Hospital Duluth, MN-WI

Community Memorial Hospital

Community Memorial Hospital in Cloquet, MN publishes cash prices for 346 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Minnesota median for 223 of 341 procedures and above it for 115. By typical cash price it ranks #28 of 79 Minnesota hospitals and #2 of 12 hospitals in the Duluth, MN area, cheapest first. Click a procedure to compare it with other hospitals nearby.

512 Skyline Blvd, Cloquet, MN 55720 Collected Sep 27, 2026 Source price file (218) 879-4641

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 241364 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 ORTHO ANKLE - 3+ VIEWS READ	$32.32	$50.50	$50.50–$530.00	85% below	36%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS	$339.20	$530.00	$50.50–$530.00	55% above	36%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ORTHO ANKLE - 3+ VIEWS READ	$32.32	$50.50	$50.50–$530.00	—	36%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS	$339.20	$530.00	$50.50–$530.00	—	36%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 RAD-ABI LIMITED BILAT,1-2 LEV	$161.28	$252.00	$236.00–$252.00	—	36%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 WC TC-TCP02/ABI-BILAT, 1-2 LEV	$161.28	$252.00	$236.00–$252.00	—	36%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 GS-NON-INVAS ARTERIAL STUDY	$151.04	$236.00	$236.00–$252.00	59% below	36%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 RAD-ABI LIMITED BILAT,1-2 LEV	$161.28	$252.00	$236.00–$252.00	—	36%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 WC TC-TCP02/ABI-BILAT, 1-2 LEV	$161.28	$252.00	$236.00–$252.00	—	36%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 GS-NON-INVAS ARTERIAL STUDY	$151.04	$236.00	$236.00–$252.00	—	36%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS INCLUDED W/OTH EXAM	$144.64	$226.00	$130.50–$646.00	51% below	36%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$413.44	$646.00	$130.50–$646.00	41% above	36%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS INCLUDED W/OTH EXAM	$144.64	$226.00	$130.50–$646.00	—	36%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$413.44	$646.00	$130.50–$646.00	—	36%
Bone scan, whole body (nuclear medicine) CPT 78306 NUC MED TOTAL BONE SCAN	$1,360.00	$2,125.00	$238.50–$2,125.00	11% above	36%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NUC MED TOTAL BONE SCAN	$1,360.00	$2,125.00	$238.50–$2,125.00	—	36%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST BILATERAL	$852.48	$1,332.00	$149.50–$1,332.00	—	36%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL	$654.08	$1,022.00	$149.50–$1,332.00	73% above	36%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST BILATERAL	$852.48	$1,332.00	$149.50–$1,332.00	—	36%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILATERAL	$654.08	$1,022.00	$149.50–$1,332.00	—	36%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WITH CONTRAST	$1,626.24	$2,541.00	$340.00–$4,421.00	2% below	36%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/O AND WITH CONTRAS	$2,007.68	$3,137.00	$340.00–$4,421.00	21% above	36%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PERFORMED ST.LUKES	$2,829.44	$4,421.00	$340.00–$4,421.00	71% above	36%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WITH CONTRAST	$1,626.24	$2,541.00	$340.00–$4,421.00	—	36%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/O AND WITH CONTRAS	$2,007.68	$3,137.00	$340.00–$4,421.00	—	36%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST PERFORMED ST.LUKES	$2,829.44	$4,421.00	$340.00–$4,421.00	—	36%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 RAD-CT HEART CALCIUM SCORING	$135.04	$211.00	$211.00–$480.00	21% above	36%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CALCIUM SCORING	$307.20	$480.00	$211.00–$480.00	176% above	36%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 RAD-CT HEART CALCIUM SCORING	