Cascade Medical Center
Listed in its price file as “Chelan County Public Hospital District No 1”.
Cascade Medical Center in Leavenworth, WA publishes cash prices for 301 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Washington median for 152 of 298 procedures and below it for 144. By typical cash price it ranks #29 of 46 Washington hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
817 Commercial Street, Leavenworth, WA, 98826-1316 Collected Sep 27, 2026 Source price file (509) 548-5815
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 501313 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 Xray ankle 3+ vws rd | $52.80 | $66.00 | $9.55–$66.00 | 82% below | 20% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-ray exam ankle 3+vw | $416.80 | $521.00 | $37.74–$468.90 | 38% above | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xray ankle 3+ vws rd RT | $53.60 | $67.00 | $9.55–$67.00 | 82% below | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xray ankle 3+ vws rd LT | $53.60 | $67.00 | $9.55–$67.00 | 82% below | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 X-ray exam ankle 3+vw RT | $377.20 | $471.50 | $37.74–$424.35 | 25% above | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 X-ray exam ankle 3+vw LT | $416.80 | $521.00 | $37.74–$468.90 | 38% above | 20% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Xray ankle 3+ vws rd | $52.80 | $66.00 | $9.55–$66.00 | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-ray exam ankle 3+vw | $416.80 | $521.00 | $37.74–$468.90 | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-ray exam ankle 3+vw RT | $377.20 | $471.50 | $37.74–$424.35 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ankle Brachial Indices Rd | $132.80 | $166.00 | $13.19–$149.40 | 63% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Upr/l xtremity art 2 levels | $423.20 | $529.00 | $84.84–$476.10 | 17% above | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Ankle Brachial Indices Rd | $132.80 | $166.00 | $13.19–$149.40 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Upr/l xtremity art 2 levels | $423.20 | $529.00 | $84.84–$476.10 | — | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Xray xm esophagus 1cntrst stdy | $702.40 | $878.00 | $100.11–$790.20 | 21% above | 20% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Xray xm esophagus 1cntrst stdy | $702.40 | $878.00 | $100.11–$790.20 | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA chest read | $516.80 | $646.00 | $95.22–$581.40 | 78% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA chest | $3,480.80 | $4,351.00 | $270.46–$3,915.90 | 49% above | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA chest read | $516.80 | $646.00 | $95.22–$581.40 | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA chest | $3,480.80 | $4,351.00 | $270.46–$3,915.90 | — | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT abdmn/pelvis w/o cntrst rd | $328.00 | $410.00 | $91.19–$369.00 | 87% below | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT abdomen/pelvis w/o contrast | $2,804.00 | $3,505.00 | $192.13–$3,154.50 | 12% above | 20% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT abdmn/pelvis w/o cntrst rd | $328.00 | $410.00 | $91.19–$369.00 | — | 20% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT abdomen/pelvis w/o contrast | $2,804.00 | $3,505.00 | $192.13–$3,154.50 | — | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT abdmn/pelvis w/cntrst rd | $348.80 | $436.00 | $95.62–$436.00 | 88% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT abdomen/pelvis w/contrast | $3,427.20 | $4,284.00 | $320.48–$3,855.60 | 15% above | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT abdmn/pelvis w/cntrst rd | $348.80 | $436.00 | $95.62–$436.00 | — | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT abdomen/pelvis w/contrast | $3,427.20 | $4,284.00 | $320.48–$3,855.60 | — | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT abdm/pelvis w/wo cntrst rd | $366.40 | $458.00 | $105.93–$458.00 | 90% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT abdmn/pelvs 1/> regns w/wo | $3,639.20 | $4,549.00 | $359.57–$4,094.10 | 3% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT abdm/pelvis w/wo cntrst rd | $366.40 | $458.00 | $105.93–$458.00 | — | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT abdmn/pelvs 1/> regns w/wo | $3,639.20 | $4,549.00 | $359.57–$4,094.10 | — | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT abdomen w/cntrst read | $392.00 | $490.00 | $66.73–$463.22 | 78% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT abdomen w/contrast | $2,626.40 | $3,283.00 | $245.07–$2,954.70 | 44% above | 20% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT abdomen w/cntrst read | $392.00 | $490.00 | $66.73–$463.22 | — | 20% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT abdomen w/contrast | $2,626.40 | $3,283.00 | $245.07–$2,954.70 | — | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT abdomen w/o cntrst read | $350.40 | $438.00 | $62.49–$394.20 | 75% below | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT abdomen w/o contrast | $2,219.20 | $2,774.00 | $143.54–$2,496.60 | 59% above | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT abdomen w/o cntrst read | $350.40 | $438.00 | $62.49–$394.20 | — | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT abdomen w/o contrast | $2,219.20 | $2,774.00 | $143.54–$2,496.60 | — | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT maxillofacial w/o cntrst rd | $376.00 | $470.00 | $45.37–$423.00 | 61% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT maxillofacial w/o contrast | $1,475.20 | $1,844.00 | $135.07–$1,659.60 | 53% above | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT maxillofacial w/o cntrst rd | $376.00 | $470.00 | $45.37–$423.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT maxillofacial w/o contrast | $1,475.20 | $1,844.00 | $135.07–$1,659.60 | — | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT head/brain w/o contrast rd | $276.00 | $345.00 | $44.98–$310.50 | 77% below | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT head/brain w/o contrast | $1,510.40 | $1,888.00 | $111.53–$1,699.20 | 26% above | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT head/brain w/o contrast rd | $276.00 | $345.00 | $44.98–$310.50 | — | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT head/brain w/o contrast | $1,510.40 | $1,888.00 | $111.53–$1,699.20 | — | 20% |
| CT scan of the head with contrast CPT 70460 CT head/brain w/contrast rd | $365.60 | $457.00 | $59.41–$411.30 | 71% below | 20% |
| CT scan of the head with contrast CPT 70460 CT head/brain w/contrast | $2,001.60 | $2,502.00 | $156.07–$2,251.80 | 57% above | 20% |
| CT scan of the head with contrast inpatient CPT 70460 CT head/brain w/contrast rd | $365.60 | $457.00 | $59.41–$411.30 | — | 20% |
| CT scan of the head with contrast inpatient CPT 70460 CT head/brain w/contrast | $2,001.60 | $2,502.00 | $156.07–$2,251.80 | — | 20% |
| CT scan of the head without and with contrast CPT 70470 CT head/brain w/wo cntrst rd | $409.60 | $512.00 | $66.73–$460.80 | 72% below | 20% |
| CT scan of the head without and with contrast CPT 70470 CT head/brain w/wo contrast | $3,004.80 | $3,756.00 | $182.77–$3,380.40 | 105% above | 20% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT head/brain w/wo cntrst rd | $409.60 | $512.00 | $66.73–$460.80 | — | 20% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT head/brain w/wo contrast | $3,004.80 | $3,756.00 | $182.77–$3,380.40 | — | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT l-spine w/o contrast read | $288.00 | $360.00 | $52.96–$324.00 | 78% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-spine w/o contrast | $1,200.80 | $1,501.00 | $135.86–$1,350.90 | 7% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT l-spine w/o contrast read | $288.00 | $360.00 | $52.96–$324.00 | — | 20% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-spine w/o contrast | $1,200.80 | $1,501.00 | $135.86–$1,350.90 | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT c-spine w/o contrast read | $347.20 | $434.00 | $52.96–$390.60 | 75% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT c-spine w/o contrast | $1,242.40 | $1,553.00 | $136.90–$1,397.70 | 12% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT c-spine w/o contrast | $1,242.40 | $1,553.00 | $136.90–$1,397.70 | 12% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT c-spine w/o contrast read | $347.20 | $434.00 | $52.96–$390.60 | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT c-spine w/o contrast | $1,242.40 | $1,553.00 | $136.90–$1,397.70 | — | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT pelvis w/contrast read | $337.60 | $422.00 | $60.95–$422.00 | 80% below | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT pelvis w/contrast | $2,550.40 | $3,188.00 | $239.74–$2,869.20 | 47% above | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT pelvis w/contrast read | $337.60 | $422.00 | $60.95–$422.00 | — | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT pelvis w/contrast | $2,550.40 | $3,188.00 | $239.74–$2,869.20 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplex Scan Carotid; complete | $214.40 | $268.00 | $42.45–$268.00 | 74% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Dup carotid arterial cmpl/CWH | $661.60 | $827.00 | $195.66–$744.30 | 19% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplex Scan Carotid; complete | $662.40 | $828.00 | $195.66–$745.20 | 18% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Duplex Scan Carotid; complete | $214.40 | $268.00 | $42.45–$268.00 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Dup carotid arterial cmpl/CWH | $661.60 | $827.00 | $195.66–$744.30 | — | 20% |
| Chest X-ray, 2 views CPT 71046 Xray chest 2 views read | $67.20 | $84.00 | $11.47–$75.60 | 75% below | 20% |
| Chest X-ray, 2 views CPT 71046 X-ray exam chest 2 views | $262.40 | $328.00 | $34.57–$295.20 | 3% below | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 Xray chest 2 views read | $67.20 | $84.00 | $11.47–$75.60 | — | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 X-ray exam chest 2 views | $262.40 | $328.00 | $34.57–$295.20 | — | 20% |
| Chest X-ray, single view CPT 71045 Xray chest 1 view read | $56.80 | $71.00 | $9.53–$63.90 | 76% below | 20% |
| Chest X-ray, single view CPT 71045 X-ray exam chest 1 view | $245.60 | $307.00 | $26.30–$276.30 | 4% above | 20% |
| Chest X-ray, single view inpatient CPT 71045 Xray chest 1 view read | $56.80 | $71.00 | $9.53–$63.90 | — | 20% |
| Chest X-ray, single view inpatient CPT 71045 X-ray exam chest 1 view | $245.60 | $307.00 | $26.30–$276.30 | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 U/S, Retroperitoneal; complete | $303.20 | $379.00 | $111.30–$341.10 | 45% below | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 U/S, Retroperitoneal; complete | $303.20 | $379.00 | $111.30–$341.10 | — | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA scan 1+ sites axial rd | $69.60 | $87.00 | $10.68–$78.30 | 83% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density 1+sites axial | $567.20 | $709.00 | $40.13–$638.10 | 37% above | 20% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA scan 1+ sites axial rd | $69.60 | $87.00 | $10.68–$78.30 | — | 20% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA bone density 1+sites axial | $567.20 | $709.00 | $40.13–$638.10 | — | 20% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 U/S PrgUte w/det fet exam 1st | $661.60 | $827.00 | $181.53–$744.30 | 4% below | 20% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 U/S PrgUte w/det fet exam 1st | $661.60 | $827.00 | $181.53–$744.30 | — | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT thorax dx w/o contrast rd | $360.00 | $450.00 | $56.43–$405.00 | 75% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT thorax dx w/o contrast | $2,097.60 | $2,622.00 | $139.86–$2,359.80 | 47% above | 20% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT thorax dx w/o contrast rd | $360.00 | $450.00 | $56.43–$405.00 | — | 20% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT thorax dx w/o contrast | $2,097.60 | $2,622.00 | $139.86–$2,359.80 | — | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT thorax dx w/contrast rd | $379.20 | $474.00 | $61.34–$426.60 | 79% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT thorax dx w/contrast | $2,438.40 | $3,048.00 | $176.04–$2,743.20 | 34% above | 20% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT thorax dx w/contrast rd | $379.20 | $474.00 | $61.34–$426.60 | — | 20% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT thorax dx w/contrast | $2,438.40 | $3,048.00 | $176.04–$2,743.20 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dplx Stdy,LE Arterl;bilat comp | $661.60 | $827.00 | $247.85–$744.30 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dplx Stdy,LE Arterl;bilat comp | $662.40 | $828.00 | $247.85–$745.20 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dplx Stdy,LE Arterl;bilat comp | $661.60 | $827.00 | $247.85–$744.30 | — | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Duplex Scan Ext Bil/Comp | $661.60 | $827.00 | $192.73–$744.30 | 36% below | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Duplex scan ext complt BL CWH | $1,531.20 | $1,914.00 | $192.73–$1,722.60 | 48% above | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Duplex Scan Ext Bil/Comp | $661.60 | $827.00 | $192.73–$744.30 | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo, Transthoracic; complete | $1,497.60 | $1,872.00 | $201.67–$1,684.80 | 7% below | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC-CWH SERVICES | $3,306.40 | $4,133.00 | $201.67–$3,719.70 | 106% above | 20% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo, Transthoracic; complete | $1,497.60 | $1,872.00 | $201.67–$1,684.80 | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC-CWH SERVICES | $3,306.40 | $4,133.00 | $201.67–$3,719.70 | — | 20% |
| Knee X-ray, 3 views CPT 73562 Xray knee 3vws read | $56.00 | $70.00 | $10.72–$70.00 | 82% below | 20% |
| Knee X-ray, 3 views CPT 73562 X-ray exam knee 3vw | $341.60 | $427.00 | $42.22–$384.30 | 10% above | 20% |
| Knee X-ray, 3 views one side CPT 73562 Xray knee 3vws read LT | $56.80 | $71.00 | $10.72–$71.00 | 82% below | 20% |
| Knee X-ray, 3 views one side CPT 73562 Xray knee 3vws read RT | $56.80 | $71.00 | $10.72–$71.00 | 82% below | 20% |
| Knee X-ray, 3 views one side CPT 73562 X-ray exam knee 3vw RT | $310.00 | $387.50 | $42.22–$348.75 | at median | 20% |
| Knee X-ray, 3 views one side CPT 73562 X-ray exam knee 3vw LT | $342.40 | $428.00 | $42.22–$385.20 | 10% above | 20% |
| Knee X-ray, 3 views inpatient CPT 73562 Xray knee 3vws read | $56.00 | $70.00 | $10.72–$70.00 | — | 20% |
