies Serum (TPO)	$52.20	$58.00	$7.18–$57.42	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO Antibody MFL	$52.20	$58.00	$7.18–$57.42	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO Antibody MFL	$52.20	$58.00	$7.18–$57.42	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroperoxidase Antibodies Serum (TPO)	$52.20	$58.00	$7.18–$57.42	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Antibody	$144.00	$160.00	$7.18–$158.40	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Antibody	$144.00	$160.00	$7.18–$158.40	—	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay thyroid stim hormone	$177.30	$197.00	$12.45–$195.03	104% above	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay thyroid stim hormone	$177.30	$197.00	$12.45–$195.03	104% above	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay thyroid stim hormone	$177.30	$197.00	$12.45–$195.03	—	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay thyroid stim hormone	$177.30	$197.00	$12.45–$195.03	—	10%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis NAM MFL	$174.60	$194.00	$19.15–$192.06	28% above	10%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis NAM MFL	$174.60	$194.00	$19.15–$192.06	28% above	10%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis NAM MFL	$174.60	$194.00	$19.15–$192.06	—	10%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis NAM MFL	$174.60	$194.00	$19.15–$192.06	—	10%
Uric acid blood test CPT 84550 URIC ACID	$67.50	$75.00	$3.35–$74.25	45% above	10%
Uric acid blood test CPT 84550 URIC ACID	$67.50	$75.00	$3.35–$74.25	45% above	10%
Uric acid blood test inpatient CPT 84550 URIC ACID	$67.50	$75.00	$3.35–$74.25	—	10%
Uric acid blood test inpatient CPT 84550 URIC ACID	$67.50	$75.00	$3.35–$74.25	—	10%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic	$71.10	$79.00	$2.35–$78.21	77% above	10%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic	$71.10	$79.00	$2.35–$78.21	77% above	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic	$71.10	$79.00	$2.35–$78.21	—	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic	$71.10	$79.00	$2.35–$78.21	—	10%
Urinalysis without microscope exam, automated CPT 81003 URINE- NO MICRO	$38.70	$43.00	$1.66–$42.57	62% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE- NO MICRO	$38.70	$43.00	$1.66–$42.57	62% above	10%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, No Microscopic	$44.10	$49.00	$1.66–$48.51	84% above	10%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, No Microscopic	$44.10	$49.00	$1.66–$48.51	84% above	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE- NO MICRO	$38.70	$43.00	$1.66–$42.57	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE- NO MICRO	$38.70	$43.00	$1.66–$42.57	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, No Microscopic	$44.10	$49.00	$1.66–$48.51	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, No Microscopic	$44.10	$49.00	$1.66–$48.51	—	10%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC.	$37.80	$42.00	$2.09–$41.58	152% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC.	$37.80	$42.00	$2.09–$41.58	152% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC	$38.70	$43.00	$2.09–$42.57	158% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC	$38.70	$43.00	$2.09–$42.57	158% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Protein	$47.70	$53.00	$2.09–$52.47	218% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Protein	$47.70	$53.00	$2.09–$52.47	218% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Gluc Qual-CliniTest	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Occult Blood	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Ketone	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Urobilinogen	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Ketone	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Leukocytes	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Urobilinogen	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Bilirubin	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Bilirubin	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Gluc Qual-CliniTest	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Leukocytes	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Nitrite	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Nitrite	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Occult Blood	$52.20	$58.00	$2.09–$57.42	248% above	10%
Urinalysis without microscope exam, manual CPT 81002 U Ketones 1	$54.00	$60.00	$2.09–$59.40	260% above	10%
Urinalysis without microscope exam, manual CPT 81002 U Ketones 1	$54.00	$60.00	$2.09–$59.40	260% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Glucose	$54.90	$61.00	$2.09–$60.39	266% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-pH	$54.90	$61.00	$2.09–$60.39	266% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-pH	$54.90	$61.00	$2.09–$60.39	266% above	10%
Urinalysis without microscope exam, manual CPT 81002 Urine-Glucose	$54.90	$61.00	$2.09–$60.39	266% above	10%
Urinalysis without microscope exam, manual CPT 81002 URINE-SPECIFIC GRAVITY	$54.90	$61.00	$2.09–$60.39	266% above	10%
Urinalysis without microscope exam, manual CPT 81002 URINE-SPECIFIC GRAVITY	$54.90	$61.00	$2.09–$60.39	266% above	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC.	$37.80	$42.00	$2.09–$41.58	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC.	$37.80	$42.00	$2.09–$41.58	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC	$38.70	$43.00	$2.09–$42.57	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC	$38.70	$43.00	$2.09–$42.57	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Protein	$47.70	$53.00	$2.09–$52.47	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Protein	$47.70	$53.00	$2.09–$52.47	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Ketone	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Bilirubin	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Bilirubin	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Gluc Qual-CliniTest	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Gluc Qual-CliniTest	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Urobilinogen	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Ketone	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Urobilinogen	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Leukocytes	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Leukocytes	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Nitrite	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Nitrite	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Occult Blood	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Occult Blood	$52.20	$58.00	$2.09–$57.42	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 U Ketones 1	$54.00	$60.00	$2.09–$59.40	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 U Ketones 1	$54.00	$60.00	$2.09–$59.40	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE-SPECIFIC GRAVITY	$54.90	$61.00	$2.09–$60.39	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Glucose	$54.90	$61.00	$2.09–$60.39	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE-SPECIFIC GRAVITY	$54.90	$61.00	$2.09–$60.39	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-pH	$54.90	$61.00	$2.09–$60.39	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-pH	$54.90	$61.00	$2.09–$60.39	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine-Glucose	$54.90	$61.00	$2.09–$60.39	—	10%
Urine culture for bacteria, with colony count CPT 87086 Urine ID Org Sensi Culture MFL	$61.20	$68.00	$3.98–$67.32	19% below	10%
Urine culture for bacteria, with colony count CPT 87086 Urine ID Org Sensi Culture MFL	$61.20	$68.00	$3.98–$67.32	19% below	10%
Urine culture for bacteria, with colony count CPT 87086 URINE-CULTURE CC	$107.10	$119.00	$3.98–$117.81	42% above	10%
Urine culture for bacteria, with colony count CPT 87086 URINE-CULTURE CC	$107.10	$119.00	$3.98–$117.81	42% above	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine ID Org Sensi Culture MFL	$61.20	$68.00	$3.98–$67.32	—	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine ID Org Sensi Culture MFL	$61.20	$68.00	$3.98–$67.32	—	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE-CULTURE CC	$107.10	$119.00	$3.98–$117.81	—	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE-CULTURE CC	$107.10	$119.00	$3.98–$117.81	—	10%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$97.20	$108.00	$5.17–$106.92	64% above	10%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$97.20	$108.00	$5.17–$106.92	64% above	10%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Urine	$98.10	$109.00	$5.17–$107.91	65% above	10%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Urine	$98.10	$109.00	$5.17–$107.91	65% above	10%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST POC	$174.60	$194.00	$5.17–$192.06	194% above	10%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST POC	$174.60	$194.00	$5.17–$192.06	194% above	10%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$97.20	$108.00	$5.17–$106.92	—	10%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$97.20	$108.00	$5.17–$106.92	—	10%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Urine	$98.10	$109.00	$5.17–$107.91	—	10%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Urine	$98.10	$109.00	$5.17–$107.91	—	10%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST POC	$174.60	$194.00	$5.17–$192.06	—	10%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST POC	$174.60	$194.00	$5.17–$192.06	—	10%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$171.00	$190.00	$8.54–$188.10	71% above	10%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$171.00	$190.00	$8.54–$188.10	71% above	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$171.00	$190.00	$8.54–$188.10	—	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$171.00	$190.00	$8.54–$188.10	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VIT. D-3)	$260.10	$289.00	$16.78–$286.11	73% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VIT. D-3)	$260.10	$289.00	$16.78–$286.11	73% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D Total	$260.10	$289.00	$16.78–$286.11	73% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D Total	$260.10	$289.00	$16.78–$286.11	73% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D Total	$260.10	$289.00	$16.78–$286.11	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D Total	$260.10	$289.00	$16.78–$286.11	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VIT. D-3)	$260.10	$289.00	$16.78–$286.11	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VIT. D-3)	$260.10	$289.00	$16.78–$286.11	—	10%
Zinc blood test CPT 84630 ZINC	$81.90	$91.00	$5.62–$90.09	6% above	10%
Zinc blood test CPT 84630 ZINC	$81.90	$91.00	$5.62–$90.09	6% above	10%
Zinc blood test inpatient CPT 84630 ZINC	$81.90	$91.00	$5.62–$90.09	—	10%
Zinc blood test inpatient CPT 84630 ZINC	$81.90	$91.00	$5.62–$90.09	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG	$207.90	$231.00	$7.44–$228.69	85% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG	$207.90	$231.00	$7.44–$228.69	85% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG QUANTITATIVE	$225.90	$251.00	$7.44–$248.49	101% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG QUANTITATIVE	$225.90	$251.00	$7.44–$248.49	101% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG	$207.90	$231.00	$7.44–$228.69	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG	$207.90	$231.00	$7.44–$228.69	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG QUANTITATIVE	$225.90	$251.00	$7.44–$248.49	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG QUANTITATIVE	$225.90	$251.00	$7.44–$248.49	—	10%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Botox injections for chronic migraine CPT 64615 Chemodenervation of muscle(s); muscle(s) innervated by facia	$930.60	$1,034.00	$527.34–$1,023.66	48% above	10%
Botox injections for chronic migraine CPT 64615 Chemodenervation of muscle(s); muscle(s) innervated by facia	$930.60	$1,034.00	$527.34–$1,023.66	48% above	10%
Botox injections for chronic migraine inpatient CPT 64615 Chemodenervation of muscle(s); muscle(s) innervated by facia	$930.60	$1,034.00	$527.34–$1,023.66	—	10%
Botox injections for chronic migraine inpatient CPT 64615 Chemodenervation of muscle(s); muscle(s) innervated by facia	$930.60	$1,034.00	$527.34–$1,023.66	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786-Distal Fibular w/o Manipulation	$428.40	$476.00	$242.76–$471.24	23% below	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786-Distal Fibular w/o Manipulation	$428.40	$476.00	$242.76–$471.24	23% below	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 clsd tx distal fib fx w/o manip	$512.10	$569.00	$290.19–$563.31	8% below	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 clsd tx distal fib fx w/o manip	$512.10	$569.00	$290.19–$563.31	8% below	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIB FX WO MANIPULATION	$631.80	$702.00	$358.02–$694.98	14% above	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIB FX WO MANIPULATION	$631.80	$702.00	$358.02–$694.98	14% above	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786-Distal Fibular w/o Manipulation	$428.40	$476.00	$242.76–$471.24	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786-Distal Fibular w/o Manipulation	$428.40	$476.00	$242.76–$471.24	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 clsd tx distal fib fx w/o manip	$512.10	$569.00	$290.19–$563.31	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 clsd tx distal fib fx w/o manip	$512.10	$569.00	$290.19–$563.31	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIB FX WO MANIPULATION	$631.80	$702.00	$358.02–$694.98	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIB FX WO MANIPULATION	$631.80	$702.00	$358.02–$694.98	—	10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TRT. FX MTATARSAL WO MANIPULATION	$496.80	$552.00	$281.52–$546.48	17% below	10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TRT. FX MTATARSAL WO MANIPULATION	$496.80	$552.00	$281.52–$546.48	17% below	10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 EDF TX METATARSAL FX W/O MAN	$590.40	$656.00	$334.56–$649.44	1% below	10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 EDF TX METATARSAL FX W/O MAN	$590.40	$656.00	$334.56–$649.44	1% below	10%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TRT. FX MTATARSAL WO MANIPULATION	$496.80	$552.00	$281.52–$546.48	—	10%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TRT. FX MTATARSAL WO MANIPULATION	$496.80	$552.00	$281.52–$546.48	—	10%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 EDF TX METATARSAL FX W/O MAN	$590.40	$656.00	$334.56–$649.44	—	10%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 EDF TX METATARSAL FX W/O MAN	$590.40	$656.00	$334.56–$649.44	—	10%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNION. W METAT. OSTEOTOMY	$3,420.90	$3,801.00	$1,938.51–$3,762.99	24% below	10%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNION. W METAT. OSTEOTOMY	$3,420.90	$3,801.00	$1,938.51–$3,762.99	24% below	10%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNION. W METAT. OSTEOTOMY	$3,420.90	$3,801.00	$1,938.51–$3,762.99	—	10%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNION. W METAT. OSTEOTOMY	$3,420.90	$3,801.00	$1,938.51–$3,762.99	—	10%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960-Cardioversion	$1,400.40	$1,556.00	$793.56–$1,540.44	62% above	10%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960-Cardioversion	$1,400.40	$1,556.00	$793.56–$1,540.44	62% above	10%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960-Cardioversion	$1,400.40	$1,556.00	$793.56–$1,540.44	—	10%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960-Cardioversion	$1,400.40	$1,556.00	$793.56–$1,540.44	—	10%
Cervical biopsy CPT 57500 Coposcopy w/biopsy of Cervix	$341.10	$379.00	$193.29–$375.21	42% below	10%
Cervical biopsy CPT 57500 Coposcopy w/biopsy of Cervix	$341.10	$379.00	$193.29–$375.21	42% below	10%
Cervical biopsy inpatient CPT 57500 Coposcopy w/biopsy of Cervix	$341.10	$379.00	$193.29–$375.21	—	10%