$135.04	$211.00	$211.00–$480.00	—	36%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART CALCIUM SCORING	$307.20	$480.00	$211.00–$480.00	—	36%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/OUT CONT	$399.36	$624.00	$624.00–$3,391.00	79% below	36%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/OUT CONT	$399.36	$624.00	$624.00–$3,391.00	—	36%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST	$3,404.16	$5,319.00	$667.50–$5,319.00	38% above	36%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST	$3,404.16	$5,319.00	$667.50–$5,319.00	—	36%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W & W/OUT CONTR	$450.24	$703.50	$703.50–$5,319.00	82% below	36%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W & W/O CONT	$3,404.16	$5,319.00	$703.50–$5,319.00	33% above	36%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W & W/OUT CONTR	$450.24	$703.50	$703.50–$5,319.00	—	36%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W & W/O CONT	$3,404.16	$5,319.00	$703.50–$5,319.00	—	36%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONTRAST	$1,626.24	$2,541.00	$349.50–$2,541.00	11% above	36%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH CONTRAST	$1,626.24	$2,541.00	$349.50–$2,541.00	—	36%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WITHOUT CONTRAST	$972.80	$1,520.00	$325.00–$1,520.00	17% below	36%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WITHOUT CONTRAST	$972.80	$1,520.00	$325.00–$1,520.00	—	36%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES/MAXILLOFAC W/O	$1,333.76	$2,084.00	$313.00–$2,490.00	7% above	36%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WITHOUT CONTRAST	$1,593.60	$2,490.00	$313.00–$2,490.00	28% above	36%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES/MAXILLOFAC W/O	$1,333.76	$2,084.00	$313.00–$2,490.00	—	36%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS WITHOUT CONTRAST	$1,593.60	$2,490.00	$313.00–$2,490.00	—	36%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST	$1,333.76	$2,084.00	$235.50–$2,084.00	6% above	36%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST	$1,333.76	$2,084.00	$235.50–$2,084.00	—	36%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN WITH CONTRAST	$1,544.32	$2,413.00	$310.50–$2,413.00	19% above	36%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN WITH CONTRAST	$1,544.32	$2,413.00	$310.50–$2,413.00	—	36%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & WITH CONTR	$1,820.16	$2,844.00	$349.50–$2,844.00	15% above	36%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & WITH CONTR	$1,820.16	$2,844.00	$349.50–$2,844.00	—	36%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WITHOUT CONTRA	$972.80	$1,520.00	$320.50–$1,520.00	29% below	36%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WITHOUT CONTRA	$972.80	$1,520.00	$320.50–$1,520.00	—	36%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WITHOUT CONT	$972.80	$1,520.00	$318.00–$1,520.00	28% below	36%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WITHOUT CONT	$972.80	$1,520.00	$318.00–$1,520.00	—	36%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,626.24	$2,541.00	$318.00–$2,541.00	11% above	36%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$1,626.24	$2,541.00	$318.00–$2,541.00	—	36%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID COLOR DOPPLER	$1,073.92	$1,678.00	$184.50–$1,678.00	30% above	36%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID COLOR DOPPLER	$1,073.92	$1,678.00	$184.50–$1,678.00	—	36%
Chest X-ray, 2 views CPT 71046 RAD EXAM, CHEST; 2 VIEWS	$311.04	$486.00	$62.50–$486.00	34% above	36%
Chest X-ray, 2 views inpatient CPT 71046 RAD EXAM, CHEST; 2 VIEWS	$311.04	$486.00	$62.50–$486.00	—	36%
Chest X-ray, single view CPT 71045 RAD EXAM, CHEST; SINGLE VIEW	$33.60	$52.50	$52.50–$453.00	81% below	36%