| Knee X-ray, 3 views inpatient CPT 73562 X-ray exam knee 3vw | $341.60 | $427.00 | $42.22–$384.30 | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 X-ray exam knee 3vw RT | $310.00 | $387.50 | $42.22–$348.75 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S Abd Ltd, with R/T imge doc | $158.40 | $198.00 | $31.30–$178.20 | 67% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S Abd rl tm w/img doc Ltd | $303.20 | $379.00 | $89.39–$341.10 | 36% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo exam of abdomen | $692.00 | $865.00 | $89.39–$778.50 | 46% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S Abd Ltd, with R/T imge doc | $158.40 | $198.00 | $31.30–$178.20 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S Abd rl tm w/img doc Ltd | $303.20 | $379.00 | $89.39–$341.10 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Echo exam of abdomen | $692.00 | $865.00 | $89.39–$778.50 | — | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT low dose lung cncr scrn rd | $360.00 | $450.00 | $56.43–$405.00 | 62% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct thorax lung cancer-LDCT | $2,097.60 | $2,622.00 | $144.62–$2,359.80 | 846% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT low dose lung cancer screen | $2,097.60 | $2,622.00 | $144.62–$2,359.80 | 846% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT low dose lung cncr scrn rd | $360.00 | $450.00 | $56.43–$405.00 | — | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT low dose lung cancer screen | $2,097.60 | $2,622.00 | $144.62–$2,359.80 | — | 20% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast, w & w/o contrast, BIL rd | $611.20 | $764.00 | $120.84–$687.60 | 67% below | 20% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast, w & w/o contrast, BIL | $2,661.60 | $3,327.00 | $362.21–$2,994.30 | 43% above | 20% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast, w & w/o contrast, BIL rd | $611.20 | $764.00 | $120.84–$687.60 | — | 20% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast, w & w/o contrast, BIL | $2,661.60 | $3,327.00 | $362.21–$2,994.30 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE Any Joint, w/o cont rd | $348.00 | $435.00 | $71.77–$398.32 | 81% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE Any Joint, w/o cont | $1,698.40 | $2,123.00 | $214.18–$1,910.70 | 5% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE Any Joint, w/o cont rd | $348.00 | $435.00 | $71.77–$398.32 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE Any Joint, w/o cont | $1,698.40 | $2,123.00 | $214.18–$1,910.70 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE Any Joint, w & w/o cont rd | $600.00 | $750.00 | $113.24–$750.00 | 81% below | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE Any Joint, w & w/o cont | $2,928.00 | $3,660.00 | $408.50–$3,294.00 | 5% below | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE Any Joint, w & w/o cont rd | $600.00 | $750.00 | $113.24–$750.00 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE Any Joint, w & w/o cont | $2,928.00 | $3,660.00 | $408.50–$3,294.00 | — | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI Abd, w/o contrast rd | $531.20 | $664.00 | $75.97–$597.60 | 74% below | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI Abd, w/o contrast | $2,589.60 | $3,237.00 | $206.71–$2,913.30 | 26% above | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abd, w/o contrast rd | $531.20 | $664.00 | $75.97–$597.60 | — | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abd, w/o contrast | $2,589.60 | $3,237.00 | $206.71–$2,913.30 | — | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abd, w & w/o contrast rd | $673.60 | $842.00 | $115.84–$757.80 | 78% below | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abd, w & w/o contrast | $3,287.20 | $4,109.00 | $357.56–$3,698.10 | 8% above | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abd, w & w/o contrast rd | $673.60 | $842.00 | $115.84–$757.80 | — | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abd, w & w/o contrast | $3,287.20 | $4,109.00 | $357.56–$3,698.10 | — | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain, w/o contrast rd | $396.00 | $495.00 | $77.41–$445.50 | 79% below | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain, w/o contrast | $1,932.00 | $2,415.00 | $207.03–$2,173.50 | 5% above | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain, w/o contrast rd | $396.00 | $495.00 | $77.41–$445.50 | — | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain, w/o contrast | $1,932.00 | $2,415.00 | $207.03–$2,173.50 | — | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain, w & w/o contrast rd | $537.60 | $672.00 | $120.07–$626.96 | 80% below | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain, w & w/o contrast | $2,624.80 | $3,281.00 | $336.26–$2,952.90 | 1% below | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain, w & w/o contrast rd | $537.60 | $672.00 | $120.07–$626.96 | — | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain, w & w/o contrast | $2,624.80 | $3,281.00 | $336.26–$2,952.90 | — | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spinal & Cnts Lmbr w/o cont rd | $409.60 | $512.00 | $78.21–$460.80 | 81% below | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spnl & Cntnts Lmbr w/out | $1,907.20 | $2,384.00 | $201.84–$2,145.60 | 10% below | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spinal & Cnts Lmbr w/o cont | $2,002.40 | $2,503.00 | $201.84–$2,252.70 | 5% below | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spinal & Cnts Lmbr w/o cont rd | $409.60 | $512.00 | $78.21–$460.80 | — | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spinal & Cnts Lmbr w/o cont | $2,002.40 | $2,503.00 | $201.84–$2,252.70 | — | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spinal & Cnts Lmbr w&w/o cont rd | $558.40 | $698.00 | $120.46–$629.34 | 82% below | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spinal & Cnts Lmbr w&w/o cont | $2,724.80 | $3,406.00 | $337.30–$3,065.40 | 12% below | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spinal & Cnts Lmbr w&w/o cont rd | $558.40 | $698.00 | $120.46–$629.34 | — | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spinal & Cnts Lmbr w&w/o cont | $2,724.80 | $3,406.00 | $337.30–$3,065.40 | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spinal & Cnts Thrc w/o cont rd | $396.80 | $496.00 | $77.82–$446.40 | 81% below | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spinal & Cnts Thrc w/o cont | $1,935.20 | $2,419.00 | $200.80–$2,177.10 | 9% below | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spinal & Cnts Thrc w/o cont rd | $396.80 | $496.00 | $77.82–$446.40 | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spinal & Cnts Thrc w/o cont | $1,935.20 | $2,419.00 | $200.80–$2,177.10 | — | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spinal & Cnts Cerv w&w/o cont rd | $596.80 | $746.00 | $120.46–$671.40 | 81% below | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spinal & Cnts Cerv w&w/o cont | $2,911.20 | $3,639.00 | $337.99–$3,275.10 | 8% below | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spinal & Cnts Cerv w&w/o cont rd | $596.80 | $746.00 | $120.46–$671.40 | — | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spinal & Cnts Cerv w&w/o cont | $2,911.20 | $3,639.00 | $337.99–$3,275.10 | — | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spinal & Cnts Cerv w/o cont rd | $408.00 | $510.00 | $77.82–$459.00 | 80% below | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spinal & Cnts Cerv w/o cont | $1,994.40 | $2,493.00 | $201.14–$2,243.70 | 1% below | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spinal & Cnts Cerv w/o cont rd | $408.00 | $510.00 | $77.82–$459.00 | — | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spinal & Cnts Cerv w/o cont | $1,994.40 | $2,493.00 | $201.14–$2,243.70 | — | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis, w & w/o contrast rd | $541.60 | $677.00 | $115.84–$667.44 | 83% below | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis, w & w/o contrast | $2,647.20 | $3,309.00 | $356.17–$2,978.10 | 16% below | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis, w & w/o contrast rd | $541.60 | $677.00 | $115.84–$667.44 | — | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis, w & w/o contrast | $2,647.20 | $3,309.00 | $356.17–$2,978.10 | — | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis, w/o contrast rd | $380.80 | $476.00 | $76.36–$453.10 | 80% below | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis, w/o contrast | $1,860.00 | $2,325.00 | $242.36–$2,092.50 | 5% below | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis, w/o contrast rd | $380.80 | $476.00 | $76.36–$453.10 | — | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis, w/o contrast | $1,860.00 | $2,325.00 | $242.36–$2,092.50 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE Any Joint, w/o cont rd | $390.40 | $488.00 | $72.16–$439.20 | 79% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE Any Joint, w/o cont | $1,908.00 | $2,385.00 | $214.52–$2,146.50 | 3% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE Any Joint, w/o cont rd | $390.40 | $488.00 | $72.16–$439.20 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE Any Joint, w/o cont | $1,908.00 | $2,385.00 | $214.52–$2,146.50 | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S Plvc(nonobs)R/Tw/imgdc ltd | $303.20 | $379.00 | $50.45–$341.10 | 20% below | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 U/S Plvc(nonobs)R/Tw/imgdc ltd | $303.20 | $379.00 | $50.45–$341.10 | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S Pelvic(non obs); complete | $303.20 | $379.00 | $108.32–$341.10 | 44% below | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US pelvis not OB/CWH purch svc | $920.80 | $1,151.00 | $108.32–$1,035.90 | 69% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S Pelvic(non obs); complete | $303.20 | $379.00 | $108.32–$341.10 | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US pelvis not OB/CWH purch svc | $920.80 | $1,151.00 | $108.32–$1,035.90 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S PrgUte(<14wks);sin/1st ges | $303.20 | $379.00 | $120.37–$341.10 | 39% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 U/S PrgUte(<14wks);sin/1st ges | $303.20 | $379.00 | $120.37–$341.10 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S PregUtrs R/T w/img doc Ltd | $303.20 | $379.00 | $83.10–$341.10 | 21% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 U/S PregUtrs R/T w/img doc Ltd | $303.20 | $379.00 | $83.10–$341.10 | — | 20% |
| Screening mammogram, both breasts both sides CPT 77067 Screenng mammo bi-2vw w/cad rd | $136.80 | $171.00 | $40.06–$171.00 | — | 20% |
| Screening mammogram, both breasts both sides CPT 77067 Screening mamm bilat 2v w/CAD | $358.40 | $448.00 | $94.00–$403.20 | — | 20% |
| Screening mammogram, both breasts CPT 77067 MAMMO SPECIAL | $120.00 | $150.00 | $80.13–$150.00 | 63% below | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Screenng mammo bi-2vw w/cad rd | $136.80 | $171.00 | $40.06–$171.00 | — | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Screening mamm bilat 2v w/CAD | $358.40 | $448.00 | $94.00–$403.20 | — | 20% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO SPECIAL | $120.00 | $150.00 | $80.13–$150.00 | — | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 Xray shoulder 2-3vw rd | $63.20 | $79.00 | $10.32–$71.10 | 79% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray exam shlder 2-3vw | $444.00 | $555.00 | $35.99–$499.50 | 48% above | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xray shoulder 2-3vw rd RT | $63.20 | $79.00 | $10.32–$71.10 | 79% below | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xray shoulder 2-3vw rd LT | $63.20 | $79.00 | $10.32–$71.10 | 79% below | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-ray exam shlder 2-3vw, RT | $444.80 | $556.00 | $35.99–$500.40 | 48% above | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-ray exam shlder 2-3vw, LT | $444.80 | $556.00 | $35.99–$500.40 | 48% above | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Xray shoulder 2-3vw rd | $63.20 | $79.00 | $10.32–$71.10 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-ray exam shlder 2-3vw | $444.00 | $555.00 | $35.99–$499.50 | — | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US transvaginal (non-obs) | $303.20 | $379.00 | $122.78–$341.10 | 37% below | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US transvaginal/CWH purch svc | $820.80 | $1,026.00 | $122.78–$923.40 | 72% above | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US transvaginal (non-obs) | $303.20 | $379.00 | $122.78–$341.10 | — | 20% |
| Transvaginal ultrasound during pregnancy one side CPT 76817 U/S PrgUtTrnsvg R/Tw/img dc Lt | $303.20 | $379.00 | $95.10–$341.10 | 31% below | 20% |
| Transvaginal ultrasound during pregnancy inpatient one side CPT 76817 U/S PrgUtTrnsvg R/Tw/img dc Lt | $303.20 | $379.00 | $95.10–$341.10 | — | 20% |
| Ultrasound of the abdomen, complete CPT 76700 U/S, Abdominal; complete rd | $216.00 | $270.00 | $42.77–$243.00 | 66% below | 20% |
| Ultrasound of the abdomen, complete CPT 76700 U/S, Abdominal; complete | $288.80 | $361.00 | $119.45–$324.90 | 55% below | 20% |
| Ultrasound of the abdomen, complete CPT 76700 U/S abdominal complete | $1,013.60 | $1,267.00 | $119.45–$1,140.30 | 60% above | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 U/S, Abdominal; complete rd | $216.00 | $270.00 | $42.77–$243.00 | — | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 U/S, Abdominal; complete | $288.80 | $361.00 | $119.45–$324.90 | — | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 U/S abdominal complete | $1,013.60 | $1,267.00 | $119.45–$1,140.30 | — | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 U/S scrotum rd | $172.00 | $215.00 | $33.90–$193.50 | 65% below | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 U/S scrotum | $303.20 | $379.00 | $102.84–$341.10 | 38% below | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 Us exam scrotum | $456.80 | $571.00 | $102.84–$513.90 | 7% below | 20% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 U/S scrotum rd | $172.00 | $215.00 | $33.90–$193.50 | — | 20% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 U/S scrotum | $303.20 | $379.00 | $102.84–$341.10 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S, Head & Neck(Thyroid) | $304.00 | $380.00 | $113.66–$342.00 | 39% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S, Head & Neck(Thyroid) | $304.00 | $380.00 | $113.66–$342.00 | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xray xm upr gi trc 1cntrt stdy | $673.60 | $842.00 | $126.13–$757.80 | at median | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Xray xm upr gi trc 1cntrt stdy | $673.60 | $842.00 | $126.13–$757.80 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplex Scan Ext Unil/Ltd | $303.20 | $379.00 | $122.70–$341.10 | 53% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplex scan ext unl/lmt-TC/CWH | $903.20 | $1,129.00 | $122.70–$1,016.10 | 41% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Duplex Scan Ext Unil/Ltd | $303.20 | $379.00 | $122.70–$341.10 | — | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 Xray wrist 3+ vws rd | $55.20 | $69.00 | $9.94–$69.00 | 82% below | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-ray exam wrist compl | $370.40 | $463.00 | $42.59–$416.70 | 19% above | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xray wrist 3+ vws rd LT | $56.00 | $70.00 | $9.94–$70.00 | 82% below | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xray wrist 3+ vws rd RT | $56.00 | $70.00 | $9.94–$70.00 | 82% below | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 X-ray exam wrist compl RT | $371.20 | $464.00 | $42.59–$417.60 | 19% above | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 X-ray exam wrist compl LT | $371.20 | $464.00 | $42.59–$417.60 | 19% above | 20% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Xray wrist 3+ vws rd | $55.20 | $69.00 | $9.94–$69.00 | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-ray exam wrist compl | $370.40 | $463.00 | $42.59–$416.70 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xray hip w/pelv 2-3vws rd | $64.80 | $81.00 | $12.26–$81.00 | 78% below | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray hip uni w/pel 2-3v | $332.80 | $416.00 | $49.10–$374.40 | 15% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray exam hip uni 2-3v | $367.20 | $459.00 | $49.10–$413.10 | 26% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xray hip w/pelv 2-3vws rd LT | $64.80 | $81.00 | $12.26–$81.00 | 78% below | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Xray hip w/pelv 2-3vws rd | $64.80 | $81.00 | $12.26–$81.00 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-ray hip uni w/pel 2-3v | $332.80 | $416.00 | $49.10–$374.40 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-ray exam hip uni 2-3v | $367.20 | $459.00 | $49.10–$413.10 | — | 20% |
| X-ray of the abdomen, 1 view CPT 74018 Xray abdomen 1vw read | $61.60 | $77.00 | $9.93–$69.30 | 75% below | 20% |
