Hospital

Chicot Memorial Medical Center

Chicot Memorial Medical Center in Lake Village, AR publishes cash prices for 294 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 Arkansas median for 210 of 293 procedures and below it for 76. By typical cash price it ranks #23 of 28 Arkansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

2729 S. Highway 65 & 82, Lake Village, AR, 71653 Collected Sep 27, 2026 Source price file (870) 265-5351

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 041328 · CMS hospital register

The price file shows no self-pay discount

For 884 of the 906 prices listed here, the cash price in Chicot Memorial Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Chicot Memorial Medical Center in Lake Village, AR:

Jun 6, 2023 Corrective action plan requested
Apr 11, 2024 Case closed

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE LT MIN 3 VIEWS	$218.00	$218.00	$18.00–$109.00	48% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE RT MIN 3V	$218.00	$218.00	$18.00–$109.00	48% above	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE RT MIN 3V	$218.00	$218.00	$18.00–$109.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE LT MIN 3 VIEWS	$218.00	$218.00	$18.00–$109.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOPPLER	$277.00	$277.00	$27.30–$138.50	33% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI LIMITED	$305.00	$305.00	$27.30–$152.50	47% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOPPLER	$277.00	$277.00	$27.30–$138.50	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS BARIUM SW	$632.00	$632.00	$36.00–$316.00	173% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS BARIUM SW	$632.00	$632.00	$36.00–$316.00	—	—
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LT COMPLETE	$287.00	$287.00	$63.40–$143.50	93% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RT COMPLETE	$287.00	$287.00	$63.40–$143.50	93% above	—
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED BILATERAL	$275.00	$275.00	$48.50–$137.50	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT LIMITED	$275.00	$275.00	$48.50–$137.50	91% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT LIMITED	$275.00	$275.00	$48.50–$137.50	91% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CTA CHEST W	$1,125.00	$1,125.00	$174.94–$562.50	3% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST PE PROTOCOL	$1,125.00	$1,125.00	$174.94–$562.50	3% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO	$1,350.00	$1,350.00	$108.30–$675.00	9% below	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD-PELVIS W/C	$1,500.00	$1,500.00	$206.27–$750.00	3% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W/WO	$1,550.00	$1,550.00	$272.95–$775.00	21% below	—
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONT	$1,125.00	$1,125.00	$174.94–$562.50	1% below	—
CT scan of the abdomen with contrast CPT 74160 CT KIDNEY WITH CONTR	$1,125.00	$1,125.00	$174.94–$562.50	1% below	—
CT scan of the abdomen without contrast CPT 74150 CT KIDNEY WO/CONTRAS	$1,125.00	$1,125.00	$107.60–$562.50	27% above	—
CT scan of the abdomen without contrast CPT 74150 CT ABD WO CONT.	$1,125.00	$1,125.00	$107.60–$562.50	27% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O CONTR	$1,125.00	$1,125.00	$107.60–$562.50	43% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO	$1,125.00	$1,125.00	$107.60–$562.50	43% above	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WITHOUT CONT	$1,129.50	$1,129.50	$92.85–$564.75	33% above	—
CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAS	$1,333.85	$1,333.85	$128.91–$666.92	52% above	—
CT scan of the head without and with contrast CPT 70470 CT HEAD WO/W CONTRAS	$1,402.50	$1,402.50	$150.36–$701.25	34% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO	$1,335.85	$1,335.85	$107.60–$667.92	43% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICALW/O	$1,335.85	$1,335.85	$107.60–$667.92	43% above	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTR	$1,307.75	$1,307.75	$174.94–$653.88	24% above	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DOPPLER CAROTID	$772.80	$772.80	$70.00–$386.40	113% above	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 RT CAROTID	$772.80	$772.80	$70.00–$386.40	113% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 RT CAROTID	$772.80	$772.80	$70.00–$386.40	—	—
Chest X-ray, 2 views CPT 71046 XR CHEST PA & LAT	$218.00	$218.00	$21.87–$109.00	52% above	—
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA & LAT	$218.00	$218.00	$21.87–$109.00	—	—
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$218.00	$218.00	$11.86–$109.00	102% above	—
Chest X-ray, single view CPT 71045 XR CHEST PORTABLE	$218.00	$218.00	$11.86–$109.00	102% above	—
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$218.00	$218.00	$11.86–$109.00	—	—
Chest X-ray, single view inpatient CPT 71045 XR CHEST PORTABLE	$218.00	$218.00	$11.86–$109.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL	$281.00	$281.00	$44.00–$140.50	at median	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL	$281.00	$281.00	$44.00–$140.50	at median	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA ABDOMINAL	$281.00	$281.00	$44.00–$140.50	at median	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US ANATOMIC 1ST GEST	$588.00	$588.00	$145.14–$294.00	135% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST LD WO 3-6	$1,423.30	$1,423.30	$107.60–$711.65	84% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WITHOUT CON	$1,423.30	$1,423.30	$107.60–$711.65	84% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRA	$1,335.85	$1,335.85	$144.51–$667.92	31% above	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAM BILAT DIAGNOSTIC	$380.00	$380.00	$111.86–$190.00	—	—
Diagnostic mammogram, both breasts CPT 77066 MAMMO BIL DX DIGITAL	$380.00	$380.00	$111.86–$190.00	82% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT DX DIGITAL	$302.00	$302.00	$87.72–$151.00	101% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM UNILAT DIAGNOSTIC	$302.00	$302.00	$87.72–$151.00	101% above	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 US ABI UPR/LXTR ART STDY3+LV	$436.41	$436.41	$73.00–$221.67	30% above	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DOPP ART BOTH LEG	$837.60	$837.60	$73.00–$418.80	150% above	—
Duplex ultrasound of the leg veins, both legs CPT 93970 US DOPP VEN BOTH UP OR LOWER	$837.60	$837.60	$42.00–$418.80	142% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO COMPLETE	$1,888.95	$1,888.95	$171.26–$944.48	71% above	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED	$373.00	$373.00	$90.40–$186.50	26% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED	$373.00	$373.00	$90.40–$186.50	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PF POLYSOM 6/>YRS CPAP 4/>PA	$2,350.00	$2,350.00	$205.37–$1,175.00	18% below	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/>PA	$2,500.00	$2,500.00	$205.37–$1,250.00	13% below	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PF POLYSOM 6/>YRS CPAP 4/>PA	$2,350.00	$2,350.00	$205.37–$1,175.00	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS CPAP 4/>PA	$2,500.00	$2,500.00	$205.37–$1,250.00	—	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE LT 3 VIEWS	$218.00	$218.00	$35.00–$109.00	42% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE RT 3 VIEW	$218.00	$218.00	$35.00–$109.00	42% above	—
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE RT 3 VIEW	$218.00	$218.00	$35.00–$109.00	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE LT 3 VIEWS	$218.00	$218.00	$35.00–$109.00	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$275.80	$275.80	$20.00–$137.90	4% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$275.80	$275.80	$20.00–$137.90	4% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIMITED SINGLE ORGAN	$287.00	$287.00	$20.00–$143.50	9% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD/RETROPERITONEUM	$287.00	$287.00	$20.00–$143.50	9% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LD WO	$278.00	$278.00	$78.83–$139.00	83% above	—
MRI of both breasts, without and then with contrast dye CPT 77049 MRI BREAST BIL WO &/OR W	$2,665.00	$2,665.00	$265.63–$1,332.50	76% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JOINT LT LOW EXT W/O	$1,800.00	$1,800.00	$177.15–$900.00	72% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JOINT RT LO EXT W/O	$1,800.00	$1,800.00	$177.15–$900.00	72% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI L EXT RT W/WO JOINT	$2,420.00	$2,420.00	$329.10–$1,210.00	85% above	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT	$1,980.00	$1,980.00	$168.62–$990.00	64% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CON	$2,200.00	$2,200.00	$290.98–$1,100.00	74% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRA	$1,980.00	$1,980.00	$170.01–$990.00	58% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTR	$2,420.00	$2,420.00	$275.32–$1,210.00	40% above	—
MRI of the lower back, no contrast dye CPT 72148 MRI LSPINE W/O CONTR	$1,980.00	$1,980.00	$166.91–$990.00	74% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LSPINE W/WO CONT	$2,420.00	$2,420.00	$276.45–$1,210.00	53% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI TSPINE W/O CONTR	$1,980.00	$1,980.00	$165.79–$990.00	94% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CSPINE W/WO CONT	$2,420.00	$2,420.00	$276.17–$1,210.00	48% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CSPINE W/O CONTR	$1,800.00	$1,800.00	$166.07–$900.00	56% above	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONT	$2,200.00	$2,200.00	$289.58–$1,100.00	74% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTR	$1,980.00	$1,980.00	$197.02–$990.00	111% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT LT UP EXT W/O	$1,800.00	$1,800.00	$177.72–$900.00	72% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT RT UP EXT W/O	$1,800.00	$1,800.00	$177.72–$900.00	72% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS (NON-O.B.)	$307.85	$307.85	$40.00–$153.92	15% below	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >14 WK 1ST GES	$287.20	$287.20	$56.00–$143.60	1% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14 WK 1ST GES	$287.00	$287.00	$42.75–$143.50	at median	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$287.00	$287.00	$26.00–$143.50	74% above	—
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT	$307.00	$307.00	$76.65–$153.50	—	—
Screening mammogram, both breasts CPT 77067 MAMMO SCREEN BIL DIGITIAL	$307.00	$307.00	$76.65–$153.50	126% above	—
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT	$307.00	$307.00	$76.65–$153.50	126% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RT 2 VIEWS	$218.00	$218.00	$20.00–$109.00	58% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LT 2 VIEWS	$218.00	$218.00	$20.00–$109.00	58% above	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RT 2 VIEWS	$218.00	$218.00	$20.00–$109.00	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LT 2 VIEWS	$218.00	$218.00	$20.00–$109.00	—	—
Sleep study in a lab (polysomnography) CPT 95810 PF POLYSOM 6/>YRS 4/>PARAM	$2,350.00	$2,350.00	$122.00–$1,175.00	12% above	—
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS 4/>PARAM	$2,491.00	$2,491.00	$122.00–$1,245.50	18% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 PF POLYSOM 6/>YRS 4/>PARAM	$2,350.00	$2,350.00	$122.00–$1,175.00	—	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS 4/>PARAM	$2,491.00	$2,491.00	$122.00–$1,245.50	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR CINE/VID THROAT/ESOP	$290.75	$290.75	$29.00–$174.94	36% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR CINE/VID THROAT/ESOP	$290.75	$290.75	$29.00–$174.94	—	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAG NON OB	$427.75	$427.75	$68.00–$213.88	27% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$343.20	$343.20	$58.50–$171.60	at median	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN	$462.05	$462.05	$56.00–$231.02	2% above	—