Cervical biopsy inpatient CPT 57500 Coposcopy w/biopsy of Cervix	$341.10	$379.00	$193.29–$375.21	—	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION, TREAMENT RM	$1,350.00	$1,500.00	$765.00–$1,485.00	677% above	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision, Treatment Room	$1,350.00	$1,500.00	$765.00–$1,485.00	677% above	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION, TREAMENT RM	$1,350.00	$1,500.00	$765.00–$1,485.00	677% above	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision, Treatment Room	$1,350.00	$1,500.00	$765.00–$1,485.00	677% above	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION, TREAMENT RM	$1,350.00	$1,500.00	$765.00–$1,485.00	—	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision, Treatment Room	$1,350.00	$1,500.00	$765.00–$1,485.00	—	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision, Treatment Room	$1,350.00	$1,500.00	$765.00–$1,485.00	—	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION, TREAMENT RM	$1,350.00	$1,500.00	$765.00–$1,485.00	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-Distal Radial w/o Manipulation	$434.70	$483.00	$246.33–$478.17	29% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-Distal Radial w/o Manipulation	$434.70	$483.00	$246.33–$478.17	29% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA	$549.00	$610.00	$311.10–$603.90	11% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA	$549.00	$610.00	$311.10–$603.90	11% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TRT. CLSD. DIST. RAD FX WO MANIP	$745.20	$828.00	$422.28–$819.72	21% above	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TRT. CLSD. DIST. RAD FX WO MANIP	$745.20	$828.00	$422.28–$819.72	21% above	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600-Distal Radial w/o Manipulation	$434.70	$483.00	$246.33–$478.17	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600-Distal Radial w/o Manipulation	$434.70	$483.00	$246.33–$478.17	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA	$549.00	$610.00	$311.10–$603.90	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA	$549.00	$610.00	$311.10–$603.90	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TRT. CLSD. DIST. RAD FX WO MANIP	$745.20	$828.00	$422.28–$819.72	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TRT. CLSD. DIST. RAD FX WO MANIP	$745.20	$828.00	$422.28–$819.72	—	10%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$3,364.20	$3,738.00	$1,823.42–$3,700.62	118% above	10%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$3,364.20	$3,738.00	$1,823.42–$3,700.62	118% above	10%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$3,364.20	$3,738.00	$1,823.42–$3,700.62	—	10%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$3,364.20	$3,738.00	$1,823.42–$3,700.62	—	10%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLP W LOOP ELECTRODE BIOPSY OF CERVIX	$1,432.80	$1,592.00	$811.92–$1,576.08	67% above	10%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLP W LOOP ELECTRODE BIOPSY OF CERVIX	$1,432.80	$1,592.00	$811.92–$1,576.08	67% above	10%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLP W LOOP ELECTRODE BIOPSY OF CERVIX	$1,432.80	$1,592.00	$811.92–$1,576.08	—	10%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLP W LOOP ELECTRODE BIOPSY OF CERVIX	$1,432.80	$1,592.00	$811.92–$1,576.08	—	10%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 57454 Colposcopy of the cervix; with biopsy(s) of the cervix and endocervical curettage	$265.50	$295.00	$150.45–$292.05	41% below	10%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 57454 Colposcopy of the cervix; with biopsy(s) of the cervix and endocervical curettage	$265.50	$295.00	$150.45–$292.05	41% below	10%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 57454 Colposcopy of the cervix; with biopsy(s) of the cervix and endocervical curettage	$265.50	$295.00	$150.45–$292.05	—	10%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 57454 Colposcopy of the cervix; with biopsy(s) of the cervix and endocervical curettage	$265.50	$295.00	$150.45–$292.05	—	10%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$3,194.10	$3,549.00	$1,809.99–$3,513.51	389% above	10%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$3,194.10	$3,549.00	$1,809.99–$3,513.51	389% above	10%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$3,194.10	$3,549.00	$1,809.99–$3,513.51	—	10%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$3,194.10	$3,549.00	$1,809.99–$3,513.51	—	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESIONS; FIRST	$103.50	$115.00	$58.65–$113.85	50% below	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESIONS; FIRST	$103.50	$115.00	$58.65–$113.85	50% below	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction premalig lesion; 1st lesion	$122.40	$136.00	$69.36–$134.64	41% below	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction premalig lesion; 1st lesion	$122.40	$136.00	$69.36–$134.64	41% below	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESIONS; FIRST	$103.50	$115.00	$58.65–$113.85	—	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESIONS; FIRST	$103.50	$115.00	$58.65–$113.85	—	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 17000 Destruction premalig lesion; 1st lesion	$122.40	$136.00	$69.36–$134.64	—	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 17000 Destruction premalig lesion; 1st lesion	$122.40	$136.00	$69.36–$134.64	—	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 ED REMOVAL IMPACTED CERUMEN IRRIGATION AND LAVAGE	$144.00	$160.00	$81.60–$158.40	152% above	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage	$144.00	$160.00	$81.60–$158.40	152% above	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage	$144.00	$160.00	$81.60–$158.40	152% above	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 ED REMOVAL IMPACTED CERUMEN IRRIGATION AND LAVAGE	$144.00	$160.00	$81.60–$158.40	152% above	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove impacted ear wax uni	$144.00	$160.00	$81.60–$158.40	152% above	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove impacted ear wax uni	$144.00	$160.00	$81.60–$158.40	152% above	10%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/Lavage, Unilateral	$38.70	$43.00	$21.93–$42.57	32% below	10%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/Lavage, Unilateral	$38.70	$43.00	$21.93–$42.57	32% below	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209 ED REMOVAL IMPACTED CERUMEN IRRIGATION AND LAVAGE	$144.00	$160.00	$81.60–$158.40	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove impacted ear wax uni	$144.00	$160.00	$81.60–$158.40	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove impacted ear wax uni	$144.00	$160.00	$81.60–$158.40	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage	$144.00	$160.00	$81.60–$158.40	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage	$144.00	$160.00	$81.60–$158.40	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209 ED REMOVAL IMPACTED CERUMEN IRRIGATION AND LAVAGE	$144.00	$160.00	$81.60–$158.40	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/Lavage, Unilateral	$38.70	$43.00	$21.93–$42.57	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/Lavage, Unilateral	$38.70	$43.00	$21.93–$42.57	—	10%
Earwax removal with instruments, one ear CPT 69210 cerumen removal	$84.60	$94.00	$47.94–$93.06	1% above	10%
Earwax removal with instruments, one ear CPT 69210 cerumen removal	$84.60	$94.00	$47.94–$93.06	1% above	10%
Earwax removal with instruments, one ear CPT 69210 69210-Cerumen w/ Instrumentation	$99.90	$111.00	$56.61–$109.89	19% above	10%
Earwax removal with instruments, one ear CPT 69210 69210-Cerumen w/ Instrumentation	$99.90	$111.00	$56.61–$109.89	19% above	10%
Earwax removal with instruments, one ear inpatient CPT 69210 cerumen removal	$84.60	$94.00	$47.94–$93.06	—	10%
Earwax removal with instruments, one ear inpatient CPT 69210 cerumen removal	$84.60	$94.00	$47.94–$93.06	—	10%
Earwax removal with instruments, one ear inpatient CPT 69210 69210-Cerumen w/ Instrumentation	$99.90	$111.00	$56.61–$109.89	—	10%
Earwax removal with instruments, one ear inpatient CPT 69210 69210-Cerumen w/ Instrumentation	$99.90	$111.00	$56.61–$109.89	—	10%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIALENDOCERVICAL BIOPSY	$341.10	$379.00	$193.29–$375.21	26% above	10%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIALENDOCERVICAL BIOPSY	$341.10	$379.00	$193.29–$375.21	26% above	10%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIALENDOCERVICAL BIOPSY	$341.10	$379.00	$193.29–$375.21	—	10%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIALENDOCERVICAL BIOPSY	$341.10	$379.00	$193.29–$375.21	—	10%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Interlaminar Epidural C/T	$3,610.80	$4,012.00	$2,046.12–$3,971.88	328% above	10%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Interlaminar Epidural C/T	$3,610.80	$4,012.00	$2,046.12–$3,971.88	328% above	10%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Interlaminar Epidural C/T	$3,610.80	$4,012.00	$2,046.12–$3,971.88	—	10%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Interlaminar Epidural C/T	$3,610.80	$4,012.00	$2,046.12–$3,971.88	—	10%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET/MBB 1ST LEVEL L/C	$3,588.30	$3,987.00	$2,033.37–$3,947.13	301% above	10%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET/MBB 1ST LEVEL L/C	$3,588.30	$3,987.00	$2,033.37–$3,947.13	301% above	10%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET/MBB 1ST LEVEL L/C	$3,588.30	$3,987.00	$2,033.37–$3,947.13	—	10%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET/MBB 1ST LEVEL L/C	$3,588.30	$3,987.00	$2,033.37–$3,947.13	—	10%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC	$5,344.20	$5,938.00	$3,028.38–$5,878.62	17% below	10%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC	$5,344.20	$5,938.00	$3,028.38–$5,878.62	17% below	10%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HRN 1ST > 10 RDC	$5,344.20	$5,938.00	$3,028.38–$5,878.62	—	10%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HRN 1ST > 10 RDC	$5,344.20	$5,938.00	$3,028.38–$5,878.62	—	10%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETERIZATION WINTRO OF SALINE	$401.40	$446.00	$227.46–$441.54	55% above	10%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETERIZATION WINTRO OF SALINE	$401.40	$446.00	$227.46–$441.54	55% above	10%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETERIZATION WINTRO OF SALINE	$401.40	$446.00	$227.46–$441.54	—	10%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETERIZATION WINTRO OF SALINE	$401.40	$446.00	$227.46–$441.54	—	10%
IUD insertion (the device itself billed separately) CPT 58300 58300 INSERTION, IUD	$221.40	$246.00	$125.46–$243.54	27% below	10%
IUD insertion (the device itself billed separately) CPT 58300 58300 INSERTION, IUD	$221.40	$246.00	$125.46–$243.54	27% below	10%
IUD insertion (the device itself billed separately) inpatient CPT 58300 58300 INSERTION, IUD	$221.40	$246.00	$125.46–$243.54	—	10%
IUD insertion (the device itself billed separately) inpatient CPT 58300 58300 INSERTION, IUD	$221.40	$246.00	$125.46–$243.54	—	10%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess, Simple/Single Charge	$212.40	$236.00	$120.36–$233.64	31% below	10%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess, Simple/Single Charge	$212.40	$236.00	$120.36–$233.64	31% below	10%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 DRAINAGE OF SKIN ABSCESS	$601.20	$668.00	$340.68–$661.32	96% above	10%
Incision and drainage of a simple or single skin abscess CPT 10060 10060-ID Abscess/Cyst/Hematoma Simple	$601.20	$668.00	$340.68–$661.32	96% above	10%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 DRAINAGE OF SKIN ABSCESS	$601.20	$668.00	$340.68–$661.32	96% above	10%
Incision and drainage of a simple or single skin abscess CPT 10060 10060-ID Abscess/Cyst/Hematoma Simple	$601.20	$668.00	$340.68–$661.32	96% above	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess, Simple/Single Charge	$212.40	$236.00	$120.36–$233.64	—	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess, Simple/Single Charge	$212.40	$236.00	$120.36–$233.64	—	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-ID Abscess/Cyst/Hematoma Simple	$601.20	$668.00	$340.68–$661.32	—	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 DRAINAGE OF SKIN ABSCESS	$601.20	$668.00	$340.68–$661.32	—	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 DRAINAGE OF SKIN ABSCESS	$601.20	$668.00	$340.68–$661.32	—	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-ID Abscess/Cyst/Hematoma Simple	$601.20	$668.00	$340.68–$661.32	—	10%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar Fascia) Charge	$130.50	$145.00	$73.95–$143.55	49% below	10%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar Fascia) Charge	$130.50	$145.00	$73.95–$143.55	49% below	10%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar Fascia) Charge	$130.50	$145.00	$73.95–$143.55	—	10%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar Fascia) Charge	$130.50	$145.00	$73.95–$143.55	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint, Shoulder, Hip,Knee Charge	$107.10	$119.00	$60.69–$117.81	69% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint, Shoulder, Hip,Knee Charge	$107.10	$119.00	$60.69–$117.81	69% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 NEEDLE ASPIRATION/INJ	$286.20	$318.00	$162.18–$314.82	17% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 NEEDLE ASPIRATION/INJ	$286.20	$318.00	$162.18–$314.82	17% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$904.50	$1,005.00	$512.55–$994.95	162% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 DRAIN/INJ JOINT/BURSA WO US	$904.50	$1,005.00	$512.55–$994.95	162% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$904.50	$1,005.00	$512.55–$994.95	162% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 DRAIN/INJ JOINT/BURSA WO US	$904.50	$1,005.00	$512.55–$994.95	162% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$1,168.20	$1,298.00	$661.98–$1,285.02	238% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$1,168.20	$1,298.00	$661.98–$1,285.02	238% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Rt - MRI	$698.40	$776.00	$395.76–$768.24	102% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Lt	$698.40	$776.00	$395.76–$768.24	102% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Rt - MRI	$698.40	$776.00	$395.76–$768.24	102% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Lt	$698.40	$776.00	$395.76–$768.24	102% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Lt - MRI	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Lt - MRI	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Fluoro Hip Joint Inj Asp Lt	$719.10	$799.00	$407.49–$791.01	108% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Major Joint, Shoulder, Hip,Knee Charge	$107.10	$119.00	$60.69–$117.81	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Major Joint, Shoulder, Hip,Knee Charge	$107.10	$119.00	$60.69–$117.81	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 NEEDLE ASPIRATION/INJ	$286.20	$318.00	$162.18–$314.82	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 NEEDLE ASPIRATION/INJ	$286.20	$318.00	$162.18–$314.82	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$904.50	$1,005.00	$512.55–$994.95	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 DRAIN/INJ JOINT/BURSA WO US	$904.50	$1,005.00	$512.55–$994.95	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$904.50	$1,005.00	$512.55–$994.95	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 DRAIN/INJ JOINT/BURSA WO US	$904.50	$1,005.00	$512.55–$994.95	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$1,168.20	$1,298.00	$661.98–$1,285.02	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$1,168.20	$1,298.00	$661.98–$1,285.02	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Lt	$698.40	$776.00	$395.76–$768.24	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Hip Joint Inj Rt - MRI	$698.40	$776.00	$395.76–$768.24	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Hip Joint Inj Rt - MRI	$698.40	$776.00	$395.76–$768.24	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Lt	$698.40	$776.00	$395.76–$768.24	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Hip Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Shoulder Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Hip Joint Inj Lt - MRI	$719.10	$799.00	$407.49–$791.01	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Hip Joint Inj Lt - MRI	$719.10	$799.00	$407.49–$791.01	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Fluoro Hip Joint Inj Asp Rt	$719.10	$799.00	$407.49–$791.01	—	10%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion, Non-Biodegradable Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	27% below	10%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion, Non-Biodegradable Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	27% below	10%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981: Insert Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	27% below	10%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981: Insert Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	27% below	10%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion, Non-Biodegradable Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	—	10%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion, Non-Biodegradable Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	—	10%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 11981: Insert Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	—	10%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 11981: Insert Drug Delivery Implant	$180.90	$201.00	$102.51–$198.99	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa without ultrasound guidance	$91.80	$102.00	$52.02–$100.98	69% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa without ultrasound guidance	$91.80	$102.00	$52.02–$100.98	69% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605: Medium Joint	$235.80	$262.00	$133.62–$259.38	19% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605: Medium Joint	$235.80	$262.00	$133.62–$259.38	19% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$252.90	$281.00	$143.31–$278.19	14% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$252.90	$281.00	$143.31–$278.19	14% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION INTERMED JOINT/BURSA	$1,012.50	$1,125.00	$573.75–$1,113.75	246% above	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION INTERMED JOINT/BURSA	$1,012.50	$1,125.00	$573.75–$1,113.75	246% above	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa without ultrasound guidance	$91.80	$102.00	$52.02–$100.98	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa without ultrasound guidance	$91.80	$102.00	$52.02–$100.98	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605: Medium Joint	$235.80	$262.00	$133.62–$259.38	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605: Medium Joint	$235.80	$262.00	$133.62–$259.38	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$252.90	$281.00	$143.31–$278.19	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$252.90	$281.00	$143.31–$278.19	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECTION INTERMED JOINT/BURSA	$1,012.50	$1,125.00	$573.75–$1,113.75	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECTION INTERMED JOINT/BURSA	$1,012.50	$1,125.00	$573.75–$1,113.75	—	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Charge	$97.20	$108.00	$55.08–$106.92	65% below	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Charge	$97.20	$108.00	$55.08–$106.92	65% below	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600: Small Joint	$225.90	$251.00	$128.01–$248.49	19% below	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600: Small Joint	$225.90	$251.00	$128.01–$248.49	19% below	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Injection Small Joint/Bursa	$711.00	$790.00	$402.90–$782.10	155% above	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Injection Small Joint/Bursa	$711.00	$790.00	$402.90–$782.10	155% above	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 - small joint aspirate/injection pain clinic	$732.60	$814.00	$415.14–$805.86	162% above	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 - small joint aspirate/injection pain clinic	$732.60	$814.00	$415.14–$805.86	162% above	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$775.80	$862.00	$439.62–$853.38	178% above	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$775.80	$862.00	$439.62–$853.38	178% above	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Charge	$97.20	$108.00	$55.08–$106.92	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Charge	$97.20	$108.00	$55.08–$106.92	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600: Small Joint	$225.90	$251.00	$128.01–$248.49	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600: Small Joint	$225.90	$251.00	$128.01–$248.49	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Injection Small Joint/Bursa	$711.00	$790.00	$402.90–$782.10	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Injection Small Joint/Bursa	$711.00	$790.00	$402.90–$782.10	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 - small joint aspirate/injection pain clinic	$732.60	$814.00	$415.14–$805.86	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 - small joint aspirate/injection pain clinic	$732.60	$814.00	$415.14–$805.86	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$775.80	$862.00	$439.62–$853.38	—	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$775.80	$862.00	$439.62–$853.38	—	10%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 DISCUSSION SECONDARY CATARACT LASER SURGERY	$1,866.60	$2,074.00	$1,057.74–$2,053.26	59% above	10%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 DISCUSSION SECONDARY CATARACT LASER SURGERY	$1,866.60	$2,074.00	$1,057.74–$2,053.26	59% above	10%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 DISCUSSION SECONDARY CATARACT LASER SURGERY	$1,866.60	$2,074.00	$1,057.74–$2,053.26	—	10%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 DISCUSSION SECONDARY CATARACT LASER SURGERY	$1,866.60	$2,074.00	$1,057.74–$2,053.26	—	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND	$405.90	$451.00	$230.01–$446.49	18% below	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND	$405.90	$451.00	$230.01–$446.49	18% below	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$607.50	$675.00	$344.25–$668.25	23% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$607.50	$675.00	$344.25–$668.25	23% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUND	$405.90	$451.00	$230.01–$446.49	—	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUND	$405.90	$451.00	$230.01–$446.49	—	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$607.50	$675.00	$344.25–$668.25	—	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$607.50	$675.00	$344.25–$668.25	—	10%
