Hospital Las Vegas, NM

Alta Vista Regional Hospital

Listed in its price file as “San Miguel Hospital Corporation”.

Alta Vista Regional Hospital in Las Vegas, NM publishes cash prices for 301 common procedures listed here, from its own machine-readable price file updated Apr 16, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the New Mexico median for 230 of 300 procedures and below it for 58. By typical cash price it ranks #17 of 20 New Mexico hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

104 LEGION DRIVE,LAS VEGAS,NM,87701-4804 Collected Sep 27, 2026 Source price file Check a bill from this hospital (505) 426-3930

Critical access hospital (rural, 25 beds or fewer) For-profit hospital Emergency department CCN 321312 · CMS hospital register NPI 1114639234

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New Mexico	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$3,307.85	$6,615.71	$326.85–$6,615.71	37% above	50%
Abdominal CT scan without and with contrast CPT 74170 CT-ABDOMEN WWO	$3,307.85	$6,615.71	$326.85–$6,615.71	37% above	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$3,307.85	$6,615.71	$326.85–$6,615.71	—	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT-ABDOMEN WWO	$3,307.85	$6,615.71	$326.85–$6,615.71	—	50%
Ankle X-ray, complete, 3 or more views CPT 73610 LE-ANKLE 3VPLUS CR	$374.82	$749.64	$73.12–$749.64	41% above	50%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$374.82	$749.64	$73.12–$749.64	41% above	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 LE-ANKLE 3VPLUS CR	$374.82	$749.64	$73.12–$749.64	—	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY EXAM OF ANKLE	$374.82	$749.64	$73.12–$749.64	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$416.18	$832.37	$65.05–$832.37	2% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NI-EXT ARTERIAL LTD	$416.18	$832.37	$65.05–$832.37	2% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$416.18	$832.37	$65.05–$832.37	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NI-EXT ARTERIAL LTD	$416.18	$832.37	$65.05–$832.37	—	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE	$2,140.31	$4,280.63	$191.17–$4,280.63	52% above	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT-UPPER EXT WO	$2,140.31	$4,280.63	$191.17–$4,280.63	52% above	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O DYE	$2,140.31	$4,280.63	$191.17–$4,280.63	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT-UPPER EXT WO	$2,140.31	$4,280.63	$191.17–$4,280.63	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL-ESOPHAGUS	$374.82	$749.64	$85.78–$749.64	24% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$374.82	$749.64	$85.78–$749.64	24% below	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL-ESOPHAGUS	$374.82	$749.64	$85.78–$749.64	—	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$374.82	$749.64	$85.78–$749.64	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN BODY	$1,802.49	$3,604.99	$242.48–$3,604.99	76% above	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,802.49	$3,604.99	$242.48–$3,604.99	76% above	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE SCAN BODY	$1,802.49	$3,604.99	$242.48–$3,604.99	—	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$1,802.49	$3,604.99	$242.48–$3,604.99	—	50%
Breast ultrasound, complete, one breast CPT 76641 US-BREAST COMPLETE	$264.34	$528.68	$74.01–$528.68	46% below	50%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$264.34	$528.68	$74.01–$528.68	46% below	50%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE	$264.34	$528.68	$74.01–$528.68	—	50%
Breast ultrasound, complete, one breast inpatient CPT 76641 US-BREAST COMPLETE	$264.34	$528.68	$74.01–$528.68	—	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$264.34	$528.68	$74.01–$528.68	1% below	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 US-BREAST LIMITED	$264.34	$528.68	$74.01–$528.68	1% below	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED	$264.34	$528.68	$74.01–$528.68	—	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US-BREAST LIMITED	$264.34	$528.68	$74.01–$528.68	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA-ABDOMEN PELVIS	$3,431.32	$6,862.64	$547.72–$6,862.64	40% above	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST	$3,431.32	$6,862.64	$547.72–$6,862.64	40% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA-ABDOMEN PELVIS	$3,431.32	$6,862.64	$547.72–$6,862.64	—	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD&PLVS W/CONTRAST	$3,431.32	$6,862.64	$547.72–$6,862.64	—	50%
CT angiography (CTA) of the head CPT 70496 CTA-HEAD	$2,655.83	$5,311.66	$333.66–$5,311.66	54% above	50%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$2,655.83	$5,311.66	$333.66–$5,311.66	54% above	50%
CT angiography (CTA) of the head inpatient CPT 70496 CTA-HEAD	$2,655.83	$5,311.66	$333.66–$5,311.66	—	50%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD	$2,655.83	$5,311.66	$333.66–$5,311.66	—	50%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$1,031.13	$2,062.26	$288.71–$2,062.26	35% below	50%
CT angiography (CTA) of the neck CPT 70498 CTA-NECK	$1,031.13	$2,062.26	$288.71–$2,062.26	35% below	50%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA-NECK	$1,031.13	$2,062.26	$288.71–$2,062.26	—	50%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK	$1,031.13	$2,062.26	$288.71–$2,062.26	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$3,431.32	$6,862.64	$333.66–$6,862.64	52% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA-CHEST	$3,431.32	$6,862.64	$333.66–$6,862.64	52% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$3,431.32	$6,862.64	$333.66–$6,862.64	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA-CHEST	$3,431.32	$6,862.64	$333.66–$6,862.64	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT-ABD PELVIS WO	$4,000.05	$8,000.11	$185.92–$8,000.11	48% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$4,000.05	$8,000.11	$185.92–$8,000.11	48% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$4,000.05	$8,000.11	$185.92–$8,000.11	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT-ABD PELVIS WO	$4,000.05	$8,000.11	$185.92–$8,000.11	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT-ABD PELVIS W	$4,903.77	$9,807.54	$287.54–$9,807.54	47% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$4,903.77	$9,807.54	$287.54–$9,807.54	47% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST	$4,903.77	$9,807.54	$287.54–$9,807.54	—	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT-ABD PELVIS W	$4,903.77	$9,807.54	$287.54–$9,807.54	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$5,623.92	$11,247.85	$320.57–$11,247.85	40% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-ABD PELVIS WWO	$5,623.92	$11,247.85	$320.57–$11,247.85	40% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-ABD PELVIS WWO	$5,623.92	$11,247.85	$320.57–$11,247.85	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$5,623.92	$11,247.85	$320.57–$11,247.85	—	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$3,056.83	$6,113.66	$291.09–$6,113.66	49% above	50%
CT scan of the abdomen with contrast CPT 74160 CT-ABDOMEN W	$3,056.83	$6,113.66	$291.09–$6,113.66	49% above	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$3,056.83	$6,113.66	$291.09–$6,113.66	—	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN W	$3,056.83	$6,113.66	$291.09–$6,113.66	—	50%
CT scan of the abdomen without contrast CPT 74150 CT-ABDOMEN WO	$2,437.06	$4,874.13	$191.17–$4,874.13	37% above	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$2,437.06	$4,874.13	$191.17–$4,874.13	37% above	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$2,437.06	$4,874.13	$191.17–$4,874.13	—	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN WO	$2,437.06	$4,874.13	$191.17–$4,874.13	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT-MAXILLOFACIAL WO	$2,213.19	$4,426.38	$191.17–$4,426.38	70% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$2,213.19	$4,426.38	$191.17–$4,426.38	70% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-MAXILLOFACIAL WO	$2,213.19	$4,426.38	$191.17–$4,426.38	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE	$2,213.19	$4,426.38	$191.17–$4,426.38	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT-HEAD WO	$2,213.19	$4,426.38	$191.17–$4,426.38	47% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$2,213.19	$4,426.38	$191.17–$4,426.38	47% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-HEAD WO	$2,213.19	$4,426.38	$191.17–$4,426.38	—	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE	$2,213.19	$4,426.38	$191.17–$4,426.38	—	50%
CT scan of the head with contrast CPT 70460 CT-HEAD W	$2,415.66	$4,831.33	$291.09–$4,831.33	35% above	50%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$2,415.66	$4,831.33	$291.09–$4,831.33	35% above	50%
CT scan of the head with contrast inpatient CPT 70460 CT-HEAD W	$2,415.66	$4,831.33	$291.09–$4,831.33	—	50%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/DYE	$2,415.66	$4,831.33	$291.09–$4,831.33	—	50%
CT scan of the head without and with contrast CPT 70470 CT-HEAD WWO	$3,255.19	$6,510.38	$326.85–$6,510.38	62% above	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$3,255.19	$6,510.38	$326.85–$6,510.38	62% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$3,255.19	$6,510.38	$326.85–$6,510.38	—	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT-HEAD WWO	$3,255.19	$6,510.38	$326.85–$6,510.38	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT-LUMB SPINE WO	$2,031.69	$4,063.39	$191.17–$4,063.39	13% above	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$2,031.69	$4,063.39	$191.17–$4,063.39	13% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$2,031.69	$4,063.39	$191.17–$4,063.39	—	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-LUMB SPINE WO	$2,031.69	$4,063.39	$191.17–$4,063.39	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT-CERV SPINE WO	$3,179.46	$6,358.93	$191.17–$6,358.93	54% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$3,179.46	$6,358.93	$191.17–$6,358.93	54% above	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE	$3,179.46	$6,358.93	$191.17–$6,358.93	—	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-CERV SPINE WO	$3,179.46	$6,358.93	$191.17–$6,358.93	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT-PELVIS W	$1,846.93	$3,693.87	$291.09–$3,693.87	6% below	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,846.93	$3,693.87	$291.09–$3,693.87	6% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W	$1,846.93	$3,693.87	$291.09–$3,693.87	—	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE	$1,846.93	$3,693.87	$291.09–$3,693.87	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$2,824.71	$5,649.43	$151.97–$11,298.86	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US-CRAN DPLX SCN BIL	$2,824.71	$5,649.43	$151.97–$11,298.86	454% above	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US-CAROTID DPLX SCAN	$2,824.71	$5,649.43	$151.97–$11,298.86	454% above	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$2,824.71	$5,649.43	$151.97–$11,298.86	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US-CAROTID DPLX SCAN	$2,824.71	$5,649.43	$151.97–$11,298.86	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US-CRAN DPLX SCN BIL	$2,824.71	$5,649.43	$151.97–$11,298.86	—	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$2,511.15	$5,022.30	$326.85–$5,022.30	19% above	50%
Chest CT scan without and with contrast CPT 71270 CT-CHEST DIAG WWO	$2,511.15	$5,022.30	$326.85–$5,022.30	19% above	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT-CHEST DIAG WWO	$2,511.15	$5,022.30	$326.85–$5,022.30	—	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DX C-/C+	$2,511.15	$5,022.30	$326.85–$5,022.30	—	50%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$327.50	$655.00	$60.87–$655.00	35% above	50%
Chest X-ray, 2 views CPT 71046 CH-CHEST 2V CR	$327.50	$655.00	$60.87–$655.00	35% above	50%
Chest X-ray, 2 views inpatient CPT 71046 CH-CHEST 2V CR	$327.50	$655.00	$60.87–$655.00	—	50%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$327.50	$655.00	$60.87–$655.00	—	50%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$249.87	$499.74	$51.62–$499.74	17% above	50%
Chest X-ray, single view CPT 71045 CH-CHEST 1V CR	$249.87	$499.74	$51.62–$499.74	17% above	50%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$249.87	$499.74	$51.62–$499.74	—	50%
Chest X-ray, single view inpatient CPT 71045 CH-CHEST 1V CR	$249.87	$499.74	$51.62–$499.74	—	50%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE	$327.50	$655.00	$58.15–$655.00	32% above	50%
Collarbone (clavicle) X-ray, complete CPT 73000 UE-CLAVICLE CR	$327.50	$655.00	$58.15–$655.00	32% above	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 UE-CLAVICLE CR	$327.50	$655.00	$58.15–$655.00	—	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY EXAM OF COLLAR BONE	$327.50	$655.00	$58.15–$655.00	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$467.49	$934.98	$95.34–$934.98	11% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US-ABDOMEN LIMITED	$467.49	$934.98	$95.34–$934.98	11% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$467.49	$934.98	$95.34–$934.98	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-ABDOMEN LIMITED	$467.49	$934.98	$95.34–$934.98	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$252.71	$505.42	$70.75–$505.42	at median	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL	$252.71	$505.42	$70.75–$505.42	at median	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$252.71	$505.42	$70.75–$505.42	—	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL	$252.71	$505.42	$70.75–$505.42	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA PERIPHERAL	$150.49	$300.99	$28.53–$300.99	32% below	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULR	$150.49	$300.99	$28.53–$300.99	32% below	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA PERIPHERAL	$150.49	$300.99	$28.53–$300.99	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY APPENDICULR	$150.49	$300.99	$28.53–$300.99	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-CHEST DIAG WO	$1,997.55	$3,995.10	$191.17–$3,995.10	23% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$1,997.55	$3,995.10	$191.17–$3,995.10	23% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-CHEST DIAG WO	$1,997.55	$3,995.10	$191.17–$3,995.10	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$1,997.55	$3,995.10	$191.17–$3,995.10	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$2,595.08	$5,190.17	$291.09–$5,190.17	37% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT-CHEST DIAG W	$2,595.08	$5,190.17	$291.09–$5,190.17	37% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX C+	$2,595.08	$5,190.17	$291.09–$5,190.17	—	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-CHEST DIAG W	$2,595.08	$5,190.17	$291.09–$5,190.17	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BILAT	$421.81	$843.63	$100.07–$1,946.83	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$551.60	$1,103.20	$100.07–$1,946.83	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BI GG	$551.60	$1,103.20	$100.07–$1,946.83	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BILAT	$421.81	$843.63	$100.07–$1,946.83	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BI GG	$551.60	$1,103.20	$100.07–$1,946.83	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$551.60	$1,103.20	$100.07–$1,946.83	—	50%