Ultrasound of the scrotum and testicles CPT 76870 US TESTICLES CONTENT	$292.85	$292.85	$31.00–$146.42	17% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK-SOFT TISSUE	$287.00	$287.00	$54.00–$143.50	25% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US PAROTID	$287.00	$287.00	$54.00–$143.50	25% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID GLAND	$287.00	$287.00	$54.00–$143.50	25% below	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI	$632.00	$632.00	$30.00–$316.00	164% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOPP RT LEG	$281.00	$281.00	$73.00–$140.50	23% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOPP LT LEG	$281.00	$281.00	$73.00–$140.50	23% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DOPP VENT RT ARM	$281.00	$281.00	$73.00–$140.50	23% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DOPP VEN LT ARM	$281.00	$281.00	$73.00–$140.50	23% below	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST LT MIN 3 VIEWS	$218.00	$218.00	$23.00–$109.00	51% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST RT-MIN 3V	$218.00	$218.00	$23.00–$109.00	51% above	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST RT-MIN 3V	$218.00	$218.00	$23.00–$109.00	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST LT MIN 3 VIEWS	$218.00	$218.00	$23.00–$109.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT W/PELVIS 2-3 VIEWS	$218.00	$218.00	$27.84–$109.00	70% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT W/PELVIS 2-3 VIEWS	$218.00	$218.00	$27.84–$109.00	70% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT W/PELVIS 2-3 VIEWS	$218.00	$218.00	$27.84–$109.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT W/PELVIS 2-3 VIEWS	$218.00	$218.00	$27.84–$109.00	—	—
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$218.00	$218.00	$20.26–$109.00	50% above	—
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMINAL AP/KUB	$218.00	$218.00	$20.26–$109.00	50% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMINAL AP/KUB	$218.00	$218.00	$20.26–$109.00	—	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE RT MIN 2 VIEW	$287.00	$287.00	$27.78–$143.50	155% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE LT MIN 2 VIEW	$287.00	$287.00	$27.78–$143.50	155% above	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE RT MIN 2 VIEW	$287.00	$287.00	$27.78–$143.50	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE LT MIN 2 VIEW	$287.00	$287.00	$27.78–$143.50	—	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS LT MINI 2 VIEWS	$218.00	$218.00	$16.00–$109.00	103% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) RT-MIN 2V	$218.00	$218.00	$16.00–$109.00	103% above	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS LT MINI 2 VIEWS	$218.00	$218.00	$16.00–$109.00	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) RT-MIN 2V	$218.00	$218.00	$16.00–$109.00	—	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT LT MIN 3 VIEWS	$218.00	$218.00	$28.00–$109.00	53% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT RT MIN 3V	$218.00	$218.00	$28.00–$109.00	53% above	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT RT MIN 3V	$218.00	$218.00	$28.00–$109.00	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT LT MIN 3 VIEWS	$218.00	$218.00	$28.00–$109.00	—	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND RT -MIN 3V	$218.00	$218.00	$25.00–$109.00	20% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND LT MIN 3 VIEWS	$218.00	$218.00	$25.00–$109.00	20% above	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND LT MIN 3 VIEWS	$218.00	$218.00	$25.00–$109.00	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND RT -MIN 3V	$218.00	$218.00	$25.00–$109.00	—	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RT 1 OR 2 VIEWS	$218.00	$218.00	$25.00–$109.00	87% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LT 1 OR 2 VIEWS	$218.00	$218.00	$25.00–$109.00	87% above	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LT 1 OR 2 VIEWS	$218.00	$218.00	$25.00–$109.00	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RT 1 OR 2 VIEWS	$218.00	$218.00	$25.00–$109.00	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR 3 VIEWS	$287.00	$287.00	$28.00–$143.50	50% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR 3 VIEWS	$287.00	$287.00	$28.00–$143.50	—	—
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBOSACRAL-5 VIEWS	$287.00	$287.00	$40.00–$143.50	at median	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBOSACRAL-5 VIEWS	$287.00	$287.00	$40.00–$143.50	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC 2V	$287.00	$287.00	$24.00–$143.50	42% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES-MIN 3V	$218.00	$218.00	$23.00–$109.00	103% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES-MIN 3V	$218.00	$218.00	$23.00–$109.00	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL AP & LATERI	$218.00	$218.00	$28.00–$109.00	82% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL AP & LATERI	$218.00	$218.00	$28.00–$109.00	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEW	$287.00	$287.00	$21.00–$143.50	85% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM & COCCYX M 2V	$286.00	$286.00	$17.00–$143.00	133% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM & COCCYX M 2V	$286.00	$286.00	$17.00–$143.00	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT REPEAT	$45.75	$45.75	$5.19–$22.88	72% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$45.75	$45.75	$5.19–$22.88	72% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$41.60	$41.60	$5.08–$20.80	36% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT REPEAT	$41.60	$41.60	$5.08–$20.80	36% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS SCREEN	$120.00	$120.00	$46.68–$68.01	44% below	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS SCREEN REPEAT	$120.00	$120.00	$46.68–$68.01	44% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 IgE GLUTEN	$14.00	$14.00	$5.12–$7.46	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 IgE COW'S MILK	$14.00	$14.00	$5.12–$7.46	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE	$34.68	$34.68	$5.12–$17.34	111% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE REPEAT	$34.68	$34.68	$5.12–$17.34	111% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY ALLERGY PROFILE ADD CHG	$34.68	$34.68	$5.12–$17.34	111% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY ALLERGY PROFILE ADD CHG REP	$34.68	$34.68	$5.12–$17.34	111% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE	$34.68	$34.68	$5.12–$17.34	111% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 14 (PED)	$34.68	$34.68	$5.12–$17.34	111% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB IGG	$120.00	$120.00	$12.69–$60.00	95% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$97.50	$97.50	$11.85–$48.75	96% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA REPEAT	$97.50	$97.50	$11.85–$48.75	96% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$134.80	$134.80	$38.47–$67.40	63% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP REPEAT	$134.80	$134.80	$38.47–$67.40	63% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$134.80	$134.80	$38.47–$67.40	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PAN REPEAT	$94.00	$94.00	$8.29–$47.00	15% below	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PAN	$94.00	$94.00	$8.29–$47.00	15% below	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIS REPEAT	$150.00	$150.00	$28.00–$75.00	40% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIS	$150.00	$150.00	$28.00–$75.00	40% above	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD AERO/A REPEAT	$97.50	$97.50	$10.11–$48.75	46% above	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD AERO/A	$97.50	$97.50	$10.11–$48.75	46% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$23.00	$23.00	$9.02–$23.00	93% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PATERNITY PHLEO	$28.15	$28.15	$9.15–$14.08	136% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING BLOOD REPEAT	$35.60	$35.60	$3.85–$17.80	22% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING BLOO	$35.60	$35.60	$3.85–$17.80	22% above	—
Blood lead test CPT 83655 LEAD LEVEL	$159.15	$159.15	$11.87–$79.58	340% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 RHC HCG QUAL	$18.72	$31.20	$7.37–$15.60	50% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL REPEAT	$31.20	$31.20	$7.37–$15.60	17% below	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL	$31.20	$31.20	$7.37–$15.60	17% below	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 RHC HCG QUAL	$18.72	$31.20	$7.37–$15.60	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 GROUP ABO BLOOD REPEAT	$305.00	$305.00	$2.93–$152.50	421% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 GROUP ABO BLOOD	$305.00	$305.00	$2.93–$152.50	421% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$120.50	$120.50	$5.08–$60.25	201% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN REPEAT	$120.50	$120.50	$5.08–$60.25	201% above	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$53.00	$53.00	$20.39–$29.72	36% below	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$68.60	$68.60	$20.39–$34.30	at median	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 REPEAT	$68.60	$68.60	$20.39–$34.30	at median	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RAPID COVID - 19	$129.00	$129.00	$50.28–$77.00	3% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, RNA REPEAT	$88.00	$88.00	$34.39–$50.12	18% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, RNA	$88.00	$88.00	$34.39–$50.12	18% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NEISSERIA GONORRHROEAE, THROAT	$88.00	$88.00	$34.39–$50.12	18% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE REPEAT	$99.65	$99.65	$13.12–$49.82	21% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$99.65	$99.65	$13.12–$49.82	21% above	—
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF REPEAT	$23.75	$23.75	$7.61–$11.88	51% below	—
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF	$23.75	$23.75	$7.61–$11.88	51% below	—
Complete blood count (CBC), no differential CPT 85027 CBC NO AUTO DIFF REPEAT	$21.10	$21.10	$6.34–$10.55	30% below	—
Complete blood count (CBC), no differential CPT 85027 CBC NO DIFF REPEAT	$21.10	$21.10	$6.34–$10.55	30% below	—
Complete blood count (CBC), no differential CPT 85027 CBC NO DIFF	$21.10	$21.10	$6.34–$10.55	30% below	—
Complete blood count (CBC), no differential CPT 85027 CBC NO AUTO DIFF	$21.10	$21.10	$6.34–$10.55	30% below	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPRE METABOLIC PAN	$113.80	$113.80	$10.35–$56.90	11% below	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPRE METABOLIC PAN REPEAT	$113.80	$113.80	$10.35–$56.90	11% below	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPRE METABOLIC PAN	$113.80	$113.80	$10.35–$56.90	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER LEVEL QUAN REPEAT	$141.00	$141.00	$9.98–$70.50	126% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER LEVEL QUAN	$141.00	$141.00	$9.98–$70.50	126% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEAS	$61.25	$61.25	$21.79–$31.74	12% below	—
Estradiol blood test CPT 82670 ESTRADIOL ULTRA SENS REPEAT	$165.00	$165.00	$27.38–$82.50	59% above	—
Estradiol blood test CPT 82670 ESTRADIOL ULTRA SENS	$165.00	$165.00	$27.38–$82.50	59% above	—
FSH (follicle-stimulating hormone) test CPT 83001 F S H	$198.65	$198.65	$18.21–$99.32	175% above	—
FSH (follicle-stimulating hormone) test CPT 83001 F S H REPEAT	$198.65	$198.65	$18.21–$99.32	175% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, STOOL	$50.00	$50.00	$19.24–$28.33	62% below	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$95.58	$95.58	$19.24–$47.79	28% below	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN SERUM	$107.25	$107.25	$13.36–$53.62	57% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN SERUM REPEAT	$107.25	$107.25	$13.36–$53.62	57% above	—
Folate (folic acid) blood test CPT 82746 FOLIC ACID REPEAT	$97.50	$97.50	$14.41–$48.75	54% above	—
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$97.50	$97.50	$14.41–$48.75	54% above	—
Free T3 thyroid hormone test CPT 84481 FREE T3 REPEAT	$43.00	$43.00	$16.60–$24.19	32% below	—