Lower-back epidural injection, with imaging guidance CPT 62323 Interlaminar Epidural L/C	$3,610.80	$4,012.00	$2,046.12–$3,971.88	510% above	10%
Lower-back epidural injection, with imaging guidance CPT 62323 Interlaminar Epidural L/C	$3,610.80	$4,012.00	$2,046.12–$3,971.88	510% above	10%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Interlaminar Epidural L/C	$3,610.80	$4,012.00	$2,046.12–$3,971.88	—	10%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Interlaminar Epidural L/C	$3,610.80	$4,012.00	$2,046.12–$3,971.88	—	10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL EPIDURAL L/S	$2,725.20	$3,028.00	$1,544.28–$2,997.72	250% above	10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL EPIDURAL L/S	$2,725.20	$3,028.00	$1,544.28–$2,997.72	250% above	10%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAMINAL EPIDURAL L/S	$2,725.20	$3,028.00	$1,544.28–$2,997.72	—	10%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAMINAL EPIDURAL L/S	$2,725.20	$3,028.00	$1,544.28–$2,997.72	—	10%
Miscarriage treatment with D&C, first trimester CPT 59820 TRTMNT OF MISSED ABORTION SURGICALLY	$1,053.00	$1,170.00	$596.70–$1,158.30	29% below	10%
Miscarriage treatment with D&C, first trimester CPT 59820 TRTMNT OF MISSED ABORTION SURGICALLY	$1,053.00	$1,170.00	$596.70–$1,158.30	29% below	10%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TRTMNT OF MISSED ABORTION SURGICALLY	$1,053.00	$1,170.00	$596.70–$1,158.30	—	10%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TRTMNT OF MISSED ABORTION SURGICALLY	$1,053.00	$1,170.00	$596.70–$1,158.30	—	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION CHARGE.	$218.70	$243.00	$123.93–$240.57	37% below	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION CHARGE.	$218.70	$243.00	$123.93–$240.57	37% below	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm	$837.90	$931.00	$474.81–$921.69	140% above	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm	$837.90	$931.00	$474.81–$921.69	140% above	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION CHARGE.	$218.70	$243.00	$123.93–$240.57	—	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION CHARGE.	$218.70	$243.00	$123.93–$240.57	—	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm	$837.90	$931.00	$474.81–$921.69	—	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm	$837.90	$931.00	$474.81–$921.69	—	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm	$339.30	$377.00	$192.27–$373.23	34% below	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm	$339.30	$377.00	$192.27–$373.23	34% below	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISE BENIGN LESION TO 0.5 CM	$358.20	$398.00	$202.98–$394.02	30% below	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISE BENIGN LESION TO 0.5 CM	$358.20	$398.00	$202.98–$394.02	30% below	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm	$339.30	$377.00	$192.27–$373.23	—	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm	$339.30	$377.00	$192.27–$373.23	—	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISE BENIGN LESION TO 0.5 CM	$358.20	$398.00	$202.98–$394.02	—	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISE BENIGN LESION TO 0.5 CM	$358.20	$398.00	$202.98–$394.02	—	10%
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion nail plate;simple/single (Surg)	$114.30	$127.00	$64.77–$125.73	49% below	10%
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion nail plate;simple/single (Surg)	$114.30	$127.00	$64.77–$125.73	49% below	10%
Nail removal (partial or complete), one nail CPT 11730 11730 REMOVAL OF NAIL PLATE	$518.40	$576.00	$293.76–$570.24	130% above	10%
Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single	$518.40	$576.00	$293.76–$570.24	130% above	10%
Nail removal (partial or complete), one nail CPT 11730 11730 REMOVAL OF NAIL PLATE	$518.40	$576.00	$293.76–$570.24	130% above	10%
Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single	$518.40	$576.00	$293.76–$570.24	130% above	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion nail plate;simple/single (Surg)	$114.30	$127.00	$64.77–$125.73	—	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion nail plate;simple/single (Surg)	$114.30	$127.00	$64.77–$125.73	—	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single	$518.40	$576.00	$293.76–$570.24	—	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single	$518.40	$576.00	$293.76–$570.24	—	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 REMOVAL OF NAIL PLATE	$518.40	$576.00	$293.76–$570.24	—	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 REMOVAL OF NAIL PLATE	$518.40	$576.00	$293.76–$570.24	—	10%
Occipital nerve block (injection for headaches) CPT 64405 64405-Inject Nerve Block Great Occipital	$765.90	$851.00	$434.01–$842.49	72% above	10%
Occipital nerve block (injection for headaches) CPT 64405 64405-Inject Nerve Block Great Occipital	$765.90	$851.00	$434.01–$842.49	72% above	10%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL	$1,122.30	$1,247.00	$635.97–$1,234.53	151% above	10%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL	$1,122.30	$1,247.00	$635.97–$1,234.53	151% above	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405-Inject Nerve Block Great Occipital	$765.90	$851.00	$434.01–$842.49	—	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405-Inject Nerve Block Great Occipital	$765.90	$851.00	$434.01–$842.49	—	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL	$1,122.30	$1,247.00	$635.97–$1,234.53	—	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL	$1,122.30	$1,247.00	$635.97–$1,234.53	—	10%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS WIMAGING	$808.20	$898.00	$457.98–$889.02	35% below	10%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS WIMAGING	$808.20	$898.00	$457.98–$889.02	35% below	10%
Paracentesis with imaging guidance CPT 49083 Abdominal paracentesis with imaging guidance	$1,214.10	$1,349.00	$687.99–$1,335.51	2% below	10%
Paracentesis with imaging guidance CPT 49083 Abdominal paracentesis with imaging guidance	$1,214.10	$1,349.00	$687.99–$1,335.51	2% below	10%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGING	$1,397.70	$1,553.00	$792.03–$1,537.47	13% above	10%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGING	$1,397.70	$1,553.00	$792.03–$1,537.47	13% above	10%
Paracentesis with imaging guidance CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide	$1,679.40	$1,866.00	$951.66–$1,847.34	36% above	10%
Paracentesis with imaging guidance CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide	$1,679.40	$1,866.00	$951.66–$1,847.34	36% above	10%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS WIMAGING	$808.20	$898.00	$457.98–$889.02	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS WIMAGING	$808.20	$898.00	$457.98–$889.02	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 Abdominal paracentesis with imaging guidance	$1,214.10	$1,349.00	$687.99–$1,335.51	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 Abdominal paracentesis with imaging guidance	$1,214.10	$1,349.00	$687.99–$1,335.51	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGING	$1,397.70	$1,553.00	$792.03–$1,537.47	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGING	$1,397.70	$1,553.00	$792.03–$1,537.47	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide	$1,679.40	$1,866.00	$951.66–$1,847.34	—	10%
Paracentesis with imaging guidance inpatient CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide	$1,679.40	$1,866.00	$951.66–$1,847.34	—	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-Excision Nail Matrix	$598.50	$665.00	$339.15–$658.35	83% above	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-Excision Nail Matrix	$598.50	$665.00	$339.15–$658.35	83% above	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 REMOVAL OF NAIL BED	$1,071.00	$1,190.00	$606.90–$1,178.10	228% above	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 REMOVAL OF NAIL BED	$1,071.00	$1,190.00	$606.90–$1,178.10	228% above	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750-Excision Nail Matrix	$598.50	$665.00	$339.15–$658.35	—	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750-Excision Nail Matrix	$598.50	$665.00	$339.15–$658.35	—	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 REMOVAL OF NAIL BED	$1,071.00	$1,190.00	$606.90–$1,178.10	—	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 REMOVAL OF NAIL BED	$1,071.00	$1,190.00	$606.90–$1,178.10	—	10%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,417.30	$3,797.00	$1,936.47–$3,759.03	86% above	10%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,417.30	$3,797.00	$1,936.47–$3,759.03	86% above	10%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Spine RF L/S	$5,779.80	$6,422.00	$3,275.22–$6,357.78	214% above	10%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Spine RF L/S	$5,779.80	$6,422.00	$3,275.22–$6,357.78	214% above	10%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,417.30	$3,797.00	$1,936.47–$3,759.03	—	10%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,417.30	$3,797.00	$1,936.47–$3,759.03	—	10%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Spine RF L/S	$5,779.80	$6,422.00	$3,275.22–$6,357.78	—	10%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Spine RF L/S	$5,779.80	$6,422.00	$3,275.22–$6,357.78	—	10%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal of Foreign Body, Subcutaneous Tissues; Simple Charge	$248.40	$276.00	$140.76–$273.24	14% below	10%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal of Foreign Body, Subcutaneous Tissues; Simple Charge	$248.40	$276.00	$140.76–$273.24	14% below	10%
Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple	$433.80	$482.00	$245.82–$477.18	50% above	10%
Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple	$433.80	$482.00	$245.82–$477.18	50% above	10%
Removal of a foreign object under the skin, simple CPT 10120 10120 REMOVE FOREIGN BODY	$792.00	$880.00	$448.80–$871.20	174% above	10%
Removal of a foreign object under the skin, simple CPT 10120 10120 REMOVE FOREIGN BODY	$792.00	$880.00	$448.80–$871.20	174% above	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal of Foreign Body, Subcutaneous Tissues; Simple Charge	$248.40	$276.00	$140.76–$273.24	—	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal of Foreign Body, Subcutaneous Tissues; Simple Charge	$248.40	$276.00	$140.76–$273.24	—	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple	$433.80	$482.00	$245.82–$477.18	—	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple	$433.80	$482.00	$245.82–$477.18	—	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 REMOVE FOREIGN BODY	$792.00	$880.00	$448.80–$871.20	—	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 REMOVE FOREIGN BODY	$792.00	$880.00	$448.80–$871.20	—	10%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID	$4,472.10	$4,969.00	$2,534.19–$4,919.31	16% above	10%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID	$4,472.10	$4,969.00	$2,534.19–$4,919.31	16% above	10%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PARTIAL REMOVAL OF THYROID	$4,472.10	$4,969.00	$2,534.19–$4,919.31	—	10%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PARTIAL REMOVAL OF THYROID	$4,472.10	$4,969.00	$2,534.19–$4,919.31	—	10%
Short arm cast (elbow to hand) CPT 29075 Applic, Cast; Elbow to Finger (Short Arm) Charge	$153.00	$170.00	$53.73–$168.30	35% below	10%
Short arm cast (elbow to hand) CPT 29075 Applic, Cast; Elbow to Finger (Short Arm) Charge	$153.00	$170.00	$53.73–$168.30	35% below	10%
Short arm cast (elbow to hand) inpatient CPT 29075 Applic, Cast; Elbow to Finger (Short Arm) Charge	$153.00	$170.00	$53.73–$168.30	—	10%
Short arm cast (elbow to hand) inpatient CPT 29075 Applic, Cast; Elbow to Finger (Short Arm) Charge	$153.00	$170.00	$53.73–$168.30	—	10%
Short arm splint (forearm and hand) CPT 29125 Applic of Short Arm Splint (Forearm to Hand); Static Charge	$118.80	$132.00	$67.32–$130.68	32% below	10%
Short arm splint (forearm and hand) CPT 29125 Applic of Short Arm Splint (Forearm to Hand); Static Charge	$118.80	$132.00	$67.32–$130.68	32% below	10%
Short arm splint (forearm and hand) CPT 29125 29125-Short Arm	$364.50	$405.00	$206.55–$400.95	107% above	10%
Short arm splint (forearm and hand) CPT 29125 29125-Short Arm	$364.50	$405.00	$206.55–$400.95	107% above	10%
Short arm splint (forearm and hand) inpatient CPT 29125 Applic of Short Arm Splint (Forearm to Hand); Static Charge	$118.80	$132.00	$67.32–$130.68	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 Applic of Short Arm Splint (Forearm to Hand); Static Charge	$118.80	$132.00	$67.32–$130.68	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm	$364.50	$405.00	$206.55–$400.95	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm	$364.50	$405.00	$206.55–$400.95	—	10%
Short leg cast (below the knee) CPT 29405 Applic of Short Leg Cast (Below Knee to toes); Charge	$144.00	$160.00	$69.26–$158.40	36% below	10%
Short leg cast (below the knee) CPT 29405 Applic of Short Leg Cast (Below Knee to toes); Charge	$144.00	$160.00	$69.26–$158.40	36% below	10%
Short leg cast (below the knee) inpatient CPT 29405 Applic of Short Leg Cast (Below Knee to toes); Charge	$144.00	$160.00	$69.26–$158.40	—	10%
Short leg cast (below the knee) inpatient CPT 29405 Applic of Short Leg Cast (Below Knee to toes); Charge	$144.00	$160.00	$69.26–$158.40	—	10%
Short leg splint (calf to foot) CPT 29515 Applic of Short Leg Splint (Calf to Foot) Charge	$129.60	$144.00	$73.44–$142.56	38% below	10%
Short leg splint (calf to foot) CPT 29515 Applic of Short Leg Splint (Calf to Foot) Charge	$129.60	$144.00	$73.44–$142.56	38% below	10%
Short leg splint (calf to foot) CPT 29515 29515-Short Leg	$196.20	$218.00	$111.18–$215.82	5% below	10%
Short leg splint (calf to foot) CPT 29515 29515-Short Leg	$196.20	$218.00	$111.18–$215.82	5% below	10%
Short leg splint (calf to foot) inpatient CPT 29515 Applic of Short Leg Splint (Calf to Foot) Charge	$129.60	$144.00	$73.44–$142.56	—	10%
Short leg splint (calf to foot) inpatient CPT 29515 Applic of Short Leg Splint (Calf to Foot) Charge	$129.60	$144.00	$73.44–$142.56	—	10%
Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg	$196.20	$218.00	$111.18–$215.82	—	10%
Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg	$196.20	$218.00	$111.18–$215.82	—	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 RPR S/N/AX/Gen/TRNK 2.5CM/<	$161.10	$179.00	$91.29–$177.21	50% below	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 RPR S/N/AX/Gen/TRNK 2.5CM/<	$161.10	$179.00	$91.29–$177.21	50% below	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$592.20	$658.00	$335.58–$651.42	82% above	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$592.20	$658.00	$335.58–$651.42	82% above	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 RPR S/N/AX/Gen/TRNK 2.5CM/<	$161.10	$179.00	$91.29–$177.21	—	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 RPR S/N/AX/Gen/TRNK 2.5CM/<	$161.10	$179.00	$91.29–$177.21	—	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$592.20	$658.00	$335.58–$651.42	—	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$592.20	$658.00	$335.58–$651.42	—	10%
Skin biopsy, punch, one lesion CPT 11104 11104 PUNCH BX SKIN SINGLE LESION	$211.50	$235.00	$119.85–$232.65	5% below	10%