Diagnostic mammogram, one breast CPT 77065 BR-DIG MAMMO UNI GG	$340.30	$680.61	$77.98–$1,361.22	84% above	50%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$340.30	$680.61	$77.98–$1,361.22	84% above	50%
Diagnostic mammogram, one breast one side CPT 77065 BR-DIG MAMMO UNILAT	$340.30	$680.61	$77.98–$1,361.22	84% above	50%
Diagnostic mammogram, one breast inpatient CPT 77065 BR-DIG MAMMO UNI GG	$340.30	$680.61	$77.98–$1,361.22	—	50%
Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI	$340.30	$680.61	$77.98–$1,361.22	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-DIG MAMMO UNILAT	$340.30	$680.61	$77.98–$1,361.22	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 NI-LW EXT DPX ART BI	$1,388.49	$2,776.99	$151.97–$2,776.99	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$1,388.49	$2,776.99	$151.97–$2,776.99	55% above	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 NI-LW EXT DPX ART BI	$1,388.49	$2,776.99	$151.97–$2,776.99	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 LOWER EXTREMITY STUDY	$1,388.49	$2,776.99	$151.97–$2,776.99	—	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 US-EXT VEINS DPLX WC	$578.61	$1,157.22	$151.97–$1,157.22	34% below	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$578.61	$1,157.22	$151.97–$1,157.22	34% below	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$578.61	$1,157.22	$151.97–$1,157.22	—	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US-EXT VEINS DPLX WC	$578.61	$1,157.22	$151.97–$1,157.22	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI-TTE 2D W DOPP	$2,679.86	$5,359.73	$441.95–$15,617.86	102% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$5,129.06	$10,258.13	$441.95–$15,617.86	286% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US-TTE 2D W DOPP WO	$5,129.06	$10,258.13	$441.95–$15,617.86	286% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI-TTE 2D W DOPP	$2,679.86	$5,359.73	$441.95–$15,617.86	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US-TTE 2D W DOPP WO	$5,129.06	$10,258.13	$441.95–$15,617.86	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$5,129.06	$10,258.13	$441.95–$15,617.86	—	50%
Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW	$152.38	$304.77	$42.66–$304.77	32% below	50%
Elbow X-ray, 2 views CPT 73070 UE-ELBOW 2V CR	$152.38	$304.77	$42.66–$304.77	32% below	50%
Elbow X-ray, 2 views inpatient CPT 73070 UE-ELBOW 2V CR	$152.38	$304.77	$42.66–$304.77	—	50%
Elbow X-ray, 2 views inpatient CPT 73070 X-RAY EXAM OF ELBOW	$152.38	$304.77	$42.66–$304.77	—	50%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW	$249.87	$499.74	$58.15–$499.74	3% above	50%
Elbow X-ray, complete, 3 or more views CPT 73080 UE-ELBOW 3V CR	$249.87	$499.74	$58.15–$499.74	3% above	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 UE-ELBOW 3V CR	$249.87	$499.74	$58.15–$499.74	—	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY EXAM OF ELBOW	$249.87	$499.74	$58.15–$499.74	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT-ORBIT EAR WO	$1,345.69	$2,691.39	$191.17–$2,691.39	at median	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$1,345.69	$2,691.39	$191.17–$2,691.39	at median	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$1,345.69	$2,691.39	$191.17–$2,691.39	—	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT-ORBIT EAR WO	$1,345.69	$2,691.39	$191.17–$2,691.39	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 HE-FACIAL BNES 3V CR	$538.56	$1,077.13	$93.08–$1,077.13	76% above	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES	$538.56	$1,077.13	$93.08–$1,077.13	76% above	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY EXAM OF FACIAL BONES	$538.56	$1,077.13	$93.08–$1,077.13	—	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HE-FACIAL BNES 3V CR	$538.56	$1,077.13	$93.08–$1,077.13	—	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM	$287.74	$575.48	$58.15–$575.48	17% above	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 UE-FOREARM 2V CR	$287.74	$575.48	$58.15–$575.48	17% above	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 UE-FOREARM 2V CR	$287.74	$575.48	$58.15–$575.48	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY EXAM OF FOREARM	$287.74	$575.48	$58.15–$575.48	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,366.28	$2,732.56	$276.77–$2,732.56	46% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HEPATOBILIARY SYS	$1,366.28	$2,732.56	$276.77–$2,732.56	46% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,366.28	$2,732.56	$276.77–$2,732.56	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HEPATOBILIARY SYS	$1,366.28	$2,732.56	$276.77–$2,732.56	—	50%
Hand X-ray, 2 views CPT 73120 UE-HAND 2V CR	$160.00	$320.00	$44.80–$320.00	32% below	50%
Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND	$160.00	$320.00	$44.80–$320.00	32% below	50%
Hand X-ray, 2 views inpatient CPT 73120 X-RAY EXAM OF HAND	$160.00	$320.00	$44.80–$320.00	—	50%
Hand X-ray, 2 views inpatient CPT 73120 UE-HAND 2V CR	$160.00	$320.00	$44.80–$320.00	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL	$209.16	$418.33	$57.35–$418.33	11% below	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 LE-CALCANEUS 2PLS CR	$209.16	$418.33	$57.35–$418.33	11% below	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY EXAM OF HEEL	$209.16	$418.33	$57.35–$418.33	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 LE-CALCANEUS 2PLS CR	$209.16	$418.33	$57.35–$418.33	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$682.69	$1,365.39	$158.82–$1,365.39	107% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED WITHOUT TIMES	$682.69	$1,365.39	$158.82–$1,365.39	107% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED WITHOUT TIMES	$682.69	$1,365.39	$158.82–$1,365.39	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$682.69	$1,365.39	$158.82–$1,365.39	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$2,395.32	$4,790.64	$670.68–$4,790.64	32% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY	$2,395.32	$4,790.64	$670.68–$4,790.64	32% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY	$2,395.32	$4,790.64	$670.68–$4,790.64	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$2,395.32	$4,790.64	$670.68–$4,790.64	—	50%
Knee X-ray, 3 views both sides CPT 73562 LE-KNEE 3VWS BI CR	$720.18	$1,440.37	$81.73–$2,286.55	—	50%
Knee X-ray, 3 views CPT 73562 LE-KNEE 3V CR	$423.09	$846.18	$81.73–$2,286.55	42% above	50%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$423.09	$846.18	$81.73–$2,286.55	42% above	50%
Knee X-ray, 3 views inpatient both sides CPT 73562 LE-KNEE 3VWS BI CR	$720.18	$1,440.37	$81.73–$2,286.55	—	50%
Knee X-ray, 3 views inpatient CPT 73562 X-RAY EXAM OF KNEE 3	$423.09	$846.18	$81.73–$2,286.55	—	50%
Knee X-ray, 3 views inpatient CPT 73562 LE-KNEE 3V CR	$423.09	$846.18	$81.73–$2,286.55	—	50%
Knee X-ray, complete, 4 or more views both sides CPT 73564 LE-KNEE 4VWPLS BI CR	$954.07	$1,908.15	$93.08–$2,862.22	—	50%
Knee X-ray, complete, 4 or more views CPT 73564 LE-KNEE 4V PLUS CR	$477.03	$954.07	$93.08–$2,862.22	36% above	50%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$477.03	$954.07	$93.08–$2,862.22	36% above	50%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 LE-KNEE 4VWPLS BI CR	$954.07	$1,908.15	$93.08–$2,862.22	—	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 LE-KNEE 4V PLUS CR	$477.03	$954.07	$93.08–$2,862.22	—	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$477.03	$954.07	$93.08–$2,862.22	—	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE	$2,745.05	$5,490.11	$191.17–$5,490.11	66% above	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT-LOWER EXT WO	$2,745.05	$5,490.11	$191.17–$5,490.11	66% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O DYE	$2,745.05	$5,490.11	$191.17–$5,490.11	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT-LOWER EXT WO	$2,745.05	$5,490.11	$191.17–$5,490.11	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US-ABDOMEN LTD WO	$270.78	$541.57	$75.81–$541.57	44% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$270.78	$541.57	$75.81–$541.57	44% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$270.78	$541.57	$75.81–$541.57	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US-ABDOMEN LTD WO	$270.78	$541.57	$75.81–$541.57	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$344.86	$689.72	$89.83–$689.72	8% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US-EXT LTD JNT UNI	$344.86	$689.72	$89.83–$689.72	8% above	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$344.86	$689.72	$89.83–$689.72	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US-EXT LTD JNT UNI	$344.86	$689.72	$89.83–$689.72	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$219.72	$439.44	$61.52–$439.44	48% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-LUNG LOWDSE SC WO	$219.72	$439.44	$61.52–$439.44	48% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-LUNG LOWDSE SC WO	$219.72	$439.44	$61.52–$439.44	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C-	$219.72	$439.44	$61.52–$439.44	—	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 LE-TIB FIB 2V CR	$337.90	$675.80	$58.15–$675.80	23% above	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG	$337.90	$675.80	$58.15–$675.80	23% above	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY EXAM OF LOWER LEG	$337.90	$675.80	$58.15–$675.80	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 LE-TIB FIB 2V CR	$337.90	$675.80	$58.15–$675.80	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRA-HEAD WO	$3,814.03	$7,628.07	$342.54–$7,628.07	109% above	50%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$3,814.03	$7,628.07	$342.54–$7,628.07	109% above	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA-HEAD WO	$3,814.03	$7,628.07	$342.54–$7,628.07	—	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$3,814.03	$7,628.07	$342.54–$7,628.07	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$3,139.95	$6,279.90	$342.54–$6,279.90	113% above	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR-LW JOINT WO	$3,139.95	$6,279.90	$342.54–$6,279.90	113% above	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$3,139.95	$6,279.90	$342.54–$6,279.90	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR-LW JOINT WO	$3,139.95	$6,279.90	$342.54–$6,279.90	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR-LW JOINT WWO	$4,021.77	$8,043.54	$524.71–$8,043.54	62% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$4,021.77	$8,043.54	$524.71–$8,043.54	62% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR-LW JOINT WWO	$4,021.77	$8,043.54	$524.71–$8,043.54	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$4,021.77	$8,043.54	$524.71–$8,043.54	—	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,907.03	$5,814.06	$342.54–$5,814.06	34% above	50%
MRI of the abdomen without contrast CPT 74181 MR-ABDOMEN WO	$2,907.03	$5,814.06	$342.54–$5,814.06	34% above	50%
MRI of the abdomen without contrast inpatient CPT 74181 MR-ABDOMEN WO	$2,907.03	$5,814.06	$342.54–$5,814.06	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,907.03	$5,814.06	$342.54–$5,814.06	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$3,973.71	$7,947.42	$524.71–$7,947.42	44% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR-ABDOMEN WWO	$3,973.71	$7,947.42	$524.71–$7,947.42	44% above	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$3,973.71	$7,947.42	$524.71–$7,947.42	—	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR-ABDOMEN WWO	$3,973.71	$7,947.42	$524.71–$7,947.42	—	50%
MRI of the brain, no contrast dye CPT 70551 MR-BRAIN WO	$3,909.50	$7,819.00	$342.54–$7,819.00	112% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	112% above	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MR-BRAIN WO	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MR-BRAIN WWO	$4,530.08	$9,060.17	$524.71–$9,060.17	64% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$4,530.08	$9,060.17	$524.71–$9,060.17	64% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE	$4,530.08	$9,060.17	$524.71–$9,060.17	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR-BRAIN WWO	$4,530.08	$9,060.17	$524.71–$9,060.17	—	50%
MRI of the lower back, no contrast dye CPT 72148 MR-LUMB SPINE WO	$3,909.50	$7,819.00	$342.54–$7,819.00	92% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	92% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR-LUMB SPINE WO	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$4,530.08	$9,060.17	$524.71–$9,060.17	58% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MR-LUMB SPINE WWO	$4,530.08	$9,060.17	$524.71–$9,060.17	58% above	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$4,530.08	$9,060.17	$524.71–$9,060.17	—	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR-LUMB SPINE WWO	$4,530.08	$9,060.17	$524.71–$9,060.17	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR-THOR SPINE WO	$3,909.50	$7,819.00	$342.54–$7,819.00	76% above	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	76% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR-THOR SPINE WO	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR-CERV SPINE WWO	$4,530.08	$9,060.17	$524.71–$9,060.17	61% above	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$4,530.08	$9,060.17	$524.71–$9,060.17	61% above	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI NECK SPINE W/O & W/DYE	$4,530.08	$9,060.17	$524.71–$9,060.17	—	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR-CERV SPINE WWO	$4,530.08	$9,060.17	$524.71–$9,060.17	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	88% above	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR-CERV SPINE WO	$3,909.50	$7,819.00	$342.54–$7,819.00	88% above	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR-CERV SPINE WO	$3,909.50	$7,819.00	$342.54–$7,819.00	—	50%
MRI of the pelvis without and with contrast CPT 72197 MR-PELVIS WWO	$4,691.40	$9,382.80	$524.71–$9,382.80	51% above	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$4,691.40	$9,382.80	$524.71–$9,382.80	51% above	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR-PELVIS WWO	$4,691.40	$9,382.80	$524.71–$9,382.80	—	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE	$4,691.40	$9,382.80	$524.71–$9,382.80	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$3,553.95	$7,107.90	$342.54–$7,107.90	79% above	50%