| X-ray of the abdomen, 1 view CPT 74018 X-ray exam abdomen 1vw | $151.20 | $189.00 | $31.15–$170.10 | 39% below | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Xray abdomen 1vw read | $61.60 | $77.00 | $9.93–$69.30 | — | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-ray exam abdomen 1vw | $151.20 | $189.00 | $31.15–$170.10 | — | 20% |
| X-ray of the ankle, 2 views CPT 73600 Xray ankle 2vw read | $50.40 | $63.00 | $9.16–$61.92 | 81% below | 20% |
| X-ray of the ankle, 2 views CPT 73600 X-ray exam ankle 2vw | $388.80 | $486.00 | $33.25–$437.40 | 48% above | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 Xray ankle 2vw read RT | $50.40 | $63.00 | $9.16–$61.92 | 81% below | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 Xray ankle 2vw read LT | $50.40 | $63.00 | $9.16–$61.92 | 81% below | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 X-ray exam ankle 2vw RT | $389.60 | $487.00 | $33.25–$438.30 | 48% above | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 X-ray exam ankle 2vw LT | $389.60 | $487.00 | $33.25–$438.30 | 48% above | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 Xray ankle 2vw read | $50.40 | $63.00 | $9.16–$61.92 | — | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 X-ray exam ankle 2vw | $388.80 | $486.00 | $33.25–$437.40 | — | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 Xray finger(s) read | $38.40 | $48.00 | $7.61–$48.00 | 85% below | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-ray exam of finger(s) | $288.00 | $360.00 | $39.51–$324.00 | 12% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xray finger(s) read LT | $39.20 | $49.00 | $7.61–$49.00 | 85% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xray finger(s) read RT | $39.20 | $49.00 | $7.61–$49.00 | 85% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 X-ray exam of finger(s) LT | $288.80 | $361.00 | $39.51–$324.90 | 12% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 X-ray exam of finger(s) RT | $288.80 | $361.00 | $39.51–$324.90 | 12% above | 20% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 Xray finger(s) read | $38.40 | $48.00 | $7.61–$48.00 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-ray exam of finger(s) | $288.00 | $360.00 | $39.51–$324.00 | — | 20% |
| X-ray of the foot, 2 views CPT 73620 Xray foot 2vw read | $47.20 | $59.00 | $8.77–$53.59 | 82% below | 20% |
| X-ray of the foot, 2 views CPT 73620 X-ray exam foot 2vw | $321.60 | $402.00 | $29.44–$361.80 | 21% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 Xray foot 2vw read RT | $47.20 | $59.00 | $8.77–$53.59 | 82% below | 20% |
| X-ray of the foot, 2 views one side CPT 73620 Xray foot 2vw read LT | $47.20 | $59.00 | $8.77–$53.59 | 82% below | 20% |
| X-ray of the foot, 2 views one side CPT 73620 X-ray exam foot 2vw LT | $322.40 | $403.00 | $29.44–$362.70 | 21% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 X-ray exam foot 2vw RT | $322.40 | $403.00 | $29.44–$362.70 | 21% above | 20% |
| X-ray of the foot, 2 views inpatient CPT 73620 Xray foot 2vw read | $47.20 | $59.00 | $8.77–$53.59 | — | 20% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-ray exam foot 2vw | $321.60 | $402.00 | $29.44–$361.80 | — | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 Xray foot 3+ vws rd | $52.00 | $65.00 | $9.15–$64.90 | 82% below | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-ray exam foot 3+vw | $377.20 | $471.50 | $35.32–$424.35 | 33% above | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xray foot 3+ vws rd RT | $52.80 | $66.00 | $9.15–$64.90 | 81% below | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xray foot 3+ vws rd LT | $52.80 | $66.00 | $9.15–$64.90 | 81% below | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 X-ray exam foot 3+vw LT | $416.80 | $521.00 | $35.32–$468.90 | 47% above | 20% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Xray foot 3+ vws rd | $52.00 | $65.00 | $9.15–$64.90 | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-ray exam foot 3+vw | $377.20 | $471.50 | $35.32–$424.35 | — | 20% |
| X-ray of the hand, 3 or more views CPT 73130 Xray hand 3+ vws read | $53.60 | $67.00 | $9.94–$67.00 | 81% below | 20% |
| X-ray of the hand, 3 or more views CPT 73130 X-ray exam hand complete | $366.40 | $458.00 | $38.43–$412.20 | 30% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xray hand 3+ vws read RT | $54.40 | $68.00 | $9.94–$68.00 | 81% below | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xray hand 3+ vws read LT | $54.40 | $68.00 | $9.94–$68.00 | 81% below | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 X-ray exam hand complete LT | $366.40 | $458.00 | $38.43–$412.20 | 30% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 X-ray exam hand complete RT | $366.40 | $458.00 | $38.43–$412.20 | 30% above | 20% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 Xray hand 3+ vws read | $53.60 | $67.00 | $9.94–$67.00 | — | 20% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-ray exam hand complete | $366.40 | $458.00 | $38.43–$412.20 | — | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 Xray knee 1/2vws read | $52.80 | $66.00 | $9.16–$64.90 | 80% below | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-ray exam knee 1/2vw | $410.40 | $513.00 | $35.33–$461.70 | 58% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xray knee 1/2vws read RT | $53.60 | $67.00 | $9.16–$64.90 | 79% below | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xray knee 1/2vws read LT | $53.60 | $67.00 | $9.16–$64.90 | 79% below | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 X-ray exam knee 1/2vw RT | $372.00 | $465.00 | $35.33–$418.50 | 43% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 X-ray exam knee 1/2vw LT | $411.20 | $514.00 | $35.33–$462.60 | 58% above | 20% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 Xray knee 1/2vws read | $52.80 | $66.00 | $9.16–$64.90 | — | 20% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-ray exam knee 1/2vw | $410.40 | $513.00 | $35.33–$461.70 | — | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-ray exam knee 1/2vw RT | $372.00 | $465.00 | $35.33–$418.50 | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xray lumbosacral 2-3vw rd | $64.80 | $81.00 | $12.26–$75.62 | 80% below | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray exam lumbosacral, 2-3vw | $504.00 | $630.00 | $41.15–$567.00 | 57% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Xray lumbosacral 2-3vw rd | $64.80 | $81.00 | $12.26–$75.62 | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-ray exam lumbosacral, 2-3vw | $504.00 | $630.00 | $41.15–$567.00 | — | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 Xray lumbosacral 4/>vws rd | $94.40 | $118.00 | $14.47–$106.20 | 79% below | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray exam l-2 spine 4/>vws | $624.00 | $780.00 | $53.56–$702.00 | 39% above | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Xray lumbosacral 4/>vws rd | $94.40 | $118.00 | $14.47–$106.20 | — | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-ray exam l-2 spine 4/>vws | $624.00 | $780.00 | $53.56–$702.00 | — | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xray thoracic spine 2vws rd | $64.00 | $80.00 | $11.07–$72.00 | 78% below | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray exam thorac spine 2vws | $557.60 | $697.00 | $33.89–$627.30 | 93% above | 20% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Xray thoracic spine 2vws rd | $64.00 | $80.00 | $11.07–$72.00 | — | 20% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-ray exam thorac spine 2vws | $557.60 | $697.00 | $33.89–$627.30 | — | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xray exm nasal bones 3+v rd | $46.40 | $58.00 | $9.55–$58.00 | 81% below | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-ray exam of nasal bones | $507.20 | $634.00 | $38.77–$570.60 | 103% above | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Xray exm nasal bones 3+v rd | $46.40 | $58.00 | $9.55–$58.00 | — | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-ray exam of nasal bones | $507.20 | $634.00 | $38.77–$570.60 | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xray c-spine 2-3 vw read | $67.20 | $84.00 | $11.86–$75.60 | 79% below | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray exam neck spine 2-3 vw | $408.00 | $510.00 | $40.79–$459.00 | 30% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Xray c-spine 2-3 vw read | $67.20 | $84.00 | $11.86–$75.60 | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-ray exam neck spine 2-3 vw | $408.00 | $510.00 | $40.79–$459.00 | — | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xray pelvis 1-2vw read | $68.80 | $86.00 | $9.55–$77.40 | 75% below | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray exam of pelvis, 1-2 vw" | $379.20 | $474.00 | $28.73–$426.60 | 38% above | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Xray pelvis 1-2vw read | $68.80 | $86.00 | $9.55–$77.40 | — | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-ray exam of pelvis, 1-2 vw" | $379.20 | $474.00 | $28.73–$426.60 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xray sacrum/coccyx 2+vws rd | $65.60 | $82.00 | $9.55–$73.80 | 72% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray exam sacrm/coccyx,min 2v | $489.60 | $612.00 | $33.58–$550.80 | 109% above | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Xray sacrum/coccyx 2+vws rd | $65.60 | $82.00 | $9.55–$73.80 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-ray exam sacrm/coccyx,min 2v | $489.60 | $612.00 | $33.58–$550.80 | — | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine amino (alt)(sgpt) | $56.00 | $70.00 | $4.31–$63.00 | 46% above | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase (ast)(sgot) | $57.60 | $72.00 | $4.21–$64.80 | 58% above | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis panel acute | $390.80 | $488.50 | $38.75–$439.65 | 63% above | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis panel acute | $390.80 | $488.50 | $38.75–$439.65 | — | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allg spec ige crude xtrc ea | $28.80 | $36.00 | $4.25–$32.40 | 8% above | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp antibody | $123.20 | $154.00 | $10.53–$138.60 | 59% above | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibodies | $131.20 | $164.00 | $9.84–$147.60 | 107% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP | $148.80 | $186.00 | $31.94–$167.40 | 20% below | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Assay of natriuretic peptide | $328.00 | $410.00 | $31.94–$369.00 | 77% above | 20% |
| Basic metabolic panel (blood test) CPT 80048 BMP, calcium total | $92.40 | $115.50 | $6.88–$103.95 | 29% above | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP, calcium total | $92.40 | $115.50 | $6.88–$103.95 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical pathology, gross & microscopic exam | $189.60 | $237.00 | $71.24–$213.30 | 6% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical pathology, gross & microscopic exam | $189.60 | $237.00 | $71.24–$213.30 | — | 20% |
| Blood culture for bacteria CPT 87040 Blood culture for bacteria | $113.60 | $142.00 | $8.40–$127.80 | 11% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine venipuncture | $33.60 | $42.00 | $2.70–$37.80 | 35% above | 20% |
| Blood glucose (sugar) test CPT 82947 Assay of gluclose blood quant | $53.60 | $67.00 | $3.20–$60.30 | 53% above | 20% |
| Blood lead test CPT 83655 Assay of lead | $126.40 | $158.00 | $9.85–$142.20 | 126% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic gonadotropin assay | $86.40 | $108.00 | $6.12–$97.20 | 22% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing serologic abo | $83.20 | $104.00 | $2.43–$93.60 | 29% above | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein | $86.40 | $108.00 | $4.21–$97.20 | 56% above | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C diff amplified probe | $222.40 | $278.00 | $30.32–$250.20 | 28% above | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay tumor ca 19-9 | $244.80 | $306.00 | $16.93–$275.40 | 123% above | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay tumor ca 125 | $259.20 | $324.00 | $16.93–$291.60 | 120% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 covid-19 amp prb | $213.60 | $267.00 | $41.74–$240.30 | 149% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trach dna amp probe | $276.00 | $345.00 | $28.55–$310.50 | 106% above | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel | $127.20 | $159.00 | $10.89–$143.10 | 45% above | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid panel | $127.20 | $159.00 | $10.89–$143.10 | — | 20% |
| Complete blood count (CBC) with differential CPT 85025 Complete cbc w/auto diff wbc | $95.20 | $119.00 | $6.32–$107.10 | 73% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 Complete cbc automated | $60.80 | $76.00 | $5.26–$68.40 | 36% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 Complete cbc automated | $80.80 | $101.00 | $5.26–$90.90 | 80% above | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete cbc automated | $60.80 | $76.00 | $5.26–$68.40 | — | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehen metabolic panel | $115.60 | $144.50 | $8.59–$130.05 | 38% above | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen metabolic panel | $115.60 | $144.50 | $8.59–$130.05 | — | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 Fibrin degrdtn, D-Dimer; quant | $136.80 | $171.00 | $8.28–$153.90 | 19% above | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrostero(DHEA-S) | $249.60 | $312.00 | $18.08–$280.80 | 88% above | 20% |
| Estradiol blood test CPT 82670 Assay of estradiol | $213.60 | $267.00 | $22.73–$240.30 | 54% above | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 Assay of gonadotropin (fsh) | $165.60 | $207.00 | $15.11–$186.30 | 73% above | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Assay for calprotectin fecal | $191.20 | $239.00 | $15.97–$215.10 | 8% above | 20% |
| Ferritin blood test (iron stores) CPT 82728 Assay of ferritin | $136.80 | $171.00 | $11.09–$153.90 | 43% above | 20% |
| Folate (folic acid) blood test CPT 82746 Assay of folic acid serum | $153.60 | $192.00 | $11.96–$172.80 | 45% above | 20% |
| Free T3 thyroid hormone test CPT 84481 Free assay (ft-3) | $196.80 | $246.00 | $13.78–$221.40 | 127% above | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Assay of free thyroxine | $130.40 | $163.00 | $7.34–$146.70 | 104% above | 20% |
| Free testosterone test CPT 84402 Assay of free testosterone | $304.00 | $380.00 | $20.72–$342.00 | 143% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HEALTH PANEL - GEN'L | $288.80 | $361.00 | $27.00–$324.90 | 29% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel | $309.20 | $386.50 | $27.00–$347.85 | 38% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HEALTH PANEL - GEN'L | $288.80 | $361.00 | $27.00–$324.90 | — | 20% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General health panel | $309.20 | $386.50 | $27.00–$347.85 | — | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose test | $70.40 | $88.00 | $3.86–$79.20 | 97% above | 20% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose tolerance test (gtt) | $136.80 | $171.00 | $10.47–$153.90 | 110% above | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.gonorrehoeae amp prob | $282.40 | $353.00 | $28.55–$317.70 | 111% above | 20% |
| H. pylori antibody blood test CPT 86677 Helicobacter pylori antibody | $237.60 | $297.00 | $13.71–$267.30 | 186% above | 20% |
| H. pylori stool antigen test CPT 87338 Hpylori stool ag ia | $132.00 | $165.00 | $11.70–$148.50 | 5% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 quantreverse trnscrpj | $332.00 | $415.00 | $69.23–$373.50 | 13% below | 20% |