Free T3 thyroid hormone test CPT 84481 FREE T3	$43.00	$43.00	$16.60–$24.19	32% below	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE REPEAT	$81.50	$81.50	$8.84–$40.75	69% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$81.50	$81.50	$8.84–$40.75	69% above	—
Free testosterone test CPT 84402 TESTOSTERONE FREE REPEAT	$169.40	$169.40	$24.96–$84.70	102% above	—
Free testosterone test CPT 84402 TESTOSTERONE FREE	$169.40	$169.40	$24.96–$84.70	102% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$157.75	$157.75	$23.56–$78.88	9% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GESTATIONAL GLUCOSE SCREE REPEAT	$47.00	$47.00	$4.66–$23.50	36% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GESTATIONAL GLUCOSE SCREE	$47.00	$47.00	$4.66–$23.50	36% above	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$69.90	$69.90	$12.61–$34.95	8% above	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS REPEAT	$69.90	$69.90	$12.61–$34.95	8% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, RNA REPEAT	$88.00	$88.00	$34.39–$50.12	15% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, RNA	$88.00	$88.00	$34.39–$50.12	15% above	—
H. pylori antibody blood test CPT 86677 HELICO PYLORI AB SER REPEAT	$124.20	$124.20	$16.51–$62.10	78% above	—
H. pylori antibody blood test CPT 86677 HELICO PYLORI AB SER	$124.20	$124.20	$16.51–$62.10	78% above	—
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN, STOOL	$36.00	$36.00	$6.12–$18.00	49% below	—
H. pylori stool antigen test CPT 87338 HPYLORI STOOL	$132.00	$132.00	$6.12–$66.00	86% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QN PCR ULT	$274.00	$274.00	$83.40–$137.00	22% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODY	$93.60	$93.60	$23.60–$46.80	17% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODY REPEAT	$93.60	$93.60	$23.60–$46.80	17% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA	$134.00	$134.00	$34.39–$67.00	28% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA REPEAT	$134.00	$134.00	$34.39–$67.00	28% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEM A1C REPEAT	$26.10	$26.10	$9.52–$13.87	33% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEM A1C	$26.10	$26.10	$9.52–$13.87	33% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B ANTIBOBY	$29.55	$29.55	$10.53–$15.33	53% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HBSAB	$29.55	$29.55	$10.53–$15.33	53% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBS AG	$34.20	$34.20	$10.12–$17.10	18% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG	$34.20	$34.20	$10.12–$17.10	18% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG REPEAT	$34.20	$34.20	$10.12–$17.10	18% below	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY REPEAT	$74.45	$74.45	$13.98–$37.22	45% above	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$74.45	$74.45	$13.98–$37.22	45% above	—
Hepatitis C antibody blood test (screening) CPT 86803 ANTI HCV	$75.85	$75.85	$13.98–$37.92	48% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY PCR QT	$222.25	$222.25	$41.98–$111.12	69% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY PCR QT REPEAT	$222.25	$222.25	$41.98–$111.12	69% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SCREEN 1	$76.05	$76.05	$12.93–$38.02	46% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIM.TYPE I IG	$214.35	$214.35	$12.93–$107.18	312% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES IGG TYPE II	$214.35	$214.35	$18.96–$107.18	271% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP REPEAT	$79.50	$79.50	$12.69–$39.75	53% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP	$79.50	$79.50	$12.69–$39.75	53% above	—
Homocysteine blood test CPT 83090 HEMOCYSTEIN LEVEL	$172.30	$172.30	$17.56–$86.15	80% above	—
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$191.00	$191.00	$17.56–$95.50	100% above	—
Insulin blood test CPT 83525 INSULIN LEVEL	$129.55	$129.55	$11.20–$64.78	182% above	—
Iron blood test (serum iron) CPT 83540 IRON	$150.90	$150.90	$6.34–$75.45	392% above	—
Iron blood test (serum iron) CPT 83540 IRON and TIBC %SAT	$150.90	$150.90	$6.34–$75.45	392% above	—
Iron blood test (serum iron) CPT 83540 IRON REPEAT	$150.90	$150.90	$6.34–$75.45	392% above	—
Iron blood test (serum iron) CPT 83540 IRON and TIBC %SAT REPEAT	$150.90	$150.90	$6.34–$75.45	392% above	—
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$97.50	$97.50	$8.57–$48.75	242% above	—
Iron-binding capacity (TIBC) test CPT 83550 TIBC REPEAT	$97.50	$97.50	$8.57–$48.75	242% above	—
Kidney function blood test panel CPT 80069 RENAL PANEL REPEAT	$59.00	$59.00	$8.51–$29.50	28% below	—
Kidney function blood test panel CPT 80069 RENAL PANEL	$59.00	$59.00	$8.51–$29.50	28% below	—
LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORM	$65.15	$65.15	$18.15–$32.58	2% below	—
LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORM REPEAT	$65.15	$65.15	$18.15–$32.58	2% below	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (URINE)	$45.50	$45.50	$6.75–$22.75	50% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$78.70	$78.70	$6.75–$39.35	159% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE REPEAT	$78.70	$78.70	$6.75–$39.35	159% above	—
Liver function blood test panel CPT 80076 HEPATIC PROFILE	$56.95	$56.95	$8.01–$28.48	36% below	—
Liver function blood test panel CPT 80076 HEPATIC PROFILE REPEAT	$56.95	$56.95	$8.01–$28.48	36% below	—
Lyme disease antibody test CPT 86618 LYME DISEASE IGM QUA REPEAT	$136.05	$136.05	$16.69–$68.02	77% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE IGM QUA	$136.05	$136.05	$16.69–$68.02	77% above	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGM QUA	$136.05	$136.05	$16.69–$68.02	—	—
Magnesium blood test CPT 83735 MAGNESIUM, URINE	$17.00	$17.00	$6.57–$9.57	47% below	—
Magnesium blood test CPT 83735 MAGNESIUM RBC	$17.00	$17.00	$6.57–$9.57	47% below	—
Magnesium blood test CPT 83735 MAGNESIUM	$17.00	$17.00	$6.57–$9.57	47% below	—
Magnesium blood test CPT 83735 MAGNESIUM REPEAT	$17.00	$17.00	$6.57–$9.57	47% below	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$38.05	$38.05	$12.62–$19.02	18% below	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN	$35.60	$35.60	$5.08–$17.80	17% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN REPEAT	$35.60	$35.60	$5.08–$17.80	17% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$46.00	$46.00	$18.02–$26.27	17% below	—
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA REPEAT	$46.00	$46.00	$18.02–$26.27	17% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA PROSTATIC SPECIF REPEAT	$84.25	$84.25	$18.02–$42.12	26% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA PROSTATIC SPECIF	$84.25	$84.25	$18.02–$42.12	26% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP REPEAT	$67.00	$67.00	$20.75–$33.50	59% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 IMG GUIDED PAP W AGE BASED SCREENING	$67.00	$67.00	$20.75–$33.50	59% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP	$67.00	$67.00	$20.75–$33.50	59% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE PTH	$104.00	$104.00	$40.45–$58.94	34% below	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE PTH REPEAT	$104.00	$104.00	$40.45–$58.94	34% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT W/ LUPUS ANTICOAG	$47.60	$47.60	$5.89–$23.80	36% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT/THROMBOPLASTIN	$50.20	$50.20	$5.89–$25.10	44% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT/THROMBOPLASTIN REPEAT	$50.20	$50.20	$5.89–$25.10	44% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT W/ LUPUS ANTICOAG	$47.60	$47.60	$5.89–$23.80	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 QNATAL ADVANCED	$1,898.00	$1,898.00	$743.87–$985.80	42% above	—
Progesterone blood test CPT 84144 PROGESTERONE REPEAT	$53.00	$53.00	$20.44–$29.79	12% below	—
Progesterone blood test CPT 84144 PROGESTERONE	$53.00	$53.00	$20.44–$29.79	12% below	—
Prolactin blood test CPT 84146 PROLACTIN LEVEL	$169.40	$169.40	$18.99–$84.70	144% above	—
Prolactin blood test CPT 84146 PROLACTIN LEVEL REPEAT	$169.40	$169.40	$18.99–$84.70	144% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$34.75	$34.75	$4.20–$17.38	28% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME REPEAT	$34.75	$34.75	$4.20–$17.38	28% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID AGGL/LATE	$33.55	$33.55	$5.56–$16.78	8% below	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID AGGL/LATE REPEAT	$33.55	$33.55	$5.56–$16.78	8% below	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER	$86.55	$86.55	$14.10–$43.28	99% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER REPEAT	$86.55	$86.55	$14.10–$43.28	99% above	—
Stool ova and parasites exam CPT 87177 OC & P ROUTINE REPEAT	$38.50	$38.50	$8.72–$19.25	4% below	—
Stool ova and parasites exam CPT 87177 OC & P ROUTINE	$38.50	$38.50	$8.72–$19.25	4% below	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD TEST	$20.00	$20.00	$4.29–$10.00	12% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SYPHILIS SERO REPEAT	$26.35	$26.35	$4.18–$13.18	53% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SYPHILIS SERO	$26.35	$26.35	$4.18–$13.18	53% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB QUANTIFERON	$155.00	$155.00	$60.74–$89.48	89% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB QUANTIFERON REPEAT	$155.00	$155.00	$60.74–$89.48	89% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$82.70	$82.70	$25.29–$41.35	4% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL REPEAT	$82.70	$82.70	$25.29–$41.35	4% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBO REPEAT	$37.00	$37.00	$14.26–$20.78	8% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBO	$37.00	$37.00	$14.26–$20.78	8% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LIVER KIDNEY	$37.00	$37.00	$14.26–$20.78	8% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-SOLUBLE LIVER	$90.00	$90.00	$14.26–$45.00	123% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$110.40	$110.40	$16.46–$55.20	82% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH REPEAT	$110.40	$110.40	$16.46–$55.20	82% above	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA	$88.00	$88.00	$34.39–$47.87	13% above	—
Uric acid blood test CPT 84550 URIC ACID SERUM	$52.05	$52.05	$4.43–$26.02	46% above	—
Uric acid blood test CPT 84550 URIC ACID SERUM REPEAT	$52.05	$52.05	$4.43–$26.02	46% above	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS MICRO	$34.35	$34.35	$3.11–$17.18	17% above	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS MICRO REPEAT	$34.35	$34.35	$3.11–$17.18	17% above	—
Urinalysis with microscope exam, manual CPT 81000 MULTISTIX AUTO-MICRO	$15.00	$15.00	$3.94–$7.50	41% below	—
Urinalysis with microscope exam, manual CPT 81000 MULTISTIX AUTO-MICRO REPEAT	$15.00	$15.00	$3.94–$7.50	41% below	—
Urinalysis without microscope exam, manual CPT 81002 RHC URINE BY STICK	$5.40	$9.00	$3.41–$4.50	67% below	40%
Urinalysis without microscope exam, manual CPT 81002 URINE PROTEIN SCREEN	$9.00	$9.00	$3.41–$4.50	45% below	—
Urinalysis without microscope exam, manual CPT 81002 SPECIFIC GRAVITY	$9.00	$9.00	$3.41–$4.50	45% below	—
Urinalysis without microscope exam, manual CPT 81002 URINE BY STICK	$9.00	$9.00	$3.41–$4.50	45% below	—
Urinalysis without microscope exam, manual CPT 81002 OB URINE SCREEN	$9.00	$9.00	$3.41–$4.50	45% below	—
Urinalysis without microscope exam, manual inpatient CPT 81002 RHC URINE BY STICK	$5.40	$9.00	$3.41–$4.50	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE (BACT) REPEAT	$100.65	$100.65	$7.91–$50.32	126% above	—
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE (BACT)	$100.65	$100.65	$7.91–$50.32	126% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 ANEMIA S	$110.40	$110.40	$14.78–$55.20	103% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 ANEMIA S REPEAT	$110.40	$110.40	$14.78–$55.20	103% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D LEVEL	$74.00	$74.00	$29.01–$42.27	4% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D LEVEL REPEAT	$74.00	$74.00	$29.01–$42.27	4% below	—
Zinc blood test CPT 84630 ZINC RBC	$29.00	$29.00	$11.16–$16.26	34% below	—