MRI of the pelvis, no contrast dye CPT 72195 MR-PELVIS WO	$3,553.95	$7,107.90	$342.54–$7,107.90	79% above	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE	$3,553.95	$7,107.90	$342.54–$7,107.90	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR-PELVIS WO	$3,553.95	$7,107.90	$342.54–$7,107.90	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR-UPPER JOINT WO	$3,139.95	$6,279.90	$342.54–$6,279.90	102% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$3,139.95	$6,279.90	$342.54–$6,279.90	102% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR-UPPER JOINT WO	$3,139.95	$6,279.90	$342.54–$6,279.90	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$3,139.95	$6,279.90	$342.54–$6,279.90	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SP-CERV SP 4TO5VW CR	$491.23	$982.47	$93.08–$982.47	25% above	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$491.23	$982.47	$93.08–$982.47	25% above	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SP-CERV SP 4TO5VW CR	$491.23	$982.47	$93.08–$982.47	—	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$491.23	$982.47	$93.08–$982.47	—	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$859.27	$1,718.55	$240.59–$1,718.55	48% below	50%
Neck soft tissue CT scan with contrast CPT 70491 CT-NECK SOFT TIS W	$859.27	$1,718.55	$240.59–$1,718.55	48% below	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/DYE	$859.27	$1,718.55	$240.59–$1,718.55	—	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT-NECK SOFT TIS W	$859.27	$1,718.55	$240.59–$1,718.55	—	50%
Neck soft tissue CT scan without contrast CPT 70490 CT-NECK SOFT TIS WO	$704.54	$1,409.08	$191.17–$1,409.08	52% below	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE	$704.54	$1,409.08	$191.17–$1,409.08	52% below	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT-NECK SOFT TIS WO	$704.54	$1,409.08	$191.17–$1,409.08	—	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O DYE	$704.54	$1,409.08	$191.17–$1,409.08	—	50%
Neck soft tissue X-ray CPT 70360 SP-NECK SOFT TISS CR	$249.87	$499.74	$58.15–$499.74	6% above	50%
Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK	$249.87	$499.74	$58.15–$499.74	6% above	50%
Neck soft tissue X-ray inpatient CPT 70360 SP-NECK SOFT TISS CR	$249.87	$499.74	$58.15–$499.74	—	50%
Neck soft tissue X-ray inpatient CPT 70360 X-RAY EXAM OF NECK	$249.87	$499.74	$58.15–$499.74	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM-MYOCRD SPECT MULT	$1,896.31	$3,792.63	$530.96–$3,792.63	18% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$1,896.31	$3,792.63	$530.96–$3,792.63	18% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$1,896.31	$3,792.63	$530.96–$3,792.63	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-MYOCRD SPECT MULT	$1,896.31	$3,792.63	$530.96–$3,792.63	—	50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$1,562.98	$3,125.96	$191.17–$3,125.96	7% below	50%
Pelvic CT scan without contrast CPT 72192 CT-PELVIS WO	$1,562.98	$3,125.96	$191.17–$3,125.96	7% below	50%
Pelvic CT scan without contrast inpatient CPT 72192 CT-PELVIS WO	$1,562.98	$3,125.96	$191.17–$3,125.96	—	50%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O DYE	$1,562.98	$3,125.96	$191.17–$3,125.96	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-PELVIS NON OB FU	$395.88	$791.77	$61.22–$791.77	4% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$395.88	$791.77	$61.22–$791.77	4% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIS NON OB FU	$395.88	$791.77	$61.22–$791.77	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$395.88	$791.77	$61.22–$791.77	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US-PELVIS NON OB	$395.88	$791.77	$95.34–$791.77	24% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$395.88	$791.77	$95.34–$791.77	24% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIS NON OB	$395.88	$791.77	$95.34–$791.77	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$395.88	$791.77	$95.34–$791.77	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$644.44	$1,288.89	$95.34–$1,288.89	26% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US-PELVIS PREG	$644.44	$1,288.89	$95.34–$1,288.89	26% above	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-PELVIS PREG	$644.44	$1,288.89	$95.34–$1,288.89	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS	$644.44	$1,288.89	$95.34–$1,288.89	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-PELVIS PREG LTD	$439.52	$879.05	$61.22–$879.05	at median	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$439.52	$879.05	$61.22–$879.05	at median	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$439.52	$879.05	$61.22–$879.05	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PELVIS PREG LTD	$439.52	$879.05	$61.22–$879.05	—	50%
Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$152.38	$304.77	$42.66–$304.77	43% below	50%
Rib X-ray, one side, 2 views one side CPT 71100 CH-RIBS UNILAT CR	$152.38	$304.77	$42.66–$304.77	43% below	50%
Rib X-ray, one side, 2 views inpatient CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$152.38	$304.77	$42.66–$304.77	—	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CH-RIBS UNILAT CR	$152.38	$304.77	$42.66–$304.77	—	50%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 CH-RIB UNI PA CXR CR	$409.83	$819.67	$84.59–$819.67	36% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$409.83	$819.67	$84.59–$819.67	36% above	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 CH-RIB UNI PA CXR CR	$409.83	$819.67	$84.59–$819.67	—	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$409.83	$819.67	$84.59–$819.67	—	50%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$295.19	$590.39	$82.44–$1,180.78	—	50%
Screening mammogram, both breasts both sides CPT 77067 BR-DIG MAMMO SCRN BI	$295.19	$590.39	$82.44–$1,180.78	—	50%
Screening mammogram, both breasts CPT 77067 BR-DIG MAMMO SCRN UN	$295.19	$590.39	$82.44–$1,180.78	4% above	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD	$295.19	$590.39	$82.44–$1,180.78	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 BR-DIG MAMMO SCRN BI	$295.19	$590.39	$82.44–$1,180.78	—	50%
Screening mammogram, both breasts inpatient CPT 77067 BR-DIG MAMMO SCRN UN	$295.19	$590.39	$82.44–$1,180.78	—	50%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 UE-SHOULDER 2V BI CR	$654.99	$1,309.99	$70.25–$1,964.99	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$327.50	$655.00	$70.25–$1,964.99	38% above	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 UE-SHLDR 2VW PLUS CR	$327.50	$655.00	$70.25–$1,964.99	38% above	50%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 UE-SHOULDER 2V BI CR	$654.99	$1,309.99	$70.25–$1,964.99	—	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY EXAM OF SHOULDER	$327.50	$655.00	$70.25–$1,964.99	—	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 UE-SHLDR 2VW PLUS CR	$327.50	$655.00	$70.25–$1,964.99	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES	$538.56	$1,077.13	$75.27–$1,077.13	75% above	50%
Sinus X-ray, complete, 3 or more views CPT 70220 HE-SINUSES 3VPLUS CR	$538.56	$1,077.13	$75.27–$1,077.13	75% above	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY EXAM OF SINUSES	$538.56	$1,077.13	$75.27–$1,077.13	—	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HE-SINUSES 3VPLUS CR	$538.56	$1,077.13	$75.27–$1,077.13	—	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL	$444.86	$889.73	$71.69–$889.73	40% above	50%
Skull X-ray, fewer than 4 views CPT 70250 HE-SKULL LIMITED CR	$444.86	$889.73	$71.69–$889.73	40% above	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HE-SKULL LIMITED CR	$444.86	$889.73	$71.69–$889.73	—	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY EXAM OF SKULL	$444.86	$889.73	$71.69–$889.73	—	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY SLEEP STUDY	$2,147.53	$4,295.07	$601.30–$4,295.07	38% above	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,147.53	$4,295.07	$601.30–$4,295.07	38% above	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY SLEEP STUDY	$2,147.53	$4,295.07	$601.30–$4,295.07	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,147.53	$4,295.07	$601.30–$4,295.07	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL-MOD BA SWALLOW	$275.43	$550.86	$77.12–$550.86	48% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$275.43	$550.86	$77.12–$550.86	48% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$275.43	$550.86	$77.12–$550.86	—	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL-MOD BA SWALLOW	$275.43	$550.86	$77.12–$550.86	—	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 LE-FEMUR 2V CR	$327.50	$655.00	$59.58–$655.00	40% above	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$327.50	$655.00	$59.58–$655.00	40% above	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 LE-FEMUR 2V CR	$327.50	$655.00	$59.58–$655.00	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/>	$327.50	$655.00	$59.58–$655.00	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT-THOR SPINE WO	$3,179.46	$6,358.93	$191.17–$6,358.93	86% above	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$3,179.46	$6,358.93	$191.17–$6,358.93	86% above	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT-THOR SPINE WO	$3,179.46	$6,358.93	$191.17–$6,358.93	—	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT CHEST SPINE W/O DYE	$3,179.46	$6,358.93	$191.17–$6,358.93	—	50%
Toe X-ray, 2 or more views CPT 73660 LE-TOE S 2VPLUS CR	$249.87	$499.74	$58.15–$499.74	32% above	50%
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$249.87	$499.74	$58.15–$499.74	32% above	50%
Toe X-ray, 2 or more views inpatient CPT 73660 LE-TOE S 2VPLUS CR	$249.87	$499.74	$58.15–$499.74	—	50%
Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY EXAM OF TOE(S)	$249.87	$499.74	$58.15–$499.74	—	50%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$293.82	$587.65	$82.27–$587.65	40% below	50%
Transvaginal pelvic ultrasound CPT 76830 US-TRANSVAGINAL	$293.82	$587.65	$82.27–$587.65	40% below	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANSVAGINAL	$293.82	$587.65	$82.27–$587.65	—	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB	$293.82	$587.65	$82.27–$587.65	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$293.82	$587.65	$61.22–$587.65	15% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 US-PLV PRG TRNSV	$293.82	$587.65	$61.22–$587.65	15% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$293.82	$587.65	$61.22–$587.65	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-PLV PRG TRNSV	$293.82	$587.65	$61.22–$587.65	—	50%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$512.76	$1,025.52	$95.34–$1,025.52	14% below	50%
Ultrasound of the abdomen, complete CPT 76700 US-ABDOMEN COMP WO	$512.76	$1,025.52	$95.34–$1,025.52	14% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN COMP WO	$512.76	$1,025.52	$95.34–$1,025.52	—	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$512.76	$1,025.52	$95.34–$1,025.52	—	50%
Ultrasound of the scrotum and testicles CPT 76870 US-SCROTUM	$512.76	$1,025.52	$95.34–$1,025.52	2% below	50%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$512.76	$1,025.52	$95.34–$1,025.52	2% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US-SCROTUM	$512.76	$1,025.52	$95.34–$1,025.52	—	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM	$512.76	$1,025.52	$95.34–$1,025.52	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US-HEAD NECK SFT TIS	$512.76	$1,025.52	$95.34–$1,025.52	12% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$512.76	$1,025.52	$95.34–$1,025.52	12% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$512.76	$1,025.52	$95.34–$1,025.52	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-HEAD NECK SFT TIS	$512.76	$1,025.52	$95.34–$1,025.52	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$989.10	$1,978.20	$85.78–$1,978.20	88% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL-UPPER GI SINGLE	$989.10	$1,978.20	$85.78–$1,978.20	88% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$989.10	$1,978.20	$85.78–$1,978.20	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL-UPPER GI SINGLE	$989.10	$1,978.20	$85.78–$1,978.20	—	50%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS	$287.74	$575.48	$58.15–$575.48	16% above	50%
Upper arm X-ray (humerus), 2 views CPT 73060 UE-HUMERUS CR	$287.74	$575.48	$58.15–$575.48	16% above	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY EXAM OF HUMERUS	$287.74	$575.48	$58.15–$575.48	—	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 UE-HUMERUS CR	$287.74	$575.48	$58.15–$575.48	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US-EXT VEINS DPX LTD	$521.83	$1,043.66	$95.34–$1,043.66	11% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$521.83	$1,043.66	$95.34–$1,043.66	11% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$521.83	$1,043.66	$95.34–$1,043.66	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US-EXT VEINS DPX LTD	$521.83	$1,043.66	$95.34–$1,043.66	—	50%
Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST	$152.38	$304.77	$42.66–$304.77	32% below	50%
Wrist X-ray, 2 views CPT 73100 UE-WRIST 2V CR	$152.38	$304.77	$42.66–$304.77	32% below	50%
Wrist X-ray, 2 views inpatient CPT 73100 UE-WRIST 2V CR	$152.38	$304.77	$42.66–$304.77	—	50%
Wrist X-ray, 2 views inpatient CPT 73100 X-RAY EXAM OF WRIST	$152.38	$304.77	$42.66–$304.77	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 UE-WRIST 3V PLUS CR	$327.50	$655.00	$58.15–$655.00	24% above	50%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$327.50	$655.00	$58.15–$655.00	24% above	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 UE-WRIST 3V PLUS CR	$327.50	$655.00	$58.15–$655.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY EXAM OF WRIST	$327.50	$655.00	$58.15–$655.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 LE-HIP PV UN2OR3V CR	$322.70	$645.41	$59.58–$645.41	38% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$322.70	$645.41	$59.58–$645.41	38% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$322.70	$645.41	$59.58–$645.41	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 LE-HIP PV UN2OR3V CR	$322.70	$645.41	$59.58–$645.41	—	50%
X-ray of the abdomen, 1 view CPT 74018 CH-ABDOMEN 1 VIEW CR	$249.87	$499.74	$60.87–$499.74	7% above	50%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$249.87	$499.74	$60.87–$499.74	7% above	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 CH-ABDOMEN 1 VIEW CR	$249.87	$499.74	$60.87–$499.74	—	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADEX ABDOMEN 1 VIEW	$249.87	$499.74	$60.87–$499.74	—	50%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$152.38	$304.77	$42.66–$304.77	24% below	50%