| HIV-1 and HIV-2 antibody test CPT 86703 Hiv-1/hiv-2 1 result antbdy | $192.80 | $241.00 | $11.15–$216.90 | 125% above | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 ag w/hiv-12 ab ag ia | $120.80 | $151.00 | $19.59–$135.90 | 24% above | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES | $155.20 | $194.00 | $28.55–$174.60 | 9% above | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycosylated hemoglobin test | $76.80 | $96.00 | $7.90–$86.40 | 10% above | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep b surface antibody | $117.60 | $147.00 | $8.74–$132.30 | 70% above | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis b surface ag ia | $116.00 | $145.00 | $8.40–$130.50 | 75% above | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis c ab test | $184.80 | $231.00 | $11.61–$207.90 | 122% above | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C revrs trnscrpj | $625.60 | $782.00 | $34.85–$703.80 | 94% above | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes simplex type 1 test | $176.80 | $221.00 | $10.73–$198.90 | 156% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes simplex type 2 test | $196.80 | $246.00 | $15.74–$221.40 | 128% above | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein hs | $120.00 | $150.00 | $10.53–$135.00 | 77% above | 20% |
| Homocysteine blood test CPT 83090 Assay of homocysteine | $201.60 | $252.00 | $14.58–$226.80 | 72% above | 20% |
| Insulin blood test CPT 83525 Assay of insulin | $142.40 | $178.00 | $9.30–$160.20 | 79% above | 20% |
| Iron blood test (serum iron) CPT 83540 Assay of iron | $70.40 | $88.00 | $5.26–$79.20 | 50% above | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity | $99.20 | $124.00 | $7.11–$111.60 | 65% above | 20% |
| Kidney function blood test panel CPT 80069 Renal function panel | $86.40 | $108.00 | $7.06–$97.20 | 33% above | 20% |
| Kidney function blood test panel inpatient CPT 80069 Renal function panel | $86.40 | $108.00 | $7.06–$97.20 | — | 20% |
| LH (luteinizing hormone) test CPT 83002 Assay of gonadotropin (lh) | $174.40 | $218.00 | $15.07–$196.20 | 92% above | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 Assay of lipase | $86.40 | $108.00 | $5.61–$97.20 | 22% above | 20% |
| Liver function blood test panel CPT 80076 Hepatic function panel | $110.80 | $138.50 | $6.65–$124.65 | 89% above | 20% |
| Liver function blood test panel inpatient CPT 80076 Hepatic function panel | $110.80 | $138.50 | $6.65–$124.65 | — | 20% |
| Lyme disease antibody test CPT 86618 Lyme disease antibody | $200.80 | $251.00 | $13.85–$225.90 | 125% above | 20% |
| Magnesium blood test CPT 83735 Assay of magnesium | $75.20 | $94.00 | $5.45–$84.60 | 49% above | 20% |
| Measles (rubeola) antibody test CPT 86765 Rubeola (measles) antibody | $146.40 | $183.00 | $10.48–$164.70 | 106% above | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibody screen | $64.00 | $80.00 | $4.21–$72.00 | 43% above | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of psa free | $184.80 | $231.00 | $14.96–$207.90 | 98% above | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of psa total | $153.60 | $192.00 | $14.96–$172.80 | 49% above | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 AUTOMATED PAP REQ MANL REVIE | $154.40 | $193.00 | $21.65–$173.70 | 87% above | 20% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopath c/v thin layer | $134.40 | $168.00 | $16.48–$151.20 | 87% above | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 Assay of parathormone | $388.00 | $485.00 | $33.58–$436.50 | 77% above | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time partial | $67.20 | $84.00 | $4.89–$75.60 | 73% above | 20% |
| Progesterone blood test CPT 84144 Assay of progesterone | $235.20 | $294.00 | $16.97–$264.60 | 141% above | 20% |
| Prolactin blood test CPT 84146 Assay of prolactin | $188.80 | $236.00 | $15.77–$212.40 | 88% above | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time | $57.60 | $72.00 | $3.49–$64.80 | 44% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug scrn class list a cntrct | $67.20 | $84.00 | $10.25–$75.60 | 11% below | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test prsmv dir opt obs | $170.40 | $213.00 | $10.25–$191.70 | 126% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug test prsmv dir opt obs | $170.40 | $213.00 | $10.25–$191.70 | — | 20% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza IAADIADOO | $52.80 | $66.00 | $13.46–$59.40 | 21% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep a assay w/optic | $110.40 | $138.00 | $13.45–$124.20 | 45% above | 20% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor quant | $82.40 | $103.00 | $4.61–$92.70 | 129% above | 20% |
| Rubella antibody test (immunity check) CPT 86762 Rubella antibody | $104.00 | $130.00 | $11.71–$117.00 | 52% above | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Rbc sed rate automated | $42.40 | $53.00 | $2.20–$47.70 | 53% above | 20% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen anal/vol/count/mot | $184.80 | $231.00 | $10.01–$207.90 | 125% above | 20% |
| Stool ova and parasites exam CPT 87177 Ova and parasites smears | $95.20 | $119.00 | $7.24–$107.10 | 68% above | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult blood feces | $40.80 | $51.00 | $3.56–$45.90 | 50% above | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Assay test for blood fecal | $74.40 | $93.00 | $12.95–$83.70 | 1% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis test non-trep qual | $62.40 | $78.00 | $3.47–$70.20 | 131% above | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test-QuantiFERON Gold | $189.60 | $237.00 | $50.42–$213.30 | 8% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Assay of total testosterone | $230.40 | $288.00 | $21.00–$259.20 | 95% above | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibody each | $184.80 | $231.00 | $11.84–$207.90 | 139% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay thyroid stim hormone | $155.20 | $194.00 | $13.67–$174.60 | 47% above | 20% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis amplif | $136.80 | $171.00 | $28.55–$153.90 | 26% above | 20% |
| Uric acid blood test CPT 84550 Assay of blood/uric acid | $53.60 | $67.00 | $3.68–$60.30 | 47% above | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis auto w/scope | $41.20 | $51.50 | $2.58–$46.35 | 13% above | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis auto w/scope | $41.20 | $51.50 | $2.58–$46.35 | — | 20% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis nonauto w/scope | $41.20 | $51.50 | $3.27–$46.35 | 141% above | 20% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis nonauto w/scope | $41.20 | $51.50 | $3.27–$46.35 | — | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis auto w/o scope | $33.60 | $42.00 | $1.83–$37.80 | 22% above | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis auto w/o scope | $33.60 | $42.00 | $1.83–$37.80 | — | 20% |
| Urinalysis without microscope exam, manual CPT 81002 Urinealysis nonauto w/o scope | $32.40 | $40.50 | $2.83–$36.45 | 66% above | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinealysis nonauto w/o scope | $32.40 | $40.50 | $2.83–$36.45 | — | 20% |
| Urine culture for bacteria, with colony count CPT 87086 Urine culture/colony count | $94.40 | $118.00 | $6.56–$106.20 | 25% above | 20% |
| Urine pregnancy test, read by color change CPT 81025 Urinary pregnancy test | $53.20 | $66.50 | $7.00–$59.85 | 11% above | 20% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urinary pregnancy test | $53.20 | $66.50 | $7.00–$59.85 | — | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin b-12 | $156.80 | $196.00 | $12.27–$176.40 | 53% above | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 Hydroxy | $171.20 | $214.00 | $24.08–$192.60 | 25% above | 20% |
| Zinc blood test CPT 84630 Assay of zinc | $132.00 | $165.00 | $9.27–$148.50 | 85% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chorionic gonadotropin test | $160.00 | $200.00 | $12.24–$180.00 | 47% above | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Cltx distal fib fx w/o man BL | $872.00 | $1,090.00 | $331.69–$981.00 | 28% above | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Cltx distal fib fx w/o man LT | $872.00 | $1,090.00 | $331.69–$981.00 | 28% above | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Cltx distal fib fx w/o man RT | $872.00 | $1,090.00 | $331.69–$981.00 | 28% above | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Cltx distal fib fx w/o man BL | $872.00 | $1,090.00 | $331.69–$981.00 | — | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Cltx distal fib fx w/o man RT | $872.00 | $1,090.00 | $331.69–$981.00 | — | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Cltx distal fib fx w/o man LT | $872.00 | $1,090.00 | $331.69–$981.00 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Cltx metatasal fx w/o man BL | $732.80 | $916.00 | $229.86–$824.40 | 28% above | 20% |
| Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 Cltx metatasal fx w/o man LT | $732.80 | $916.00 | $229.86–$824.40 | 28% above | 20% |
| Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 Cltx metatasal fx w/o man RT | $732.80 | $916.00 | $229.86–$824.40 | 28% above | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Cltx metatasal fx w/o man BL | $732.80 | $916.00 | $229.86–$824.40 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient one side CPT 28470 Cltx metatasal fx w/o man LT | $732.80 | $916.00 | $229.86–$824.40 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient one side CPT 28470 Cltx metatasal fx w/o man RT | $732.80 | $916.00 | $229.86–$824.40 | — | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion | $566.40 | $708.00 | $155.52–$637.20 | 47% below | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardiopulmonary Resuscitation | $696.00 | $870.00 | $107.99–$783.00 | 35% below | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardiopulmonary Resuscitation | $731.20 | $914.00 | $155.52–$822.60 | 32% below | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardionversion elective ext | $731.20 | $914.00 | $155.52–$822.60 | 32% below | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion | $566.40 | $708.00 | $155.52–$637.20 | — | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardiopulmonary Resuscitation | $696.00 | $870.00 | $107.99–$783.00 | — | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardionversion elective ext | $731.20 | $914.00 | $155.52–$822.60 | — | 20% |
| Cervical biopsy CPT 57500 Biopsy Cervix Sing/Mult Exci | $443.20 | $554.00 | $157.39–$498.60 | 53% below | 20% |
| Cervical biopsy inpatient CPT 57500 Biopsy Cervix Sing/Mult Exci | $443.20 | $554.00 | $157.39–$498.60 | — | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/regionl block | $367.20 | $459.00 | $150.42–$413.10 | 27% below | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/regionl block | $367.20 | $459.00 | $150.42–$413.10 | — | 20% |
| Circumcision, surgical, older than a newborn CPT 54160 Circumcision neonate | $434.40 | $543.00 | $225.33–$488.70 | 4% above | 20% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision neonate | $434.40 | $543.00 | $225.33–$488.70 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cltx fx dist rad w/o man BL | $1,138.40 | $1,423.00 | $361.03–$1,280.70 | 90% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 Cltx fx dist rad w/o man LT | $1,138.40 | $1,423.00 | $361.03–$1,280.70 | 90% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 Cltx fx dist rad w/o man RT | $1,138.40 | $1,423.00 | $361.03–$1,280.70 | 90% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cltx fx dist rad w/o man BL | $1,138.40 | $1,423.00 | $361.03–$1,280.70 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 Cltx fx dist rad w/o man LT | $1,138.40 | $1,423.00 | $361.03–$1,280.70 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 Cltx fx dist rad w/o man RT | $1,138.40 | $1,423.00 | $361.03–$1,280.70 | — | 20% |
| Colonoscopy with polyp removal CPT 45385 Colnscpy w/les rmvl snare pro | $1,192.00 | $1,490.00 | $252.85–$1,341.00 | 26% below | 20% |
| Colonoscopy with polyp removal CPT 45385 Colonoscopy w/les rmvl snare | $2,676.80 | $3,346.00 | $461.38–$3,011.40 | 65% above | 20% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colnscpy w/les rmvl snare pro | $1,192.00 | $1,490.00 | $252.85–$1,341.00 | — | 20% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w/les rmvl snare | $2,676.80 | $3,346.00 | $461.38–$3,011.40 | — | 20% |
| Colonoscopy with tissue sample CPT 45380 Colonoscpy flxbl diag w/bx pro | $940.00 | $1,175.00 | $201.04–$1,057.50 | 51% below | 20% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy flexible diag w/bx | $2,676.80 | $3,346.00 | $442.31–$3,011.40 | 39% above | 20% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscpy flxbl diag w/bx pro | $940.00 | $1,175.00 | $201.04–$1,057.50 | — | 20% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy flexible diag w/bx | $2,676.80 | $3,346.00 | $442.31–$3,011.40 | — | 20% |
| Colonoscopy, diagnostic CPT 45378 Colonoscpy flxbl diag pro | $432.00 | $540.00 | $186.12–$486.00 | 74% below | 20% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy flexible diag | $2,054.40 | $2,568.00 | $345.87–$2,311.20 | 25% above | 20% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscpy flxbl diag pro | $432.00 | $540.00 | $186.12–$486.00 | — | 20% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy flexible diag | $2,054.40 | $2,568.00 | $345.87–$2,311.20 | — | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy cerv-inc vag & biop | $500.00 | $625.00 | $170.92–$562.50 | 6% above | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colposcopy cerv-inc vag & biop | $500.00 | $625.00 | $170.92–$562.50 | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct premalg lesion | $207.20 | $259.00 | $69.48–$233.10 | 6% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct premalg lesion 1st | $240.80 | $301.00 | $55.13–$270.90 | 24% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct premalg lesion | $207.20 | $259.00 | $69.48–$233.10 | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct premalg lesion 1st | $240.80 | $301.00 | $55.13–$270.90 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove imp ear wax lav, BL | $36.80 | $46.00 | $16.54–$41.40 | 67% below | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove impctd earwax lav BL | $116.00 | $145.00 | $16.54–$130.50 | 3% above | 20% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove imp ear wax Lav, LT | $36.80 | $46.00 | $16.54–$41.40 | 67% below | 20% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove imp ear wax lav, RT | $36.80 | $46.00 | $16.54–$41.40 | 67% below | 20% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove impctd earwax lav RT | $58.40 | $73.00 | $16.54–$65.70 | 48% below | 20% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove impctd earwax lav LT | $58.40 | $73.00 | $16.54–$65.70 | 48% below | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove imp ear wax lav, BL | $36.80 | $46.00 | $16.54–$41.40 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove impctd earwax lav BL | $116.00 | $145.00 | $16.54–$130.50 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove imp ear wax lav, RT | $36.80 | $46.00 | $16.54–$41.40 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove imp ear wax Lav, LT | $36.80 | $46.00 | $16.54–$41.40 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove impctd earwax lav RT | $58.40 | $73.00 | $16.54–$65.70 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove impctd earwax lav LT | $58.40 | $73.00 | $16.54–$65.70 | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 Remove impctd earwax instr BL | $128.00 | $160.00 | $48.55–$144.00 | 25% below | 20% |
| Earwax removal with instruments, one ear CPT 69210 Remove imp ear wax instru, BL | $130.40 | $163.00 | $48.55–$146.70 | 23% below | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 Remove imp ear wax instru, RT | $129.60 | $162.00 | $48.55–$145.80 | 24% below | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 Remove imp ear wax instru, LT | $129.60 | $162.00 | $48.55–$145.80 | 24% below | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 Remove impctd earwax instr LT | $171.20 | $214.00 | $48.55–$192.60 | 1% above | 20% |