Chest X-ray, single view inpatient CPT 71045 RAD EXAM, CHEST; SINGLE VIEW	$33.60	$52.50	$52.50–$453.00	—	36%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL/KIDNEY	$654.08	$1,022.00	$204.00–$1,022.00	26% above	36%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL	$654.08	$1,022.00	$204.00–$1,022.00	26% above	36%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA	$654.08	$1,022.00	$204.00–$1,022.00	26% above	36%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US AORTA	$654.08	$1,022.00	$204.00–$1,022.00	—	36%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL	$654.08	$1,022.00	$204.00–$1,022.00	—	36%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL/KIDNEY	$654.08	$1,022.00	$204.00–$1,022.00	—	36%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY PERIPHERAL	$113.92	$178.00	$178.00	41% below	36%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY PERIPHERAL	$113.92	$178.00	$178.00	—	36%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$972.80	$1,520.00	$318.00–$1,520.00	22% below	36%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$972.80	$1,520.00	$318.00–$1,520.00	—	36%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST	$1,626.24	$2,541.00	$340.00–$2,541.00	9% above	36%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH CONTRAST	$1,626.24	$2,541.00	$340.00–$2,541.00	—	36%
Diagnostic mammogram, both breasts both sides CPT 77066 RAD-MAMMO DIAGNOSTIC 2D; BILAT	$97.60	$152.50	$152.50–$908.40	—	36%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAGN 2D; BILAT, IMPLANT	$405.76	$634.00	$152.50–$908.40	—	36%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAGNOSTIC 2D; BILAT	$581.38	$908.40	$152.50–$908.40	—	36%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 RAD-MAMMO DIAGNOSTIC 2D; BILAT	$97.60	$152.50	$152.50–$908.40	—	36%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAGN 2D; BILAT, IMPLANT	$405.76	$634.00	$152.50–$908.40	—	36%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAGNOSTIC 2D; BILAT	$581.38	$908.40	$152.50–$908.40	—	36%
Diagnostic mammogram, one breast CPT 77065 RAD-MAMMO DIAG 2D;UNIL,IMPLANT	$72.96	$114.00	$114.00–$596.00	77% below	36%
Diagnostic mammogram, one breast one side CPT 77065 RAD-MAMMO DIAGNOSTIC 2D;UNILAT	$72.96	$114.00	$114.00–$596.00	77% below	36%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAGNOSTIC 2D; UNILAT	$236.54	$369.60	$114.00–$596.00	24% below	36%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAGN 2D;UNILAT,IMPLANTS	$381.44	$596.00	$114.00–$596.00	23% above	36%
Diagnostic mammogram, one breast inpatient CPT 77065 RAD-MAMMO DIAG 2D;UNIL,IMPLANT	$72.96	$114.00	$114.00–$596.00	—	36%
Diagnostic mammogram, one breast inpatient one side CPT 77065 RAD-MAMMO DIAGNOSTIC 2D;UNILAT	$72.96	$114.00	$114.00–$596.00	—	36%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAGNOSTIC 2D; UNILAT	$236.54	$369.60	$114.00–$596.00	—	36%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAGN 2D;UNILAT,IMPLANTS	$381.44	$596.00	$114.00–$596.00	—	36%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS COLOR FLOW US/BI AT SLH	$1,073.92	$1,678.00	$208.00–$1,678.00	—	36%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS COLOR FLOW US BILATERAL	$1,073.92	$1,678.00	$208.00–$1,678.00	—	36%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS COLOR FLOW US/BI AT SLH	$1,073.92	$1,678.00	$208.00–$1,678.00	—	36%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS COLOR FLOW US BILATERAL	$1,073.92	$1,678.00	$208.00–$1,678.00	—	36%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY	$3,907.20	$6,105.00	$6,105.00	210% above	36%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY	$3,907.20	$6,105.00	$6,105.00	—	36%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUC MED HEPATOBILIARY W/GALLBL	$1,176.96	$1,839.00	$111.50–$1,839.00	13% below	36%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NUC MED HEPATOBILIARY W/GALLBL	$1,176.96	$1,839.00	$111.50–$1,839.00	—	36%