X-ray of the ankle, 2 views CPT 73600 LE-ANKLE 2V CR	$152.38	$304.77	$42.66–$304.77	24% below	50%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY EXAM OF ANKLE	$152.38	$304.77	$42.66–$304.77	—	50%
X-ray of the ankle, 2 views inpatient CPT 73600 LE-ANKLE 2V CR	$152.38	$304.77	$42.66–$304.77	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$249.87	$499.74	$58.15–$499.74	38% above	50%
X-ray of the finger(s), 2 or more views CPT 73140 UE-FINGER S 2VPLS CR	$249.87	$499.74	$58.15–$499.74	38% above	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S)	$249.87	$499.74	$58.15–$499.74	—	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 UE-FINGER S 2VPLS CR	$249.87	$499.74	$58.15–$499.74	—	50%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$165.00	$330.00	$46.20–$330.00	24% below	50%
X-ray of the foot, 2 views CPT 73620 LE-FOOT 2V CR	$165.00	$330.00	$46.20–$330.00	24% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 LE-FOOT 2V CR	$165.00	$330.00	$46.20–$330.00	—	50%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY EXAM OF FOOT	$165.00	$330.00	$46.20–$330.00	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 LE-FOOT 3V PLUS CR	$374.82	$749.64	$58.15–$749.64	40% above	50%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$374.82	$749.64	$58.15–$749.64	40% above	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY EXAM OF FOOT	$374.82	$749.64	$58.15–$749.64	—	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 LE-FOOT 3V PLUS CR	$374.82	$749.64	$58.15–$749.64	—	50%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$327.50	$655.00	$58.15–$655.00	34% above	50%
X-ray of the hand, 3 or more views CPT 73130 UE-HAND 3V CR	$327.50	$655.00	$58.15–$655.00	34% above	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY EXAM OF HAND	$327.50	$655.00	$58.15–$655.00	—	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 UE-HAND 3V CR	$327.50	$655.00	$58.15–$655.00	—	50%
X-ray of the knee, 1 or 2 views both sides CPT 73560 LE-KNEE 1TO2V BI CR	$654.99	$1,309.99	$58.15–$1,964.99	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 LE-KNEE 1 TO 2V CR	$327.50	$655.00	$58.15–$1,964.99	40% above	50%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$654.99	$1,309.99	$58.15–$1,964.99	180% above	50%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 LE-KNEE 1TO2V BI CR	$654.99	$1,309.99	$58.15–$1,964.99	—	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 LE-KNEE 1 TO 2V CR	$327.50	$655.00	$58.15–$1,964.99	—	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$654.99	$1,309.99	$58.15–$1,964.99	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP-LS SPN 2 TO 3V CR	$327.50	$655.00	$80.29–$655.00	5% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$327.50	$655.00	$80.29–$655.00	5% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP-LS SPN 2 TO 3V CR	$327.50	$655.00	$80.29–$655.00	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$327.50	$655.00	$80.29–$655.00	—	50%
X-ray of the lower back, 4 or more views CPT 72110 SP-LS SPNE 4VPLUS CR	$491.23	$982.47	$93.08–$982.47	25% above	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$491.23	$982.47	$93.08–$982.47	25% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SP-LS SPNE 4VPLUS CR	$491.23	$982.47	$93.08–$982.47	—	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$491.23	$982.47	$93.08–$982.47	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SP-T SPINE 2 VIEW CR	$327.50	$655.00	$65.95–$655.00	11% above	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$327.50	$655.00	$65.95–$655.00	11% above	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SP-T SPINE 2 VIEW CR	$327.50	$655.00	$65.95–$655.00	—	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$327.50	$655.00	$65.95–$655.00	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 HE-NASAL BONES CR	$327.50	$655.00	$58.15–$655.00	40% above	50%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$327.50	$655.00	$58.15–$655.00	40% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES	$327.50	$655.00	$58.15–$655.00	—	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HE-NASAL BONES CR	$327.50	$655.00	$58.15–$655.00	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$249.87	$499.74	$69.96–$499.74	8% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP-CERV SP 2TO3VW CR	$249.87	$499.74	$69.96–$499.74	8% below	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$249.87	$499.74	$69.96–$499.74	—	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP-CERV SP 2TO3VW CR	$249.87	$499.74	$69.96–$499.74	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 LE-PELVIS CR	$287.74	$575.48	$55.91–$575.48	14% above	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$287.74	$575.48	$55.91–$575.48	14% above	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS	$287.74	$575.48	$55.91–$575.48	—	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 LE-PELVIS CR	$287.74	$575.48	$55.91–$575.48	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$287.74	$575.48	$58.15–$575.48	13% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SP-SCRM COCCYX 2V CR	$287.74	$575.48	$58.15–$575.48	13% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE	$287.74	$575.48	$58.15–$575.48	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SP-SCRM COCCYX 2V CR	$287.74	$575.48	$58.15–$575.48	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New Mexico	Off list
ACTH blood test CPT 82024 ADRENOCORT ACTH	$301.24	$602.49	$38.62–$602.49	67% above	50%
ACTH blood test CPT 82024 ASSAY OF ACTH	$301.24	$602.49	$38.62–$602.49	67% above	50%
ACTH blood test inpatient CPT 82024 ASSAY OF ACTH	$301.24	$602.49	$38.62–$602.49	—	50%
ACTH blood test inpatient CPT 82024 ADRENOCORT ACTH	$301.24	$602.49	$38.62–$602.49	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALT	$111.94	$223.88	$5.30–$223.88	54% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$111.94	$223.88	$5.30–$223.88	54% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALT	$111.94	$223.88	$5.30–$223.88	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$111.94	$223.88	$5.30–$223.88	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE AST	$111.94	$223.88	$5.18–$223.88	82% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$111.94	$223.88	$5.18–$223.88	82% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE AST	$111.94	$223.88	$5.18–$223.88	—	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$111.94	$223.88	$5.18–$223.88	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$367.09	$734.18	$47.63–$734.18	35% above	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANE	$367.09	$734.18	$47.63–$734.18	35% above	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANE	$367.09	$734.18	$47.63–$734.18	—	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$367.09	$734.18	$47.63–$734.18	—	50%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$111.94	$223.88	$4.95–$223.88	156% above	50%
Albumin blood test CPT 82040 ALBUMIN SERUM	$111.94	$223.88	$4.95–$223.88	156% above	50%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$111.94	$223.88	$4.95–$223.88	—	50%
Albumin blood test inpatient CPT 82040 ASSAY OF SERUM ALBUMIN	$111.94	$223.88	$4.95–$223.88	—	50%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$541.57	$1,083.14	$40.75–$1,083.14	183% above	50%
Aldosterone blood test CPT 82088 ALDOSTERONE	$541.57	$1,083.14	$40.75–$1,083.14	183% above	50%
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$541.57	$1,083.14	$40.75–$1,083.14	—	50%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$541.57	$1,083.14	$40.75–$1,083.14	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$54.32	$108.65	$5.18–$108.65	22% below	50%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE,ALKALINE	$54.32	$108.65	$5.18–$108.65	22% below	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE	$54.32	$108.65	$5.18–$108.65	—	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE,ALKALINE	$54.32	$108.65	$5.18–$108.65	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$280.00	$560.00	$5.22–$560.00	846% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE QUANT	$280.00	$560.00	$5.22–$560.00	846% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$280.00	$560.00	$5.22–$560.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE QUANT	$280.00	$560.00	$5.22–$560.00	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$264.19	$528.38	$16.77–$528.38	127% above	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SERUM	$264.19	$528.38	$16.77–$528.38	127% above	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$264.19	$528.38	$16.77–$528.38	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SERUM	$264.19	$528.38	$16.77–$528.38	—	50%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$212.35	$424.71	$14.57–$424.71	84% above	50%
Ammonia blood test CPT 82140 AMMONIA	$212.35	$424.71	$14.57–$424.71	84% above	50%
Ammonia blood test inpatient CPT 82140 ASSAY OF AMMONIA	$212.35	$424.71	$14.57–$424.71	—	50%
Ammonia blood test inpatient CPT 82140 AMMONIA	$212.35	$424.71	$14.57–$424.71	—	50%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$133.33	$266.67	$6.37–$266.67	34% above	50%
Amylase blood test CPT 82150 AMYLASE	$133.33	$266.67	$6.37–$266.67	34% above	50%
Amylase blood test inpatient CPT 82150 AMYLASE	$133.33	$266.67	$6.37–$266.67	—	50%
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE	$133.33	$266.67	$6.37–$266.67	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$123.46	$246.93	$12.95–$246.93	49% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$123.46	$246.93	$12.95–$246.93	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$120.98	$241.97	$12.08–$241.97	23% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$120.98	$241.97	$12.08–$241.97	23% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$120.98	$241.97	$12.08–$241.97	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$120.98	$241.97	$12.08–$241.97	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$360.50	$721.01	$38.44–$721.01	110% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$360.50	$721.01	$38.44–$721.01	110% above	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$360.50	$721.01	$38.44–$721.01	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$360.50	$721.01	$38.44–$721.01	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$84.78	$169.56	$8.62–$169.56	at median	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIA OTH	$84.78	$169.56	$8.62–$169.56	at median	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIA OTH	$84.78	$169.56	$8.62–$169.56	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$84.78	$169.56	$8.62–$169.56	—	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABO CA TOTA	$204.94	$409.89	$8.39–$409.89	35% above	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL TOTAL CA	$204.94	$409.89	$8.39–$409.89	35% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL TOTAL CA	$204.94	$409.89	$8.39–$409.89	—	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABO CA TOTA	$204.94	$409.89	$8.39–$409.89	—	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$148.15	$296.30	$5.02–$296.30	128% above	50%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$148.15	$296.30	$5.02–$296.30	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$210.70	$421.40	$26.63–$421.40	2% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS LVL4	$210.70	$421.40	$26.63–$421.40	2% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS LVL4	$210.70	$421.40	$26.63–$421.40	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$210.70	$421.40	$26.63–$421.40	—	50%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$149.80	$299.60	$10.32–$299.60	14% above	50%
Blood culture for bacteria CPT 87040 CULTURE BLOOD BACTER	$149.80	$299.60	$10.32–$299.60	14% above	50%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD BACTER	$149.80	$299.60	$10.32–$299.60	—	50%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$149.80	$299.60	$10.32–$299.60	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$31.28	$62.57	$2.82–$62.57	36% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE,ROUTINE	$31.28	$62.57	$2.82–$62.57	36% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$31.28	$62.57	$2.82–$62.57	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE,ROUTINE	$31.28	$62.57	$2.82–$62.57	—	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE, QUANT	$105.35	$210.71	$3.93–$210.71	169% above	50%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$105.35	$210.71	$3.93–$210.71	169% above	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, QUANT	$105.35	$210.71	$3.93–$210.71	—	50%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$105.35	$210.71	$3.93–$210.71	—	50%
Blood lead test CPT 83655 LEAD	$311.11	$622.23	$12.08–$622.23	353% above	50%
Blood lead test CPT 83655 ASSAY OF LEAD	$311.11	$622.23	$12.08–$622.23	353% above	50%
Blood lead test inpatient CPT 83655 LEAD	$311.11	$622.23	$12.08–$622.23	—	50%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$311.11	$622.23	$12.08–$622.23	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$33.82	$67.65	$7.52–$197.65	69% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, QUAL	$65.00	$130.00	$7.52–$197.65	40% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$33.82	$67.65	$7.52–$197.65	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, QUAL	$65.00	$130.00	$7.52–$197.65	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$107.01	$214.02	$2.99–$214.02	20% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$107.01	$214.02	$2.99–$214.02	20% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$107.01	$214.02	$2.99–$214.02	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$107.01	$214.02	$2.99–$214.02	—	50%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN,QUAN	$123.46	$246.93	$3.95–$246.93	71% above	50%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$123.46	$246.93	$3.95–$246.93	71% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN	$123.46	$246.93	$3.95–$246.93	—	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN,QUAN	$123.46	$246.93	$3.95–$246.93	—	50%
C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE	$401.65	$803.31	$20.81–$803.31	262% above	50%
C-peptide blood test CPT 84681 C-PEPTIDE	$401.65	$803.31	$20.81–$803.31	262% above	50%