Zinc blood test CPT 84630 ZINC	$29.00	$29.00	$11.16–$16.26	34% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUAN	$56.50	$56.50	$11.54–$28.25	59% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUAN REPEAT	$56.50	$56.50	$11.54–$28.25	59% above	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 PF APPENDECTOMY TUBE	$1,997.00	$1,997.00	$697.40–$878.68	—	—
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 PF APPENDECTOMY TUBE	$1,997.00	$1,997.00	$718.33–$1,797.30	—	—
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 PF APPENDECTOMY TUBE	$1,997.00	$1,997.00	$697.40–$878.68	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD FX RED WO MANIP DISTAL FIBULAR	$562.73	$562.73	$220.59–$506.46	51% above	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD FX RED WO MANIP METATARSAL	$562.73	$562.73	$205.51–$506.46	31% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,025.45	$1,025.45	$76.00–$922.90	127% above	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$1,915.00	$1,915.00	$130.41–$1,723.50	217% above	—
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$1,915.00	$1,915.00	$130.41–$1,723.50	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD FX REDUCTION WO MAN - DISTAL RADIAL	$562.00	$562.00	$220.30–$505.80	67% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD FX REDUCTION WO MAN - DISTAL RADIAL	$562.00	$562.00	$220.30–$505.80	—	—
Colonoscopy with polyp removal CPT 45385 PF COLONOSCOPY W LESION REMOVAL	$579.00	$579.00	$226.97–$521.10	42% below	—
Colonoscopy with polyp removal CPT 45385 PF COLONOSCOPY W LESION REMOVAL	$579.00	$579.00	$226.97–$686.17	42% below	—
Colonoscopy with polyp removal CPT 45385 PF COLONOSCOPY W/REMOVAL	$1,500.00	$1,500.00	$233.39–$1,350.00	51% above	—
Colonoscopy with polyp removal CPT 45385 PF COLONOSCOPY W/REMOVAL	$1,500.00	$1,500.00	$435.76–$686.17	51% above	—
Colonoscopy with polyp removal inpatient CPT 45385 PF COLONOSCOPY W LESION REMOVAL	$579.00	$579.00	$226.97–$686.17	—	—
Colonoscopy with polyp removal inpatient CPT 45385 PF COLONOSCOPY W/REMOVAL	$1,500.00	$1,500.00	$435.76–$686.17	—	—
Colonoscopy with tissue sample CPT 45380 PF COLONOSCOPY W BIOPSY	$457.00	$457.00	$179.14–$415.33	45% below	—
Colonoscopy with tissue sample CPT 45380 PF COLONOSCOPY W BIOPSY	$457.00	$457.00	$179.14–$649.26	45% below	—
Colonoscopy with tissue sample CPT 45380 PF COLONOSCOPY W/BIOPOSY	$1,300.00	$1,300.00	$415.33–$649.26	56% above	—
Colonoscopy with tissue sample CPT 45380 PF COLONOSCOPY W/BIOPOSY	$1,300.00	$1,300.00	$184.99–$1,170.00	56% above	—
Colonoscopy with tissue sample inpatient CPT 45380 PF COLONOSCOPY W BIOPSY	$457.00	$457.00	$179.14–$649.26	—	—
Colonoscopy with tissue sample inpatient CPT 45380 PF COLONOSCOPY W/BIOPOSY	$1,300.00	$1,300.00	$415.33–$649.26	—	—
Colonoscopy, diagnostic CPT 45378 PF EXC PRO INTESTIONS (EXC RECT)	$444.00	$444.00	$170.98–$399.60	34% below	—
Colonoscopy, diagnostic CPT 45378 PF EXC PRO INTESTIONS (EXC RECT)	$444.00	$444.00	$174.05–$507.65	34% below	—
Colonoscopy, diagnostic CPT 45378 PF DIAGNOSTIC COLONOSCOPY PRO FEES	$444.00	$444.00	$174.05–$507.65	34% below	—
Colonoscopy, diagnostic CPT 45378 PF COLORECTAL SCREENING N/HIGH RISK	$444.00	$444.00	$174.05–$507.65	34% below	—
Colonoscopy, diagnostic CPT 45378 PF COLORECTAL SCREENING N/HIGH RISK	$444.00	$444.00	$170.98–$399.60	34% below	—
Colonoscopy, diagnostic CPT 45378 PF DIAGNOSTIC COLONOSCOPY PRO FEES	$444.00	$444.00	$170.98–$399.60	34% below	—
Colonoscopy, diagnostic inpatient CPT 45378 PF DIAGNOSTIC COLONOSCOPY PRO FEES	$444.00	$444.00	$174.05–$507.65	—	—
Colonoscopy, diagnostic inpatient CPT 45378 PF COLORECTAL SCREENING N/HIGH RISK	$444.00	$444.00	$174.05–$507.65	—	—
Colonoscopy, diagnostic inpatient CPT 45378 PF EXC PRO INTESTIONS (EXC RECT)	$444.00	$444.00	$174.05–$507.65	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO BIOPSY CERVIX	$337.40	$337.40	$132.26–$303.66	19% below	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO BIOPSY CERVIX	$337.40	$337.40	$132.26–$303.66	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPE	$1,628.00	$1,628.00	$186.27–$814.00	2% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PREMALIGNANT LESIONS	$175.00	$175.00	$48.60–$175.00	75% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PREMALIGNANT LESIONS	$175.00	$175.00	$48.60–$175.00	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 CERUMEN REMOVAL W/IRRIGATION	$35.00	$35.00	$13.27–$21.18	31% below	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR IRRIGATION AND RMVL OF CERUMEN	$146.00	$146.00	$14.23–$146.00	188% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 CERUMEN RMVL SYRINGE IRRIG/LAVAGE MOD 50	$146.00	$146.00	$14.23–$146.00	188% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 CERUMEN REMOVAL W/IRRIGATION	$146.00	$146.00	$14.23–$146.00	188% above	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 CERUMEN RMVL SYRINGE RIGHT IRRIG/LAVAGE	$146.00	$146.00	$14.23–$146.00	188% above	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 CERUMEN RMVL SYRINGE LEFT IRRIG/LAVAGE	$146.00	$146.00	$14.23–$146.00	188% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CERUMEN REMOVAL W/IRRIGATION	$35.00	$35.00	$13.27–$21.18	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CERUMEN RMVL SYRINGE IRRIG/LAVAGE MOD 50	$146.00	$146.00	$14.23–$146.00	—	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 CERUMEN RMVL SYRINGE RIGHT IRRIG/LAVAGE	$146.00	$146.00	$14.23–$146.00	—	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 CERUMEN RMVL SYRINGE LEFT IRRIG/LAVAGE	$146.00	$146.00	$14.23–$146.00	—	—
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL W/INSTRUMENT	$110.45	$110.45	$35.15–$75.11	84% above	—
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL W/INSTRUMENT	$110.45	$110.45	$28.41–$110.45	84% above	—
Earwax removal with instruments, one ear CPT 69210 CERUMEN RMVL	$146.00	$146.00	$42.14–$146.00	143% above	—
Earwax removal with instruments, one ear CPT 69210 CERUMEN RMVL MOD 50	$146.00	$146.00	$42.14–$146.00	143% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL W/INSTRUMENT	$110.45	$110.45	$35.15–$75.11	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN RMVL MOD 50	$146.00	$146.00	$42.14–$146.00	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1L	$1,825.84	$1,825.84	$165.52–$912.92	129% above	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC	$1,287.00	$1,287.00	$363.00–$1,158.30	26% below	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC	$1,287.00	$1,287.00	$458.77–$602.46	26% below	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PF HERNIA RPR 3-10CM, REDUC INIT	$2,112.00	$2,112.00	$458.77–$929.28	21% above	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PF HERNIA RPR 3-10CM, REDUC INIT	$2,112.00	$2,112.00	$363.00–$1,900.80	21% above	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HRN 1ST 3-10 RDC	$1,287.00	$1,287.00	$458.77–$602.46	—	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 PF HERNIA RPR 3-10CM, REDUC INIT	$2,112.00	$2,112.00	$458.77–$929.28	—	—
First repair of a front abdominal hernia larger than 10 cm CPT 49595 PF HERNIA RPR >10CM, REDUC INIT	$2,112.00	$2,112.00	$616.65–$929.28	25% above	—
First repair of a front abdominal hernia larger than 10 cm CPT 49595 PF HERNIA RPR >10CM, REDUC INIT	$2,112.00	$2,112.00	$363.00–$1,900.80	25% above	—
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 PF HERNIA RPR >10CM, REDUC INIT	$2,112.00	$2,112.00	$616.65–$929.28	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$767.00	$767.00	$275.75–$690.30	46% below	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$767.00	$767.00	$275.75–$359.17	46% below	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PF HERNIA RPR <3CM, REDUCIBLE INIT	$2,112.00	$2,112.00	$275.75–$1,900.80	49% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PF HERNIA RPR <3CM, REDUCIBLE INIT	$2,112.00	$2,112.00	$275.75–$929.28	49% above	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$767.00	$767.00	$275.75–$359.17	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 PF HERNIA RPR <3CM, REDUCIBLE INIT	$2,112.00	$2,112.00	$275.75–$929.28	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF DIAGNOSTIC SIGMOIDOSCOPY	$128.00	$128.00	$50.18–$265.12	69% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF DIAGNOSTIC SIGMOIDOSCOPY	$128.00	$128.00	$50.18–$128.00	69% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF SIGMOIDOSCOPY;DIAGNOSTIC	$650.00	$650.00	$54.86–$585.00	59% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF SIGMOIDOSCOPY;DIAGNOSTIC	$650.00	$650.00	$110.50–$286.00	59% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PF DIAGNOSTIC SIGMOIDOSCOPY	$128.00	$128.00	$50.18–$265.12	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PF SIGMOIDOSCOPY;DIAGNOSTIC	$650.00	$650.00	$110.50–$286.00	—	—
Gallbladder removal, laparoscopic CPT 47562 PF WC LAP CHOLE	$550.00	$550.00	$215.60–$550.00	92% below	—
Gallbladder removal, laparoscopic CPT 47562 PF WC LAP CHOLE	$550.00	$550.00	$215.60–$631.40	92% below	—
Gallbladder removal, laparoscopic CPT 47562 PF LAPAROSCOPIC CHOLECYSTECTOMY	$1,481.00	$1,481.00	$363.00–$1,332.90	77% below	—
Gallbladder removal, laparoscopic CPT 47562 PF LAPAROSCOPIC CHOLECYSTECTOMY	$1,481.00	$1,481.00	$549.04–$708.73	77% below	—
Gallbladder removal, laparoscopic CPT 47562 PF LAPROSCOP CHOLECTSTE	$1,900.00	$1,900.00	$363.00–$1,710.00	71% below	—
Gallbladder removal, laparoscopic CPT 47562 PF LAPROSCOP CHOLECTSTE	$1,900.00	$1,900.00	$549.04–$836.00	71% below	—
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLECYSTECTOMY	$13,744.00	$13,744.00	$363.00–$6,872.00	111% above	—
Gallbladder removal, laparoscopic inpatient CPT 47562 PF WC LAP CHOLE	$550.00	$550.00	$215.60–$550.00	—	—
Gallbladder removal, laparoscopic inpatient CPT 47562 PF LAPAROSCOPIC CHOLECYSTECTOMY	$1,481.00	$1,481.00	$549.04–$708.73	—	—
Gallbladder removal, laparoscopic inpatient CPT 47562 PF LAPROSCOP CHOLECTSTE	$1,900.00	$1,900.00	$549.04–$836.00	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PF LAPARO, SURG; CHOLESTYECTOMY W/ CHOLA	$1,634.00	$1,634.00	$363.00–$1,470.60	40% below	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PF LAPARO, SURG; CHOLESTYECTOMY W/ CHOLA	$1,634.00	$1,634.00	$594.62–$769.37	40% below	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 PF LAPARO, SURG; CHOLESTYECTOMY W/ CHOLA	$1,634.00	$1,634.00	$594.62–$769.37	—	—
Gallbladder removal, open surgery through a larger incision CPT 47600 PF CHOLECYSTECTOMY	$2,431.00	$2,431.00	$880.22–$2,187.90	29% above	—
Gallbladder removal, open surgery through a larger incision CPT 47600 PF CHOLECYSTECTOMY	$2,431.00	$2,431.00	$880.22–$1,069.64	29% above	—
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 PF CHOLECYSTECTOMY	$2,431.00	$2,431.00	$880.22–$1,069.64	—	—