Skin biopsy, punch, one lesion CPT 11104 11104 PUNCH BX SKIN SINGLE LESION	$211.50	$235.00	$119.85–$232.65	5% below	10%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch biopsy ofskin	$417.60	$464.00	$236.64–$459.36	88% above	10%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch biopsy ofskin	$417.60	$464.00	$236.64–$459.36	88% above	10%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$558.00	$620.00	$316.20–$613.80	151% above	10%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$558.00	$620.00	$316.20–$613.80	151% above	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 PUNCH BX SKIN SINGLE LESION	$211.50	$235.00	$119.85–$232.65	—	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 PUNCH BX SKIN SINGLE LESION	$211.50	$235.00	$119.85–$232.65	—	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch biopsy ofskin	$417.60	$464.00	$236.64–$459.36	—	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch biopsy ofskin	$417.60	$464.00	$236.64–$459.36	—	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$558.00	$620.00	$316.20–$613.80	—	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$558.00	$620.00	$316.20–$613.80	—	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISE MALIG. LESION TO 0.5 CM	$477.00	$530.00	$270.30–$524.70	30% above	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISE MALIG. LESION TO 0.5 CM	$477.00	$530.00	$270.30–$524.70	30% above	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISE MALIG. LESION TO 0.5 CM	$477.00	$530.00	$270.30–$524.70	—	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISE MALIG. LESION TO 0.5 CM	$477.00	$530.00	$270.30–$524.70	—	10%
Skin tag removal, up to 15 tags CPT 11200 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to & w/15 Lesions Charge	$159.30	$177.00	$90.27–$175.23	13% above	10%
Skin tag removal, up to 15 tags CPT 11200 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to & w/15 Lesions Charge	$159.30	$177.00	$90.27–$175.23	13% above	10%
Skin tag removal, up to 15 tags CPT 11200 11200-Removal Skin Tag up to 15	$190.80	$212.00	$108.12–$209.88	35% above	10%
Skin tag removal, up to 15 tags CPT 11200 11200-Removal Skin Tag up to 15	$190.80	$212.00	$108.12–$209.88	35% above	10%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to & w/15 Lesions Charge	$159.30	$177.00	$90.27–$175.23	—	10%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to & w/15 Lesions Charge	$159.30	$177.00	$90.27–$175.23	—	10%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200-Removal Skin Tag up to 15	$190.80	$212.00	$108.12–$209.88	—	10%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200-Removal Skin Tag up to 15	$190.80	$212.00	$108.12–$209.88	—	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic	$601.20	$668.00	$340.68–$661.32	4% above	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic	$601.20	$668.00	$340.68–$661.32	4% above	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$650.70	$723.00	$368.73–$715.77	12% above	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$650.70	$723.00	$368.73–$715.77	12% above	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic	$601.20	$668.00	$340.68–$661.32	—	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic	$601.20	$668.00	$340.68–$661.32	—	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$650.70	$723.00	$368.73–$715.77	—	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$650.70	$723.00	$368.73–$715.77	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$191.70	$213.00	$108.63–$210.87	5% below	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$191.70	$213.00	$108.63–$210.87	5% below	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$517.50	$575.00	$293.25–$569.25	156% above	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$517.50	$575.00	$293.25–$569.25	156% above	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$191.70	$213.00	$108.63–$210.87	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$191.70	$213.00	$108.63–$210.87	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$517.50	$575.00	$293.25–$569.25	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$517.50	$575.00	$293.25–$569.25	—	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 RPR F/E/E/N/L/M 2.5 CM/<	$183.60	$204.00	$104.04–$201.96	41% below	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 RPR F/E/E/N/L/M 2.5 CM/<	$183.60	$204.00	$104.04–$201.96	41% below	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$581.40	$646.00	$329.46–$639.54	88% above	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$581.40	$646.00	$329.46–$639.54	88% above	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 RPR F/E/E/N/L/M 2.5 CM/<	$183.60	$204.00	$104.04–$201.96	—	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 RPR F/E/E/N/L/M 2.5 CM/<	$183.60	$204.00	$104.04–$201.96	—	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$581.40	$646.00	$329.46–$639.54	—	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$581.40	$646.00	$329.46–$639.54	—	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 - Tangential biopsy of single skin lesion	$165.60	$184.00	$93.84–$182.16	28% below	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 - Tangential biopsy of single skin lesion	$165.60	$184.00	$93.84–$182.16	28% below	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 TANGNTL BX SKIN SINGLE LES	$422.10	$469.00	$239.19–$464.31	84% above	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 TANGNTL BX SKIN SINGLE LES	$422.10	$469.00	$239.19–$464.31	84% above	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 - Tangential biopsy of single skin lesion	$165.60	$184.00	$93.84–$182.16	—	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 - Tangential biopsy of single skin lesion	$165.60	$184.00	$93.84–$182.16	—	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 TANGNTL BX SKIN SINGLE LES	$422.10	$469.00	$239.19–$464.31	—	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 TANGNTL BX SKIN SINGLE LES	$422.10	$469.00	$239.19–$464.31	—	10%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WIMAGING GUIDANCE	$816.30	$907.00	$462.57–$897.93	29% below	10%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WIMAGING GUIDANCE	$816.30	$907.00	$462.57–$897.93	29% below	10%
Thoracentesis with imaging guidance CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$1,655.10	$1,839.00	$937.89–$1,820.61	44% above	10%
Thoracentesis with imaging guidance CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$1,655.10	$1,839.00	$937.89–$1,820.61	44% above	10%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING	$2,551.50	$2,835.00	$1,445.85–$2,806.65	122% above	10%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING	$2,551.50	$2,835.00	$1,445.85–$2,806.65	122% above	10%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WIMAGING GUIDANCE	$816.30	$907.00	$462.57–$897.93	—	10%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WIMAGING GUIDANCE	$816.30	$907.00	$462.57–$897.93	—	10%
Thoracentesis with imaging guidance inpatient CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$1,655.10	$1,839.00	$937.89–$1,820.61	—	10%
Thoracentesis with imaging guidance inpatient CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$1,655.10	$1,839.00	$937.89–$1,820.61	—	10%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING	$2,551.50	$2,835.00	$1,445.85–$2,806.65	—	10%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING	$2,551.50	$2,835.00	$1,445.85–$2,806.65	—	10%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSCL	$150.30	$167.00	$85.17–$165.33	42% below	10%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSCL	$150.30	$167.00	$85.17–$165.33	42% below	10%
Trigger point injections, 1 or 2 muscles CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$486.90	$541.00	$275.91–$535.59	87% above	10%
Trigger point injections, 1 or 2 muscles CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$486.90	$541.00	$275.91–$535.59	87% above	10%
Trigger point injections, 1 or 2 muscles CPT 20552 US Guided Trigger Point Inj 1-2 Muscles	$565.20	$628.00	$320.28–$621.72	117% above	10%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCL	$624.60	$694.00	$353.94–$687.06	140% above	10%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCL	$624.60	$694.00	$353.94–$687.06	140% above	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSCL	$150.30	$167.00	$85.17–$165.33	—	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSCL	$150.30	$167.00	$85.17–$165.33	—	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$486.90	$541.00	$275.91–$535.59	—	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$486.90	$541.00	$275.91–$535.59	—	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCL	$624.60	$694.00	$353.94–$687.06	—	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCL	$624.60	$694.00	$353.94–$687.06	—	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST 1ST LESION	$1,447.20	$1,608.00	$820.08–$1,591.92	21% below	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST 1ST LESION	$1,447.20	$1,608.00	$820.08–$1,591.92	21% below	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY BREAST 1ST LESION RT	$1,447.20	$1,608.00	$820.08–$1,591.92	21% below	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY BREAST 1ST LESION LT	$1,447.20	$1,608.00	$820.08–$1,591.92	21% below	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY BREAST 1ST LESION LT	$1,447.20	$1,608.00	$820.08–$1,591.92	21% below	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY BREAST 1ST LESION RT	$1,447.20	$1,608.00	$820.08–$1,591.92	21% below	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST 1ST LESION	$1,447.20	$1,608.00	$820.08–$1,591.92	—	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST 1ST LESION	$1,447.20	$1,608.00	$820.08–$1,591.92	—	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BIOPSY BREAST 1ST LESION RT	$1,447.20	$1,608.00	$820.08–$1,591.92	—	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BIOPSY BREAST 1ST LESION RT	$1,447.20	$1,608.00	$820.08–$1,591.92	—	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BIOPSY BREAST 1ST LESION LT	$1,447.20	$1,608.00	$820.08–$1,591.92	—	10%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BIOPSY BREAST 1ST LESION LT	$1,447.20	$1,608.00	$820.08–$1,591.92	—	10%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$2,187.90	$2,431.00	$1,239.81–$2,406.69	49% above	10%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$2,187.90	$2,431.00	$1,239.81–$2,406.69	49% above	10%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$2,187.90	$2,431.00	$1,239.81–$2,406.69	—	10%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$2,187.90	$2,431.00	$1,239.81–$2,406.69	—	10%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy, unilateral or Bilateral(separate procedure) w/Pos	$567.00	$630.00	$321.30–$623.70	—	10%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy, unilateral or Bilateral(separate procedure) w/Pos	$567.00	$630.00	$321.30–$623.70	—	10%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 Vasectomy, unilateral or Bilateral(separate procedure) w/Pos	$567.00	$630.00	$321.30–$623.70	—	10%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 Vasectomy, unilateral or Bilateral(separate procedure) w/Pos	$567.00	$630.00	$321.30–$623.70	—	10%
Wart removal, up to 14 warts CPT 17110 17110 removal of benign lesions up to 14 lesions	$196.20	$218.00	$111.18–$215.82	2% above	10%
Wart removal, up to 14 warts CPT 17110 17110 removal of benign lesions up to 14 lesions	$196.20	$218.00	$111.18–$215.82	2% above	10%
Wart removal, up to 14 warts CPT 17110 17110 DESTR Benign lesions up to 14 charge	$196.20	$218.00	$111.18–$215.82	2% above	10%
Wart removal, up to 14 warts CPT 17110 17110 DESTR Benign lesions up to 14 charge	$196.20	$218.00	$111.18–$215.82	2% above	10%
Wart removal, up to 14 warts inpatient CPT 17110 17110 DESTR Benign lesions up to 14 charge	$196.20	$218.00	$111.18–$215.82	—	10%
Wart removal, up to 14 warts inpatient CPT 17110 17110 removal of benign lesions up to 14 lesions	$196.20	$218.00	$111.18–$215.82	—	10%
Wart removal, up to 14 warts inpatient CPT 17110 17110 removal of benign lesions up to 14 lesions	$196.20	$218.00	$111.18–$215.82	—	10%
Wart removal, up to 14 warts inpatient CPT 17110 17110 DESTR Benign lesions up to 14 charge	$196.20	$218.00	$111.18–$215.82	—	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$932.40	$1,036.00	$528.36–$1,025.64	106% above	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$932.40	$1,036.00	$528.36–$1,025.64	106% above	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,391.40	$1,546.00	$788.46–$1,530.54	207% above	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,391.40	$1,546.00	$788.46–$1,530.54	207% above	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$932.40	$1,036.00	$528.36–$1,025.64	—	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$932.40	$1,036.00	$528.36–$1,025.64	—	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,391.40	$1,546.00	$788.46–$1,530.54	—	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,391.40	$1,546.00	$788.46–$1,530.54	—	10%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion < 2 HR	$145.80	$162.00	$82.62–$160.38	75% below	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion < 2 HR	$145.80	$162.00	$82.62–$160.38	75% below	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion 2-4 HR	$435.60	$484.00	$246.84–$479.16	25% below	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion 2-4 HR	$435.60	$484.00	$246.84–$479.16	25% below	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion 4-6 HR	$724.50	$805.00	$410.55–$796.95	24% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion 4-6 HR	$724.50	$805.00	$410.55–$796.95	24% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion > 6 HR	$1,159.20	$1,288.00	$656.88–$1,275.12	99% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion > 6 HR	$1,159.20	$1,288.00	$656.88–$1,275.12	99% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion >6 HR	$1,194.30	$1,327.00	$676.77–$1,313.73	105% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion >6 HR	$1,194.30	$1,327.00	$676.77–$1,313.73	105% above	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion < 2 HR	$145.80	$162.00	$82.62–$160.38	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion < 2 HR	$145.80	$162.00	$82.62–$160.38	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion 2-4 HR	$435.60	$484.00	$246.84–$479.16	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion 2-4 HR	$435.60	$484.00	$246.84–$479.16	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion 4-6 HR	$724.50	$805.00	$410.55–$796.95	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion 4-6 HR	$724.50	$805.00	$410.55–$796.95	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion > 6 HR	$1,159.20	$1,288.00	$656.88–$1,275.12	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion > 6 HR	$1,159.20	$1,288.00	$656.88–$1,275.12	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion >6 HR	$1,194.30	$1,327.00	$676.77–$1,313.73	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion >6 HR	$1,194.30	$1,327.00	$676.77–$1,313.73	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640: Inhalation/Aerosol	$19.80	$22.00	$11.22–$21.78	70% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640: Inhalation/Aerosol	$19.80	$22.00	$11.22–$21.78	70% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NONPRESSURIZED INHALATION TREATMENT	$148.50	$165.00	$84.15–$163.35	122% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NONPRESSURIZED INHALATION TREATMENT	$148.50	$165.00	$84.15–$163.35	122% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Treatment Subsequent	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP Therapy Subsequent	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler (MDI) Subsequent	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP SUBSEQUENT	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Treatment Subsequent	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP Therapy Subsequent	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SUBSQNT NEB TREATMENT	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Subsequent	$162.00	$180.00	$91.80–$178.20	142% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Subsequent	$166.50	$185.00	$94.35–$183.15	149% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Initial	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Initial	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB ACUTE	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB ACUTE	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Initial ER	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Initial ER	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Initiate IPPB Therapy	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Initiate IPPB Therapy	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Initiate EZPAP Therapy	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Initiate EZPAP Therapy	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP INITIAL	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP INITIAL	$324.90	$361.00	$184.11–$357.39	385% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Initial	$334.80	$372.00	$189.72–$368.28	400% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Initial	$334.80	$372.00	$189.72–$368.28	400% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INTL NEB TREATMENT	$334.80	$372.00	$189.72–$368.28	400% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INTL NEB TREATMENT	$334.80	$372.00	$189.72–$368.28	400% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640: Inhalation/Aerosol	$19.80	$22.00	$11.22–$21.78	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640: Inhalation/Aerosol	$19.80	$22.00	$11.22–$21.78	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NONPRESSURIZED INHALATION TREATMENT	$148.50	$165.00	$84.15–$163.35	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NONPRESSURIZED INHALATION TREATMENT	$148.50	$165.00	$84.15–$163.35	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB Treatment Subsequent	$162.00	$180.00	$91.80–$178.20	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZPAP Therapy Subsequent	$162.00	$180.00	$91.80–$178.20	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZPAP Therapy Subsequent	$162.00	$180.00	$91.80–$178.20	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB Treatment Subsequent	$162.00	$180.00	$91.80–$178.20	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB Initial	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZPAP INITIAL	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Initiate EZPAP Therapy	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB Initial	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Initiate EZPAP Therapy	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Initiate IPPB Therapy	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Initiate IPPB Therapy	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Neb Initial ER	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Neb Initial ER	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB ACUTE	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB ACUTE	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZPAP INITIAL	$324.90	$361.00	$184.11–$357.39	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Initial	$334.80	$372.00	$189.72–$368.28	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INTL NEB TREATMENT	$334.80	$372.00	$189.72–$368.28	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Initial	$334.80	$372.00	$189.72–$368.28	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INTL NEB TREATMENT	$334.80	$372.00	$189.72–$368.28	—	10%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Administration IV Infusion up to 1 hour	$870.30	$967.00	$493.17–$957.33	60% above	10%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Administration IV Infusion up to 1 hour	$870.30	$967.00	$493.17–$957.33	60% above	10%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF,INT/S -1HR	$896.40	$996.00	$507.96–$986.04	65% above	10%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF,INT/S -1HR	$896.40	$996.00	$507.96–$986.04	65% above	10%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Administration IV Infusion up to 1 hour	$870.30	$967.00	$493.17–$957.33	—	10%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Administration IV Infusion up to 1 hour	$870.30	$967.00	$493.17–$957.33	—	10%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INF,INT/S -1HR	$896.40	$996.00	$507.96–$986.04	—	10%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INF,INT/S -1HR	$896.40	$996.00	$507.96–$986.04	—	10%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE INT 30-74 MIN OP	$2,505.60	$2,784.00	$1,419.84–$2,756.16	81% above	10%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE INT 30-74 MIN OP	$2,505.60	$2,784.00	$1,419.84–$2,756.16	81% above	10%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, INT 30-74 MIN	$2,505.60	$2,784.00	$1,698.24–$2,756.16	81% above	10%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$2,722.50	$3,025.00	$1,542.75–$2,994.75	97% above	10%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$2,722.50	$3,025.00	$1,542.75–$2,994.75	97% above	10%