Knee X-ray, 3 views CPT 73562 ORTHO KNEE - 3 VIEWS READ	$34.56	$54.00	$54.00–$652.00	85% below	36%
Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS	$417.28	$652.00	$54.00–$652.00	80% above	36%
Knee X-ray, 3 views inpatient CPT 73562 ORTHO KNEE - 3 VIEWS READ	$34.56	$54.00	$54.00–$652.00	—	36%
Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS	$417.28	$652.00	$54.00–$652.00	—	36%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL REAL TIME LIMITED	$654.08	$1,022.00	$162.50–$1,533.00	57% above	36%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SINGLE ORGAN	$654.08	$1,022.00	$162.50–$1,533.00	57% above	36%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US RIGHT UPPER QUADRANT	$981.12	$1,533.00	$162.50–$1,533.00	135% above	36%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL REAL TIME LIMITED	$654.08	$1,022.00	$162.50–$1,533.00	—	36%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SINGLE ORGAN	$654.08	$1,022.00	$162.50–$1,533.00	—	36%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US RIGHT UPPER QUADRANT	$981.12	$1,533.00	$162.50–$1,533.00	—	36%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-LOW DOSE,LUNG CANCER SCREEN	$1,267.84	$1,981.00	$318.00–$1,981.00	119% above	36%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-LOW DOSE,LUNG CANCER SCREEN	$1,267.84	$1,981.00	$318.00–$1,981.00	—	36%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXTREMITY JOINT W/O	$2,170.24	$3,391.00	$369.00–$3,391.00	22% above	36%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXTREMITY JOINT W/O	$2,170.24	$3,391.00	$369.00–$3,391.00	—	36%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXTREM JOINT W & W/O	$3,404.16	$5,319.00	$575.00–$5,319.00	33% above	36%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXTREM JOINT W & W/O	$3,404.16	$5,319.00	$575.00–$5,319.00	—	36%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN	$2,170.24	$3,391.00	$399.50–$3,391.00	at median	36%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN	$2,170.24	$3,391.00	$399.50–$3,391.00	—	36%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI RENAL W & W/O CONTRAST	$3,404.16	$5,319.00	$615.00–$5,319.00	15% above	36%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & W/O CONTRAST	$3,404.16	$5,319.00	$615.00–$5,319.00	15% above	36%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & W/O CONTRAST	$3,404.16	$5,319.00	$615.00–$5,319.00	—	36%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI RENAL W & W/O CONTRAST	$3,404.16	$5,319.00	$615.00–$5,319.00	—	36%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN & STEM W/O CONTRAST	$2,170.24	$3,391.00	$406.00–$3,391.00	7% above	36%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN & STEM W/O CONTRAST	$2,170.24	$3,391.00	$406.00–$3,391.00	—	36%
MRI of the brain, with and without contrast dye CPT 70553 MRI,BRAIN & STEM W/WO CONTRAST	$3,404.16	$5,319.00	$645.50–$5,319.00	26% above	36%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI,BRAIN & STEM W/WO CONTRAST	$3,404.16	$5,319.00	$645.50–$5,319.00	—	36%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$2,170.24	$3,391.00	$406.00–$3,391.00	4% above	36%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$2,170.24	$3,391.00	$406.00–$3,391.00	—	36%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W & W/O CONTR	$3,404.16	$5,319.00	$645.50–$5,319.00	33% above	36%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W & W/O CONTR	$3,404.16	$5,319.00	$645.50–$5,319.00	—	36%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE W/O CONTR	$2,170.24	$3,391.00	$439.50–$3,391.00	2% above	36%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE W/O CONTR	$2,170.24	$3,391.00	$439.50–$3,391.00	—	36%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W & W/O CON	$3,404.16	$5,319.00	$701.00–$5,319.00	36% above	36%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W & W/O CON	$3,404.16	$5,319.00	$701.00–$5,319.00	—	36%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O CONTR	$2,170.24	$3,391.00	$439.50–$3,391.00	3% above	36%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O CONTR	$2,170.24	$3,391.00	$439.50–$3,391.00	—	36%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WITH/WO CONTRAST	$413.12	$645.50	$645.50–$5,319.00	84% below	36%