IUD insertion (the device itself billed separately) CPT 58300 IUD INSERTION	$74.73	$124.55	$40.48–$112.10	92% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 DO NOT USE	$128.78	$214.64	$84.14–$214.64	31% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 PF I&D ABSCESS SIMPLE	$241.00	$241.00	$94.47–$241.00	29% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 WC PF I&D ABSCESS SIMPLE	$241.00	$241.00	$94.47–$241.00	29% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 WC I&D ABSCESS SIMPLE	$437.00	$437.00	$112.28–$393.30	133% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$477.00	$477.00	$112.28–$429.30	154% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 ER I&D, SIMPLE OR SINGLE	$477.00	$477.00	$112.28–$429.30	154% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC PF I&D ABSCESS SIMPLE	$241.00	$241.00	$94.47–$241.00	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PF I&D ABSCESS SIMPLE	$241.00	$241.00	$94.47–$241.00	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC I&D ABSCESS SIMPLE	$437.00	$437.00	$112.28–$393.30	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ER I&D, SIMPLE OR SINGLE	$477.00	$477.00	$112.28–$429.30	—	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF PRP I/HERN INIT REDUC >5 YR	$1,175.00	$1,175.00	$440.40–$539.90	60% below	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF PRP I/HERN INIT REDUC >5 YR	$1,175.00	$1,175.00	$363.00–$1,057.50	60% below	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF INGUINAL HERNIA REPAIR INITIAL	$1,500.00	$1,500.00	$363.00–$1,350.00	49% below	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PF PRP I/HERN INIT REDUC >5 YR	$1,175.00	$1,175.00	$440.40–$539.90	—	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PF INGUINAL HERNIA REPAIR INITIAL	$1,500.00	$1,500.00	$363.00–$1,350.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP OR INJ MAJOR JOINT/B	$140.25	$140.25	$40.89–$140.25	19% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT MOD 51	$706.00	$706.00	$60.02–$635.40	308% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP OR INJ MAJOR JOINT/B	$706.00	$706.00	$60.02–$635.40	308% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ INTO LG JOINT OR BURS	$706.00	$706.00	$60.02–$353.00	308% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT	$706.00	$706.00	$60.02–$635.40	308% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 X-RAY DRAIN/ INJ JOINT/ BURSA W/O US	$706.00	$706.00	$60.02–$635.40	308% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ INTO LG JOINT OR BURS	$706.00	$706.00	$60.02–$353.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JOINT MOD 51	$706.00	$706.00	$60.02–$635.40	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP OR INJ MAJOR JOINT/B	$706.00	$706.00	$60.02–$635.40	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JOINT	$706.00	$706.00	$60.02–$635.40	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTO MED JOINT OR BURS	$706.00	$706.00	$50.22–$353.00	383% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN INJ JOINT BURSA W/O US	$706.00	$706.00	$50.22–$635.40	383% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTO MED JOINT OR BURS	$706.00	$706.00	$50.22–$353.00	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN INJ JOINT BURSA W/O US	$706.00	$706.00	$50.22–$635.40	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS	$706.00	$706.00	$49.29–$635.40	481% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIR/INJ INTO SM JOINT OR BUR	$706.00	$706.00	$49.29–$353.00	481% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIR/INJ INTO SM JOINT OR BUR	$706.00	$706.00	$49.29–$353.00	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS	$706.00	$706.00	$49.29–$635.40	—	—
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY	$7,711.00	$7,711.00	$297.00–$3,855.50	25% above	—
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY	$7,711.00	$7,711.00	$297.00–$3,855.50	—	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF LAPAROSCOPY, SURGICAL, APPENDECTOMY	$1,369.00	$1,369.00	$502.43–$602.36	62% below	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF LAPAROSCOPY, SURGICAL, APPENDECTOMY	$1,369.00	$1,369.00	$363.00–$1,232.10	62% below	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF APPENDECTOMY LAPAROSCOPIC	$1,437.00	$1,437.00	$363.00–$1,293.30	60% below	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 PF LAPAROSCOPY, SURGICAL, APPENDECTOMY	$1,369.00	$1,369.00	$502.43–$602.36	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF INTMD RPR S/A/T/EXT 2.5 CM/<	$342.00	$342.00	$134.06–$307.80	6% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF INTMD RPR S/A/T/EXT 2.5 CM/<	$342.00	$342.00	$105.43–$382.96	6% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD WND REPAIR	$799.00	$799.00	$136.39–$719.10	148% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD WND REPAIR	$799.00	$799.00	$105.43–$382.96	148% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT =/<2.5 CM	$950.00	$950.00	$225.16–$855.00	195% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PF INTMD RPR S/A/T/EXT 2.5 CM/<	$342.00	$342.00	$105.43–$382.96	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD WND REPAIR	$799.00	$799.00	$105.43–$382.96	—	—
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	$950.00	$950.00	$225.16–$855.00	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 PF NJX INTERLAMINAR LMBR/SAC W IMAGE	$228.00	$228.00	$89.38–$228.00	68% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 PF NJX INTERLAMINAR LMBR/SAC W IMAGE	$228.00	$228.00	$89.38–$391.07	68% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 PF INJ SPINE LUMBAR/SACRAL	$451.00	$451.00	$93.47–$405.90	37% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJ SPINE LUMBAR/SACRAL W/FLORA	$1,648.00	$1,648.00	$236.21–$824.00	129% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PF NJX INTERLAMINAR LMBR/SAC W IMAGE	$228.00	$228.00	$89.38–$391.07	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PF INJ SPINE LUMBAR/SACRAL	$451.00	$451.00	$93.47–$405.90	—	—
Lower-back epidural injection, without imaging guidance CPT 62322 PF INJ SPINE LUMBAR/SACRAL	$204.00	$204.00	$77.85–$204.00	69% below	—
Lower-back epidural injection, without imaging guidance CPT 62322 PF INJ SPINE LUMBAR/SACRAL W FLORA	$204.00	$204.00	$79.97–$242.54	69% below	—
Lower-back epidural injection, without imaging guidance CPT 62322 PF INJ SPINE LUMBAR/SACRAL W FLORA	$204.00	$204.00	$77.85–$204.00	69% below	—
Lower-back epidural injection, without imaging guidance CPT 62322 PF INJ SPINE LUMBAR/SACRAL	$204.00	$204.00	$79.97–$242.54	69% below	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJ SPINE LUMBAR/SACRAL	$2,172.00	$2,172.00	$127.87–$1,086.00	225% above	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PF INJ SPINE LUMBAR/SACRAL W FLORA	$204.00	$204.00	$79.97–$242.54	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PF INJ SPINE LUMBAR/SACRAL	$204.00	$204.00	$79.97–$242.54	—	—
Lumpectomy (partial mastectomy) CPT 19301 PF MASECTOMY PARTIAL	$1,498.00	$1,498.00	$483.73–$659.12	at median	—
Lumpectomy (partial mastectomy) CPT 19301 PF MASECTOMY PARTIAL	$1,498.00	$1,498.00	$320.00–$1,348.20	at median	—
Lumpectomy (partial mastectomy) inpatient CPT 19301 PF MASECTOMY PARTIAL	$1,498.00	$1,498.00	$483.73–$659.12	—	—
Nail removal (partial or complete), one nail CPT 11730 PF REMOVAL OF NAIL PLATE	$133.00	$133.00	$51.59–$133.00	5% below	—
Nail removal (partial or complete), one nail CPT 11730 PF AVULSION NAIL PLA	$133.00	$133.00	$51.59–$133.00	5% below	—
Nail removal (partial or complete), one nail CPT 11730 PF AVULSION NAIL PLA	$133.00	$133.00	$49.50–$171.87	5% below	—
Nail removal (partial or complete), one nail CPT 11730 PF REMOVAL OF NAIL PLATE	$133.00	$133.00	$49.50–$171.87	5% below	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE	$477.00	$477.00	$97.72–$429.30	241% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 PF AVULSION NAIL PLA	$133.00	$133.00	$49.50–$171.87	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 PF REMOVAL OF NAIL PLATE	$133.00	$133.00	$49.50–$171.87	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE	$477.00	$477.00	$97.72–$429.30	—	—
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOCK	$706.00	$706.00	$68.24–$635.40	320% above	—
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W IMAG GUIDE	$2,160.00	$2,160.00	$245.91–$1,944.00	258% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF EXCISION OF INGROWN	$350.00	$350.00	$137.20–$245.82	3% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF EXCISION OF INGROWN	$350.00	$350.00	$97.54–$315.00	3% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PF EXCISION OF INGROWN	$350.00	$350.00	$137.20–$245.82	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JN	$4,484.00	$4,484.00	$297.00–$2,242.00	175% above	—
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$7,043.03	$7,043.03	$320.00–$6,338.73	457% above	—
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$7,043.03	$7,043.03	$359.70–$3,098.93	457% above	—
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION	$7,043.03	$7,043.03	$359.70–$3,098.93	—	—
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY, SIMPLE	$799.00	$799.00	$103.45–$719.10	241% above	—
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY, SIMPLE	$799.00	$799.00	$63.73–$351.56	241% above	—
Removal of a foreign object under the skin, simple CPT 10120 ER INCISION & REMOVAL FOREIGN BODY; SIMP	$950.00	$950.00	$136.35–$855.00	305% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 FOREIGN BODY, SIMPLE	$799.00	$799.00	$63.73–$351.56	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 ER INCISION & REMOVAL FOREIGN BODY; SIMP	$950.00	$950.00	$136.35–$855.00	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PF EXC PRO INTESTIONS (EXC RECT)	$444.00	$444.00	$171.18–$399.60	29% below	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PF COLORECTAL SCREENING N/HIGH RISK	$444.00	$444.00	$171.18–$399.60	29% below	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PF DIAGNOSTIC COLONOSCOPY PRO FEES	$444.00	$444.00	$171.18–$399.60	29% below	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PF EXC PRO INTESTIONS (EXC RECT)	$444.00	$444.00	$171.18–$399.60	—	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PF COLORECTAL SCREENING N/HIGH RISK	$444.00	$444.00	$171.18–$399.60	—	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PF DIAGNOSTIC COLONOSCOPY PRO FEES	$444.00	$444.00	$171.18–$399.60	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PF COLORECTAL SCREENING HIGH RISK	$650.00	$650.00	$170.98–$585.00	4% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PF COLORECTAL SCREENING HIGH RISK	$650.00	$650.00	$254.80–$507.31	4% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PF COLORECTAL SCREENING HIGH RISK	$650.00	$650.00	$254.80–$507.31	—	—
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM	$640.00	$640.00	$83.99–$576.00	548% above	—
Short arm splint (forearm and hand) CPT 29125 ER APPLY SPLINT UNDER BODY & UE	$305.00	$305.00	$67.88–$274.50	168% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 ER APPLY SPLINT UNDER BODY & UE	$305.00	$305.00	$67.88–$274.50	—	—
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG	$640.00	$640.00	$76.09–$576.00	609% above	—
Short leg cast (below the knee) one side CPT 29405 CAST LEFT SHORT LEG	$640.00	$640.00	$76.09–$576.00	609% above	—
Short leg cast (below the knee) one side CPT 29405 CAST RIGHT SHORT LEG	$640.00	$640.00	$76.09–$576.00	609% above	—
Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG	$376.00	$376.00	$71.37–$338.40	197% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE SUTURE <2.5 CM	$437.00	$437.00	$97.64–$250.00	84% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR LAC S/N/AX/GEN/TRNK 2.5CM/<	$477.00	$477.00	$97.64–$429.30	101% above	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX OF SKIN; SINGLE LESION	$375.00	$375.00	$104.79–$375.00	99% above	—
Skin tag removal, up to 15 tags CPT 11200 PF SKIN TAGS REMOVAL </= 15 LESIONS	$170.00	$170.00	$66.64–$170.00	20% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS < 15	$477.00	$477.00	$80.40–$429.30	236% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$1,648.00	$1,648.00	$141.13–$1,483.20	332% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP-LUMBAR	$1,648.00	$1,648.00	$141.13–$824.00	332% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$1,648.00	$1,648.00	$141.13–$1,483.20	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP-LUMBAR	$1,648.00	$1,648.00	$141.13–$824.00	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SR WOUND 2.6CM-7.5CM	$477.00	$477.00	$119.67–$429.30	45% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE SUTURE 2.6 - 7.5 CM	$477.00	$477.00	$119.67–$250.00	45% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF SIMPLE REPAIR 2.5 CM	$134.00	$134.00	$52.53–$170.94	19% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF SIMPLE REPAIR 2.5 CM	$134.00	$134.00	$52.53–$134.00	19% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF LACERATION RPR 2.5 CM/LS	$134.00	$134.00	$52.53–$134.00	19% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR LAC F/E/E/N/L/M 2.5CM/<	$477.00	$477.00	$119.75–$429.30	190% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PF LACERATION RPR 2.5 CM/LS	$134.00	$134.00	$52.53–$134.00	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PF SIMPLE REPAIR 2.5 CM	$134.00	$134.00	$52.53–$170.94	—	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W IMAGE GUIDE	$1,577.00	$1,577.00	$250.00–$1,419.30	110% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES	$706.00	$706.00	$45.75–$635.40	366% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES	$706.00	$706.00	$45.75–$635.40	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US GUIDE FOR BIOPSY	$329.00	$329.00	$128.97–$322.42	67% below	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US GUIDE FOR BIOPSY	$329.00	$329.00	$128.97–$322.42	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 PF ENDOSCOPY W/BIOPSY	$332.00	$332.00	$128.51–$325.36	52% below	—