Critical care, first 30 to 74 minutes CPT 99291 99291 - ED Critical Care	$2,804.40	$3,116.00	$1,589.16–$3,084.84	102% above	10%
Critical care, first 30 to 74 minutes CPT 99291 99291 - ED Critical Care	$2,804.40	$3,116.00	$1,589.16–$3,084.84	102% above	10%
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care E/M	$2,804.40	$3,116.00	$1,589.16–$3,084.84	102% above	10%
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care E/M	$2,804.40	$3,116.00	$1,589.16–$3,084.84	102% above	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE INT 30-74 MIN OP	$2,505.60	$2,784.00	$1,419.84–$2,756.16	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, INT 30-74 MIN	$2,505.60	$2,784.00	$1,698.24–$2,756.16	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, INT 30-74 MIN	$2,505.60	$2,784.00	$1,698.24–$2,756.16	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE INT 30-74 MIN OP	$2,505.60	$2,784.00	$1,419.84–$2,756.16	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$2,722.50	$3,025.00	$1,542.75–$2,994.75	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$2,722.50	$3,025.00	$1,542.75–$2,994.75	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 Critical Care E/M	$2,804.40	$3,116.00	$1,589.16–$3,084.84	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - ED Critical Care	$2,804.40	$3,116.00	$1,589.16–$3,084.84	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - ED Critical Care	$2,804.40	$3,116.00	$1,589.16–$3,084.84	—	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 Critical Care E/M	$2,804.40	$3,116.00	$1,589.16–$3,084.84	—	10%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Routine ECG w at least 12 leads; w l andR	$244.80	$272.00	$138.72–$269.28	362% above	10%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Routine ECG w at least 12 leads; w l andR	$244.80	$272.00	$138.72–$269.28	362% above	10%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Routine ECG w at least 12 leads; w l andR	$244.80	$272.00	$138.72–$269.28	—	10%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Routine ECG w at least 12 leads; w l andR	$244.80	$272.00	$138.72–$269.28	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005-ED EKG	$134.10	$149.00	$16.41–$147.51	4% below	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005-ED EKG	$134.10	$149.00	$16.41–$147.51	4% below	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV Electrocardiogram (EKG)	$179.10	$199.00	$16.41–$197.01	28% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV Electrocardiogram (EKG)	$179.10	$199.00	$16.41–$197.01	28% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12-Lead Acquisition	$199.80	$222.00	$16.41–$219.78	43% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12-Lead Acquisition	$199.80	$222.00	$16.41–$219.78	43% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead, Tracing Only Charge	$246.60	$274.00	$16.41–$271.26	76% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$246.60	$274.00	$16.41–$271.26	76% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$246.60	$274.00	$16.41–$271.26	76% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead, Tracing Only Charge	$246.60	$274.00	$16.41–$271.26	76% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005-ED EKG	$134.10	$149.00	$16.41–$147.51	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005-ED EKG	$134.10	$149.00	$16.41–$147.51	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV Electrocardiogram (EKG)	$179.10	$199.00	$16.41–$197.01	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV Electrocardiogram (EKG)	$179.10	$199.00	$16.41–$197.01	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12-Lead Acquisition	$199.80	$222.00	$16.41–$219.78	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12-Lead Acquisition	$199.80	$222.00	$16.41–$219.78	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$246.60	$274.00	$16.41–$271.26	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead, Tracing Only Charge	$246.60	$274.00	$16.41–$271.26	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead, Tracing Only Charge	$246.60	$274.00	$16.41–$271.26	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$246.60	$274.00	$16.41–$271.26	—	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$222.30	$247.00	$125.97–$244.53	101% above	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$222.30	$247.00	$125.97–$244.53	101% above	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - ED Level 1	$228.60	$254.00	$129.54–$251.46	107% above	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - ED Level 1	$228.60	$254.00	$129.54–$251.46	107% above	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$222.30	$247.00	$125.97–$244.53	—	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$222.30	$247.00	$125.97–$244.53	—	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - ED Level 1	$228.60	$254.00	$129.54–$251.46	—	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - ED Level 1	$228.60	$254.00	$129.54–$251.46	—	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$279.00	$310.00	$158.10–$306.90	5% above	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$279.00	$310.00	$158.10–$306.90	5% above	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - ED Level 2	$287.10	$319.00	$162.69–$315.81	8% above	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - ED Level 2	$287.10	$319.00	$162.69–$315.81	8% above	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$279.00	$310.00	$158.10–$306.90	—	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$279.00	$310.00	$158.10–$306.90	—	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - ED Level 2	$287.10	$319.00	$162.69–$315.81	—	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - ED Level 2	$287.10	$319.00	$162.69–$315.81	—	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$412.20	$458.00	$233.58–$453.42	3% above	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$412.20	$458.00	$233.58–$453.42	3% above	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - ED Level 3	$424.80	$472.00	$240.72–$467.28	6% above	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - ED Level 3	$424.80	$472.00	$240.72–$467.28	6% above	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$412.20	$458.00	$233.58–$453.42	—	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$412.20	$458.00	$233.58–$453.42	—	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - ED Level 3	$424.80	$472.00	$240.72–$467.28	—	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - ED Level 3	$424.80	$472.00	$240.72–$467.28	—	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$738.90	$821.00	$418.71–$812.79	24% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$738.90	$821.00	$418.71–$812.79	24% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - ED Level 4	$761.40	$846.00	$431.46–$837.54	28% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - ED Level 4	$761.40	$846.00	$431.46–$837.54	28% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$738.90	$821.00	$418.71–$812.79	—	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$738.90	$821.00	$418.71–$812.79	—	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - ED Level 4	$761.40	$846.00	$431.46–$837.54	—	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - ED Level 4	$761.40	$846.00	$431.46–$837.54	—	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$1,492.20	$1,658.00	$845.58–$1,641.42	47% above	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$1,492.20	$1,658.00	$845.58–$1,641.42	47% above	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - ED Level 5	$1,537.20	$1,708.00	$871.08–$1,690.92	52% above	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - ED Level 5	$1,537.20	$1,708.00	$871.08–$1,690.92	52% above	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,492.20	$1,658.00	$845.58–$1,641.42	—	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,492.20	$1,658.00	$845.58–$1,641.42	—	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - ED Level 5	$1,537.20	$1,708.00	$871.08–$1,690.92	—	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - ED Level 5	$1,537.20	$1,708.00	$871.08–$1,690.92	—	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test	$1,289.70	$1,433.00	$62.79–$1,418.67	63% above	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	63% above	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test	$1,289.70	$1,433.00	$62.79–$1,418.67	63% above	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 BRMH NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	63% above	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 BRMH NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	63% above	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	63% above	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiovascular stress test	$1,289.70	$1,433.00	$62.79–$1,418.67	—	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 BRMH NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	—	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 BRMH NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	—	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiovascular stress test	$1,289.70	$1,433.00	$62.79–$1,418.67	—	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	—	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM Cardio Stress Tracing Only	$1,289.70	$1,433.00	$62.79–$1,418.67	—	10%
Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy (conjoint psychotherapy with pt present) 50 minutes	$103.50	$115.00	$58.65–$113.85	45% below	10%
Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy (conjoint psychotherapy with pt present) 50 minutes	$103.50	$115.00	$58.65–$113.85	45% below	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psychotherapy (conjoint psychotherapy with pt present) 50 minutes	$103.50	$115.00	$58.65–$113.85	—	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psychotherapy (conjoint psychotherapy with pt present) 50 minutes	$103.50	$115.00	$58.65–$113.85	—	10%
Family therapy without the patient, 50 minutes CPT 90846 90846 Family Psychotherapy w/o patient, 50 minutes	$90.00	$100.00	$51.00–$99.00	49% below	10%
Family therapy without the patient, 50 minutes CPT 90846 90846 Family Psychotherapy w/o patient, 50 minutes	$90.00	$100.00	$51.00–$99.00	49% below	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY WO PT - COUNSELOR	$180.90	$201.00	$102.51–$198.99	2% above	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY WO PT - COUNSELOR	$180.90	$201.00	$102.51–$198.99	2% above	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY WO PATIENT PRESENT	$180.90	$201.00	$102.51–$198.99	2% above	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY WO PATIENT PRESENT	$180.90	$201.00	$102.51–$198.99	2% above	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 Family Psychotherapy w/o patient, 50 minutes	$90.00	$100.00	$51.00–$99.00	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 Family Psychotherapy w/o patient, 50 minutes	$90.00	$100.00	$51.00–$99.00	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY WO PATIENT PRESENT	$180.90	$201.00	$102.51–$198.99	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY WO PT - COUNSELOR	$180.90	$201.00	$102.51–$198.99	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY WO PATIENT PRESENT	$180.90	$201.00	$102.51–$198.99	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY WO PT - COUNSELOR	$180.90	$201.00	$102.51–$198.99	—	10%
Group psychotherapy session CPT 90853 90853 Group Psychotherapy	$19.80	$22.00	$11.22–$21.78	73% below	10%
Group psychotherapy session CPT 90853 90853 Group Psychotherapy	$19.80	$22.00	$11.22–$21.78	73% below	10%
Group psychotherapy session inpatient CPT 90853 90853 Group Psychotherapy	$19.80	$22.00	$11.22–$21.78	—	10%
Group psychotherapy session inpatient CPT 90853 90853 Group Psychotherapy	$19.80	$22.00	$11.22–$21.78	—	10%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 ECG MONITORING WSUPERIMPOSITOPN SCAN	$1,770.30	$1,967.00	$1,003.17–$1,947.33	391% above	10%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 ECG MONITORING WSUPERIMPOSITOPN SCAN	$1,770.30	$1,967.00	$1,003.17–$1,947.33	391% above	10%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 ECG MONITORING WSUPERIMPOSITOPN SCAN	$1,770.30	$1,967.00	$1,003.17–$1,947.33	—	10%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 ECG MONITORING WSUPERIMPOSITOPN SCAN	$1,770.30	$1,967.00	$1,003.17–$1,947.33	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 31 MIN. TO 1 HR.	$299.70	$333.00	$169.83–$329.67	5% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 31 MIN. TO 1 HR.	$299.70	$333.00	$169.83–$329.67	5% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360-59 IV Hydrtate Initial Addl w/Modif	$341.10	$379.00	$193.29–$375.21	20% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$573.30	$637.00	$324.87–$630.63	101% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$573.30	$637.00	$324.87–$630.63	101% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 31 MIN. TO 1 HR.	$299.70	$333.00	$169.83–$329.67	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 31 MIN. TO 1 HR.	$299.70	$333.00	$169.83–$329.67	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$573.30	$637.00	$324.87–$630.63	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$573.30	$637.00	$324.87–$630.63	—	10%
IV infusion of a medicine, first hour CPT 96365 96365-59 Infuse Initial Addl w/ Modif	$357.30	$397.00	$202.47–$393.03	14% above	10%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR THERAPY UP TO 1 HR.	$502.20	$558.00	$284.58–$552.42	60% above	10%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR THERAPY UP TO 1 HR.	$502.20	$558.00	$284.58–$552.42	60% above	10%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$682.20	$758.00	$386.58–$750.42	117% above	10%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$682.20	$758.00	$386.58–$750.42	117% above	10%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR THERAPY UP TO 1 HR.	$502.20	$558.00	$284.58–$552.42	—	10%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR THERAPY UP TO 1 HR.	$502.20	$558.00	$284.58–$552.42	—	10%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$682.20	$758.00	$386.58–$750.42	—	10%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$682.20	$758.00	$386.58–$750.42	—	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION INTRAMUSCULAR/SQ	$141.30	$157.00	$80.07–$155.43	78% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION INTRAMUSCULAR/SQ	$141.30	$157.00	$80.07–$155.43	78% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-59 SQ/IM Injection w/ Modif	$180.00	$200.00	$102.00–$198.00	127% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Admin Other Charge	$185.40	$206.00	$105.06–$203.94	134% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Admin Other Charge	$185.40	$206.00	$105.06–$203.94	134% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372: SUBQ/IM	$185.40	$206.00	$105.06–$203.94	134% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$185.40	$206.00	$105.06–$203.94	134% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372: SUBQ/IM	$185.40	$206.00	$105.06–$203.94	134% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$185.40	$206.00	$105.06–$203.94	134% above	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION INTRAMUSCULAR/SQ	$141.30	$157.00	$80.07–$155.43	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION INTRAMUSCULAR/SQ	$141.30	$157.00	$80.07–$155.43	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$185.40	$206.00	$105.06–$203.94	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Admin Other Charge	$185.40	$206.00	$105.06–$203.94	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Admin Other Charge	$185.40	$206.00	$105.06–$203.94	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372: SUBQ/IM	$185.40	$206.00	$105.06–$203.94	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372: SUBQ/IM	$185.40	$206.00	$105.06–$203.94	—	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$185.40	$206.00	$105.06–$203.94	—	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL - COUNSELOR HO	$201.60	$224.00	$114.24–$221.76	8% below	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation	$201.60	$224.00	$114.24–$221.76	8% below	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation	$201.60	$224.00	$114.24–$221.76	8% below	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL - COUNSELOR HO	$201.60	$224.00	$114.24–$221.76	8% below	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diagnostic Evaluation	$201.60	$224.00	$114.24–$221.76	—	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diagnostic Evaluation	$201.60	$224.00	$114.24–$221.76	—	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL - COUNSELOR HO	$201.60	$224.00	$114.24–$221.76	—	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL - COUNSELOR HO	$201.60	$224.00	$114.24–$221.76	—	10%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nrv cndj tst 7-8 studies	$1,515.60	$1,684.00	$858.84–$1,667.16	240% above	10%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$151.20	$168.00	$21.50–$166.32	61% above	10%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges	$151.20	$168.00	$21.50–$166.32	61% above	10%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED	$151.20	$168.00	$21.50–$166.32	61% above	10%