MRI of the pelvis without and with contrast CPT 72197 MRI-PELVIS, W & WO CONTRAST	$3,404.16	$5,319.00	$645.50–$5,319.00	28% above	36%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WITH/WO CONTRAST	$413.12	$645.50	$645.50–$5,319.00	—	36%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI-PELVIS, W & WO CONTRAST	$3,404.16	$5,319.00	$645.50–$5,319.00	—	36%
MRI of the pelvis, no contrast dye CPT 72195 MRI-PELVIS, W/O CONTRAST	$2,170.24	$3,391.00	$399.50–$3,391.00	3% above	36%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI-PELVIS, W/O CONTRAST	$2,170.24	$3,391.00	$399.50–$3,391.00	—	36%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI ELBOW	$2,170.24	$3,391.00	$369.00–$3,391.00	2% above	36%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXTREMITY JOINT W/0	$2,170.24	$3,391.00	$369.00–$3,391.00	2% above	36%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI WRIST	$2,170.24	$3,391.00	$369.00–$3,391.00	2% above	36%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI WRIST	$2,170.24	$3,391.00	$369.00–$3,391.00	—	36%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI ELBOW	$2,170.24	$3,391.00	$369.00–$3,391.00	—	36%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXTREMITY JOINT W/0	$2,170.24	$3,391.00	$369.00–$3,391.00	—	36%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT - SKULL BASE/MID THIGH	$4,401.28	$6,877.00	$250.00–$6,877.00	72% above	36%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT - SKULL BASE/MID THIGH	$4,401.28	$6,877.00	$250.00–$6,877.00	—	36%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS - LIMITED	$616.32	$963.00	$107.00–$1,337.00	102% above	36%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS FOLLOW-UP NON OB	$855.68	$1,337.00	$107.00–$1,337.00	180% above	36%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS - LIMITED	$616.32	$963.00	$107.00–$1,337.00	—	36%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS FOLLOW-UP NON OB	$855.68	$1,337.00	$107.00–$1,337.00	—	36%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON OB	$855.68	$1,337.00	$192.50–$1,337.00	83% above	36%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON OB	$855.68	$1,337.00	$192.50–$1,337.00	—	36%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US COMPLETE OB 14+ WKS	$1,050.88	$1,642.00	$277.00–$1,642.00	120% above	36%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US COMPLETE OB 14+ WKS	$1,050.88	$1,642.00	$277.00–$1,642.00	—	36%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 FP-COMPLETE OB US < 14 WEEKS	$176.32	$275.50	$275.50–$1,337.00	58% below	36%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US COMPLETE OB < 14 WEEKS	$855.68	$1,337.00	$275.50–$1,337.00	105% above	36%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 FP-COMPLETE OB US < 14 WEEKS	$176.32	$275.50	$275.50–$1,337.00	—	36%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US COMPLETE OB < 14 WEEKS	$855.68	$1,337.00	$275.50–$1,337.00	—	36%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 FP-US,PELVIS LIMITD OB(GLOBAL)	$204.80	$320.00	$182.50–$1,337.00	36% below	36%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-PELVIS LIMITED OB	$855.68	$1,337.00	$182.50–$1,337.00	166% above	36%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 FP-US,PELVIS LIMITD OB(GLOBAL)	$204.80	$320.00	$182.50–$1,337.00	—	36%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PELVIS LIMITED OB	$855.68	$1,337.00	$182.50–$1,337.00	—	36%
Screening mammogram, both breasts both sides CPT 77067 RAD-MAMMO SCRN 2D;BILAT,IMPLNT	$64.00	$100.00	$100.00–$908.40	—	36%