Upper endoscopy (EGD) with biopsy CPT 43239 PF ENDOSCOPY W/BIOPSY	$332.00	$332.00	$130.14–$557.33	52% below	—
Upper endoscopy (EGD) with biopsy CPT 43239 PF EGD W/BX PRO FEES	$1,650.00	$1,650.00	$128.51–$1,485.00	139% above	—
Upper endoscopy (EGD) with biopsy CPT 43239 PF EGD W/BX PRO FEES	$1,650.00	$1,650.00	$360.31–$726.00	139% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PF ENDOSCOPY W/BIOPSY	$332.00	$332.00	$130.14–$557.33	—	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PF EGD W/BX PRO FEES	$1,650.00	$1,650.00	$360.31–$726.00	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PF EGD W/REMOVAL OF TUMOR/POLYPS/LESION	$453.00	$453.00	$177.58–$443.94	58% below	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PF EGD W/REMOVAL OF TUMOR/POLYPS/LESION	$453.00	$453.00	$177.58–$715.53	58% below	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PF EGD W/REMOVAL OF TUMOR/POLYPS/LESION	$453.00	$453.00	$177.58–$715.53	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 PF EGD, DX BRUSH OR WASH	$279.00	$279.00	$109.37–$273.42	59% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 PF EGD, DX BRUSH OR WASH	$279.00	$279.00	$109.37–$417.88	59% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 PF DIAGNOSTIC EGC W/O BIOPSY	$294.00	$294.00	$114.75–$278.33	57% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 PF DIAGNOSTIC EGC W/O BIOPSY	$294.00	$294.00	$115.25–$417.88	57% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 PF EGD DX WITH SPECIMEN COL BR/WA	$550.00	$550.00	$114.75–$495.00	19% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 PF EGD DX WITH SPECIMEN COL BR/WA	$550.00	$550.00	$215.60–$417.88	19% below	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PF EGD, DX BRUSH OR WASH	$279.00	$279.00	$109.37–$417.88	—	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PF DIAGNOSTIC EGC W/O BIOPSY	$294.00	$294.00	$115.25–$417.88	—	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PF EGD DX WITH SPECIMEN COL BR/WA	$550.00	$550.00	$215.60–$417.88	—	—
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION <15	$251.58	$251.58	$49.50–$171.07	63% above	—
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION <15	$477.00	$477.00	$95.98–$429.30	210% above	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESION <15	$251.58	$251.58	$49.50–$171.07	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PF DEBRIDE SUBQ TISSUE <=20 SQ CM	$140.00	$140.00	$54.88–$140.00	47% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DO NOT USE	$270.60	$451.00	$57.53–$405.90	3% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC PF DEBRIDE SKIN, SUBQ	$680.00	$680.00	$57.53–$612.00	160% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SUBQ TISS <20 CM OR LESS	$950.00	$950.00	$114.69–$855.00	263% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC DEBRIDE SKIN SUBQ	$950.00	$950.00	$114.69–$855.00	263% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN, SUBQ	$950.00	$950.00	$114.69–$855.00	263% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC PF DEBRIDE SKIN, SUBQ	$680.00	$680.00	$57.53–$612.00	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC DEBRIDE SKIN SUBQ	$950.00	$950.00	$114.69–$855.00	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SUBQ TISS <20 CM OR LESS	$950.00	$950.00	$114.69–$855.00	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,035.00	$1,035.00	$39.59–$931.50	144% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$1,035.00	$1,035.00	$39.59–$931.50	144% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$24.55	$24.55	$6.00–$24.55	69% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB INITIAL	$76.70	$76.70	$6.00–$76.70	2% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 UDN SUB EA ADDTL-ER USE ONLY	$122.60	$122.60	$6.00–$122.60	57% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 UDN SUBSEQUENT	$132.60	$132.60	$6.00–$132.60	70% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 UDN INIT	$193.35	$193.35	$6.00–$181.78	148% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 UDN SUB 2ND FREQUENCY	$509.00	$509.00	$6.00–$254.50	553% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL INITIAL	$509.00	$509.00	$6.00–$254.50	553% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 UDN INITIAL TREATMENT	$509.00	$509.00	$6.00–$254.50	553% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MTRD DOSE TX SUBSEQUENT	$509.00	$509.00	$6.00–$254.50	553% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MTRD DOSE TX INITIAL	$509.00	$509.00	$6.00–$254.50	553% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$24.55	$24.55	$6.00–$24.55	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB INITIAL	$76.70	$76.70	$6.00–$76.70	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 UDN SUB EA ADDTL-ER USE ONLY	$122.60	$122.60	$6.00–$122.60	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 UDN SUBSEQUENT	$132.60	$132.60	$6.00–$132.60	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 UDN INIT	$193.35	$193.35	$6.00–$181.78	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL INITIAL	$509.00	$509.00	$6.00–$254.50	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MTRD DOSE TX INITIAL	$509.00	$509.00	$6.00–$254.50	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 UDN INITIAL TREATMENT	$509.00	$509.00	$6.00–$254.50	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MTRD DOSE TX SUBSEQUENT	$509.00	$509.00	$6.00–$254.50	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 UDN SUB 2ND FREQUENCY	$509.00	$509.00	$6.00–$254.50	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE MOD 25	$2,114.00	$2,114.00	$51.00–$1,057.00	219% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE	$2,114.00	$2,114.00	$51.00–$1,057.00	219% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE MOD 25	$2,114.00	$2,114.00	$51.00–$1,057.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG SUB	$240.02	$240.02	$5.79–$120.01	128% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG INITIAL	$240.02	$240.02	$5.79–$120.01	128% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG INITIAL	$240.02	$240.02	$5.79–$120.01	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG SUB	$240.02	$240.02	$5.79–$120.01	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER ROOM LEVEL 1	$212.00	$212.00	$10.09–$148.43	95% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1 MOD 25	$212.00	$212.00	$10.09–$148.43	95% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 MEDICAL SCREEN ONLY	$212.00	$212.00	$10.09–$148.43	95% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER ROOM LEVEL 2	$390.00	$390.00	$37.07–$195.00	155% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 MOD 25	$390.00	$390.00	$37.07–$195.00	155% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2 MOD 25	$390.00	$390.00	$37.07–$195.00	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER ROOM LEVEL 3	$680.00	$680.00	$51.00–$340.00	146% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 MOD 25	$680.00	$680.00	$51.00–$340.00	146% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3 MOD 25	$680.00	$680.00	$51.00–$340.00	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER ROOM LEVEL 4	$1,055.00	$1,055.00	$51.00–$527.50	134% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 MOD 25	$1,055.00	$1,055.00	$51.00–$527.50	134% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4 MOD 25	$1,055.00	$1,055.00	$51.00–$527.50	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER ROOM LEVEL 5	$1,530.00	$1,530.00	$51.00–$765.00	119% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5 MOD 25	$1,530.00	$1,530.00	$51.00–$765.00	119% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5 MOD 25	$1,530.00	$1,530.00	$51.00–$765.00	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$650.00	$650.00	$32.67–$325.00	70% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$650.00	$650.00	$32.67–$325.00	—	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/ PATIENT PRESENT	$500.00	$500.00	$105.20–$250.00	215% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/ PATIENT PRESENT	$500.00	$500.00	$105.20–$250.00	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PATIENT PRESENT	$450.00	$450.00	$101.44–$225.00	183% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY W/O PATIENT PRESENT	$450.00	$450.00	$101.44–$225.00	—	—
Group psychotherapy session CPT 90853 Group Psychotherapy	$252.00	$420.00	$28.57–$210.00	122% above	40%
Group psychotherapy session CPT 90853 GROUP THERAPY IOP	$420.00	$420.00	$28.57–$210.00	271% above	—
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY IOP	$420.00	$420.00	$28.57–$210.00	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYD INFUS 1ST HR	$523.00	$523.00	$28.79–$261.50	193% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR	$523.00	$523.00	$28.79–$261.50	193% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR	$523.00	$523.00	$28.79–$261.50	193% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR	$523.00	$523.00	$28.79–$261.50	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYD INFUS 1ST HR	$523.00	$523.00	$28.79–$261.50	—	—
IV infusion of a medicine, first hour CPT 96365 IV DRUG INFUSION	$523.00	$523.00	$57.04–$261.50	182% above	—
IV infusion of a medicine, first hour CPT 96365 IV DRUG INFUSION	$523.00	$523.00	$57.04–$261.50	182% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV DRUG INFUSION	$523.00	$523.00	$57.04–$261.50	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION	$146.00	$146.00	$13.60–$73.00	91% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION	$146.00	$146.00	$13.60–$64.24	91% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ANTIBIOTIC	$169.00	$169.00	$13.60–$84.50	121% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM / SC INJ EACH	$169.00	$169.00	$13.60–$84.50	121% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SUBQ/IM INJ	$169.00	$169.00	$13.60–$84.50	121% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUBQ INJECTION	$169.00	$169.00	$13.60–$84.50	121% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SUBQ/IM INJ	$169.00	$169.00	$13.60–$84.50	121% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION	$146.00	$146.00	$13.60–$64.24	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SUBQ/IM INJ	$169.00	$169.00	$13.60–$84.50	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUBQ INJECTION	$169.00	$169.00	$13.60–$84.50	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION ANTIBIOTIC	$169.00	$169.00	$13.60–$84.50	—	—
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE	$73.75	$73.75	$28.91–$36.88	9% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT-NEURO MUS RE-ED	$84.00	$84.00	$29.75–$42.00	24% above	—
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED	$84.00	$84.00	$29.75–$42.00	24% above	—
New patient office visit, about 30 minutes CPT 99203 WC PF NEW VISIT LEVEL 3	$252.28	$252.28	$70.19–$138.56	213% above	—
New patient office visit, about 30 minutes CPT 99203 PF NEW VISIT LEVEL 3	$252.28	$252.28	$70.19–$138.56	213% above	—
New patient office visit, about 30 minutes CPT 99203 WC NEW PATIENT LEVEL 3	$252.28	$252.28	$73.58–$126.14	213% above	—
New patient office visit, about 30 minutes CPT 99203 WC PF NEW VISIT LEVEL 3	$252.28	$252.28	$73.58–$126.14	213% above	—
New patient office visit, about 30 minutes CPT 99203 PF NEW VISIT LEVEL 3	$252.28	$252.28	$73.58–$126.14	213% above	—
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3	$252.28	$252.28	$73.58–$126.14	213% above	—
New patient office visit, about 30 minutes CPT 99203 99203- NEW PATIENT LEVEL 3	$252.28	$252.28	$73.58–$126.14	213% above	—