New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	90% below	10%
New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	90% below	10%
New patient office visit, about 30 minutes CPT 99203 99203 Office Visit New -Low MDM	$105.30	$117.00	$59.67–$115.83	47% below	10%
New patient office visit, about 30 minutes CPT 99203 99203 Office Visit New -Low MDM	$105.30	$117.00	$59.67–$115.83	47% below	10%
New patient office visit, about 30 minutes CPT 99203 99203 Office Outreach Services/Specialty NEW LOW 30 min	$120.60	$134.00	$68.34–$132.66	39% below	10%
New patient office visit, about 30 minutes CPT 99203 99203 Office Outreach Services/Specialty NEW LOW 30 min	$120.60	$134.00	$68.34–$132.66	39% below	10%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPT NEW 3	$405.00	$450.00	$229.50–$445.50	105% above	10%
New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW	$405.00	$450.00	$229.50–$445.50	105% above	10%
New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW	$405.00	$450.00	$229.50–$445.50	105% above	10%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPT NEW 3	$405.00	$450.00	$229.50–$445.50	105% above	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Visit New -Low MDM	$105.30	$117.00	$59.67–$115.83	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Visit New -Low MDM	$105.30	$117.00	$59.67–$115.83	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Outreach Services/Specialty NEW LOW 30 min	$120.60	$134.00	$68.34–$132.66	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Outreach Services/Specialty NEW LOW 30 min	$120.60	$134.00	$68.34–$132.66	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPT NEW 3	$405.00	$450.00	$229.50–$445.50	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW	$405.00	$450.00	$229.50–$445.50	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPT NEW 3	$405.00	$450.00	$229.50–$445.50	—	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW	$405.00	$450.00	$229.50–$445.50	—	10%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW - Infusion	$153.00	$170.00	$86.70–$168.30	25% below	10%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW - Infusion	$153.00	$170.00	$86.70–$168.30	25% below	10%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE VISIT NEW PT- MOD MDM	$162.00	$180.00	$91.80–$178.20	21% below	10%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE VISIT NEW PT- MOD MDM	$162.00	$180.00	$91.80–$178.20	21% below	10%
New patient office visit, about 45 minutes CPT 99204 Office Outreach Services/Specialty NEW MOD 45 min	$180.90	$201.00	$102.51–$198.99	12% below	10%
New patient office visit, about 45 minutes CPT 99204 Office Outreach Services/Specialty NEW MOD 45 min	$180.90	$201.00	$102.51–$198.99	12% below	10%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPT NEW 4	$281.70	$313.00	$159.63–$309.87	37% above	10%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPT NEW 4	$281.70	$313.00	$159.63–$309.87	37% above	10%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW	$551.70	$613.00	$312.63–$606.87	169% above	10%
New patient office visit, about 45 minutes CPT 99204 99204 New Pain Clinic patient level 4	$551.70	$613.00	$312.63–$606.87	169% above	10%
New patient office visit, about 45 minutes CPT 99204 99204 New Pain Clinic patient level 4	$551.70	$613.00	$312.63–$606.87	169% above	10%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW	$551.70	$613.00	$312.63–$606.87	169% above	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW - Infusion	$153.00	$170.00	$86.70–$168.30	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW - Infusion	$153.00	$170.00	$86.70–$168.30	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE VISIT NEW PT- MOD MDM	$162.00	$180.00	$91.80–$178.20	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE VISIT NEW PT- MOD MDM	$162.00	$180.00	$91.80–$178.20	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 Office Outreach Services/Specialty NEW MOD 45 min	$180.90	$201.00	$102.51–$198.99	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 Office Outreach Services/Specialty NEW MOD 45 min	$180.90	$201.00	$102.51–$198.99	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPT NEW 4	$281.70	$313.00	$159.63–$309.87	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPT NEW 4	$281.70	$313.00	$159.63–$309.87	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW	$551.70	$613.00	$312.63–$606.87	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 New Pain Clinic patient level 4	$551.70	$613.00	$312.63–$606.87	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 New Pain Clinic patient level 4	$551.70	$613.00	$312.63–$606.87	—	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW	$551.70	$613.00	$312.63–$606.87	—	10%
New patient office visit, about 60 minutes CPT 99205 Office/OP New Visit Level 5 99205	$199.80	$222.00	$113.22–$219.78	34% below	10%
New patient office visit, about 60 minutes CPT 99205 Office/OP New Visit Level 5 99205	$199.80	$222.00	$113.22–$219.78	34% below	10%
New patient office visit, about 60 minutes CPT 99205 Office Outreach Services/Specialty NEW HI 60 Min	$233.10	$259.00	$132.09–$256.41	23% below	10%
New patient office visit, about 60 minutes CPT 99205 Office Outreach Services/Specialty NEW HI 60 Min	$233.10	$259.00	$132.09–$256.41	23% below	10%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPT NEW 5	$368.10	$409.00	$208.59–$404.91	21% above	10%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPT NEW 5	$368.10	$409.00	$208.59–$404.91	21% above	10%
New patient office visit, about 60 minutes CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW	$782.10	$869.00	$443.19–$860.31	157% above	10%
New patient office visit, about 60 minutes CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW	$782.10	$869.00	$443.19–$860.31	157% above	10%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/OP New Visit Level 5 99205	$199.80	$222.00	$113.22–$219.78	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/OP New Visit Level 5 99205	$199.80	$222.00	$113.22–$219.78	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 Office Outreach Services/Specialty NEW HI 60 Min	$233.10	$259.00	$132.09–$256.41	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 Office Outreach Services/Specialty NEW HI 60 Min	$233.10	$259.00	$132.09–$256.41	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPT NEW 5	$368.10	$409.00	$208.59–$404.91	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPT NEW 5	$368.10	$409.00	$208.59–$404.91	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW	$782.10	$869.00	$443.19–$860.31	—	10%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW	$782.10	$869.00	$443.19–$860.31	—	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99201 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	85% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99201 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	85% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW - Infusion	$83.70	$93.00	$47.43–$92.07	36% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW - Infusion	$83.70	$93.00	$47.43–$92.07	36% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE VISIT NEW PT- SFW MDM	$83.70	$93.00	$47.43–$92.07	36% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE VISIT NEW PT- SFW MDM	$83.70	$93.00	$47.43–$92.07	36% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Visit New Pt. -	$83.70	$93.00	$47.43–$92.07	36% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Visit New Pt. -	$83.70	$93.00	$47.43–$92.07	36% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 office Outreach Services/Specialty NEW SF 15min	$102.60	$114.00	$58.14–$112.86	21% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 office Outreach Services/Specialty NEW SF 15min	$102.60	$114.00	$58.14–$112.86	21% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPT NEW 2	$171.90	$191.00	$97.41–$189.09	32% above	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPT NEW 2	$171.90	$191.00	$97.41–$189.09	32% above	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW	$285.30	$317.00	$161.67–$313.83	118% above	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW	$285.30	$317.00	$161.67–$313.83	118% above	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99201 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99201 OFFICE/OUTPATIENT VISIT NEW - Infusion	$19.80	$22.00	$11.22–$21.78	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office Visit New Pt. -	$83.70	$93.00	$47.43–$92.07	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE VISIT NEW PT- SFW MDM	$83.70	$93.00	$47.43–$92.07	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE VISIT NEW PT- SFW MDM	$83.70	$93.00	$47.43–$92.07	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office Visit New Pt. -	$83.70	$93.00	$47.43–$92.07	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW - Infusion	$83.70	$93.00	$47.43–$92.07	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW - Infusion	$83.70	$93.00	$47.43–$92.07	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 office Outreach Services/Specialty NEW SF 15min	$102.60	$114.00	$58.14–$112.86	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 office Outreach Services/Specialty NEW SF 15min	$102.60	$114.00	$58.14–$112.86	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPT NEW 2	$171.90	$191.00	$97.41–$189.09	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPT NEW 2	$171.90	$191.00	$97.41–$189.09	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW	$285.30	$317.00	$161.67–$313.83	—	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE/OUTPATIENT VISIT NEW	$285.30	$317.00	$161.67–$313.83	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT Initial Eval units	$63.00	$70.00	$35.70–$69.30	10% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT Initial Eval units	$63.00	$70.00	$35.70–$69.30	10% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MNT IND INIT A EA 15 CHARGE	$63.00	$70.00	$35.70–$69.30	10% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MNT IND INIT A EA 15 CHARGE	$63.00	$70.00	$35.70–$69.30	10% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MNT IND INIT A EA 15 CHARGE	$63.00	$70.00	$35.70–$69.30	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT Initial Eval units	$63.00	$70.00	$35.70–$69.30	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT Initial Eval units	$63.00	$70.00	$35.70–$69.30	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MNT IND INIT A EA 15 CHARGE	$63.00	$70.00	$35.70–$69.30	—	10%
Occupational therapy evaluation, low complexity CPT 97165 OT Low Complex Units	$315.00	$350.00	$178.50–$346.50	77% above	10%
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity Units	$315.00	$350.00	$178.50–$346.50	77% above	10%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity Units	$450.00	$500.00	$66.41–$495.00	54% above	10%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT High Complex Units	$450.00	$500.00	$66.41–$495.00	54% above	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity Units	$315.00	$350.00	$66.41–$346.50	77% above	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Low Complex Units	$315.00	$350.00	$66.41–$346.50	77% above	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Moderate Complex Units	$360.00	$400.00	$66.41–$396.00	50% above	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity Units	$360.00	$400.00	$66.41–$396.00	50% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units	$102.60	$114.00	$27.06–$112.86	17% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Mobilization	$119.70	$133.00	$27.06–$131.67	37% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 mobilization with motion and stabilization	$119.70	$133.00	$27.06–$131.67	37% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Mobilization with Motion	$119.70	$133.00	$27.06–$131.67	37% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15''''	$153.00	$170.00	$27.06–$168.30	75% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$153.00	$170.00	$27.06–$168.30	75% above	10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges	$164.70	$183.00	$21.85–$181.17	88% above	10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EX 15''''	$164.70	$183.00	$21.85–$181.17	88% above	10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$221.40	$246.00	$21.85–$243.54	153% above	10%
Preventive checkup, new patient aged 18–39 CPT 99385 Preventive Medicine 18-39 years New - 99385	$162.00	$180.00	$91.80–$178.20	16% above	10%
Preventive checkup, new patient aged 18–39 CPT 99385 Preventive Medicine 18-39 years New - 99385	$162.00	$180.00	$91.80–$178.20	16% above	10%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Preventive Medicine 18-39 years New - 99385	$162.00	$180.00	$91.80–$178.20	—	10%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Preventive Medicine 18-39 years New - 99385	$162.00	$180.00	$91.80–$178.20	—	10%
Preventive checkup, new patient aged 40–64 CPT 99386 Preventive Medicine 40-64 years New - 99386	$182.70	$203.00	$103.53–$200.97	37% below	10%
Preventive checkup, new patient aged 40–64 CPT 99386 Preventive Medicine 40-64 years New - 99386	$182.70	$203.00	$103.53–$200.97	37% below	10%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Preventive Medicine 40-64 years New - 99386	$182.70	$203.00	$103.53–$200.97	—	10%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Preventive Medicine 40-64 years New - 99386	$182.70	$203.00	$103.53–$200.97	—	10%
Preventive checkup, new patient aged 65 or older CPT 99387 Preventive Medicine 65+ years New - 99387	$204.30	$227.00	$115.77–$224.73	35% below	10%
Preventive checkup, new patient aged 65 or older CPT 99387 Preventive Medicine 65+ years New - 99387	$204.30	$227.00	$115.77–$224.73	35% below	10%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Preventive Medicine 65+ years New - 99387	$204.30	$227.00	$115.77–$224.73	—	10%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Preventive Medicine 65+ years New - 99387	$204.30	$227.00	$115.77–$224.73	—	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Sports physical age 18-39	$22.50	$25.00	$12.75–$24.75	86% below	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Sports physical age 18-39	$22.50	$25.00	$12.75–$24.75	86% below	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 Preventive Medicine 18-39 years Established - 99395	$144.90	$161.00	$82.11–$159.39	7% below	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 Preventive Medicine 18-39 years Established - 99395	$144.90	$161.00	$82.11–$159.39	7% below	10%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 Sports physical age 18-39	$22.50	$25.00	$12.75–$24.75	—	10%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 Sports physical age 18-39	$22.50	$25.00	$12.75–$24.75	—	10%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Preventive Medicine 18-39 years Established - 99395	$144.90	$161.00	$82.11–$159.39	—	10%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Preventive Medicine 18-39 years Established - 99395	$144.90	$161.00	$82.11–$159.39	—	10%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396 PREV VISIT, EST, AGE 40-64	$163.80	$182.00	$92.82–$180.18	3% below	10%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396 PREV VISIT, EST, AGE 40-64	$163.80	$182.00	$92.82–$180.18	3% below	10%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 PREV VISIT, EST, AGE 40-64	$163.80	$182.00	$92.82–$180.18	—	10%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 PREV VISIT, EST, AGE 40-64	$163.80	$182.00	$92.82–$180.18	—	10%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Medicine 65+ years Established	$183.60	$204.00	$104.04–$201.96	29% below	10%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Medicine 65+ years Established	$183.60	$204.00	$104.04–$201.96	29% below	10%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Preventive Medicine 65+ years Established	$183.60	$204.00	$104.04–$201.96	—	10%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Preventive Medicine 65+ years Established	$183.60	$204.00	$104.04–$201.96	—	10%
Psychiatric evaluation with medical services CPT 90792 90792 Psych Diag Eval w/ Med Services	$137.70	$153.00	$78.03–$151.47	50% below	10%
Psychiatric evaluation with medical services CPT 90792 90792 Psych Diag Eval w/ Med Services	$137.70	$153.00	$78.03–$151.47	50% below	10%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$253.80	$282.00	$143.82–$279.18	8% below	10%
Psychiatric evaluation with medical services CPT 90792 New Patient Eval	$253.80	$282.00	$143.82–$279.18	8% below	10%
Psychiatric evaluation with medical services CPT 90792 New Patient Eval	$253.80	$282.00	$143.82–$279.18	8% below	10%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$253.80	$282.00	$143.82–$279.18	8% below	10%
Psychiatric evaluation with medical services inpatient CPT 90792 90792 Psych Diag Eval w/ Med Services	$137.70	$153.00	$78.03–$151.47	—	10%
Psychiatric evaluation with medical services inpatient CPT 90792 90792 Psych Diag Eval w/ Med Services	$137.70	$153.00	$78.03–$151.47	—	10%