C-peptide blood test inpatient CPT 84681 ASSAY OF C-PEPTIDE	$401.65	$803.31	$20.81–$803.31	—	50%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$401.65	$803.31	$20.81–$803.31	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$162.14	$324.28	$5.18–$324.28	168% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$162.14	$324.28	$5.18–$324.28	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE	$306.01	$612.02	$37.27–$612.02	105% above	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$306.01	$612.02	$37.27–$612.02	105% above	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE	$306.01	$612.02	$37.27–$612.02	—	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$306.01	$612.02	$37.27–$612.02	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 TUMOR AG CA 19-9	$249.38	$498.77	$20.81–$498.77	75% above	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$249.38	$498.77	$20.81–$498.77	75% above	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$249.38	$498.77	$20.81–$498.77	—	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 TUMOR AG CA 19-9	$249.38	$498.77	$20.81–$498.77	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 TUMOR AG CA 125	$249.38	$498.77	$20.81–$498.77	94% above	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$249.38	$498.77	$20.81–$498.77	94% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 TUMOR AG CA 125	$249.38	$498.77	$20.81–$498.77	—	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125	$249.38	$498.77	$20.81–$498.77	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$171.99	$343.98	$51.31–$459.81	54% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 PRB	$171.99	$343.98	$51.31–$459.81	54% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 PRB	$171.99	$343.98	$51.31–$459.81	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$171.99	$343.98	$51.31–$459.81	—	50%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$111.94	$223.88	$5.16–$223.88	123% above	50%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$111.94	$223.88	$5.16–$223.88	123% above	50%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$111.94	$223.88	$5.16–$223.88	—	50%
Calcium blood test, total inpatient CPT 82310 ASSAY OF CALCIUM	$111.94	$223.88	$5.16–$223.88	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$149.80	$299.60	$18.96–$299.60	6% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG	$149.80	$299.60	$18.96–$299.60	6% above	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN	$149.80	$299.60	$18.96–$299.60	—	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG	$149.80	$299.60	$18.96–$299.60	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$191.77	$383.54	$12.88–$383.54	185% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB	$191.77	$383.54	$12.88–$383.54	185% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB	$191.77	$383.54	$12.88–$383.54	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY	$191.77	$383.54	$12.88–$383.54	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP	$140.00	$280.00	$35.09–$280.00	19% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$140.00	$280.00	$35.09–$280.00	19% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP	$140.00	$280.00	$35.09–$280.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP PROBE	$140.00	$280.00	$35.09–$280.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$162.97	$325.94	$13.39–$325.94	22% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$162.97	$325.94	$13.39–$325.94	—	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$90.53	$181.06	$7.72–$181.06	at median	50%
Complete blood count (CBC) with differential CPT 85025 CBC W-PLT AUTO COMPD	$90.53	$181.06	$7.72–$181.06	at median	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W-PLT AUTO COMPD	$90.53	$181.06	$7.72–$181.06	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$90.53	$181.06	$7.72–$181.06	—	50%
Complete blood count (CBC), no differential CPT 85027 CBC W-PLT	$64.20	$128.40	$6.37–$128.40	35% above	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$64.20	$128.40	$6.37–$128.40	35% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W-PLT	$64.20	$128.40	$6.37–$128.40	—	50%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$64.20	$128.40	$6.37–$128.40	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METAB PANEL	$226.34	$452.68	$10.56–$452.68	16% above	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$226.34	$452.68	$10.56–$452.68	16% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METAB PANEL	$226.34	$452.68	$10.56–$452.68	—	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$226.34	$452.68	$10.56–$452.68	—	50%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$102.06	$204.12	$16.30–$204.12	at median	50%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$102.06	$204.12	$16.30–$204.12	at median	50%
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL	$102.06	$204.12	$16.30–$204.12	—	50%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$102.06	$204.12	$16.30–$204.12	—	50%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$133.33	$266.67	$6.51–$266.67	78% above	50%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK)	$133.33	$266.67	$6.51–$266.67	78% above	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CK (CPK)	$133.33	$266.67	$6.51–$266.67	—	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$133.33	$266.67	$6.51–$266.67	—	50%
Creatinine blood test CPT 82565 CREATININE BLOOD	$105.35	$210.71	$5.03–$210.71	45% above	50%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$105.35	$210.71	$5.03–$210.71	45% above	50%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$105.35	$210.71	$5.03–$210.71	—	50%
Creatinine blood test inpatient CPT 82565 ASSAY OF CREATININE	$105.35	$210.71	$5.03–$210.71	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB	$163.79	$327.58	$14.39–$327.58	117% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$163.79	$327.58	$14.39–$327.58	117% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$163.79	$327.58	$14.39–$327.58	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB	$163.79	$327.58	$14.39–$327.58	—	50%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$65.03	$130.06	$10.18–$130.06	48% below	50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANT	$65.03	$130.06	$10.18–$130.06	48% below	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANT	$65.03	$130.06	$10.18–$130.06	—	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$65.03	$130.06	$10.18–$130.06	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$52.84	$105.69	$14.79–$105.69	58% below	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$52.84	$105.69	$14.79–$105.69	58% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$52.84	$105.69	$14.79–$105.69	—	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE	$52.84	$105.69	$14.79–$105.69	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$534.54	$1,069.08	$61.61–$1,069.08	214% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PRS DRG IA ANAZ	$534.54	$1,069.08	$61.61–$1,069.08	214% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PRS DRG IA ANAZ	$534.54	$1,069.08	$61.61–$1,069.08	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$534.54	$1,069.08	$61.61–$1,069.08	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$297.12	$594.24	$7.01–$594.24	174% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$297.12	$594.24	$7.01–$594.24	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR, VCA	$311.11	$622.23	$18.11–$622.23	178% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA	$311.11	$622.23	$18.11–$622.23	178% above	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR CAPSID VCA	$311.11	$622.23	$18.11–$622.23	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR, VCA	$311.11	$622.23	$18.11–$622.23	—	50%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$218.10	$436.21	$27.94–$436.21	24% above	50%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$218.10	$436.21	$27.94–$436.21	24% above	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL	$218.10	$436.21	$27.94–$436.21	—	50%
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$218.10	$436.21	$27.94–$436.21	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORM	$146.50	$293.01	$18.58–$293.01	8% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$146.50	$293.01	$18.58–$293.01	8% above	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$146.50	$293.01	$18.58–$293.01	—	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM HORM	$146.50	$293.01	$18.58–$293.01	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$515.23	$1,030.47	$19.63–$1,030.47	180% above	50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$515.23	$1,030.47	$19.63–$1,030.47	180% above	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$515.23	$1,030.47	$19.63–$1,030.47	—	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$515.23	$1,030.47	$19.63–$1,030.47	—	50%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$111.94	$223.88	$13.63–$223.88	at median	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$111.94	$223.88	$13.63–$223.88	at median	50%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$111.94	$223.88	$13.63–$223.88	—	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$111.94	$223.88	$13.63–$223.88	—	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$144.03	$288.06	$9.52–$288.06	37% above	50%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$144.03	$288.06	$9.52–$288.06	—	50%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$123.46	$246.93	$14.70–$246.93	36% above	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$123.46	$246.93	$14.70–$246.93	36% above	50%
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$123.46	$246.93	$14.70–$246.93	—	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$123.46	$246.93	$14.70–$246.93	—	50%
Free T3 thyroid hormone test CPT 84481 T3,FREE	$234.57	$469.15	$16.94–$469.15	95% above	50%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$234.57	$469.15	$16.94–$469.15	95% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$234.57	$469.15	$16.94–$469.15	—	50%
Free T3 thyroid hormone test inpatient CPT 84481 T3,FREE	$234.57	$469.15	$16.94–$469.15	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$192.60	$385.20	$9.02–$385.20	56% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE T4, FREE	$192.60	$385.20	$9.02–$385.20	56% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$192.60	$385.20	$9.02–$385.20	—	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE T4, FREE	$192.60	$385.20	$9.02–$385.20	—	50%
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$197.53	$395.07	$25.47–$395.07	51% above	50%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$197.53	$395.07	$25.47–$395.07	51% above	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$197.53	$395.07	$25.47–$395.07	—	50%
Free testosterone test inpatient CPT 84402 ASSAY OF FREE TESTOSTERONE	$197.53	$395.07	$25.47–$395.07	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$149.80	$299.60	$7.20–$299.60	164% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$149.80	$299.60	$7.20–$299.60	164% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$149.80	$299.60	$7.20–$299.60	—	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT	$149.80	$299.60	$7.20–$299.60	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$171.12	$342.25	$47.91–$342.25	54% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$171.12	$342.25	$47.91–$342.25	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, POST DOSE	$86.42	$172.84	$4.70–$172.84	143% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$86.42	$172.84	$4.70–$172.84	143% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST	$86.42	$172.84	$4.70–$172.84	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, POST DOSE	$86.42	$172.84	$4.70–$172.84	—	50%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPEC	$148.15	$296.30	$12.87–$296.30	33% above	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$148.15	$296.30	$12.87–$296.30	33% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$148.15	$296.30	$12.87–$296.30	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPEC	$148.15	$296.30	$12.87–$296.30	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$140.00	$280.00	$35.09–$280.00	11% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHO,DNA,AMPPR	$140.00	$280.00	$35.09–$280.00	11% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHO,DNA,AMPPR	$140.00	$280.00	$35.09–$280.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB	$140.00	$280.00	$35.09–$280.00	—	50%
H. pylori antibody blood test CPT 86677 H PYLORI AB QL	$152.26	$304.53	$16.50–$304.53	46% above	50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$152.26	$304.53	$16.50–$304.53	46% above	50%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODY	$152.26	$304.53	$16.50–$304.53	—	50%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB QL	$152.26	$304.53	$16.50–$304.53	—	50%
H. pylori stool antigen test CPT 87338 HPYLORI,STOOL,EIA	$148.15	$296.30	$12.36–$296.30	86% above	50%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$148.15	$296.30	$12.36–$296.30	86% above	50%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL AG IA	$148.15	$296.30	$12.36–$296.30	—	50%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI,STOOL,EIA	$148.15	$296.30	$12.36–$296.30	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1, DNA, QUANT	$539.92	$1,079.84	$85.10–$1,079.84	62% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$539.92	$1,079.84	$85.10–$1,079.84	62% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$539.92	$1,079.84	$85.10–$1,079.84	—	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1, DNA, QUANT	$539.92	$1,079.84	$85.10–$1,079.84	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$240.25	$480.50	$35.09–$480.50	94% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$240.25	$480.50	$35.09–$480.50	94% above	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HI-RISK TYP POOLED RSLT	$240.25	$480.50	$35.09–$480.50	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$240.25	$480.50	$35.09–$480.50	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$44.72	$89.44	$9.71–$484.51	40% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$197.53	$395.07	$9.71–$484.51	165% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$44.72	$89.44	$9.71–$484.51	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$197.53	$395.07	$9.71–$484.51	—	50%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$52.68	$105.36	$2.35–$105.36	31% above	50%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$52.68	$105.36	$2.35–$105.36	—	50%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE TOT	$91.36	$182.72	$12.05–$182.72	36% above	50%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$91.36	$182.72	$12.05–$182.72	36% above	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$91.36	$182.72	$12.05–$182.72	—	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE TOT	$91.36	$182.72	$12.05–$182.72	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB	$240.34	$480.68	$10.73–$480.68	134% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$240.34	$480.68	$10.73–$480.68	134% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB	$240.34	$480.68	$10.73–$480.68	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$240.34	$480.68	$10.73–$480.68	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG	$254.31	$508.63	$10.33–$508.63	314% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$254.31	