| Earwax removal with instruments, one ear one side CPT 69210 Remove impctd earwax instr RT | $171.20 | $214.00 | $48.55–$192.60 | 1% above | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Remove impctd earwax instr BL | $128.00 | $160.00 | $48.55–$144.00 | — | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Remove imp ear wax instru, BL | $130.40 | $163.00 | $48.55–$146.70 | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove imp ear wax instru, RT | $129.60 | $162.00 | $48.55–$145.80 | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove imp ear wax instru, LT | $129.60 | $162.00 | $48.55–$145.80 | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove impctd earwax instr LT | $171.20 | $214.00 | $48.55–$192.60 | — | 20% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove impctd earwax instr RT | $171.20 | $214.00 | $48.55–$192.60 | — | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of uterus lining | $304.00 | $380.00 | $103.03–$342.00 | 4% above | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Biopsy of uterus lining | $304.00 | $380.00 | $103.03–$342.00 | — | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmdscpy diag w/spec coll pro | $264.00 | $330.00 | $61.26–$297.00 | 75% below | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy diag w/spec coll | $2,054.40 | $2,568.00 | $191.65–$2,311.20 | 96% above | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmdscpy diag w/spec coll pro | $264.00 | $330.00 | $61.26–$297.00 | — | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmoidoscopy diag w/spec coll | $2,054.40 | $2,568.00 | $191.65–$2,311.20 | — | 20% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Hemrdctmy inter/exte 1 col/grp | $1,048.80 | $1,311.00 | $529.00–$1,179.90 | 72% below | 20% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 Hemrdctmy inter/exte 1 col/grp | $1,048.80 | $1,311.00 | $529.00–$1,179.90 | — | 20% |
| IUD insertion (the device itself billed separately) CPT 58300 Insertion IUD | $316.00 | $395.00 | $105.13–$355.50 | at median | 20% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion IUD | $316.00 | $395.00 | $105.13–$355.50 | — | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D abscess simple/single | $214.40 | $268.00 | $130.22–$241.20 | 43% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D abscess single/simple | $292.00 | $365.00 | $130.22–$328.50 | 22% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drnge-Smpl/Sngl Pro | $398.40 | $498.00 | $116.09–$448.20 | 6% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D absc/cyst simple/single | $461.60 | $577.00 | $116.09–$519.30 | 23% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drnge-Smpl/Sngl Fac | $781.60 | $977.00 | $130.22–$879.30 | 109% above | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D abscess simple/single | $214.40 | $268.00 | $130.22–$241.20 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D abscess single/simple | $292.00 | $365.00 | $130.22–$328.50 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drnge-Smpl/Sngl Pro | $398.40 | $498.00 | $116.09–$448.20 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D absc/cyst simple/single | $461.60 | $577.00 | $116.09–$519.30 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drnge-Smpl/Sngl Fac | $781.60 | $977.00 | $130.22–$879.30 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj tendon sheath/ligament BL | $156.80 | $196.00 | $58.62–$176.40 | 47% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj tendon sheath/ligament,RT | $191.20 | $239.00 | $58.62–$215.10 | 35% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj tendon sheath/ligament,LT | $191.20 | $239.00 | $58.62–$215.10 | 35% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj tendon sheath/ligamnt sing | $225.60 | $282.00 | $37.55–$253.80 | 24% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 Inj tendon sheath/ligament RT | $248.00 | $310.00 | $58.62–$279.00 | 16% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 Inj tendon sheath/ligament LT | $248.00 | $310.00 | $58.62–$279.00 | 16% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj tendon sheath/ligament BL | $156.80 | $196.00 | $58.62–$176.40 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj tendon sheath/ligament,LT | $191.20 | $239.00 | $58.62–$215.10 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj tendon sheath/ligament,RT | $191.20 | $239.00 | $58.62–$215.10 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj tendon sheath/ligamnt sing | $225.60 | $282.00 | $37.55–$253.80 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 Inj tendon sheath/ligament RT | $248.00 | $310.00 | $58.62–$279.00 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 Inj tendon sheath/ligament LT | $248.00 | $310.00 | $58.62–$279.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp/inj maj jnt/brsa w/o us | $212.00 | $265.00 | $65.96–$238.50 | 56% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp/Inj Maj Jnt/Brs W/O US | $245.60 | $307.00 | $65.96–$276.30 | 49% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Asp/inj maj jnt/brsa w/o us RT | $132.00 | $165.00 | $65.96–$148.50 | 73% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Asp/inj maj jnt/brsa w/o us LT | $132.00 | $165.00 | $65.96–$148.50 | 73% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Asp/Inj Maj Jnt/Brs W/O US RT | $213.60 | $267.00 | $65.96–$240.30 | 56% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Asp/Inj Maj Jnt/Brs W/O US LT | $213.60 | $267.00 | $65.96–$240.30 | 56% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Asp/inj maj jnt/brsa w/o us | $212.00 | $265.00 | $65.96–$238.50 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Asp/Inj Maj Jnt/Brs W/O US | $245.60 | $307.00 | $65.96–$276.30 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Asp/inj maj jnt/brsa w/o us RT | $132.00 | $165.00 | $65.96–$148.50 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Asp/inj maj jnt/brsa w/o us LT | $132.00 | $165.00 | $65.96–$148.50 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Asp/Inj Maj Jnt/Brs W/O US RT | $213.60 | $267.00 | $65.96–$240.30 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Asp/Inj Maj Jnt/Brs W/O US LT | $213.60 | $267.00 | $65.96–$240.30 | — | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert drug implant device | $356.80 | $446.00 | $101.99–$401.40 | 33% above | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert drug implant device | $356.80 | $446.00 | $101.99–$401.40 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/inj joint/bursa w/o us | $163.20 | $204.00 | $56.01–$183.60 | 65% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/inj intr jnt/brs w/o us | $268.80 | $336.00 | $56.01–$302.40 | 43% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Intermediate Jnt/Bursa | $872.00 | $1,090.00 | $56.01–$981.00 | 86% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Asp/inj joint/bursa w/o us LT | $179.20 | $224.00 | $56.01–$201.60 | 62% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Asp/inj joint/bursa w/o us RT | $179.20 | $224.00 | $56.01–$201.60 | 62% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Asp/inj intr jnt/brs w/o us RT | $268.80 | $336.00 | $56.01–$302.40 | 43% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Asp/inj intr jnt/brs w/o us LT | $268.80 | $336.00 | $56.01–$302.40 | 43% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp/inj joint/bursa w/o us | $163.20 | $204.00 | $56.01–$183.60 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp/inj intr jnt/brs w/o us | $268.80 | $336.00 | $56.01–$302.40 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp/Inj Intermediate Jnt/Bursa | $872.00 | $1,090.00 | $56.01–$981.00 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Asp/inj joint/bursa w/o us LT | $179.20 | $224.00 | $56.01–$201.60 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Asp/inj joint/bursa w/o us RT | $179.20 | $224.00 | $56.01–$201.60 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Asp/inj intr jnt/brs w/o us RT | $268.80 | $336.00 | $56.01–$302.40 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Asp/inj intr jnt/brs w/o us LT | $268.80 | $336.00 | $56.01–$302.40 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj joint/bursa w/o us BL | $128.80 | $161.00 | $54.65–$144.90 | 67% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RF 4th | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RF 3rd | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RF 2nd | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RF grt | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LF 5th | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LF 4th | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LF 3rd | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LF 2nd | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LH thum | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RH lttl | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RH ring | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RH midd | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RH inde | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RH thum | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LH lttl | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LH ring | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LH midd | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LH inde | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Sm Joint/Bursa w/o US | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o LF grt | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj sm jnt/brs w/o RF 5th | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous LF 5th | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us LH inde | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us LH midd | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us LH ring | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us LH lttl | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us RH thum | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us RH inde | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us RH midd | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us RH ring | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us RH lttl | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/o us LH thum | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous LF 2nd | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous LF 3rd | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous LF 4th | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous RF great | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous RF 2nd | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous RF 3rd | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous RF 4th | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous RF 5th | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/inj jnt/brs w/ous LF great | $182.40 | $228.00 | $54.65–$205.20 | 54% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Small Joint/Bursa | $872.00 | $1,090.00 | $54.65–$981.00 | 121% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Asp/inj smll jnt/brs w/o us RT | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Asp/inj smll jnt/brs w/o us LT | $167.20 | $209.00 | $54.65–$188.10 | 58% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Asp/inj joint/bursa w/o us LT | $192.00 | $240.00 | $54.65–$216.00 | 51% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj joint/bursa w/o us BL | $128.80 | $161.00 | $54.65–$144.90 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LF 3rd | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RH thum | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RH ring | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RH lttl | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LH thum | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LF 2nd | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LF 4th | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LF 5th | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RF grt | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RF 2nd | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RF 3rd | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RF 4th | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RH midd | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RF 5th | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LF grt | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o RH inde | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/Inj Sm Joint/Bursa w/o US | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LH inde | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LH midd | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LH ring | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj sm jnt/brs w/o LH lttl | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous LF 3rd | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us LH inde | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us LH midd | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us LH ring | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us LH lttl | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us RH thum | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us RH inde | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us RH midd | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us RH ring | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us RH lttl | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/o us LH thum | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous LF 2nd | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous LF 4th | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous LF 5th | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous RF great | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous RF 2nd | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous RF 3rd | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous RF 4th | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous RF 5th | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/inj jnt/brs w/ous LF great | $182.40 | $228.00 | $54.65–$205.20 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/Inj Small Joint/Bursa | $872.00 | $1,090.00 | $54.65–$981.00 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Asp/inj smll jnt/brs w/o us LT | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Asp/inj smll jnt/brs w/o us RT | $167.20 | $209.00 | $54.65–$188.10 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Asp/inj joint/bursa w/o us LT | $192.00 | $240.00 | $54.65–$216.00 | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Rpr of tong lac over 2.6cm | $445.60 | $557.00 | $269.66–$501.30 | 30% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd rpr s/a/t/ext 2.5 cm/< | $492.00 | $615.00 | $269.66–$553.50 | 22% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Rpr tong lac over 2.6cm | $656.40 | $820.50 | $152.68–$738.45 | 4% above | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd rpr s/a/t/ext 2.5 cm/< | $492.00 | $615.00 | $269.66–$553.50 | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc tr-ext b9+marg 0.5 cm< | $323.20 | $404.00 | $132.04–$363.60 | 58% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc tr-ext b9+marg 0.5 cm< | $323.20 | $404.00 | $132.04–$363.60 | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc face-mm b9+marg 0.5 cm/< | $375.20 | $469.00 | $147.87–$422.10 | 53% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc face-mm b9+marg 0.5 cm/< | $375.20 | $469.00 | $147.87–$422.10 | — | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 2nd fing | $192.00 | $240.00 | $117.91–$216.00 | 31% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 4th | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 3rd | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 5th fing | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,RH thumb | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,RH 2nd fing | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,RH 3rd fing | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,RH 4th fing | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,RH 5th fing | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH thumb | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, LF 2nd toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, LF 3rd toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, LF 4th toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, LF 5th toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, RF great | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, RF 2nd toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, RF 3rd toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, RF 4th toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, RF 5th toe | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate, LF great | $201.60 | $252.00 | $117.91–$226.80 | 28% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 4th fing | $203.20 | $254.00 | $117.91–$228.60 | 27% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 3rd fing | $203.20 | $254.00 | $117.91–$228.60 | 27% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal nail plate,LH 2nd fing | $203.20 | $254.00 | $117.91–$228.60 | 27% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Remov single nail plate;simple | $224.80 | $281.00 | $117.91–$252.90 | 20% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Removal Nail Plate:First | $781.60 | $977.00 | $117.91–$879.30 | 179% above | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Removal nail plate,LH 2nd fing | $192.00 | $240.00 | $117.91–$216.00 | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Remov single nail plate;simple | $224.80 | $281.00 | $117.91–$252.90 | — | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Inj aa/strd grt ocpl nrv BL | $287.20 | $359.00 | $75.81–$323.10 | 56% below | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Inj aa/strd grtr occip nrv BL | $292.80 | $366.00 | $75.81–$329.40 | 55% below | 20% |
| Occipital nerve block (injection for headaches) one side CPT 64405 Inj aa/strd grtr occip nrv LT | $292.80 | $366.00 | $75.81–$329.40 | 55% below | 20% |
| Occipital nerve block (injection for headaches) one side CPT 64405 Inj aa/strd grtr occip nrv RT | $292.80 | $366.00 | $75.81–$329.40 | 55% below | 20% |
| Occipital nerve block (injection for headaches) one side CPT 64405 Inj aa/strd grt ocpl nrv RT | $379.20 | $474.00 | $75.81–$426.60 | 42% below | 20% |
| Occipital nerve block (injection for headaches) one side CPT 64405 Inj aa/strd grt ocpl nrv LT | $379.20 | $474.00 | $75.81–$426.60 | 42% below | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj aa/strd grt ocpl nrv BL | $287.20 | $359.00 | $75.81–$323.10 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj aa/strd grtr occip nrv BL | $292.80 | $366.00 | $75.81–$329.40 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient one side CPT 64405 Inj aa/strd grtr occip nrv LT | $292.80 | $366.00 | $75.81–$329.40 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient one side CPT 64405 Inj aa/strd grtr occip nrv RT | $292.80 | $366.00 | $75.81–$329.40 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient one side CPT 64405 Inj aa/strd grt ocpl nrv LT | $379.20 | $474.00 | $75.81–$426.60 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient one side CPT 64405 Inj aa/strd grt ocpl nrv RT | $379.20 | $474.00 | $75.81–$426.60 | — | 20% |
| Paracentesis with imaging guidance CPT 49083 Paracntsis abdom dx/ther w/gui | $808.80 | $1,011.00 | $297.75–$909.90 | 30% below | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 Paracntsis abdom dx/ther w/gui | $808.80 | $1,011.00 | $297.75–$909.90 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LF 3rd toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RF great | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 2nd fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 3rd fng | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LF 5th toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LF 4th toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH thumb | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 5th fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 4th fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 2nd fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 5th fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH thumb | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LF 2nd toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RF 5th toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RF 4th toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 3rd fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RF 3rd toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 4th fing | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RF 2nd toe | $457.60 | $572.00 | $164.79–$514.80 | 38% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed | $480.80 | $601.00 | $164.79–$540.90 | 35% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 4th fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 5th fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 5th fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 2nd fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 4th fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, LH 2nd fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal nail bed, RH 3rd fng | $644.80 | $806.00 | $107.92–$725.40 | 13% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Perm Nail Removal | $1,173.60 | $1,467.00 | $164.79–$1,320.30 | 59% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH thumb | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 3rd fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 2nd fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 5th fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 4th fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 3rd fng | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 2nd fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 4th fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 5th fing | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH thumb | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LF 2nd toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LF 3rd toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LF 4th toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LF 5th toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RF great | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RF 2nd toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RF 3rd toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RF 4th toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RF 5th toe | $457.60 | $572.00 | $164.79–$514.80 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed | $480.80 | $601.00 | $164.79–$540.90 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 5th fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 3rd fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 2nd fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 4th fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 4th fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, LH 5th fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal nail bed, RH 2nd fng | $644.80 | $806.00 | $107.92–$725.40 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Perm Nail Removal | $1,173.60 | $1,467.00 | $164.79–$1,320.30 | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Incis/Remove FB Simple | $296.80 | $371.00 | $156.38–$333.90 | 46% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Remove foreign body | $309.60 | $387.00 | $156.38–$348.30 | 43% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Incis/remov FB subq tiss simpl | $470.40 | $588.00 | $117.96–$529.20 | 14% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Incis & Rmvl of Frgn Bdy-Smpl | $1,173.60 | $1,467.00 | $156.38–$1,320.30 | 115% above | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Incis/Remove FB Simple | $296.80 | $371.00 | $156.38–$333.90 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove foreign body | $309.60 | $387.00 | $156.38–$348.30 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Incis/remov FB subq tiss simpl | $470.40 | $588.00 | $117.96–$529.20 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Incis & Rmvl of Frgn Bdy-Smpl | $1,173.60 | $1,467.00 | $156.38–$1,320.30 | — | 20% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon cancer scrnng low risk | $2,054.40 | $2,568.00 | $346.14–$2,311.20 | 37% above | 20% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colon cancer scrnng low risk | $2,054.40 | $2,568.00 | $346.14–$2,311.20 | — | 20% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colon cancer scrnng high risk | $2,054.40 | $2,568.00 | $345.87–$2,311.20 | 26% above | 20% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colon cancer scrnng high risk | $2,054.40 | $2,568.00 | $345.87–$2,311.20 | — | 20% |
| Short arm cast (elbow to hand) CPT 29075 Applic cast forearm BL | $233.60 | $292.00 | $91.09–$262.80 | 47% below | 20% |
| Short arm cast (elbow to hand) CPT 29075 Applic short arm cast BL | $238.40 | $298.00 | $91.09–$268.20 | 46% below | 20% |
| Short arm cast (elbow to hand) one side CPT 29075 Applic short arm cast RT | $238.40 | $298.00 | $91.09–$268.20 | 46% below | 20% |
| Short arm cast (elbow to hand) one side CPT 29075 Applic short arm cast LT | $238.40 | $298.00 | $91.09–$268.20 | 46% below | 20% |
| Short arm cast (elbow to hand) one side CPT 29075 Applic cast forearm RT | $300.80 | $376.00 | $91.09–$338.40 | 32% below | 20% |
| Short arm cast (elbow to hand) one side CPT 29075 Applic cast forearm LT | $300.80 | $376.00 | $91.09–$338.40 | 32% below | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Applic cast forearm BL | $233.60 | $292.00 | $91.09–$262.80 | — | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Applic short arm cast BL | $238.40 | $298.00 | $91.09–$268.20 | — | 20% |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 Applic short arm cast LT | $238.40 | $298.00 | $91.09–$268.20 | — | 20% |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 Applic short arm cast RT | $238.40 | $298.00 | $91.09–$268.20 | — | 20% |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 Applic cast forearm RT | $300.80 | $376.00 | $91.09–$338.40 | — | 20% |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 Applic cast forearm LT | $300.80 | $376.00 | $91.09–$338.40 | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 Applic short arm splint BL | $174.40 | $218.00 | $69.71–$196.20 | 39% below | 20% |
| Short arm splint (forearm and hand) CPT 29125 Applic short arm splint, BL | $207.20 | $259.00 | $69.71–$233.10 | 27% below | 20% |
| Short arm splint (forearm and hand) one side CPT 29125 Applic short arm splint, RT | $207.20 | $259.00 | $69.71–$233.10 | 27% below | 20% |
| Short arm splint (forearm and hand) one side CPT 29125 Applic short arm splint, LT | $207.20 | $259.00 | $69.71–$233.10 | 27% below | 20% |
| Short arm splint (forearm and hand) one side CPT 29125 Applic short arm splint LT | $227.20 | $284.00 | $69.71–$255.60 | 20% below | 20% |
| Short arm splint (forearm and hand) one side CPT 29125 Applic short arm splint RT | $227.20 | $284.00 | $69.71–$255.60 | 20% below | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Applic short arm splint BL | $174.40 | $218.00 | $69.71–$196.20 | — | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Applic short arm splint, BL | $207.20 | $259.00 | $69.71–$233.10 | — | 20% |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 Applic short arm splint, LT | $207.20 | $259.00 | $69.71–$233.10 | — | 20% |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 Applic short arm splint, RT | $207.20 | $259.00 | $69.71–$233.10 | — | 20% |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 Applic short arm splint RT | $227.20 | $284.00 | $69.71–$255.60 | — | 20% |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 Applic short arm splint LT | $227.20 | $284.00 | $69.71–$255.60 | — | 20% |
| Short leg cast (below the knee) CPT 29405 Applic short leg cast BL | $268.80 | $336.00 | $83.26–$302.40 | 24% below | 20% |
| Short leg cast (below the knee) one side CPT 29405 Applic short leg cast RT | $268.80 | $336.00 | $83.26–$302.40 | 24% below | 20% |
| Short leg cast (below the knee) one side CPT 29405 Applic short leg cast LT | $268.80 | $336.00 | $83.26–$302.40 | 24% below | 20% |
| Short leg cast (below the knee) inpatient CPT 29405 Applic short leg cast BL | $268.80 | $336.00 | $83.26–$302.40 | — | 20% |
| Short leg cast (below the knee) inpatient one side CPT 29405 Applic short leg cast LT | $268.80 | $336.00 | $83.26–$302.40 | — | 20% |
| Short leg cast (below the knee) inpatient one side CPT 29405 Applic short leg cast RT | $268.80 | $336.00 | $83.26–$302.40 | — | 20% |
| Short leg splint (calf to foot) CPT 29515 Applic splint short leg BL | $193.60 | $242.00 | $74.84–$217.80 | 45% below | 20% |
| Short leg splint (calf to foot) CPT 29515 Applic short leg splint BL | $285.60 | $357.00 | $74.84–$321.30 | 19% below | 20% |
| Short leg splint (calf to foot) CPT 29515 Application Short Leg Cast | $744.00 | $930.00 | $74.84–$837.00 | 110% above | 20% |
| Short leg splint (calf to foot) one side CPT 29515 Applic splint short leg RT | $208.00 | $260.00 | $74.84–$234.00 | 41% below | 20% |
| Short leg splint (calf to foot) one side CPT 29515 Applic splint short leg LT | $208.00 | $260.00 | $74.84–$234.00 | 41% below | 20% |
| Short leg splint (calf to foot) one side CPT 29515 Applic short leg splint LT | $285.60 | $357.00 | $74.84–$321.30 | 19% below | 20% |
| Short leg splint (calf to foot) one side CPT 29515 Applic short leg splint RT | $285.60 | $357.00 | $74.84–$321.30 | 19% below | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 Applic splint short leg BL | $193.60 | $242.00 | $74.84–$217.80 | — | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 Applic short leg splint BL | $285.60 | $357.00 | $74.84–$321.30 | — | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 Application Short Leg Cast | $744.00 | $930.00 | $74.84–$837.00 | — | 20% |
| Short leg splint (calf to foot) inpatient one side CPT 29515 Applic splint short leg LT | $208.00 | $260.00 | $74.84–$234.00 | — | 20% |
| Short leg splint (calf to foot) inpatient one side CPT 29515 Applic splint short leg RT | $208.00 | $260.00 | $74.84–$234.00 | — | 20% |
| Short leg splint (calf to foot) inpatient one side CPT 29515 Applic short leg splint RT | $285.60 | $357.00 | $74.84–$321.30 | — | 20% |
| Short leg splint (calf to foot) inpatient one side CPT 29515 Applic short leg splint LT | $285.60 | $357.00 | $74.84–$321.30 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr s/n/ax/gen/trk 2.5cm/< | $237.60 | $297.00 | $49.11–$267.30 | 30% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Smp rpr s/n/ax/gn/tk 2.5cm< | $280.80 | $351.00 | $96.14–$315.90 | 17% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr s/n/ax/gen/trnk 2.5cm/< | $501.60 | $627.00 | $96.14–$564.30 | 48% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Sprfl Wnd 2.5cm or less | $744.00 | $930.00 | $96.14–$837.00 | 120% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr s/n/ax/gen/trk 2.5cm/< | $237.60 | $297.00 | $49.11–$267.30 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Smp rpr s/n/ax/gn/tk 2.5cm< | $280.80 | $351.00 | $96.14–$315.90 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr s/n/ax/gen/trnk 2.5cm/< | $501.60 | $627.00 | $96.14–$564.30 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Sprfl Wnd 2.5cm or less | $744.00 | $930.00 | $96.14–$837.00 | — | 20% |