Psychiatric evaluation with medical services inpatient CPT 90792 New Patient Eval	$253.80	$282.00	$143.82–$279.18	—	10%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$253.80	$282.00	$143.82–$279.18	—	10%
Psychiatric evaluation with medical services inpatient CPT 90792 New Patient Eval	$253.80	$282.00	$143.82–$279.18	—	10%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$253.80	$282.00	$143.82–$279.18	—	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 Psychotherapy for crisis; first 60 minutes	$125.10	$139.00	$70.89–$137.61	58% below	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 Psychotherapy for crisis; first 60 minutes	$125.10	$139.00	$70.89–$137.61	58% below	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 Psychotherapy for crisis; first 60 minutes	$125.10	$139.00	$70.89–$137.61	—	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 Psychotherapy for crisis; first 60 minutes	$125.10	$139.00	$70.89–$137.61	—	10%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes with patient and/or family member	$65.70	$73.00	$37.23–$72.27	38% below	10%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes with patient and/or family member	$65.70	$73.00	$37.23–$72.27	38% below	10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 16-37 MINUTES (HO)	$98.10	$109.00	$55.59–$107.91	8% below	10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 16-37 MINUTES (HO)	$98.10	$109.00	$55.59–$107.91	8% below	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy, 30 minutes with patient and/or family member	$65.70	$73.00	$37.23–$72.27	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy, 30 minutes with patient and/or family member	$65.70	$73.00	$37.23–$72.27	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 16-37 MINUTES (HO)	$98.10	$109.00	$55.59–$107.91	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 16-37 MINUTES (HO)	$98.10	$109.00	$55.59–$107.91	—	10%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes with patient and/or family member	$84.60	$94.00	$47.94–$93.06	40% below	10%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes with patient and/or family member	$84.60	$94.00	$47.94–$93.06	40% below	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 38-53 MINUTES (HO)	$136.80	$152.00	$77.52–$150.48	3% below	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 38-53 MINUTES	$136.80	$152.00	$77.52–$150.48	3% below	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 38-53 MINUTES (HO)	$136.80	$152.00	$77.52–$150.48	3% below	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 38-53 MINUTES	$136.80	$152.00	$77.52–$150.48	3% below	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 minutes with patient and/or family member	$84.60	$94.00	$47.94–$93.06	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 minutes with patient and/or family member	$84.60	$94.00	$47.94–$93.06	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 38-53 MINUTES (HO)	$136.80	$152.00	$77.52–$150.48	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 38-53 MINUTES (HO)	$136.80	$152.00	$77.52–$150.48	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 38-53 MINUTES	$136.80	$152.00	$77.52–$150.48	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 38-53 MINUTES	$136.80	$152.00	$77.52–$150.48	—	10%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 minutes with patient and/or family member	$130.50	$145.00	$73.95–$143.55	39% below	10%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 minutes with patient and/or family member	$130.50	$145.00	$73.95–$143.55	39% below	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES (HO)	$182.70	$203.00	$103.53–$200.97	14% below	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES (HO)	$182.70	$203.00	$103.53–$200.97	14% below	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES	$182.70	$203.00	$103.53–$200.97	14% below	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES	$182.70	$203.00	$103.53–$200.97	14% below	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy, 60 minutes with patient and/or family member	$130.50	$145.00	$73.95–$143.55	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy, 60 minutes with patient and/or family member	$130.50	$145.00	$73.95–$143.55	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES (HO)	$182.70	$203.00	$103.53–$200.97	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES	$182.70	$203.00	$103.53–$200.97	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES	$182.70	$203.00	$103.53–$200.97	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY GREATER THAN 53 MINUTES (HO)	$182.70	$203.00	$103.53–$200.97	—	10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 - BEHAV CHNG SMOKING 3-10 MINS	$21.60	$24.00	$12.24–$23.76	21% below	10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 - BEHAV CHNG SMOKING 3-10 MINS	$21.60	$24.00	$12.24–$23.76	21% below	10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Cessation	$98.10	$109.00	$55.59–$107.91	259% above	10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Cessation	$98.10	$109.00	$55.59–$107.91	259% above	10%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406 - BEHAV CHNG SMOKING 3-10 MINS	$21.60	$24.00	$12.24–$23.76	—	10%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406 - BEHAV CHNG SMOKING 3-10 MINS	$21.60	$24.00	$12.24–$23.76	—	10%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Cessation	$98.10	$109.00	$55.59–$107.91	—	10%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Cessation	$98.10	$109.00	$55.59–$107.91	—	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office Visit Established - High MDM	$146.70	$163.00	$83.13–$161.37	48% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office Visit Established - High MDM	$146.70	$163.00	$83.13–$161.37	48% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Outreach Services/Specialty EST HI 40 Min	$196.20	$218.00	$111.18–$215.82	31% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Outreach Services/Specialty EST HI 40 Min	$196.20	$218.00	$111.18–$215.82	31% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPT VISIT EST 5	$246.60	$274.00	$139.74–$271.26	13% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPT VISIT EST 5	$246.60	$274.00	$139.74–$271.26	13% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OFFICE/OUTPATIENT VISIT EST	$551.70	$613.00	$312.63–$606.87	95% above	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OFFICE/OUTPATIENT VISIT EST	$551.70	$613.00	$312.63–$606.87	95% above	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office Visit Established - High MDM	$146.70	$163.00	$83.13–$161.37	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office Visit Established - High MDM	$146.70	$163.00	$83.13–$161.37	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Outreach Services/Specialty EST HI 40 Min	$196.20	$218.00	$111.18–$215.82	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Outreach Services/Specialty EST HI 40 Min	$196.20	$218.00	$111.18–$215.82	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPT VISIT EST 5	$246.60	$274.00	$139.74–$271.26	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPT VISIT EST 5	$246.60	$274.00	$139.74–$271.26	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OFFICE/OUTPATIENT VISIT EST	$551.70	$613.00	$312.63–$606.87	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OFFICE/OUTPATIENT VISIT EST	$551.70	$613.00	$312.63–$606.87	—	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT VISIT EST 99213	$83.70	$93.00	$47.43–$92.07	47% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST - Infusion	$83.70	$93.00	$47.43–$92.07	47% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST - Infusion	$83.70	$93.00	$47.43–$92.07	47% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT VISIT EST 99213	$83.70	$93.00	$47.43–$92.07	47% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Outreach Services/Specialty EST LOW 20 min	$99.00	$110.00	$56.10–$108.90	37% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Outreach Services/Specialty EST LOW 20 min	$99.00	$110.00	$56.10–$108.90	37% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 URGENT CARE LEVEL 3	$177.30	$197.00	$100.47–$195.03	12% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 URGENT CARE LEVEL 3	$177.30	$197.00	$100.47–$195.03	12% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	91% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	91% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	91% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	91% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PAIN CLINIC LEVEL 3	$413.10	$459.00	$234.09–$454.41	162% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PAIN CLINIC LEVEL 3	$413.10	$459.00	$234.09–$454.41	162% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3 WITH EMG	$702.00	$780.00	$397.80–$772.20	344% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3 WITH EMG	$702.00	$780.00	$397.80–$772.20	344% above	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST - Infusion	$83.70	$93.00	$47.43–$92.07	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT VISIT EST 99213	$83.70	$93.00	$47.43–$92.07	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST - Infusion	$83.70	$93.00	$47.43–$92.07	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT VISIT EST 99213	$83.70	$93.00	$47.43–$92.07	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Outreach Services/Specialty EST LOW 20 min	$99.00	$110.00	$56.10–$108.90	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Outreach Services/Specialty EST LOW 20 min	$99.00	$110.00	$56.10–$108.90	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 URGENT CARE LEVEL 3	$177.30	$197.00	$100.47–$195.03	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 URGENT CARE LEVEL 3	$177.30	$197.00	$100.47–$195.03	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT VISIT EST	$301.50	$335.00	$170.85–$331.65	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PAIN CLINIC LEVEL 3	$413.10	$459.00	$234.09–$454.41	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PAIN CLINIC LEVEL 3	$413.10	$459.00	$234.09–$454.41	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3 WITH EMG	$702.00	$780.00	$397.80–$772.20	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3 WITH EMG	$702.00	$780.00	$397.80–$772.20	—	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST - Infusion	$103.50	$115.00	$58.65–$113.85	43% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST - Infusion	$103.50	$115.00	$58.65–$113.85	43% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office visit Established PT- Moderate MDM	$113.40	$126.00	$64.26–$124.74	38% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office visit Established PT- Moderate MDM	$113.40	$126.00	$64.26–$124.74	38% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Outreach Services/Specialty EST MOD 30 min	$140.40	$156.00	$79.56–$154.44	23% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Outreach Services/Specialty EST MOD 30 min	$140.40	$156.00	$79.56–$154.44	23% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	125% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	125% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	125% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	125% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4-CHEMO	$510.30	$567.00	$289.17–$561.33	180% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4-CHEMO	$510.30	$567.00	$289.17–$561.33	180% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PAIN CLINIC LEVEL 4	$535.50	$595.00	$303.45–$589.05	194% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PAIN CLINIC LEVEL 4	$535.50	$595.00	$303.45–$589.05	194% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4 WITH EMG	$835.20	$928.00	$473.28–$918.72	358% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4 WITH EMG	$835.20	$928.00	$473.28–$918.72	358% above	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST - Infusion	$103.50	$115.00	$58.65–$113.85	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST - Infusion	$103.50	$115.00	$58.65–$113.85	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office visit Established PT- Moderate MDM	$113.40	$126.00	$64.26–$124.74	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office visit Established PT- Moderate MDM	$113.40	$126.00	$64.26–$124.74	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Outreach Services/Specialty EST MOD 30 min	$140.40	$156.00	$79.56–$154.44	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Outreach Services/Specialty EST MOD 30 min	$140.40	$156.00	$79.56–$154.44	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OFFICE/OUTPATIENT VISIT EST	$411.30	$457.00	$233.07–$452.43	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4-CHEMO	$510.30	$567.00	$289.17–$561.33	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4-CHEMO	$510.30	$567.00	$289.17–$561.33	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PAIN CLINIC LEVEL 4	$535.50	$595.00	$303.45–$589.05	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PAIN CLINIC LEVEL 4	$535.50	$595.00	$303.45–$589.05	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4 WITH EMG	$835.20	$928.00	$473.28–$918.72	—	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4 WITH EMG	$835.20	$928.00	$473.28–$918.72	—	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST - Infusion	$56.70	$63.00	$32.13–$62.37	42% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/Visit SFW MDW	$56.70	$63.00	$32.13–$62.37	42% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/Visit SFW MDW	$56.70	$63.00	$32.13–$62.37	42% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST - Infusion	$56.70	$63.00	$32.13–$62.37	42% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Outreach Services/Specialty EST SF 10 min	$62.10	$69.00	$35.19–$68.31	36% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Outreach Services/Specialty EST SF 10 min	$62.10	$69.00	$35.19–$68.31	36% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 URGENT CARE LEVEL 2	$135.90	$151.00	$77.01–$149.49	39% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 URGENT CARE LEVEL 2	$135.90	$151.00	$77.01–$149.49	39% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL 2-1 RESOURCE	$162.90	$181.00	$92.31–$179.19	67% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL 2-1 RESOURCE	$162.90	$181.00	$92.31–$179.19	67% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED	$171.90	$191.00	$97.41–$189.09	76% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED	$171.90	$191.00	$97.41–$189.09	76% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPT VISIT 2	$188.10	$209.00	$106.59–$206.91	93% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPT VISIT 2	$188.10	$209.00	$106.59–$206.91	93% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	124% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	124% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	124% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	124% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PAIN CLINIC LEVEL 2	$276.30	$307.00	$156.57–$303.93	183% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PAIN CLINIC LEVEL 2	$276.30	$307.00	$156.57–$303.93	183% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL 2 WITH EMG	$567.90	$631.00	$321.81–$624.69	482% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL 2 WITH EMG	$567.90	$631.00	$321.81–$624.69	482% above	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office/Visit SFW MDW	$56.70	$63.00	$32.13–$62.37	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST - Infusion	$56.70	$63.00	$32.13–$62.37	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST - Infusion	$56.70	$63.00	$32.13–$62.37	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office/Visit SFW MDW	$56.70	$63.00	$32.13–$62.37	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Outreach Services/Specialty EST SF 10 min	$62.10	$69.00	$35.19–$68.31	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Outreach Services/Specialty EST SF 10 min	$62.10	$69.00	$35.19–$68.31	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 URGENT CARE LEVEL 2	$135.90	$151.00	$77.01–$149.49	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 URGENT CARE LEVEL 2	$135.90	$151.00	$77.01–$149.49	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LEVEL 2-1 RESOURCE	$162.90	$181.00	$92.31–$179.19	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LEVEL 2-1 RESOURCE	$162.90	$181.00	$92.31–$179.19	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHED	$171.90	$191.00	$97.41–$189.09	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHED	$171.90	$191.00	$97.41–$189.09	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPT VISIT 2	$188.10	$209.00	$106.59–$206.91	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPT VISIT 2	$188.10	$209.00	$106.59–$206.91	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OFFICE/OUTPATIENT VISIT EST	$218.70	$243.00	$123.93–$240.57	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PAIN CLINIC LEVEL 2	$276.30	$307.00	$156.57–$303.93	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PAIN CLINIC LEVEL 2	$276.30	$307.00	$156.57–$303.93	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LEVEL 2 WITH EMG	$567.90	$631.00	$321.81–$624.69	—	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LEVEL 2 WITH EMG	$567.90	$631.00	$321.81–$624.69	—	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 OFFICE CONSULTATION - Infusion	$19.80	$22.00	$11.22–$21.78	90% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 OFFICE CONSULTATION - Infusion	$19.80	$22.00	$11.22–$21.78	90% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consult Level 3 Established Pt. --99243	$152.10	$169.00	$86.19–$167.31	24% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consult Level 3 Established Pt. --99243	$152.10	$169.00	$86.19–$167.31	24% below	10%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243 OFFICE CONSULTATION - Infusion	$19.80	$22.00	$11.22–$21.78	—	10%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243 OFFICE CONSULTATION - Infusion	$19.80	$22.00	$11.22–$21.78	—	10%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consult Level 3 Established Pt. --99243	$152.10	$169.00	$86.19–$167.31	—	10%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consult Level 3 Established Pt. --99243	$152.10	$169.00	$86.19–$167.31	—	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99214 Est Consult Level 4	$192.60	$214.00	$109.14–$211.86	40% below	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99214 Est Consult Level 4	$192.60	$214.00	$109.14–$211.86	40% below	10%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99214 Est Consult Level 4	$192.60	$214.00	$109.14–$211.86	—	10%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99214 Est Consult Level 4	$192.60	$214.00	$109.14–$211.86	—	10%