$508.63	$10.33–$508.63	314% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$254.31	$508.63	$10.33–$508.63	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG	$254.31	$508.63	$10.33–$508.63	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$260.90	$521.80	$14.27–$521.80	211% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST	$260.90	$521.80	$14.27–$521.80	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$350.86	$701.72	$42.84–$701.72	10% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C,RNA,QUAN	$350.86	$701.72	$42.84–$701.72	10% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C,RNA,QUAN	$350.86	$701.72	$42.84–$701.72	—	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$350.86	$701.72	$42.84–$701.72	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMP TYPE 1	$275.73	$551.46	$13.19–$551.46	302% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$275.73	$551.46	$13.19–$551.46	302% above	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMP TYPE 1	$275.73	$551.46	$13.19–$551.46	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$275.73	$551.46	$13.19–$551.46	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMP TYPE 2	$275.73	$551.46	$19.35–$551.46	221% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$275.73	$551.46	$19.35–$551.46	221% above	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$275.73	$551.46	$19.35–$551.46	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMP TYPE 2	$275.73	$551.46	$19.35–$551.46	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$162.14	$324.28	$12.95–$324.28	141% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP,HIGHLY SENS	$162.14	$324.28	$12.95–$324.28	141% above	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP,HIGHLY SENS	$162.14	$324.28	$12.95–$324.28	—	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$162.14	$324.28	$12.95–$324.28	—	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$133.33	$266.67	$17.92–$266.67	7% below	50%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$133.33	$266.67	$17.92–$266.67	7% below	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$133.33	$266.67	$17.92–$266.67	—	50%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTEINE	$133.33	$266.67	$17.92–$266.67	—	50%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$102.06	$204.12	$11.41–$204.12	34% above	50%
Insulin blood test CPT 83525 INSULIN, TOTAL	$102.06	$204.12	$11.41–$204.12	34% above	50%
Insulin blood test inpatient CPT 83525 INSULIN, TOTAL	$102.06	$204.12	$11.41–$204.12	—	50%
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN	$102.06	$204.12	$11.41–$204.12	—	50%
Iron blood test (serum iron) CPT 83540 IRON	$149.80	$299.60	$6.37–$299.60	92% above	50%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$149.80	$299.60	$6.37–$299.60	92% above	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$149.80	$299.60	$6.37–$299.60	—	50%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$149.80	$299.60	$6.37–$299.60	—	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACIT	$116.05	$232.11	$8.72–$232.11	48% above	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$116.05	$232.11	$8.72–$232.11	48% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING TEST	$116.05	$232.11	$8.72–$232.11	—	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACIT	$116.05	$232.11	$8.72–$232.11	—	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$158.85	$317.71	$8.68–$317.71	3% above	50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$158.85	$317.71	$8.68–$317.71	—	50%
LH (luteinizing hormone) test CPT 83002 LEUTEINIZING HORMONE	$146.50	$293.01	$18.52–$293.01	8% above	50%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$146.50	$293.01	$18.52–$293.01	8% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 LEUTEINIZING HORMONE	$146.50	$293.01	$18.52–$293.01	—	50%
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH)	$146.50	$293.01	$18.52–$293.01	—	50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$146.50	$293.01	$11.57–$293.01	19% above	50%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$146.50	$293.01	$11.57–$293.01	19% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$146.50	$293.01	$11.57–$293.01	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID	$146.50	$293.01	$11.57–$293.01	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$148.15	$296.30	$6.04–$296.30	96% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROLDH	$148.15	$296.30	$6.04–$296.30	96% above	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME	$148.15	$296.30	$6.04–$296.30	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROLDH	$148.15	$296.30	$6.04–$296.30	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$213.17	$426.35	$6.89–$426.35	111% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$213.17	$426.35	$6.89–$426.35	111% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$213.17	$426.35	$6.89–$426.35	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$213.17	$426.35	$6.89–$426.35	—	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PAN	$249.38	$498.77	$8.17–$498.77	67% above	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$249.38	$498.77	$8.17–$498.77	67% above	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$249.38	$498.77	$8.17–$498.77	—	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PAN	$249.38	$498.77	$8.17–$498.77	—	50%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$133.33	$266.67	$17.03–$266.67	16% above	50%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$133.33	$266.67	$17.03–$266.67	16% above	50%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$133.33	$266.67	$17.03–$266.67	—	50%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$133.33	$266.67	$17.03–$266.67	—	50%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$144.03	$288.06	$6.70–$288.06	89% above	50%
Magnesium blood test CPT 83735 MAGNESIUM	$144.03	$288.06	$6.70–$288.06	89% above	50%
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$144.03	$288.06	$6.70–$288.06	—	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$144.03	$288.06	$6.70–$288.06	—	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$163.79	$327.58	$12.88–$327.58	120% above	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$163.79	$327.58	$12.88–$327.58	120% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$163.79	$327.58	$12.88–$327.58	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$163.79	$327.58	$12.88–$327.58	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREE	$111.94	$223.88	$5.18–$265.16	39% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$111.94	$223.88	$5.18–$265.16	39% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREE	$111.94	$223.88	$5.18–$265.16	—	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN	$111.94	$223.88	$5.18–$265.16	—	50%
Mumps immunity blood test CPT 86735 MUMPS AB	$142.38	$284.76	$13.05–$284.76	96% above	50%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$142.38	$284.76	$13.05–$284.76	96% above	50%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB	$142.38	$284.76	$13.05–$284.76	—	50%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$142.38	$284.76	$13.05–$284.76	—	50%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$324.28	$648.57	$47.81–$648.57	at median	50%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$324.28	$648.57	$47.81–$648.57	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$317.70	$635.41	$18.39–$635.41	260% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$317.70	$635.41	$18.39–$635.41	260% above	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE	$317.70	$635.41	$18.39–$635.41	—	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$317.70	$635.41	$18.39–$635.41	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$146.50	$293.01	$18.39–$293.01	48% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$146.50	$293.01	$18.39–$293.01	48% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$146.50	$293.01	$18.39–$293.01	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$146.50	$293.01	$18.39–$293.01	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$94.59	$189.19	$23.74–$189.19	1% above	50%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP DIAG AUTO MAN RS	$94.59	$189.19	$23.74–$189.19	1% above	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP DIAG AUTO MAN RS	$94.59	$189.19	$23.74–$189.19	—	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$94.59	$189.19	$23.74–$189.19	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$688.06	$1,376.13	$41.28–$1,376.13	254% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE PTH	$688.06	$1,376.13	$41.28–$1,376.13	254% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE PTH	$688.06	$1,376.13	$41.28–$1,376.13	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$688.06	$1,376.13	$41.28–$1,376.13	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$90.17	$180.35	$6.01–$180.35	23% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TIMEPTT	$90.17	$180.35	$6.01–$180.35	23% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$90.17	$180.35	$6.01–$180.35	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TIMEPTT	$90.17	$180.35	$6.01–$180.35	—	50%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS, BLOOD	$98.77	$197.55	$4.70–$197.55	31% above	50%
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS	$98.77	$197.55	$4.70–$197.55	31% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS	$98.77	$197.55	$4.70–$197.55	—	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS, BLOOD	$98.77	$197.55	$4.70–$197.55	—	50%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$73.25	$146.50	$4.70–$146.50	27% above	50%
Potassium blood test CPT 84132 POTASSIUM SER PL WB	$73.25	$146.50	$4.70–$146.50	27% above	50%
Potassium blood test inpatient CPT 84132 ASSAY OF SERUM POTASSIUM	$73.25	$146.50	$4.70–$146.50	—	50%
Potassium blood test inpatient CPT 84132 POTASSIUM SER PL WB	$73.25	$146.50	$4.70–$146.50	—	50%
Progesterone blood test CPT 84144 PROGESTERONE	$174.49	$348.99	$20.86–$348.99	42% above	50%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$174.49	$348.99	$20.86–$348.99	42% above	50%
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$174.49	$348.99	$20.86–$348.99	—	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$174.49	$348.99	$20.86–$348.99	—	50%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$149.80	$299.60	$19.38–$299.60	at median	50%
Prolactin blood test CPT 84146 PROLACTIN	$149.80	$299.60	$19.38–$299.60	at median	50%
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN	$149.80	$299.60	$19.38–$299.60	—	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$149.80	$299.60	$19.38–$299.60	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$51.85	$103.71	$4.28–$141.55	at median	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$51.85	$103.71	$4.28–$141.55	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$60.50	$121.00	$11.55–$121.00	199% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR	$60.50	$121.00	$11.55–$121.00	199% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR	$60.50	$121.00	$11.55–$121.00	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$60.50	$121.00	$11.55–$121.00	—	50%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$126.75	$253.50	$15.45–$307.39	149% above	50%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W-OP	$126.75	$253.50	$15.45–$307.39	149% above	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W-OP	$126.75	$253.50	$15.45–$307.39	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$126.75	$253.50	$15.45–$307.39	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W-OPTI	$48.83	$97.67	$15.45–$157.29	26% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$48.83	$97.67	$15.45–$157.29	26% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W-OPTI	$48.83	$97.67	$15.45–$157.29	—	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$48.83	$97.67	$15.45–$157.29	—	50%
Renin blood test CPT 84244 RENIN	$173.66	$347.33	$21.99–$347.33	65% above	50%
Renin blood test CPT 84244 ASSAY OF RENIN	$173.66	$347.33	$21.99–$347.33	65% above	50%
Renin blood test inpatient CPT 84244 ASSAY OF RENIN	$173.66	$347.33	$21.99–$347.33	—	50%
Renin blood test inpatient CPT 84244 RENIN	$173.66	$347.33	$21.99–$347.33	—	50%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$107.01	$214.02	$2.99–$214.02	74% above	50%
Rh blood typing CPT 86901 BLOOD TYPING RH D	$107.01	$214.02	$2.99–$214.02	74% above	50%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH D	$107.01	$214.02	$2.99–$214.02	—	50%
Rh blood typing inpatient CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$107.01	$214.02	$2.99–$214.02	—	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACT QUAN	$61.72	$123.45	$5.67–$123.45	at median	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$61.72	$123.45	$5.67–$123.45	at median	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$61.72	$123.45	$5.67–$123.45	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACT QUAN	$61.72	$123.45	$5.67–$123.45	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$110.31	$220.62	$14.39–$220.62	51% above	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$110.31	$220.62	$14.39–$220.62	51% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$110.31	$220.62	$14.39–$220.62	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$110.31	$220.62	$14.39–$220.62	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE, AUTOMATED	$83.13	$166.27	$2.68–$166.27	91% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$83.13	$166.27	$2.68–$166.27	91% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$83.13	$166.27	$2.68–$166.27	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE, AUTOMATED	$83.13	$166.27	$2.68–$166.27	—	50%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$86.42	$172.84	$4.70–$172.84	98% above	50%
Sodium blood test CPT 84295 SODIUM,SER PL OR WB	$86.42	$172.84	$4.70–$172.84	98% above	50%
Sodium blood test inpatient CPT 84295 SODIUM,SER PL OR WB	$86.42	$172.84	$4.70–$172.84	—	50%
Sodium blood test inpatient CPT 84295 ASSAY OF SERUM SODIUM	$86.42	$172.84	$4.70–$172.84	—	50%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$231.28	$462.57	$8.90–$462.57	80% above	50%
Stool ova and parasites exam CPT 87177 OVA-PARASITES SMEARS	$231.28	$462.57	$8.90–$462.57	80% above	50%