| Skin biopsy, punch, one lesion CPT 11104 Punch bx skin single lesion | $272.00 | $340.00 | $128.47–$306.00 | 20% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Bpsy Skn;Sng Lsn | $1,173.60 | $1,467.00 | $128.47–$1,320.30 | 244% above | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch bx skin single lesion | $272.00 | $340.00 | $128.47–$306.00 | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bpsy Skn;Sng Lsn | $1,173.60 | $1,467.00 | $128.47–$1,320.30 | — | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc tr-ext mal+marg 0.5 cm/< | $442.40 | $553.00 | $202.46–$497.70 | 43% below | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc tr-ext mal+marg 0.5 cm/< | $442.40 | $553.00 | $202.46–$497.70 | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags <w/15 | $217.60 | $272.00 | $94.97–$244.80 | 4% above | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tags <w/15 | $217.60 | $272.00 | $94.97–$244.80 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture, lumb, diag | $383.20 | $479.00 | $148.50–$431.10 | 55% below | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx lmbr spi pnxr | $788.80 | $986.00 | $148.50–$887.40 | 7% below | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal puncture, lumb, diag | $383.20 | $479.00 | $148.50–$431.10 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Dx lmbr spi pnxr | $788.80 | $986.00 | $148.50–$887.40 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Smp rpr s/n/ax/gn/tk 2.6-7.5cm | $394.40 | $493.00 | $116.10–$443.70 | 1% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm | $524.80 | $656.00 | $116.10–$590.40 | 32% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Sprfl Wnd 2.5-7.5cm | $744.00 | $930.00 | $116.10–$837.00 | 87% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Smp rpr s/n/ax/gn/tk 2.6-7.5cm | $394.40 | $493.00 | $116.10–$443.70 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm | $524.80 | $656.00 | $116.10–$590.40 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair Sprfl Wnd 2.5-7.5cm | $744.00 | $930.00 | $116.10–$837.00 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Smp rpr f/e/e/n/l/m 2.5 cm/< | $347.20 | $434.00 | $114.18–$390.60 | 8% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr f/e/e/n/l/m 2.5 cm/< | $630.40 | $788.00 | $114.18–$709.20 | 66% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Smp rpr f/e/e/n/l/m 2.5 cm/< | $347.20 | $434.00 | $114.18–$390.60 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr f/e/e/n/l/m 2.5 cm/< | $630.40 | $788.00 | $114.18–$709.20 | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl bx skin single les | $180.00 | $225.00 | $103.27–$202.50 | 33% below | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bpsy Skn;Sng Lsn | $781.60 | $977.00 | $103.27–$879.30 | 190% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl bx skin single les | $180.00 | $225.00 | $103.27–$202.50 | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bpsy Skn;Sng Lsn | $781.60 | $977.00 | $103.27–$879.30 | — | 20% |
| Thoracentesis with imaging guidance CPT 32555 Aspirate pleura w/ imaging BL | $858.40 | $1,073.00 | $319.46–$965.70 | 37% below | 20% |
| Thoracentesis with imaging guidance one side CPT 32555 Aspirate pleura w/ imaging RT | $1,009.60 | $1,262.00 | $319.46–$1,135.80 | 26% below | 20% |
| Thoracentesis with imaging guidance one side CPT 32555 Aspirate pleura w/ imaging LT | $1,009.60 | $1,262.00 | $319.46–$1,135.80 | 26% below | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate pleura w/ imaging BL | $858.40 | $1,073.00 | $319.46–$965.70 | — | 20% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 Aspirate pleura w/ imaging RT | $1,009.60 | $1,262.00 | $319.46–$1,135.80 | — | 20% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 Aspirate pleura w/ imaging LT | $1,009.60 | $1,262.00 | $319.46–$1,135.80 | — | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj trigger point 1/2 muscl,LT | $100.00 | $125.00 | $53.34–$112.50 | 72% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj trigger point 1/2 muscl,RT | $100.00 | $125.00 | $53.34–$112.50 | 72% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj trigger point 1/2 muscl | $191.20 | $239.00 | $53.34–$215.10 | 47% below | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj trigger point 1/2 muscl,RT | $100.00 | $125.00 | $53.34–$112.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj trigger point 1/2 muscl,LT | $100.00 | $125.00 | $53.34–$112.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj trigger point 1/2 muscl | $191.20 | $239.00 | $53.34–$215.10 | — | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD diag w/balloon dial pro | $720.00 | $900.00 | $154.52–$1,103.58 | 64% below | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD diag w/balloon dialation | $4,304.80 | $5,381.00 | $1,103.58–$4,842.90 | 118% above | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD diag w/balloon dial pro | $720.00 | $900.00 | $154.52–$1,103.58 | — | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD diag w/balloon dialation | $4,304.80 | $5,381.00 | $1,103.58–$4,842.90 | — | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD diag w/biopsy pro | $648.00 | $810.00 | $140.19–$729.00 | 65% below | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD diag w/biopsy | $2,040.80 | $2,551.00 | $385.51–$2,295.90 | 12% above | 20% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD diag w/biopsy pro | $648.00 | $810.00 | $140.19–$729.00 | — | 20% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD diag w/biopsy | $2,040.80 | $2,551.00 | $385.51–$2,295.90 | — | 20% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD w/les rmvl by snare pro | $920.00 | $1,150.00 | $195.95–$1,035.00 | 37% below | 20% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD diag w/les rmvl by snare | $4,304.80 | $5,381.00 | $504.89–$4,842.90 | 195% above | 20% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD w/les rmvl by snare pro | $920.00 | $1,150.00 | $195.95–$1,035.00 | — | 20% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD diag w/les rmvl by snare | $4,304.80 | $5,381.00 | $504.89–$4,842.90 | — | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD diag w/spec collection pro | $576.00 | $720.00 | $125.49–$648.00 | 51% below | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD diag w/spec collection | $2,040.80 | $2,551.00 | $294.41–$2,295.90 | 73% above | 20% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD diag w/spec collection pro | $576.00 | $720.00 | $125.49–$648.00 | — | 20% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD diag w/spec collection | $2,040.80 | $2,551.00 | $294.41–$2,295.90 | — | 20% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct(s) | $2,132.80 | $2,666.00 | $342.45–$2,399.40 | at median | 20% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Removal of sperm duct(s) | $2,132.80 | $2,666.00 | $342.45–$2,399.40 | — | 20% |
| Wart removal, up to 14 warts CPT 17110 Destruct b9 lesion 1-14 | $241.60 | $302.00 | $117.43–$271.80 | 2% above | 20% |
| Wart removal, up to 14 warts CPT 17110 Destruct b9 lesion 2-14 | $317.60 | $397.00 | $72.33–$357.30 | 34% above | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 Destruct b9 lesion 1-14 | $241.60 | $302.00 | $117.43–$271.80 | — | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 Destruct b9 lesion 2-14 | $317.60 | $397.00 | $72.33–$357.30 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb subq tissue 20 sq cm/< | $292.00 | $365.00 | $132.88–$328.50 | 54% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrd Skn,SQ Tis, 1st 20sqcm | $1,173.60 | $1,467.00 | $132.88–$1,320.30 | 87% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb subq tissue 20 sq cm/< | $292.00 | $365.00 | $132.88–$328.50 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debrd Skn,SQ Tis, 1st 20sqcm | $1,173.60 | $1,467.00 | $132.88–$1,320.30 | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $310.40 | $388.00 | $43.73–$349.20 | 67% below | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $310.40 | $388.00 | $43.73–$349.20 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway inhalation treatment | $67.20 | $84.00 | $8.23–$75.60 | 66% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER/INHALATION TX/GLOBAL | $75.20 | $94.00 | $8.23–$84.60 | 62% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway inhalation treatment | $67.20 | $84.00 | $8.23–$75.60 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER/INHALATION TX/GLOBAL | $75.20 | $94.00 | $8.23–$84.60 | — | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care E&M 30-74min Fac | $2,351.20 | $2,939.00 | $274.92–$2,645.10 | 24% below | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care E&M 30-74min Fac | $2,351.20 | $2,939.00 | $274.92–$2,645.10 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Tracing | $184.00 | $230.00 | $6.49–$207.00 | 2% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Tracing | $184.00 | $230.00 | $6.49–$207.00 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER Visit Not Req Phy Fac | $391.20 | $489.00 | $11.26–$440.10 | 67% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER Visit Not Req Phy Fac | $391.20 | $489.00 | $11.26–$440.10 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER Visit Strghtfwrd MDM Fac | $643.20 | $804.00 | $41.12–$723.60 | 59% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER Visit Strghtfwrd MDM Fac | $643.20 | $804.00 | $41.12–$723.60 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER Visit Low Level MDM Fac | $885.60 | $1,107.00 | $69.95–$996.30 | 14% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER Visit Low Level MDM Fac | $885.60 | $1,107.00 | $69.95–$996.30 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER Visit Mod Level MDM Fac | $1,523.20 | $1,904.00 | $118.98–$1,713.60 | 22% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER Visit Mod Level MDM Fac | $1,523.20 | $1,904.00 | $118.98–$1,713.60 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER Visit High Level MDM Fac | $1,996.80 | $2,496.00 | $172.32–$2,246.40 | 4% below | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER Visit High Level MDM Fac | $1,996.80 | $2,496.00 | $172.32–$2,246.40 | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill/ tracing only | $441.60 | $552.00 | $38.96–$496.80 | 25% below | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill/ tracing only | $441.60 | $552.00 | $38.96–$496.80 | — | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 Family psytx w/pt 26-50 min | $364.40 | $455.50 | $107.22–$409.95 | 76% above | 20% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family psytx w/pt 26-50 min | $364.40 | $455.50 | $107.22–$409.95 | — | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 Family psytx w/o pt 26-50 min | $181.20 | $226.50 | $98.66–$203.85 | 3% below | 20% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family psytx w/o pt 26-50 min | $181.20 | $226.50 | $98.66–$203.85 | — | 20% |
| Group psychotherapy session CPT 90853 Group psychotherapy | $102.80 | $128.50 | $29.41–$115.65 | 22% below | 20% |
| Group psychotherapy session inpatient CPT 90853 Group psychotherapy | $102.80 | $128.50 | $29.41–$115.65 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Therapy - Hydra 31-60 min | $195.20 | $244.00 | $33.32–$219.60 | 41% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV therapy-hydra 31-60 min | $270.40 | $338.00 | $33.32–$304.20 | 18% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Therapy - Hydra 31-60 min | $195.20 | $244.00 | $33.32–$219.60 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV therapy-hydra 31-60 min | $270.40 | $338.00 | $33.32–$304.20 | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 Intrave infus therapy 1st hour | $308.00 | $385.00 | $64.54–$346.50 | 20% below | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Intrave infus therapy 1st hour | $308.00 | $385.00 | $64.54–$346.50 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/proph/diag inj sc/im | $54.40 | $68.00 | $14.62–$61.20 | 47% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection; thera, proph,diag | $56.00 | $70.00 | $14.62–$63.00 | 45% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection;Thera, Proph, Diag | $180.00 | $225.00 | $14.62–$202.50 | 77% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/proph/diag inj sc/im | $54.40 | $68.00 | $14.62–$61.20 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection; thera, proph,diag | $56.00 | $70.00 | $14.62–$63.00 | — | 20% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych diagnostic eval >16 min | $195.20 | $244.00 | $130.34–$219.60 | 18% below | 20% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych diagnostic eval >16 min | $195.20 | $244.00 | $130.34–$219.60 | — | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromusic re-edu per 15mn | $94.40 | $118.00 | $33.83–$106.20 | 3% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular re-educ per 15mn | $108.00 | $135.00 | $33.83–$121.50 | 11% above | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromusic re-edu per 15mn | $94.40 | $118.00 | $33.83–$106.20 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular re-educ per 15mn | $108.00 | $135.00 | $33.83–$121.50 | — | 20% |
| New patient office visit, about 30 minutes CPT 99203 Office o/p new low 30-44 min | $294.40 | $368.00 | $114.30–$331.20 | 66% above | 20% |
| New patient office visit, about 30 minutes CPT 99203 Intl Vst Low Lvl MDM 30-44mn | $744.00 | $930.00 | $114.30–$837.00 | 319% above | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office o/p new low 30-44 min | $294.40 | $368.00 | $114.30–$331.20 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Intl Vst Low Lvl MDM 30-44mn | $744.00 | $930.00 | $114.30–$837.00 | — | 20% |
| New patient office visit, about 45 minutes CPT 99204 Office o/p new mod 45-59 min | $405.60 | $507.00 | $171.05–$456.30 | 61% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 Intl Vst Mod Lvl MDM 45-59mn | $744.00 | $930.00 | $171.05–$837.00 | 195% above | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office o/p new mod 45-59 min | $405.60 | $507.00 | $171.05–$456.30 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Intl Vst Mod Lvl MDM 45-59mn | $744.00 | $930.00 | $171.05–$837.00 | — | 20% |
| New patient office visit, about 60 minutes CPT 99205 Office o/p new hi 60-74 min | $480.80 | $601.00 | $225.67–$540.90 | 41% above | 20% |