Screening mammogram, both breasts both sides CPT 77067 RAD-MAMMO SCREEN 2D; BILAT	$64.00	$100.00	$100.00–$908.40	—	36%
Screening mammogram, both breasts both sides CPT 77067 RAD-MAMM DIAG 2D;BILAT,IMPLANT	$97.60	$152.50	$100.00–$908.40	—	36%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN 2D;BILAT,IMPLANTS	$581.38	$908.40	$100.00–$908.40	—	36%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN 2D; BILAT	$581.38	$908.40	$100.00–$908.40	—	36%
Screening mammogram, both breasts inpatient both sides CPT 77067 RAD-MAMMO SCRN 2D;BILAT,IMPLNT	$64.00	$100.00	$100.00–$908.40	—	36%
Screening mammogram, both breasts inpatient both sides CPT 77067 RAD-MAMMO SCREEN 2D; BILAT	$64.00	$100.00	$100.00–$908.40	—	36%
Screening mammogram, both breasts inpatient both sides CPT 77067 RAD-MAMM DIAG 2D;BILAT,IMPLANT	$97.60	$152.50	$100.00–$908.40	—	36%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN 2D; BILAT	$581.38	$908.40	$100.00–$908.40	—	36%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN 2D;BILAT,IMPLANTS	$581.38	$908.40	$100.00–$908.40	—	36%
Shoulder X-ray, complete, 2 or more views CPT 73030 ORTHO SHOULDER 2+ VIEWS READ	$33.60	$52.50	$52.50–$499.00	85% below	36%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER INT/EXT AXIAL 2+ VIEW	$319.36	$499.00	$52.50–$499.00	42% above	36%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 ORTHO SHOULDER 2+ VIEWS READ	$33.60	$52.50	$52.50–$499.00	—	36%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER INT/EXT AXIAL 2+ VIEW	$319.36	$499.00	$52.50–$499.00	—	36%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW	$474.88	$742.00	$149.00–$742.00	60% above	36%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW	$474.88	$742.00	$149.00–$742.00	—	36%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB	$558.72	$873.00	$192.50–$873.00	44% above	36%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB	$558.72	$873.00	$192.50–$873.00	—	36%
Transvaginal ultrasound during pregnancy CPT 76817 FP-US TRANSVAGINAL,OB (GLOBAL)	$233.60	$365.00	$192.50–$873.00	30% below	36%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB	$558.72	$873.00	$192.50–$873.00	67% above	36%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 FP-US TRANSVAGINAL,OB (GLOBAL)	$233.60	$365.00	$192.50–$873.00	—	36%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB	$558.72	$873.00	$192.50–$873.00	—	36%
Ultrasound of the abdomen, complete CPT 76700 US ABD SURVEY 2 OR MORE ORGANS	$1,050.88	$1,642.00	$224.50–$1,642.00	79% above	36%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD SURVEY 2 OR MORE ORGANS	$1,050.88	$1,642.00	$224.50–$1,642.00	—	36%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$654.08	$1,022.00	$178.50–$1,022.00	43% above	36%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$654.08	$1,022.00	$178.50–$1,022.00	—	36%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US PAROTID ULTRASOUND	$654.08	$1,022.00	$155.00–$1,022.00	44% above	36%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID/PARATHYROID	$654.08	$1,022.00	$155.00–$1,022.00	44% above	36%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$654.08	$1,022.00	$155.00–$1,022.00	44% above	36%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US PAROTID ULTRASOUND	$654.08	$1,022.00	$155.00–$1,022.00	—	36%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$654.08	$1,022.00	$155.00–$1,022.00	—	36%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID/PARATHYROID	$654.08	$1,022.00	$155.00–$1,022.00	—	36%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS STUDY UPPER EXTRM US	$795.52	$1,243.00	$137.50–$1,243.00	45% above	36%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS STUDY LOWER EXTREM US	$795.52	$1,243.00	$137.50–$1,243.00	45% above	36%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS STUDY UPPER EXTRM US	$795.52	$1,243.00	$137.50–$1,243.00	—	36%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS STUDY LOWER EXTREM US	$795.52	$1,243.00	$137.50–$1,243.00	—	36%