Stool ova and parasites exam inpatient CPT 87177 OVA-PARASITES SMEARS	$231.28	$462.57	$8.90–$462.57	—	50%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$231.28	$462.57	$8.90–$462.57	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$15.47	$30.95	$4.19–$197.22	37% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCULT FECES 1-3	$83.13	$166.27	$4.19–$197.22	238% above	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$15.47	$30.95	$4.19–$197.22	—	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCULT FECES 1-3	$83.13	$166.27	$4.19–$197.22	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$11.52	$23.05	$3.22–$23.05	84% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREP. PALLIDUM,CONFI	$11.52	$23.05	$3.22–$23.05	84% below	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$11.52	$23.05	$3.22–$23.05	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREP. PALLIDUM,CONFI	$11.52	$23.05	$3.22–$23.05	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$90.53	$181.06	$4.27–$181.06	89% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, QUAL	$90.53	$181.06	$4.27–$181.06	89% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$90.53	$181.06	$4.27–$181.06	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, QUAL	$90.53	$181.06	$4.27–$181.06	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IM MEAS	$217.93	$435.87	$61.02–$435.87	1% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$217.93	$435.87	$61.02–$435.87	1% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IM MEAS	$217.93	$435.87	$61.02–$435.87	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$217.93	$435.87	$61.02–$435.87	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$265.85	$531.70	$25.81–$531.70	101% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$265.85	$531.70	$25.81–$531.70	101% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$265.85	$531.70	$25.81–$531.70	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$265.85	$531.70	$25.81–$531.70	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$353.91	$707.82	$14.55–$707.82	315% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$353.91	$707.82	$14.55–$707.82	315% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB	$353.91	$707.82	$14.55–$707.82	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$353.91	$707.82	$14.55–$707.82	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM TSH	$123.46	$246.93	$16.78–$246.93	2% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$123.46	$246.93	$16.78–$246.93	2% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM TSH	$123.46	$246.93	$16.78–$246.93	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$123.46	$246.93	$16.78–$246.93	—	50%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE	$51.85	$103.71	$14.51–$103.71	51% below	50%
Total IgE blood test CPT 82785 ASSAY OF IGE	$51.85	$103.71	$14.51–$103.71	51% below	50%
Total IgE blood test inpatient CPT 82785 ASSAY OF IGE	$51.85	$103.71	$14.51–$103.71	—	50%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN IGE	$51.85	$103.71	$14.51–$103.71	—	50%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$137.45	$274.90	$4.35–$274.90	146% above	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$137.45	$274.90	$4.35–$274.90	146% above	50%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$137.45	$274.90	$4.35–$274.90	—	50%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$137.45	$274.90	$4.35–$274.90	—	50%
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4,TOTAL	$162.97	$325.94	$6.87–$325.94	147% above	50%
Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE	$162.97	$325.94	$6.87–$325.94	147% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE T4,TOTAL	$162.97	$325.94	$6.87–$325.94	—	50%
Total thyroxine (T4) blood test inpatient CPT 84436 ASSAY OF TOTAL THYROXINE	$162.97	$325.94	$6.87–$325.94	—	50%
Total triiodothyronine (T3) blood test CPT 84480 T3,TOTAL	$234.57	$469.15	$14.18–$469.15	141% above	50%
Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$234.57	$469.15	$14.18–$469.15	141% above	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$234.57	$469.15	$14.18–$469.15	—	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3,TOTAL	$234.57	$469.15	$14.18–$469.15	—	50%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$102.06	$204.12	$12.75–$204.12	14% above	50%
Transferrin blood test CPT 84466 TRANSFERRIN	$102.06	$204.12	$12.75–$204.12	14% above	50%
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN	$102.06	$204.12	$12.75–$204.12	—	50%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$102.06	$204.12	$12.75–$204.12	—	50%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS AMP	$67.06	$134.12	$18.77–$134.12	4% above	50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$67.06	$134.12	$18.77–$134.12	4% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$67.06	$134.12	$18.77–$134.12	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS AMP	$67.06	$134.12	$18.77–$134.12	—	50%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$149.80	$299.60	$5.70–$299.60	129% above	50%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$149.80	$299.60	$5.70–$299.60	129% above	50%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES	$149.80	$299.60	$5.70–$299.60	—	50%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$149.80	$299.60	$5.70–$299.60	—	50%
Troponin test, quantitative CPT 84484 TROPONIN,QNT	$133.33	$266.67	$12.21–$266.67	at median	50%
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$133.33	$266.67	$12.21–$266.67	at median	50%
Troponin test, quantitative inpatient CPT 84484 TROPONIN,QNT	$133.33	$266.67	$12.21–$266.67	—	50%
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANT	$133.33	$266.67	$12.21–$266.67	—	50%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$123.46	$246.93	$4.52–$246.93	102% above	50%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$123.46	$246.93	$4.52–$246.93	102% above	50%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$123.46	$246.93	$4.52–$246.93	—	50%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$123.46	$246.93	$4.52–$246.93	—	50%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTO W-SCOPE	$90.53	$181.06	$3.17–$181.06	54% above	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$90.53	$181.06	$3.17–$181.06	54% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTO W-SCOPE	$90.53	$181.06	$3.17–$181.06	—	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$90.53	$181.06	$3.17–$181.06	—	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$16.05	$32.11	$2.25–$127.59	32% below	50%
Urinalysis without microscope exam, automated CPT 81003 UA, AUTO, W-O SCOPE	$47.74	$95.48	$2.25–$127.59	101% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$16.05	$32.11	$2.25–$127.59	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA, AUTO, W-O SCOPE	$47.74	$95.48	$2.25–$127.59	—	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$11.46	$22.93	$3.29–$87.13	11% below	50%
Urinalysis without microscope exam, manual CPT 81002 UA NONAUTO W-O SCOPE	$32.10	$64.20	$3.29–$87.13	149% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$11.46	$22.93	$3.29–$87.13	—	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NONAUTO W-O SCOPE	$32.10	$64.20	$3.29–$87.13	—	50%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE-COLONY CT	$133.33	$266.67	$8.05–$266.67	48% above	50%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$133.33	$266.67	$8.05–$266.67	48% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE-COLONY CT	$133.33	$266.67	$8.05–$266.67	—	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT	$133.33	$266.67	$8.05–$266.67	—	50%
Urine microalbumin (albumin) test CPT 82043 MICROALB QNT	$123.46	$246.93	$5.70–$296.24	41% above	50%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$123.46	$246.93	$5.70–$296.24	41% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALB QNT	$123.46	$246.93	$5.70–$296.24	—	50%
Urine microalbumin (albumin) test inpatient CPT 82043 UR ALBUMIN QUANTITATIVE	$123.46	$246.93	$5.70–$296.24	—	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST QL	$23.50	$47.01	$6.58–$47.01	34% below	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$23.50	$47.01	$6.58–$47.01	34% below	50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$23.50	$47.01	$6.58–$47.01	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST QL	$23.50	$47.01	$6.58–$47.01	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$127.57	$255.15	$15.08–$255.15	13% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$127.57	$255.15	$15.08–$255.15	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH	$221.40	$442.80	$29.60–$442.80	31% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$221.40	$442.80	$29.60–$442.80	31% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25OH	$221.40	$442.80	$29.60–$442.80	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$221.40	$442.80	$29.60–$442.80	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXY VITAMIN D	$309.46	$618.93	$38.50–$618.93	77% above	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$309.46	$618.93	$38.50–$618.93	77% above	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXY VITAMIN D	$309.46	$618.93	$38.50–$618.93	—	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY	$309.46	$618.93	$38.50–$618.93	—	50%
Zinc blood test CPT 84630 ZINC	$102.06	$204.12	$11.39–$204.12	31% above	50%
Zinc blood test CPT 84630 ASSAY OF ZINC	$102.06	$204.12	$11.39–$204.12	31% above	50%
Zinc blood test inpatient CPT 84630 ZINC	$102.06	$204.12	$11.39–$204.12	—	50%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$102.06	$204.12	$11.39–$204.12	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$215.64	$431.29	$15.05–$431.29	49% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT	$215.64	$431.29	$15.05–$431.29	49% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT	$215.64	$431.29	$15.05–$431.29	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$215.64	$431.29	$15.05–$431.29	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New Mexico	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI-CARDIOVERSION	$638.69	$1,277.38	$178.83–$1,277.38	46% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$638.69	$1,277.38	$178.83–$1,277.38	46% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$638.69	$1,277.38	$178.83–$1,277.38	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI-CARDIOVERSION	$638.69	$1,277.38	$178.83–$1,277.38	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$433.51	$867.02	$121.38–$867.02	40% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$433.51	$867.02	$121.38–$867.02	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,595.67	$3,191.34	$446.78–$3,191.34	at median	50%
Lower-back epidural injection, with imaging guidance CPT 62323 IR-DI L-S INJ W IM	$1,595.67	$3,191.34	$446.78–$3,191.34	at median	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR-DI L-S INJ W IM	$1,595.67	$3,191.34	$446.78–$3,191.34	—	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,595.67	$3,191.34	$446.78–$3,191.34	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$416.47	$832.94	$116.61–$832.94	51% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 S-SPINAL TAP DIAGNST	$416.47	$832.94	$116.61–$832.94	51% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 S-SPINAL TAP DIAGNST	$416.47	$832.94	$116.61–$832.94	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$416.47	$832.94	$116.61–$832.94	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New Mexico	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$429.64	$859.28	$223.33–$18,904.18	38% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 0 2 HRS	$730.86	$1,461.73	$223.33–$18,904.18	6% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,148.16	$2,296.33	$223.33–$18,904.18	67% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 2 4 HRS	$1,148.16	$2,296.33	$223.33–$18,904.18	67% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 4 6 HRS	$1,603.30	$3,206.60	$223.33–$18,904.18	133% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 6 8 HRS	$1,858.46	$3,716.93	$223.33–$18,904.18	170% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 8 10 HR	$2,124.31	$4,248.62	$223.33–$18,904.18	209% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPNT	$429.64	$859.28	$223.33–$18,904.18	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 0 2 HRS	$730.86	$1,461.73	$223.33–$18,904.18	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 2 4 HRS	$1,148.16	$2,296.33	$223.33–$18,904.18	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$1,148.16	$2,296.33	$223.33–$18,904.18	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 4 6 HRS	$1,603.30	$3,206.60	$223.33–$18,904.18	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 6 8 HRS	$1,858.46	$3,716.93	$223.33–$18,904.18	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 8 10 HR	$2,124.31	$4,248.62	$223.33–$18,904.18	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT SUB	$92.50	$185.00	$125.72–$898.14	23% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$128.52	$257.05	$125.72–$898.14	7% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT INI	$147.37	$294.74	$125.72–$898.14	22% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT SUB	$92.50	$185.00	$125.72–$898.14	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$128.52	$257.05	$125.72–$898.14	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT INI	$147.37	$294.74	$125.72–$898.14	—	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$462.02	$924.05	$129.36–$924.05	11% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFU 1ST HR	$462.02	$924.05	$129.36–$924.05	11% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFU 1ST HR	$462.02	$924.05	$129.36–$924.05	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$462.02	$924.05	$129.36–$924.05	—	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$5,448.62	$10,897.25	$485.47–$10,897.25	159% above	50%
Critical care, first 30 to 74 minutes one side CPT 99291 CRITICAL CARE LT 74M	$5,448.62	$10,897.25	$485.47–$10,897.25	159% above	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$5,448.62	$10,897.25	$485.47–$10,897.25	—	50%