New patient office visit, about 30 minutes CPT 99203 PF SURGICAL NEW PT LEVEL 3	$252.28	$252.28	$73.58–$126.14	213% above	—
New patient office visit, about 30 minutes CPT 99203 WC NEW PATIENT LEVEL 3 MOD 25	$371.83	$371.83	$73.58–$185.91	362% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 PF NEW VISIT LEVEL 3	$252.28	$252.28	$70.19–$138.56	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 WC PF NEW VISIT LEVEL 3	$252.28	$252.28	$73.58–$126.14	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 PF SURGICAL NEW PT LEVEL 3	$252.28	$252.28	$73.58–$126.14	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 99203- NEW PATIENT LEVEL 3	$252.28	$252.28	$73.58–$126.14	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 WC NEW PATIENT LEVEL 3	$252.28	$252.28	$73.58–$126.14	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 WC NEW PATIENT LEVEL 3 MOD 25	$371.83	$371.83	$73.58–$185.91	—	—
New patient office visit, about 45 minutes CPT 99204 99204- NEW PATIENT LEVEL 4	$386.18	$386.18	$125.88–$193.09	279% above	—
New patient office visit, about 45 minutes CPT 99204 WC NEW PATIENT LEVEL 4	$386.18	$386.18	$125.88–$193.09	279% above	—
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4	$386.18	$386.18	$125.88–$193.09	279% above	—
New patient office visit, about 45 minutes CPT 99204 PF NEW VISIT LEVEL 4	$386.18	$386.18	$123.87–$193.09	279% above	—
New patient office visit, about 45 minutes CPT 99204 PF NEW VISIT LEVEL 4	$386.18	$386.18	$95.17–$211.54	279% above	—
New patient office visit, about 45 minutes CPT 99204 WC PF NEW VISIT LEVEL 4	$386.18	$386.18	$123.87–$193.09	279% above	—
New patient office visit, about 45 minutes CPT 99204 WC PF NEW VISIT LEVEL 4	$386.18	$386.18	$95.17–$211.54	279% above	—
New patient office visit, about 45 minutes CPT 99204 WC NEW PATIENT LEVEL 4 MOD 25	$386.18	$386.18	$125.88–$193.09	279% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 99204- NEW PATIENT LEVEL 4	$386.18	$386.18	$125.88–$193.09	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 WC NEW PATIENT LEVEL 4 MOD 25	$386.18	$386.18	$125.88–$193.09	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 PF NEW VISIT LEVEL 4	$386.18	$386.18	$95.17–$211.54	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 WC PF NEW VISIT LEVEL 4	$386.18	$386.18	$123.87–$193.09	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 WC NEW PATIENT LEVEL 4	$386.18	$386.18	$125.88–$193.09	—	—
New patient office visit, about 60 minutes CPT 99205 PF NEW VISIT LEVEL 5	$486.60	$486.60	$12.00–$243.30	154% above	—
New patient office visit, about 60 minutes CPT 99205 WC NEW PATIENT LEVEL 5	$486.60	$486.60	$12.00–$243.30	154% above	—
New patient office visit, about 60 minutes CPT 99205 PF NEW VISIT LEVEL 5	$486.60	$486.60	$148.71–$266.92	154% above	—
New patient office visit, about 60 minutes CPT 99205 99205- NEW PATIENT LEVEL 5	$486.60	$486.60	$12.00–$243.30	154% above	—
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5	$486.60	$486.60	$12.00–$243.30	154% above	—
New patient office visit, about 60 minutes CPT 99205 NEW OB COMPLETE EXAM	$486.60	$486.60	$12.00–$243.30	154% above	—
New patient office visit, about 60 minutes CPT 99205 WC PF NEW VISIT LEVEL 5	$486.60	$486.60	$12.00–$243.30	154% above	—
New patient office visit, about 60 minutes CPT 99205 WC NEW PATIENT LEVEL 5 MOD 25	$540.75	$540.75	$12.00–$270.38	183% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 99205- NEW PATIENT LEVEL 5	$486.60	$486.60	$12.00–$243.30	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 PF NEW VISIT LEVEL 5	$486.60	$486.60	$148.71–$266.92	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 WC NEW PATIENT LEVEL 5	$486.60	$486.60	$12.00–$243.30	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW OB COMPLETE EXAM	$486.60	$486.60	$12.00–$243.30	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 WC PF NEW VISIT LEVEL 5	$486.60	$486.60	$12.00–$243.30	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 WC NEW PATIENT LEVEL 5 MOD 25	$540.75	$540.75	$12.00–$270.38	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC NEW PATIENT LEVEL 2	$177.50	$177.50	$49.05–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC NEW PATIENT LEVEL 2 MOD 25	$177.50	$177.50	$49.05–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CL-NEW PATIENT LEVEL 2	$177.50	$177.50	$49.05–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP EXPANDED	$177.50	$177.50	$49.05–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC PF NEW VISIT LEVEL 2	$177.50	$177.50	$48.78–$93.77	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC PF NEW VISIT LEVEL 2	$177.50	$177.50	$43.81–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202- NP LEVEL 2	$177.50	$177.50	$49.05–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF NEW VISIT LEVEL 2	$177.50	$177.50	$48.78–$93.77	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF NEW VISIT LEVEL 2	$177.50	$177.50	$43.81–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2	$177.50	$177.50	$49.05–$88.75	198% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF NEW VISIT LEVEL 2	$177.50	$177.50	$48.78–$93.77	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC NEW PATIENT LEVEL 2 MOD 25	$177.50	$177.50	$49.05–$88.75	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NP EXPANDED	$177.50	$177.50	$49.05–$88.75	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC PF NEW VISIT LEVEL 2	$177.50	$177.50	$43.81–$88.75	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC NEW PATIENT LEVEL 2	$177.50	$177.50	$49.05–$88.75	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202- NP LEVEL 2	$177.50	$177.50	$49.05–$88.75	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CL-NEW PATIENT LEVEL 2	$177.50	$177.50	$49.05–$88.75	—	—
Occupational therapy evaluation, low complexity CPT 97165 OT-EVALUATION LOW COMPLEXITY 30 MIN	$237.00	$237.00	$91.63–$118.50	120% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT-EVALUATION- HIGH	$282.64	$282.64	$89.38–$197.76	84% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT-EVALUATION- HIGH	$282.64	$282.64	$89.38–$197.76	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT-EVALUATION LOW COMPLEXITY 20 MIN	$235.00	$235.00	$89.38–$117.50	110% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT-EVALUATION MOD COMPLEX 30 MIN	$235.00	$235.00	$89.38–$148.32	81% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT-EVALUATION MOD COMPLEX 30 MIN	$235.00	$235.00	$89.38–$148.32	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THER. 15 MIN	$67.00	$67.00	$25.21–$33.50	5% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT-MANUAL THERAPY	$67.00	$67.00	$25.21–$33.50	5% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$67.00	$67.00	$25.21–$33.50	5% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EX	$73.00	$73.00	$21.76–$36.50	15% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT-THERAPEUTIC EXER	$73.00	$73.00	$21.76–$36.50	15% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EX 15MIN	$73.00	$73.00	$21.76–$36.50	15% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EX	$73.00	$73.00	$21.76–$36.50	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EX 15MIN	$73.00	$73.00	$21.76–$36.50	—	—
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW 18-39 WELL VISIT	$150.00	$150.00	$58.80–$135.00	53% above	—
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT, NEW AGE 18-39	$150.00	$150.00	$58.80–$135.00	53% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV VISIT NEW 18-39 WELL VISIT	$150.00	$150.00	$58.80–$135.00	—	—
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW 40-64 WELL VISIT	$150.00	$150.00	$58.80–$135.00	38% above	—
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT, NEW AGE 40-65	$150.00	$150.00	$58.80–$135.00	38% above	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV VISIT NEW 40-64 WELL VISIT	$150.00	$150.00	$58.80–$135.00	—	—
Preventive checkup, new patient aged 65 or older CPT 99387 PREV VISIT NEW 65+ WELL VISIT	$90.00	$150.00	$58.80–$135.00	5% below	40%
Preventive checkup, new patient aged 65 or older CPT 99387 65 OLDER NEW PT WELL ADULT	$210.00	$210.00	$82.32–$189.00	121% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST 18-39 WELL VISIT	$125.00	$125.00	$49.00–$112.50	37% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 18-39 YEARS PERIODIC COMP PREV MEDICINE	$125.00	$125.00	$49.00–$112.50	37% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST 18-39 WELL VISIT	$125.00	$125.00	$49.00–$112.50	37% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV VISIT EST 18-39 WELL VISIT	$125.00	$125.00	$49.00–$112.50	—	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST 40-64 WELL VISIT	$235.88	$235.88	$92.46–$212.29	148% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST 40-64 WELL VISIT	$235.88	$235.88	$92.46–$212.29	148% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 40-64 YEARS PERIODIC COMP PREV MEDICINE	$235.88	$235.88	$92.46–$212.29	148% above	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV VISIT EST 40-64 WELL VISIT	$235.88	$235.88	$92.46–$212.29	—	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PREV VISIT EST 65+ WELL VISIT	$253.34	$253.34	$99.31–$228.01	150% above	—
Preventive checkup, returning patient aged 65 or older CPT 99397 65 OLDER ESTABLISHED PT WELL ADULT EXAM	$253.34	$253.34	$99.31–$228.01	150% above	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREV VISIT EST 65+ WELL VISIT	$253.34	$253.34	$99.31–$228.01	—	—
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL PSYCHOTHERAPY 20-30 MIN	$400.00	$400.00	$81.10–$200.00	300% above	—
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL PSYCH 20-30 MIN TELEHEALTH	$400.00	$400.00	$77.43–$200.00	300% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL PSYCHOTHERAPY 20-30 MIN	$400.00	$400.00	$81.10–$200.00	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL PSYCH 20-30 MIN TELEHEALTH	$400.00	$400.00	$77.43–$200.00	—	—
Psychotherapy session, 45 minutes CPT 90834 PSY IND THERAPY (50 MIN)	$420.00	$420.00	$107.47–$210.00	242% above	—
Psychotherapy session, 45 minutes CPT 90834 PSY IND THERAPY (50 MIN) TELEHEALTH	$420.00	$420.00	$102.25–$210.00	242% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSY IND THERAPY (50 MIN)	$420.00	$420.00	$107.47–$210.00	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSY IND THERAPY (50 MIN) TELEHEALTH	$420.00	$420.00	$102.25–$210.00	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION LESS THAN 10 MINUTES	$77.00	$77.00	$13.82–$38.50	115% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION LESS THAN 10 MINUTES	$77.00	$77.00	$13.82–$38.50	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL 5 AMB CARE MOD 25	$155.01	$155.01	$60.76–$151.91	21% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PATIENT LEVEL 5	$342.45	$342.45	$133.72–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CL-EST PATIENT COMPLEX LEVEL 5	$342.45	$342.45	$134.24–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 - EST PT COMPLETE EXAM	$342.45	$342.45	$134.24–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PATIENT LEVEL 5	$342.45	$342.45	$114.64–$187.61	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC EST PATIENT LEVEL 5 MOD 25	$342.45	$342.45	$134.24–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC EST PATIENT LEVEL 5	$342.45	$342.45	$134.24–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF EST PATIENT LEVEL 5	$342.45	$342.45	$133.72–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF EST PATIENT LEVEL 5	$342.45	$342.45	$114.64–$187.61	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL 5 AMB CARE ONLY	$342.45	$342.45	$134.24–$172.52	166% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 LEVEL 5 AMB CARE MOD 25	$155.01	$155.01	$60.76–$151.91	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CL-EST PATIENT COMPLEX LEVEL 5	$342.45	$342.45	$134.24–$172.52	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC EST PATIENT LEVEL 5 MOD 25	$342.45	$342.45	$134.24–$172.52	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 LEVEL 5 AMB CARE ONLY	$342.45	$342.45	