Wrist X-ray, complete, 3 or more views CPT 73110 ORTHO WRIST - 3+ VIEWS READ	$32.32	$50.50	$50.50–$390.00	85% below	36%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST WITH NAVICULAR	$249.60	$390.00	$50.50–$390.00	14% above	36%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MINIMUM 3 VIEWS	$249.60	$390.00	$50.50–$390.00	14% above	36%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 ORTHO WRIST - 3+ VIEWS READ	$32.32	$50.50	$50.50–$390.00	—	36%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST WITH NAVICULAR	$249.60	$390.00	$50.50–$390.00	—	36%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MINIMUM 3 VIEWS	$249.60	$390.00	$50.50–$390.00	—	36%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 ORT-RAD EXAM,HIP,UNI;2-3 VIEWS	$39.04	$61.00	$61.00–$776.00	86% below	36%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 RAD EXA,HIP,UNI,W/PELV;2-3 VIE	$496.64	$776.00	$61.00–$776.00	80% above	36%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD EXAM,HIP,UNILAT; 2-3 VIEWS	$380.16	$594.00	$61.00–$776.00	38% above	36%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 ORT-RAD EXAM,HIP,UNI;2-3 VIEWS	$39.04	$61.00	$61.00–$776.00	—	36%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 RAD EXA,HIP,UNI,W/PELV;2-3 VIE	$496.64	$776.00	$61.00–$776.00	—	36%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD EXAM,HIP,UNILAT; 2-3 VIEWS	$380.16	$594.00	$61.00–$776.00	—	36%
X-ray of the abdomen, 1 view CPT 74018 RAD EXAM, ABDOMEN; 1 VIEW	$261.76	$409.00	$52.50–$409.00	24% above	36%
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD EXAM, ABDOMEN; 1 VIEW	$261.76	$409.00	$52.50–$409.00	—	36%
X-ray of the ankle, 2 views CPT 73600 ORTHO ANKLE - 2 VIEWS READ	$30.40	$47.50	$47.50–$448.00	81% below	36%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS	$239.36	$374.00	$47.50–$448.00	47% above	36%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS IN OP ROOM	$286.72	$448.00	$47.50–$448.00	76% above	36%
X-ray of the ankle, 2 views inpatient CPT 73600 ORTHO ANKLE - 2 VIEWS READ	$30.40	$47.50	$47.50–$448.00	—	36%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS	$239.36	$374.00	$47.50–$448.00	—	36%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS IN OP ROOM	$286.72	$448.00	$47.50–$448.00	—	36%
X-ray of the finger(s), 2 or more views CPT 73140 ORTHO FINGERS - 2+ VIEWS READ	$24.96	$39.00	$39.00–$331.00	87% below	36%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER	$211.84	$331.00	$39.00–$331.00	9% above	36%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 ORTHO FINGERS - 2+ VIEWS READ	$24.96	$39.00	$39.00–$331.00	—	36%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER	$211.84	$331.00	$39.00–$331.00	—	36%
X-ray of the foot, 2 views CPT 73620 RAD EXAM,FOOT;2 VIEW, OP ROOM	$30.40	$47.50	$47.50–$341.00	82% below	36%
X-ray of the foot, 2 views CPT 73620 RAD EXAM, FOOT;2 VIEW,RE-CHECK	$30.40	$47.50	$47.50–$341.00	82% below	36%
X-ray of the foot, 2 views CPT 73620 ORT-RAD EXAM, FOOT; 2 VIEWS	$30.40	$47.50	$47.50–$341.00	82% below	36%
X-ray of the foot, 2 views CPT 73620 RAD EXAM, FOOT; 2 VIEWS	$218.24	$341.00	$47.50–$341.00	31% above	36%
X-ray of the foot, 2 views inpatient CPT 73620 ORT-RAD EXAM, FOOT; 2 VIEWS	$30.40	$47.50	$47.50–$341.00	—	36%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM,FOOT;2 VIEW, OP ROOM	$30.40	$47.50	$47.50–$341.00	—	36%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM, FOOT;2 VIEW,RE-CHECK	$30.40	$47.50	$47.50–$341.00	—	36%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM, FOOT; 2 VIEWS	$218.24	$341.00	$47.50–$341.00	—	36%