Critical care, first 30 to 74 minutes inpatient one side CPT 99291 CRITICAL CARE LT 74M	$5,448.62	$10,897.25	$485.47–$10,897.25	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$1,916.89	$3,833.79	$158.82–$3,833.79	113% above	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE DROWSY	$1,916.89	$3,833.79	$158.82–$3,833.79	113% above	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$1,916.89	$3,833.79	$158.82–$3,833.79	—	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE DROWSY	$1,916.89	$3,833.79	$158.82–$3,833.79	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$92.75	$185.51	$76.87–$825.08	49% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD ED STAFF	$92.75	$185.51	$76.87–$825.08	49% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NI-EKG, 12 LEADS	$293.41	$586.83	$76.87–$825.08	62% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD ED STAFF	$92.75	$185.51	$76.87–$825.08	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$92.75	$185.51	$76.87–$825.08	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NI-EKG, 12 LEADS	$293.41	$586.83	$76.87–$825.08	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$257.60	$515.21	$52.10–$515.21	28% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF ED VISIT	$257.60	$515.21	$52.10–$515.21	28% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF ED VISIT	$257.60	$515.21	$52.10–$515.21	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$257.60	$515.21	$52.10–$515.21	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED ED VISIT	$390.94	$781.89	$86.09–$781.89	33% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$390.94	$781.89	$86.09–$781.89	33% above	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED ED VISIT	$390.94	$781.89	$86.09–$781.89	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$390.94	$781.89	$86.09–$781.89	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMEDIATE ED VIST	$936.64	$1,873.28	$137.38–$1,873.28	76% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$936.64	$1,873.28	$137.38–$1,873.28	76% above	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMEDIATE ED VIST	$936.64	$1,873.28	$137.38–$1,873.28	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$936.64	$1,873.28	$137.38–$1,873.28	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED ED VISIT	$1,106.18	$2,212.36	$218.71–$2,212.36	29% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$1,106.18	$2,212.36	$218.71–$2,212.36	29% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED ED VISIT	$1,106.18	$2,212.36	$218.71–$2,212.36	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$1,106.18	$2,212.36	$218.71–$2,212.36	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$2,727.59	$5,455.19	$323.14–$5,455.19	91% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE ED VST	$2,727.59	$5,455.19	$323.14–$5,455.19	91% above	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE ED VST	$2,727.59	$5,455.19	$323.14–$5,455.19	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$2,727.59	$5,455.19	$323.14–$5,455.19	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM-STRESS TEST	$908.28	$1,816.56	$233.19–$3,814.58	67% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$999.01	$1,998.02	$233.19–$3,814.58	84% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI-STRESS TEST	$999.01	$1,998.02	$233.19–$3,814.58	84% above	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM-STRESS TEST	$908.28	$1,816.56	$233.19–$3,814.58	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$999.01	$1,998.02	$233.19–$3,814.58	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI-STRESS TEST	$999.01	$1,998.02	$233.19–$3,814.58	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$406.59	$813.18	$74.18–$3,781.12	20% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1 HR	$504.53	$1,009.06	$74.18–$3,781.12	49% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$406.59	$813.18	$74.18–$3,781.12	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1 HR	$504.53	$1,009.06	$74.18–$3,781.12	—	50%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY DX 1 HR	$625.00	$1,250.00	$124.24–$3,750.00	46% above	50%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$625.00	$1,250.00	$124.24–$3,750.00	46% above	50%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$625.00	$1,250.00	$124.24–$3,750.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DX 1 HR	$625.00	$1,250.00	$124.24–$3,750.00	—	50%
IV push of a medicine, first drug CPT 96374 INJECTION IV PUSH	$161.31	$322.63	$36.69–$1,856.82	13% below	50%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$464.20	$928.40	$36.69–$1,856.82	151% above	50%
IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH	$464.20	$928.40	$36.69–$1,856.82	151% above	50%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PUSH	$161.31	$322.63	$36.69–$1,856.82	—	50%
IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH	$464.20	$928.40	$36.69–$1,856.82	—	50%
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$464.20	$928.40	$36.69–$1,856.82	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC DX SQ IM	$67.08	$134.16	$25.16–$552.16	41% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$73.25	$146.50	$25.16–$552.16	36% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC DX SQ IM	$67.08	$134.16	$25.16–$552.16	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$73.25	$146.50	$25.16–$552.16	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PT	$146.66	$293.33	$27.75–$879.99	42% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PTA	$146.66	$293.33	$27.75–$879.99	42% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$146.66	$293.33	$27.75–$879.99	42% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN OT	$146.66	$293.33	$27.75–$879.99	42% above	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PT	$146.66	$293.33	$27.75–$879.99	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$146.66	$293.33	$27.75–$879.99	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PTA	$146.66	$293.33	$27.75–$879.99	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN OT	$146.66	$293.33	$27.75–$879.99	—	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$226.36	$452.72	$24.17–$452.72	2% below	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW CMP OT	$226.36	$452.72	$24.17–$452.72	2% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$226.36	$452.72	$24.17–$452.72	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW CMP OT	$226.36	$452.72	$24.17–$452.72	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH CMP PT	$369.97	$739.95	$67.61–$739.95	1% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$369.97	$739.95	$67.61–$739.95	1% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$369.97	$739.95	$67.61–$739.95	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH CMP PT	$369.97	$739.95	$67.61–$739.95	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW CMP PT	$369.97	$739.95	$22.31–$1,479.90	53% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$369.97	$739.95	$22.31–$1,479.90	53% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$369.97	$739.95	$22.31–$1,479.90	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW CMP PT	$369.97	$739.95	$22.31–$1,479.90	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD CMP PT	$369.97	$739.95	$44.62–$1,479.90	40% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$369.97	$739.95	$44.62–$1,479.90	40% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$369.97	$739.95	$44.62–$1,479.90	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD CMP PT	$369.97	$739.95	$44.62–$1,479.90	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN OT	$155.65	$311.31	$24.99–$945.03	45% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$158.43	$316.86	$24.99–$945.03	47% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PT	$158.43	$316.86	$24.99–$945.03	47% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PTA	$158.43	$316.86	$24.99–$945.03	47% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN OT	$155.65	$311.31	$24.99–$945.03	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PTA	$158.43	$316.86	$24.99–$945.03	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1/> REGIONS	$158.43	$316.86	$24.99–$945.03	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PT	$158.43	$316.86	$24.99–$945.03	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PT	$154.50	$309.00	$26.76–$938.99	59% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$154.50	$309.00	$26.76–$938.99	59% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN OT	$154.50	$309.00	$26.76–$938.99	59% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PTA	$160.49	$320.99	$26.76–$938.99	65% above	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES	$154.50	$309.00	$26.76–$938.99	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN OT	$154.50	$309.00	$26.76–$938.99	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PT	$154.50	$309.00	$26.76–$938.99	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PTA	$160.49	$320.99	$26.76–$938.99	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$32.93	$65.86	$9.22–$65.86	1% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHG SMOKE U 10	$32.93	$65.86	$9.22–$65.86	1% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHG SMOKE U 10	$32.93	$65.86	$9.22–$65.86	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$32.93	$65.86	$9.22–$65.86	—	50%
Speech and language evaluation CPT 92523 EVAL SP SND PROD CMP	$514.77	$1,029.54	$115.54–$1,029.54	59% above	50%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$514.77	$1,029.54	$115.54–$1,029.54	59% above	50%
Speech and language evaluation inpatient CPT 92523 EVAL SP SND PROD CMP	$514.77	$1,029.54	$115.54–$1,029.54	—	50%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$514.77	$1,029.54	$115.54–$1,029.54	—	50%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST	$331.37	$662.74	$57.59–$662.74	56% above	50%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$331.37	$662.74	$57.59–$662.74	56% above	50%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST	$331.37	$662.74	$57.59–$662.74	—	50%
Speech therapy session, individual inpatient CPT 92507 TX SP LANG VOICE COMM INDIV	$331.37	$662.74	$57.59–$662.74	—	50%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$265.02	$530.05	$74.20–$530.05	49% above	50%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$265.02	$530.05	$74.20–$530.05	49% above	50%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$265.02	$530.05	$74.20–$530.05	—	50%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$265.02	$530.05	$74.20–$530.05	—	50%
Spirometry before and after a bronchodilator CPT 94060 BRONCHO EVAL PRE/PST	$489.72	$979.44	$93.42–$979.44	29% above	50%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$489.72	$979.44	$93.42–$979.44	29% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$489.72	$979.44	$93.42–$979.44	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHO EVAL PRE/PST	$489.72	$979.44	$93.42–$979.44	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PT	$146.66	$293.33	$27.72–$879.99	31% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PTA	$146.66	$293.33	$27.72–$879.99	31% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN OT	$146.66	$293.33	$27.72–$879.99	31% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$146.66	$293.33	$27.72–$879.99	31% above	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PTA	$146.66	$293.33	$27.72–$879.99	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PT	$146.66	$293.33	$27.72–$879.99	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES	$146.66	$293.33	$27.72–$879.99	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN OT	$146.66	$293.33	$27.72–$879.99	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$207.40	$414.81	$77.21–$829.62	15% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUT	$207.40	$414.81	$77.21–$829.62	15% above	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUT	$207.40	$414.81	$77.21–$829.62	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$207.40	$414.81	$77.21–$829.62	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New Mexico	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$83.47	$166.95	$16.67–$166.95	81% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUVACC NO PRES OV3Y	$83.47	$166.95	$16.67–$166.95	81% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUVACC NO PRES OV3Y	$83.47	$166.95	$16.67–$166.95	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$83.47	$166.95	$16.67–$166.95	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$92.71	$185.42	$18.52–$185.42	1% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE ADULT IM SYRINGE	$92.71	$185.42	$18.52–$185.42	1% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$92.71	$185.42	$18.52–$185.42	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE ADULT IM SYRINGE	$92.71	$185.42	$18.52–$185.42	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B RECOMBINANT SYRINGE PEDI	$63.00	$126.00	$12.58–$126.00	at median	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$63.00	$126.00	$12.58–$126.00	at median	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B RECOMBINANT SYRINGE PEDI	$63.00	$126.00	$12.58–$126.00	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$63.00	$126.00	$12.58–$126.00	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC NOPRSV ANTIG	$69.54	$139.09	$13.89–$139.09	24% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$69.54	$139.09	$13.89–$139.09	24% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC NOPRSV ANTIG	$69.54	$139.09	$13.89–$139.09	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV NO PRSV INCREASED AG IM	$69.54	$139.09	$13.89–$139.09	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II INJ	$205.00	$410.00	$57.40–$410.00	71% above	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II INJ	$205.00	$410.00	$57.40–$410.00	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMO CONJ VAC 20IM	$628.12	$1,256.25	$175.87–$1,256.25	51% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMO CONJ VAC 20IM	$628.12	$1,256.25	$175.87–$1,256.25	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$422.90	$845.81	$84.50–$845.81	150% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO-VAC 2YR-ADULT	$422.90	$845.81	$84.50–$845.81	150% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMO-VAC 2YR-ADULT	$422.90	$845.81	$84.50–$845.81	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$422.90	$845.81	$84.50–$845.81	—	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$985.37	$1,970.75	$232.63–$1,970.75	140% above	50%
Rabies vaccine, one dose CPT 90675 RABIES VAC IM	$985.37	$1,970.75	$232.63–$1,970.75	140% above	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$985.37	$1,970.75	$232.63–$1,970.75	—	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC IM	$985.37	$1,970.75	$232.63–$1,970.75	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH/TET/ACPERT .5ML	$253.08	$506.17	$100.12–$715.17	209% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH/TET/ACPERT .5ML	$253.08	$506.17	$100.12–$715.17	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$47.74	$95.48	$25.16–$542.22	2% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE	$114.41	$228.83	$25.16–$542.22	145% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$47.74	$95.48	$25.16–$542.22	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE	$114.41	$228.83	$25.16–$542.22	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$51.03	$102.07	$25.16–$199.28	105% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EA ADD VACC	$51.03	$102.07	$25.16–$199.28	105% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD	$51.03	$102.07	$25.16–$199.28	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM EA ADD VACC	$51.03	$102.07	$25.16–$199.28	—	50%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://cea75026-66bc-472a-a0d7-7ec217c282dd.usrfiles.com/ugd/cea750_94493978988643ae88d1770dfb23e785.csv?dn=742930034_ALTA_VISTA_REGIONAL_HOSPITAL_standardcharges.csv