$134.24–$172.52	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PATIENT LEVEL 5	$342.45	$342.45	$114.64–$187.61	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC EST PATIENT LEVEL 5	$342.45	$342.45	$134.24–$172.52	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF EST PATIENT LEVEL 5	$342.45	$342.45	$114.64–$187.61	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 - EST PT COMPLETE EXAM	$342.45	$342.45	$134.24–$172.52	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213- EST PT DETAILED LEVEL 3	$173.53	$173.53	$68.02–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3 AMB CARE MOD 25	$173.53	$173.53	$68.02–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC EST PATIENT LEVEL 3 MOD 25	$173.53	$173.53	$68.02–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3 AMB CARE ONLY	$173.53	$173.53	$68.02–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC PF EST PATIENT LEVEL 3	$173.53	$173.53	$39.26–$94.30	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC PF EST PATIENT LEVEL 3	$173.53	$173.53	$61.36–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC EST PATIENT LEVEL 3	$173.53	$173.53	$68.02–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF EST PATIENT LEVEL 3	$173.53	$173.53	$39.26–$94.30	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF EST PATIENT LEVEL 3	$173.53	$173.53	$61.36–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PATIENT LEVEL 3	$173.53	$173.53	$68.02–$86.76	106% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EP DETAILED-DO NOT USE	$285.60	$476.00	$61.36–$238.00	239% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3 AMB CARE MOD 25	$173.53	$173.53	$68.02–$86.76	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213- EST PT DETAILED LEVEL 3	$173.53	$173.53	$68.02–$86.76	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3 AMB CARE ONLY	$173.53	$173.53	$68.02–$86.76	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC PF EST PATIENT LEVEL 3	$173.53	$173.53	$61.36–$86.76	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC EST PATIENT LEVEL 3	$173.53	$173.53	$68.02–$86.76	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC EST PATIENT LEVEL 3 MOD 25	$173.53	$173.53	$68.02–$86.76	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF EST PATIENT LEVEL 3	$173.53	$173.53	$39.26–$94.30	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4 AMB CARE MOD 25	$133.10	$133.10	$52.18–$121.44	37% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4 AMB CARE ONLY	$255.05	$255.05	$99.98–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC EST PATIENT LEVEL 4 MOD 25	$255.05	$255.05	$99.98–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC EST PATIENT LEVEL 4	$255.05	$255.05	$99.98–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF EST PATIENT LEVEL 4	$255.05	$255.05	$75.76–$138.68	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF EST PATIENT LEVEL 4	$255.05	$255.05	$90.18–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PATIENT LEVEL 4	$255.05	$255.05	$99.98–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC PF EST PATIENT LEVEL 4	$255.05	$255.05	$90.18–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 - EST PATIENT COMP LEVEL 4	$255.05	$255.05	$99.98–$127.52	162% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4 AMB CARE MOD 25	$133.10	$133.10	$52.18–$121.44	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC EST PATIENT LEVEL 4	$255.05	$255.05	$99.98–$127.52	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC EST PATIENT LEVEL 4 MOD 25	$255.05	$255.05	$99.98–$127.52	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4 AMB CARE ONLY	$255.05	$255.05	$99.98–$127.52	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF EST PATIENT LEVEL 4	$255.05	$255.05	$75.76–$138.68	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 - EST PATIENT COMP LEVEL 4	$255.05	$255.05	$99.98–$127.52	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212- EST PATIENT LEVEL 2	$104.25	$104.25	$40.87–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF EST PATIENT LEVEL 2	$104.25	$104.25	$33.01–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF EST PATIENT LEVEL 2	$104.25	$104.25	$29.75–$56.46	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP LEVEL 2 AMB CARE ONLY	$104.25	$104.25	$40.87–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PATIENT LEVEL 2	$104.25	$104.25	$40.87–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC EST PATIENT LEVEL 2 MOD 25	$104.25	$104.25	$40.87–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC EST PATIENT LEVEL 2	$104.25	$104.25	$40.87–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP LEVEL 2 AMB CARE MOD 25	$104.25	$104.25	$40.87–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC PF EST PATIENT LEVEL 2	$104.25	$104.25	$33.01–$52.61	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC PF EST PATIENT LEVEL 2	$104.25	$104.25	$29.75–$56.46	66% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC EST PATIENT LEVEL 2 MOD 25	$104.25	$104.25	$40.87–$52.61	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212- EST PATIENT LEVEL 2	$104.25	$104.25	$40.87–$52.61	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC PF EST PATIENT LEVEL 2	$104.25	$104.25	$33.01–$52.61	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF EST PATIENT LEVEL 2	$104.25	$104.25	$29.75–$56.46	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP LEVEL 2 AMB CARE ONLY	$104.25	$104.25	$40.87–$52.61	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP LEVEL 2 AMB CARE MOD 25	$104.25	$104.25	$40.87–$52.61	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC EST PATIENT LEVEL 2	$104.25	$104.25	$40.87–$52.61	—	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION LEVEL 3	$251.60	$251.60	$98.63–$160.70	182% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 SURG CONSULTATION LEVEL 3	$251.60	$251.60	$98.63–$226.44	182% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION LEVEL 3	$251.60	$251.60	$98.63–$226.44	182% above	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 SURG CONSULTATION LEVEL 3	$251.60	$251.60	$98.63–$226.44	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION LEVEL 3	$251.60	$251.60	$98.63–$160.70	—	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION	$369.50	$369.50	$144.84–$332.55	192% above	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULTATION	$369.50	$369.50	$144.84–$332.55	—	—
Speech and language evaluation CPT 92523 SP SOUND LANG COMPREHENSION	$538.00	$538.00	$208.25–$269.00	196% above	—
Speech therapy session, individual CPT 92507 SP TREATMENT	$190.00	$190.00	$21.76–$95.00	39% above	—
Spirometry (breathing test) CPT 94010 PULMONARY FT W/O BD	$373.00	$373.00	$24.00–$186.50	83% above	—
Spirometry (breathing test) CPT 94010 PEAK FLOW PROCEDURE	$373.00	$373.00	$24.00–$186.50	83% above	—
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FT W/O BD	$373.00	$373.00	$24.00–$186.50	—	—
Spirometry (breathing test) inpatient CPT 94010 PEAK FLOW PROCEDURE	$373.00	$373.00	$24.00–$186.50	—	—
Spirometry before and after a bronchodilator CPT 94060 PULMONARY FT WITH BD	$748.00	$748.00	$37.30–$374.00	177% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 PULMONARY FT WITH BD	$748.00	$748.00	$37.30–$374.00	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PT FUNCTIONAL TRAINING	$63.85	$63.85	$21.76–$37.57	6% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT-THERAPEUTIC ACT'S	$92.00	$92.00	$21.76–$46.00	35% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$305.00	$305.00	$82.10–$152.50	127% above	—
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIO STRESS TEST	$80.00	$80.00	$31.36–$74.50	14% below	—
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIO STRESS TEST	$80.00	$80.00	$31.36–$74.50	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAC VARICELLA VIRUS LIVE	$208.80	$348.00	$132.86–$348.00	14% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VAC VARICELLA VIRUS LIVE	$208.80	$348.00	$132.86–$348.00	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 VAC INFLUENZA VIRUS INJ [0.5ML] SYR	$75.00	$75.00	$13.12–$59.92	103% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 VAC INFLUENZA VIRUS INJ [0.5ML] SYR	$75.00	$75.00	$13.12–$59.92	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 VAC GARDASIL 9	$418.20	$697.00	$215.02–$697.00	39% above	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 VAC GARDASIL 9	$418.20	$697.00	$215.02–$697.00	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE ADULT	$125.70	$125.70	$49.27–$125.70	13% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE	$125.70	$125.70	$49.27–$125.70	13% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VAC HEPATITIS B INJ [20MCG/ML]ADULT	$336.00	$336.00	$56.70–$213.25	203% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE	$125.70	$125.70	$49.27–$125.70	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE ADULT	$125.70	$125.70	$49.27–$125.70	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VAC HEPATITIS B INJ [20MCG/ML]ADULT	$336.00	$336.00	$56.70–$213.25	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 VAC MEASLES/MUMPS/RUBELLA	$115.20	$192.00	$34.64–$192.00	20% below	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VAC MEASLES/MUMPS/RUBELLA	$115.20	$192.00	$34.64–$192.00	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 VAC MENINGOCOCCAL ACY W-135 [0.5ML]	$183.30	$305.50	$65.60–$305.50	25% below	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 VAC MENINGOCOCCAL ACY W-135 [0.5ML]	$183.30	$305.50	$65.60–$305.50	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 VAC PNEUMOCOCCAL 20 INJ [0.5ML]	$988.00	$988.00	$283.71–$874.72	7% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 VAC PNEUMOCOCCAL 20 INJ [0.5ML]	$988.00	$988.00	$283.71–$874.72	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC	$155.20	$155.20	$60.84–$155.20	2% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 VAC PNEUMOCOCCAL 23 INJ [0.5ML]	$223.20	$372.00	$130.80–$372.00	41% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC	$155.20	$155.20	$60.84–$155.20	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 VAC PNEUMOCOCCAL 23 INJ [0.5ML]	$223.20	$372.00	$130.80–$372.00	—	40%
Rabies vaccine, one dose CPT 90675 VAC RABIES PF CHIC-EMB CELL	$670.20	$1,117.00	$262.98–$984.04	29% below	40%
Rabies vaccine, one dose inpatient CPT 90675 VAC RABIES PF CHIC-EMB CELL	$670.20	$1,117.00	$262.98–$984.04	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 VAC TETANUS DIPH TOX INJ ADULT 0.5ML	$60.50	$60.50	$14.00–$60.50	at median	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 VAC TETANUS DIPH TOX INJ ADULT 0.5ML	$60.50	$60.50	$14.00–$60.50	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACC ADULT	$97.64	$97.64	$28.80–$97.64	at median	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 VAC TETAN/DIPH/PERT INJ ADULT 0.5ML	$175.75	$175.75	$28.80–$116.07	80% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACC ADULT	$97.64	$97.64	$28.80–$97.64	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 VAC TETAN/DIPH/PERT INJ ADULT 0.5ML	$175.75	$175.75	$28.80–$116.07	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA H1N1	$150.00	$150.00	$13.14–$75.00	524% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE/TOXOID ADM	$169.00	$169.00	$13.14–$84.50	603% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION; 1 VACCINE	$169.00	$169.00	$13.14–$84.50	603% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN - COMMERCIAL PAYERS	$169.00	$169.00	$13.14–$84.50	603% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN INFLUENZA H1N1	$150.00	$150.00	$13.14–$75.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN - COMMERCIAL PAYERS	$169.00	$169.00	$13.14–$84.50	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION; 1 VACCINE	$169.00	$169.00	$13.14–$84.50	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADDTL VACCINATION	$5.00	$5.00	$1.96–$5.00	66% below	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IM ADMIN PRQ ID SUBQ/IM EACH VACCINE	$50.26	$50.26	$13.14–$45.23	—	—

Source file: https://chicotmemorial.com/mrf/383807713_CHICOT-MEMORIAL-MEDICAL-CENTER_standardcharges.csv