Speech and language evaluation CPT 92523 EVAL SPEECH PROD W/LANG	$727.20	$808.00	$412.08–$799.92	114% above	10%
Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg	$405.00	$450.00	$229.50–$445.50	60% above	10%
Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid	$405.00	$450.00	$229.50–$445.50	60% above	10%
Speech therapy session, individual CPT 92507 Treatment of SLP, Communication, Auditory Processing	$405.00	$450.00	$229.50–$445.50	60% above	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$135.90	$151.00	$77.01–$149.49	21% below	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$135.90	$151.00	$77.01–$149.49	21% below	10%
Spirometry (breathing test) CPT 94010 Bedside Spirometry with Peak Flows	$142.20	$158.00	$80.58–$156.42	18% below	10%
Spirometry (breathing test) CPT 94010 Bedside Spirometry	$142.20	$158.00	$80.58–$156.42	18% below	10%
Spirometry (breathing test) CPT 94010 Bedside Spirometry	$142.20	$158.00	$80.58–$156.42	18% below	10%
Spirometry (breathing test) CPT 94010 Bedside Spirometry with Peak Flows	$142.20	$158.00	$80.58–$156.42	18% below	10%
Spirometry (breathing test) CPT 94010 Spirometry Test	$153.00	$170.00	$86.70–$168.30	12% below	10%
Spirometry (breathing test) CPT 94010 Spirometry Test	$153.00	$170.00	$86.70–$168.30	12% below	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY-MD	$234.90	$261.00	$133.11–$258.39	36% above	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY-MD	$234.90	$261.00	$133.11–$258.39	36% above	10%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test with MD Interpretation	$274.50	$305.00	$155.55–$301.95	59% above	10%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test with MD Interpretation	$274.50	$305.00	$155.55–$301.95	59% above	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCLUDING GRAPHIC RECORD	$296.10	$329.00	$167.79–$325.71	71% above	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCLUDING GRAPHIC RECORD	$296.10	$329.00	$167.79–$325.71	71% above	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$135.90	$151.00	$77.01–$149.49	—	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$135.90	$151.00	$77.01–$149.49	—	10%
Spirometry (breathing test) inpatient CPT 94010 Bedside Spirometry with Peak Flows	$142.20	$158.00	$80.58–$156.42	—	10%
Spirometry (breathing test) inpatient CPT 94010 Bedside Spirometry with Peak Flows	$142.20	$158.00	$80.58–$156.42	—	10%
Spirometry (breathing test) inpatient CPT 94010 Bedside Spirometry	$142.20	$158.00	$80.58–$156.42	—	10%
Spirometry (breathing test) inpatient CPT 94010 Bedside Spirometry	$142.20	$158.00	$80.58–$156.42	—	10%
Spirometry (breathing test) inpatient CPT 94010 Spirometry Test	$153.00	$170.00	$86.70–$168.30	—	10%
Spirometry (breathing test) inpatient CPT 94010 Spirometry Test	$153.00	$170.00	$86.70–$168.30	—	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-MD	$234.90	$261.00	$133.11–$258.39	—	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-MD	$234.90	$261.00	$133.11–$258.39	—	10%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test with MD Interpretation	$274.50	$305.00	$155.55–$301.95	—	10%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test with MD Interpretation	$274.50	$305.00	$155.55–$301.95	—	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY INCLUDING GRAPHIC RECORD	$296.10	$329.00	$167.79–$325.71	—	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY INCLUDING GRAPHIC RECORD	$296.10	$329.00	$167.79–$325.71	—	10%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL B4AFTER BRONCHODILATO	$529.20	$588.00	$299.88–$582.12	49% above	10%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL B4AFTER BRONCHODILATO	$529.20	$588.00	$299.88–$582.12	49% above	10%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test A P with MD Interpretation	$630.90	$701.00	$357.51–$693.99	78% above	10%
Spirometry before and after a bronchodilator CPT 94060 Bedside Spirometry A P	$630.90	$701.00	$357.51–$693.99	78% above	10%
Spirometry before and after a bronchodilator CPT 94060 Bedside Spirometry A P	$630.90	$701.00	$357.51–$693.99	78% above	10%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL B4AFTER BRONCHODILATO	$529.20	$588.00	$299.88–$582.12	—	10%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL B4AFTER BRONCHODILATO	$529.20	$588.00	$299.88–$582.12	—	10%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bedside Spirometry A P	$630.90	$701.00	$357.51–$693.99	—	10%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bedside Spirometry A P	$630.90	$701.00	$357.51–$693.99	—	10%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACT 15''''	$171.90	$191.00	$22.94–$189.09	103% above	10%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge	$221.40	$246.00	$22.94–$243.54	161% above	10%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, therapeutic 99195	$438.30	$487.00	$248.37–$482.13	120% above	10%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, therapeutic 99195	$438.30	$487.00	$248.37–$482.13	120% above	10%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, therapeutic 99195	$438.30	$487.00	$248.37–$482.13	—	10%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, therapeutic 99195	$438.30	$487.00	$248.37–$482.13	—	10%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 STRESS TEST W INTERPRET and REPORT	$1,289.70	$1,433.00	$730.83–$1,418.67	194% above	10%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 STRESS TEST W INTERPRET and REPORT	$1,289.70	$1,433.00	$730.83–$1,418.67	194% above	10%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 STRESS TEST W INTERPRET and REPORT	$1,289.70	$1,433.00	$730.83–$1,418.67	—	10%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 STRESS TEST W INTERPRET and REPORT	$1,289.70	$1,433.00	$730.83–$1,418.67	—	10%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine, FLUAD, inact.,adjuv.PF trival Sus UD[BRMH]	$213.42	$237.14	$88.50–$241.88	218% above	10%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine, FLUAD, inact.,adjuv.PF trival Sus UD[BRMH]	$213.42	$237.14	$88.50–$241.88	218% above	10%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine, FLUAD, inact.,adjuv.PF trival Sus UD[BRMH]	$213.42	$237.14	$88.50–$241.88	—	10%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine, FLUAD, inact.,adjuv.PF trival Sus UD[BRMH]	$213.42	$237.14	$88.50–$241.88	—	10%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) preservative-free 50 mcg/0.5 mL Sus[BRMH]	$382.86	$425.40	$171.35–$433.91	129% above	10%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) preservative-free 50 mcg/0.5 mL Sus[BRMH]	$382.86	$425.40	$171.35–$433.91	129% above	10%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) preservative-free 50 mcg/0.5 mL Sus[BRMH]	$382.86	$425.40	$171.35–$433.91	—	10%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) preservative-free 50 mcg/0.5 mL Sus[BRMH]	$382.86	$425.40	$171.35–$433.91	—	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine - Pow [BRMH]	$470.67	$522.97	$221.74–$533.43	187% above	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine - Pow [BRMH]	$470.67	$522.97	$221.74–$533.43	187% above	10%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine - Pow [BRMH]	$470.67	$522.97	$221.74–$533.43	—	10%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine - Pow [BRMH]	$470.67	$522.97	$221.74–$533.43	—	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent Sus [BRMH]	$1,552.69	$1,725.21	$731.49–$1,759.71	396% above	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent Sus [BRMH]	$1,552.69	$1,725.21	$731.49–$1,759.71	396% above	10%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent Sus [BRMH]	$1,552.69	$1,725.21	$731.49–$1,759.71	—	10%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent Sus [BRMH]	$1,552.69	$1,725.21	$731.49–$1,759.71	—	10%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A adult vaccine 1440 units/mL preservative free Sus [BRMH]	$213.19	$236.87	$100.44–$241.61	11% above	10%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A adult vaccine 1440 units/mL preservative free Sus [BRMH]	$213.19	$236.87	$100.44–$241.61	11% above	10%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A adult vaccine 1440 units/mL preservative free Sus [BRMH]	$213.19	$236.87	$100.44–$241.61	—	10%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A adult vaccine 1440 units/mL preservative free Sus [BRMH]	$213.19	$236.87	$100.44–$241.61	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus [BRMH]	$171.15	$190.17	$74.60–$193.97	40% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus [BRMH]	$171.15	$190.17	$74.60–$193.97	40% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus	$180.44	$200.48	$74.60–$204.49	48% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus	$180.44	$200.48	$74.60–$204.49	48% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus [BRMH]	$171.15	$190.17	$74.60–$193.97	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus [BRMH]	$171.15	$190.17	$74.60–$193.97	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus	$180.44	$200.48	$74.60–$204.49	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 10 mcg/mL Sus	$180.44	$200.48	$74.60–$204.49	—	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj [BRMH]	$249.73	$277.48	$117.65–$283.03	63% above	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj [BRMH]	$249.73	$277.48	$117.65–$283.03	63% above	10%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj [BRMH]	$249.73	$277.48	$117.65–$283.03	—	10%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj [BRMH]	$249.73	$277.48	$117.65–$283.03	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-polyvalent vaccine - Sol [BRMH]	$316.12	$351.24	$141.48–$358.27	124% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-polyvalent vaccine - Sol [BRMH]	$316.12	$351.24	$141.48–$358.27	124% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-valent vaccine Inj Sol 0 mL [BRMH]	$316.12	$351.24	$141.48–$358.27	124% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-valent vaccine Inj Sol 0 mL [BRMH]	$316.12	$351.24	$141.48–$358.27	124% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-valent vaccine Inj Sol 0 mL [BRMH]	$316.12	$351.24	$141.48–$358.27	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-valent vaccine Inj Sol 0 mL [BRMH]	$316.12	$351.24	$141.48–$358.27	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-polyvalent vaccine - Sol [BRMH]	$316.12	$351.24	$141.48–$358.27	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-polyvalent vaccine - Sol [BRMH]	$316.12	$351.24	$141.48–$358.27	—	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg / 0.5 mL Injection [BRMH]	$1,501.58	$1,668.43	$707.41–$1,701.79	47% above	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg / 0.5 mL Injection [BRMH]	$1,501.58	$1,668.43	$707.41–$1,701.79	47% above	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip 50 mg / 0.5 mL Injection [BRMH]	$1,501.58	$1,668.43	$707.41–$1,701.79	—	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip 50 mg / 0.5 mL Injection [BRMH]	$1,501.58	$1,668.43	$707.41–$1,701.79	—	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Inj [BRMH]	$796.50	$885.00	$375.24–$902.70	46% above	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Inj [BRMH]	$796.50	$885.00	$375.24–$902.70	46% above	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Pow[BRMH]	$828.36	$920.40	$390.25–$938.81	52% above	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Pow[BRMH]	$828.36	$920.40	$390.25–$938.81	52% above	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Inj [BRMH]	$796.50	$885.00	$375.24–$902.70	—	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Inj [BRMH]	$796.50	$885.00	$375.24–$902.70	—	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Pow[BRMH]	$828.36	$920.40	$390.25–$938.81	—	10%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Pow[BRMH]	$828.36	$920.40	$390.25–$938.81	—	10%
Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,010.25	$1,122.50	$330.75–$1,144.95	87% above	10%
Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,010.25	$1,122.50	$330.75–$1,144.95	87% above	10%
Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,074.58	$1,193.98	$330.75–$1,217.85	98% above	10%
Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,074.58	$1,193.98	$330.75–$1,217.85	98% above	10%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,010.25	$1,122.50	$330.75–$1,144.95	—	10%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,010.25	$1,122.50	$330.75–$1,144.95	—	10%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,074.58	$1,193.98	$330.75–$1,217.85	—	10%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 intl units Pow [BRMH]	$1,074.58	$1,193.98	$330.75–$1,217.85	—	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine, inactivated adjuvanted Pow [BRMH]	$495.21	$550.23	$233.30–$561.23	150% above	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine, inactivated adjuvanted Pow [BRMH]	$495.21	$550.23	$233.30–$561.23	150% above	10%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine, inactivated adjuvanted Pow [BRMH]	$495.21	$550.23	$233.30–$561.23	—	10%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine, inactivated adjuvanted Pow [BRMH]	$495.21	$550.23	$233.30–$561.23	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoids adult IM Susp 0 mL [BRMH]	$94.92	$105.47	$38.55–$107.58	129% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2units/0.5 mL Sus [BRMH]	$94.92	$105.47	$38.55–$107.58	129% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2units/0.5 mL Sus [BRMH]	$94.92	$105.47	$38.55–$107.58	129% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoids adult IM Susp 0 mL [BRMH]	$94.92	$105.47	$38.55–$107.58	129% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2units/0.5 mL Sus [BRMH]	$94.92	$105.47	$38.55–$107.58	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria toxoids adult IM Susp 0 mL [BRMH]	$94.92	$105.47	$38.55–$107.58	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria toxoids adult IM Susp 0 mL [BRMH]	$94.92	$105.47	$38.55–$107.58	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2units/0.5 mL Sus [BRMH]	$94.92	$105.47	$38.55–$107.58	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus [BRMH]	$127.82	$142.03	$42.09–$144.87	65% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus [BRMH]	$127.82	$142.03	$42.09–$144.87	65% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus [BRMH]	$127.82	$142.03	$42.09–$144.87	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus [BRMH]	$127.82	$142.03	$42.09–$144.87	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration for Immunization (MC) Patient Purchased vaccine	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471: IM/SUBQ First Dose	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration for Immunization (MC) Patient Purchased vaccine	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471: IM/SUBQ First Dose	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-SINGLE	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-SINGLE	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$144.90	$161.00	$82.11–$159.39	288% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 rabies vaccine, purified chick embryo cell 2.5 intl units Pow[BRMH]	$1,173.44	$1,303.83	$552.82–$1,329.90	3038% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 rabies vaccine, purified chick embryo cell 2.5 intl units Pow[BRMH]	$1,173.44	$1,303.83	$552.82–$1,329.90	3038% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471: IM/SUBQ First Dose	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration for Immunization (MC) Patient Purchased vaccine	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration for Immunization (MC) Patient Purchased vaccine	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471: IM/SUBQ First Dose	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION-SINGLE	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION-SINGLE	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$144.90	$161.00	$82.11–$159.39	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 rabies vaccine, purified chick embryo cell 2.5 intl units Pow[BRMH]	$1,173.44	$1,303.83	$552.82–$1,329.90	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 rabies vaccine, purified chick embryo cell 2.5 intl units Pow[BRMH]	$1,173.44	$1,303.83	$552.82–$1,329.90	—	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN (2 SINGLECOMB)	$125.10	$139.00	$70.89–$137.61	285% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN (2 SINGLECOMB)	$125.10	$139.00	$70.89–$137.61	285% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADDTL IMMUNIZATION ADMIN	$128.70	$143.00	$72.93–$141.57	296% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADDTL IMMUNIZATION ADMIN	$128.70	$143.00	$72.93–$141.57	296% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472: IM/SUBQ Each Additional	$128.70	$143.00	$72.93–$141.57	296% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472: IM/SUBQ Each Additional	$128.70	$143.00	$72.93–$141.57	296% above	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN (2 SINGLECOMB)	$125.10	$139.00	$70.89–$137.61	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN (2 SINGLECOMB)	$125.10	$139.00	$70.89–$137.61	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472: IM/SUBQ Each Additional	$128.70	$143.00	$72.93–$141.57	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472: IM/SUBQ Each Additional	$128.70	$143.00	$72.93–$141.57	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADDTL IMMUNIZATION ADMIN	$128.70	$143.00	$72.93–$141.57	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADDTL IMMUNIZATION ADMIN	$128.70	$143.00	$72.93–$141.57	—	10%

Source file: https://blackriverhealth.com/wp-content/uploads/2026/05/391027536_Black-River-Health-Inc_standardcharges.csv