| New patient office visit, about 60 minutes CPT 99205 Intl Vst High Lvl MDM 60-74mn | $744.00 | $930.00 | $225.67–$837.00 | 119% above | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office o/p new hi 60-74 min | $480.80 | $601.00 | $225.67–$540.90 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Intl Vst High Lvl MDM 60-74mn | $744.00 | $930.00 | $225.67–$837.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office o/p new sf 15-29 min | $184.00 | $230.00 | $73.62–$207.00 | 21% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Intl Vst Strgt Fwd MDM 15-29mn | $744.00 | $930.00 | $73.62–$837.00 | 390% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office o/p new sf 15-29 min | $184.00 | $230.00 | $73.62–$207.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Intl Vst Strgt Fwd MDM 15-29mn | $744.00 | $930.00 | $73.62–$837.00 | — | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT intial ind per 15min | $90.40 | $113.00 | $37.63–$101.70 | 42% above | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 OT therapy eval low compl 30mn | $227.20 | $284.00 | $90.95–$255.60 | 5% above | 20% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT therapy eval low compl 30mn | $227.20 | $284.00 | $90.95–$255.60 | — | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT eval high complexity 45mn | $284.00 | $355.00 | $84.60–$319.50 | 3% above | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT eval high complexity 45mn | $284.00 | $355.00 | $84.60–$319.50 | — | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT eval low complexity 20mn | $227.20 | $284.00 | $84.60–$255.60 | 4% above | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT eval low complexity 20mn | $227.20 | $284.00 | $84.60–$255.60 | — | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT eval mod complexity 30mn | $256.00 | $320.00 | $84.60–$288.00 | 7% above | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT eval mod complexity 30mn | $256.00 | $320.00 | $84.60–$288.00 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy per 15min | $108.00 | $135.00 | $27.85–$121.50 | 54% above | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual therapy per 15min | $108.00 | $135.00 | $27.85–$121.50 | 54% above | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual therapy per 15min | $108.00 | $135.00 | $27.85–$121.50 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy per 15min | $108.00 | $135.00 | $27.85–$121.50 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therpeutic Exer per 15min | $96.00 | $120.00 | $30.41–$108.00 | 3% above | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic indiv per 15mn | $96.00 | $120.00 | $30.41–$108.00 | 3% above | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic indiv per 15mn | $96.00 | $120.00 | $30.41–$108.00 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therpeutic Exer per 15min | $96.00 | $120.00 | $30.41–$108.00 | — | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Prev visit new age 18-39 | $422.40 | $528.00 | $126.15–$475.20 | 293% above | 20% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Prev visit new age 18-39 | $422.40 | $528.00 | $126.15–$475.20 | — | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Prev visit new age 40-64 | $448.80 | $561.00 | $145.24–$504.90 | 318% above | 20% |
| Preventive checkup, new patient aged 65 or older CPT 99387 Init pm e/m new pat 65+ yrs | $539.20 | $674.00 | $157.85–$606.60 | 346% above | 20% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Init pm e/m new pat 65+ yrs | $539.20 | $674.00 | $157.85–$606.60 | — | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Prev visit est age 18-39 | $351.20 | $439.00 | $113.86–$395.10 | 333% above | 20% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Prev visit est age 18-39 | $351.20 | $439.00 | $113.86–$395.10 | — | 20% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Preventative Vst Est- 40-64yrs | $386.40 | $483.00 | $120.98–$434.70 | 260% above | 20% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Preventative Vst Est- 40-64yrs | $386.40 | $483.00 | $120.98–$434.70 | — | 20% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Per pm reeval est pat 65+ yr | $429.60 | $537.00 | $130.36–$483.30 | 255% above | 20% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Per pm reeval est pat 65+ yr | $429.60 | $537.00 | $130.36–$483.30 | — | 20% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psych tst/eval phy/ohcp 1st hr | $205.60 | $257.00 | $120.87–$231.30 | 6% below | 20% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psych tst/eval phy/ohcp 1st hr | $205.60 | $257.00 | $120.87–$231.30 | — | 20% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psytx crisis initial 60 min | $357.20 | $446.50 | $155.23–$401.85 | 40% above | 20% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psytx crisis initial 60 min | $357.20 | $446.50 | $155.23–$401.85 | — | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psytx w/pt 16-37 minutes | $159.60 | $199.50 | $82.58–$179.55 | 12% above | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psytx w/pt 16-37 minutes | $159.60 | $199.50 | $82.58–$179.55 | — | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psytx w/pt 38-52 minutes | $221.60 | $277.00 | $109.01–$249.30 | 5% above | 20% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psytx w/pt 38-52 minutes | $221.60 | $277.00 | $109.01–$249.30 | — | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psytx w/pt 53-60 minutes | $325.20 | $406.50 | $161.44–$365.85 | 16% above | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx w/pt 53-60 minutes | $325.20 | $406.50 | $161.44–$365.85 | — | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smkng cesstion cnslng 3-10min | $48.00 | $60.00 | $12.10–$54.00 | 46% above | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smkng/Tbcc Cessation; 4-10min | $49.60 | $62.00 | $14.55–$55.80 | 51% above | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Cnsl 3-10min-risk fact | $744.00 | $930.00 | $14.55–$837.00 | 2168% above | 20% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smkng cesstion cnslng 3-10min | $48.00 | $60.00 | $12.10–$54.00 | — | 20% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smkng/Tbcc Cessation; 4-10min | $49.60 | $62.00 | $14.55–$55.80 | — | 20% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Cnsl 3-10min-risk fact | $744.00 | $930.00 | $14.55–$837.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office o/p est high 40-54 min | $369.60 | $462.00 | $184.30–$415.80 | 53% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Pt High Lvl MDM 40-54mn | $744.00 | $930.00 | $184.30–$837.00 | 208% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office o/p est high 40-54 min | $369.60 | $462.00 | $184.30–$415.80 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Est Pt High Lvl MDM 40-54mn | $744.00 | $930.00 | $184.30–$837.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office o/p est low 20-29 min | $188.80 | $236.00 | $93.52–$212.40 | 29% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Pt Low Lvl MDM 20-29mn | $744.00 | $930.00 | $93.52–$837.00 | 409% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office o/p est low 20-29 min | $188.80 | $236.00 | $93.52–$212.40 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Est Pt Low Lvl MDM 20-29mn | $744.00 | $930.00 | $93.52–$837.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office o/p est mod 30-39 min | $240.80 | $301.00 | $131.43–$270.90 | 34% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Pt Mod Lvl MDM 30-39mn | $744.00 | $930.00 | $131.43–$837.00 | 314% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office o/p est mod 30-39 min | $240.80 | $301.00 | $131.43–$270.90 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Est Pt Mod Lvl MDM 30-39mn | $744.00 | $930.00 | $131.43–$837.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office o/p est sf 10-19 min | $127.20 | $159.00 | $58.02–$143.10 | 15% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Pt Strgt Fwd MDM 10-19mn | $744.00 | $930.00 | $58.02–$837.00 | 575% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office o/p est sf 10-19 min | $127.20 | $159.00 | $58.02–$143.10 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Est Pt Strgt Fwd MDM 10-19mn | $744.00 | $930.00 | $58.02–$837.00 | — | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office consultation | $404.80 | $506.00 | $109.33–$455.40 | 90% above | 20% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office consultation | $404.80 | $506.00 | $109.33–$455.40 | — | 20% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office consultation | $645.60 | $807.00 | $155.59–$726.30 | 126% above | 20% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office consultation | $645.60 | $807.00 | $155.59–$726.30 | — | 20% |
| Speech and language evaluation CPT 92523 Eval spch/snd prd w/lang eval | $369.60 | $462.00 | $235.56–$415.80 | 4% below | 20% |
| Speech and language evaluation inpatient CPT 92523 Eval spch/snd prd w/lang eval | $369.60 | $462.00 | $235.56–$415.80 | — | 20% |
| Speech therapy session, individual CPT 92507 Trtmt speech/lang/vce/com ind | $312.00 | $390.00 | $79.11–$351.00 | 42% above | 20% |
| Speech therapy session, individual inpatient CPT 92507 Trtmt speech/lang/vce/com ind | $312.00 | $390.00 | $79.11–$351.00 | — | 20% |
| Spirometry (breathing test) CPT 94010 Spirometry prov interp | $54.40 | $68.00 | $9.55–$61.20 | 73% below | 20% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $104.00 | $130.00 | $28.05–$117.00 | 49% below | 20% |
| Spirometry (breathing test) CPT 94010 Spirometry, w/VC Exp Flo w/out | $116.80 | $146.00 | $28.05–$131.40 | 42% below | 20% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry prov interp | $54.40 | $68.00 | $9.55–$61.20 | — | 20% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $104.00 | $130.00 | $28.05–$117.00 | — | 20% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry, w/VC Exp Flo w/out | $116.80 | $146.00 | $28.05–$131.40 | — | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Pre/post bronch dial prointerp | $96.00 | $120.00 | $11.86–$108.00 | 74% below | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Evaluation of wheezing | $204.00 | $255.00 | $40.11–$229.50 | 45% below | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pre/post bronch dial prointerp | $96.00 | $120.00 | $11.86–$108.00 | — | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Evaluation of wheezing | $204.00 | $255.00 | $40.11–$229.50 | — | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Funct therap act per 15min | $111.20 | $139.00 | $36.69–$125.10 | 6% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Functional Actvts per 15mn | $111.20 | $139.00 | $36.69–$125.10 | 6% above | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Funct therap act per 15min | $111.20 | $139.00 | $36.69–$125.10 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Functional Actvts per 15mn | $111.20 | $139.00 | $36.69–$125.10 | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $325.60 | $407.00 | $98.89–$366.30 | 61% above | 20% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 Treadmill w/supv, interp, rep | $490.40 | $613.00 | $73.64–$551.70 | 136% above | 20% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Treadmill w/supv, interp, rep | $490.40 | $613.00 | $73.64–$551.70 | — | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 3 COVID MOD SPIKEVAX 23/24 12YR+ | $132.00 | $165.00 | $88.14–$161.65 | 6% below | 20% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVD19 MDRN(19+) 24/25 Vac PT | $132.00 | $165.00 | $88.14–$161.65 | — | 20% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 3 COVID MOD SPIKEVAX 23/24 12YR+ | $132.00 | $165.00 | $88.14–$161.65 | — | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 9 COVID PFR 23/24 12yrs+ PF Vial | $132.00 | $165.00 | $88.14–$155.90 | 23% below | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 9 COVID PFR 23/24 12yrs+ PF Vial | $132.00 | $165.00 | $88.14–$155.90 | — | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID19 PFIZER 24/25 (19YRS+) | $132.00 | $165.00 | $88.14–$155.90 | — | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA NON HD | $153.60 | $192.00 | $77.90–$185.91 | 24% below | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA NON HD | $153.60 | $192.00 | $77.90–$185.91 | — | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU SHOT SPECIAL- CASH ONLY | $42.40 | $53.00 | $22.35–$47.70 | 88% above | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone Trivalent 19yrs+ | $32.00 | $40.00 | $21.37–$36.00 | — | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU SHOT SPECIAL- CASH ONLY | $42.40 | $53.00 | $22.35–$47.70 | — | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9vhpv vacc 2/3 dose im non HD | $168.40 | $210.50 | $112.44–$310.38 | 38% below | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL PFS W/O NEEDLS 6 SYR | $1,225.60 | $1,532.00 | $310.38–$1,378.80 | 351% above | 20% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9vhpv vacc 2/3 dose im non HD | $168.40 | $210.50 | $112.44–$310.38 | — | 20% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL PFS W/O NEEDLS 6 SYR | $1,225.60 | $1,532.00 | $310.38–$1,378.80 | — | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE | $234.80 | $293.50 | $70.48–$264.15 | 221% above | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS-A VAC 1440 ELU VIAL | $213.17 | $266.46 | $142.33–$101,491.20 | — | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE | $234.80 | $293.50 | $70.48–$264.15 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B/ADULT | $109.60 | $137.00 | $70.38–$123.30 | 33% above | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B/ADULT | $109.60 | $137.00 | $70.38–$123.30 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS-B VAC 20 MCG/1ML SYR | $178.44 | $223.05 | $119.15–$1,407.60 | — | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HIGH DOSE FLU SHOT-CASH ONLY | $100.80 | $126.00 | $67.31–$113.40 | 48% above | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZone High Dose 65+ | $88.00 | $110.00 | $58.76–$99.00 | — | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HIGH DOSE FLU SHOT-CASH ONLY | $100.80 | $126.00 | $67.31–$113.40 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR DRG/ADLT DOS/NON HD | $96.00 | $120.00 | $53.20–$108.00 | 44% below | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR DRG/ADLT DOS/NON HD | $96.00 | $120.00 | $53.20–$108.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MUMPS+MESLS+RUBELLA VAC 1VI | $257.38 | $321.72 | $53.20–$289.55 | — | 20% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCCAL - Menactra; IM | $168.00 | $210.00 | $100.70–$189.00 | 13% below | 20% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCCAL - Menactra; IM | $168.00 | $210.00 | $100.70–$189.00 | — | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 (Prevnar 20) | $656.70 | $820.88 | $159.52–$738.79 | — | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX/ADULT DOSE | $100.40 | $125.50 | $67.04–$133.47 | 36% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX/ADULT DOSE | $100.40 | $125.50 | $67.04–$133.47 | — | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE VIAL | $1,147.37 | $1,434.21 | $766.11–$1,290.79 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD/NON HD | $109.39 | $136.74 | $30.40–$123.07 | 110% above | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD NON HEALTH DEPT | $109.39 | $136.74 | $30.40–$123.07 | 110% above | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TDAP TOXOID 0.5ML | $106.58 | $133.23 | $71.17–$21,830.00 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD/NON HD | $109.39 | $136.74 | $30.40–$123.07 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD NON HEALTH DEPT | $109.39 | $136.74 | $30.40–$123.07 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP ADULT | $109.39 | $136.74 | $37.19–$123.07 | 32% above | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP ADULT | $109.39 | $136.74 | $37.19–$123.07 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP .5 ML SYR | $117.19 | $146.49 | $37.19–$131.84 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm admin 1st component 18> | $20.00 | $25.00 | $13.35–$22.50 | 58% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin; 1st vac | $67.60 | $84.50 | $21.20–$76.05 | 43% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin; 1st administerd | $67.60 | $84.50 | $21.20–$76.05 | 43% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Imm admin 1st component 18> | $20.00 | $25.00 | $13.35–$22.50 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin; 1st vac | $67.60 | $84.50 | $21.20–$76.05 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm admin each add'l 18> | $18.75 | $23.44 | $12.52–$21.10 | 54% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm admin each add'l 18> | $20.00 | $25.00 | $13.35–$22.50 | 50% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin; each add | $35.60 | $44.50 | $14.99–$40.05 | 12% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Imm admin each add'l 18> | $20.00 | $25.00 | $13.35–$22.50 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Admin; each add | $35.60 | $44.50 | $14.99–$40.05 | — | 20% |