X-ray of the foot, complete, 3 or more views CPT 73630 ORTHO FOOT - 3+ VIEWS READ	$32.32	$50.50	$50.50–$494.00	85% below	36%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MINIMUM 3 VIEWS	$316.16	$494.00	$50.50–$494.00	51% above	36%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 ORTHO FOOT - 3+ VIEWS READ	$32.32	$50.50	$50.50–$494.00	—	36%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT MINIMUM 3 VIEWS	$316.16	$494.00	$50.50–$494.00	—	36%
X-ray of the hand, 3 or more views CPT 73130 ORTHO HAND - 3+ VIEWS READ	$32.32	$50.50	$50.50–$390.00	85% below	36%
X-ray of the hand, 3 or more views CPT 73130 HAND XRAY MINIMUM 3 VIEWS	$249.60	$390.00	$50.50–$390.00	16% above	36%
X-ray of the hand, 3 or more views inpatient CPT 73130 ORTHO HAND - 3+ VIEWS READ	$32.32	$50.50	$50.50–$390.00	—	36%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND XRAY MINIMUM 3 VIEWS	$249.60	$390.00	$50.50–$390.00	—	36%
X-ray of the knee, 1 or 2 views CPT 73560 ORTHO KNEE - 1 OR 2 VIEWS READ	$33.60	$52.50	$52.50–$490.00	82% below	36%
X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM, KNEE; 1 OR 2 VIEWS	$172.16	$269.00	$52.50–$490.00	8% below	36%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE AP AND LATERAL	$313.60	$490.00	$52.50–$490.00	67% above	36%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 ORTHO KNEE - 1 OR 2 VIEWS READ	$33.60	$52.50	$52.50–$490.00	—	36%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD EXAM, KNEE; 1 OR 2 VIEWS	$172.16	$269.00	$52.50–$490.00	—	36%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE AP AND LATERAL	$313.60	$490.00	$52.50–$490.00	—	36%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 ORTHO LUMBOSACRAL SPINE READ	$40.00	$62.50	$62.50–$724.00	85% below	36%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBOSACRAL	$463.36	$724.00	$62.50–$724.00	76% above	36%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 ORTHO LUMBOSACRAL SPINE READ	$40.00	$62.50	$62.50–$724.00	—	36%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBOSACRAL	$463.36	$724.00	$62.50–$724.00	—	36%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBOSACRA WITH OBL	$508.16	$794.00	$89.00–$794.00	48% above	36%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBOSACRA WITH OBL	$508.16	$794.00	$89.00–$794.00	—	36%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$304.00	$475.00	$50.50–$475.00	39% above	36%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$304.00	$475.00	$50.50–$475.00	—	36%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 ORTHO XRAY NECK AND SPINE READ	$40.00	$62.50	$62.50–$475.00	84% below	36%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2 VIEWS	$304.00	$475.00	$62.50–$475.00	22% above	36%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 ORTHO XRAY NECK AND SPINE READ	$40.00	$62.50	$62.50–$475.00	—	36%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2 VIEWS	$304.00	$475.00	$62.50–$475.00	—	36%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS PC 1 OR 2 VIEWS	$32.32	$50.50	$50.50–$408.00	84% below	36%
X-ray of the pelvis, 1 or 2 views CPT 72170 ORTHO PELVIS -1 OR 2 VIEW READ	$32.32	$50.50	$50.50–$408.00	84% below	36%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$261.12	$408.00	$50.50–$408.00	31% above	36%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 ORTHO PELVIS -1 OR 2 VIEW READ	$32.32	$50.50	$50.50–$408.00	—	36%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS PC 1 OR 2 VIEWS	$32.32	$50.50	$50.50–$408.00	—	36%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$261.12	$408.00	$50.50–$408.00	—	36%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX	$380.16	$594.00	$50.50–$594.00	68% above	36%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX	$380.16	$594.00	$50.50–$594.00	—	36%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT), (SGPT)	$39.04	$61.00	$61.00	13% below	36%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT), (SGPT)	$39.04	$61.00	$61.00	—	36%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE;ASP AMINO(SGOT,AST	$38.40	$60.00	$60.00	14% below	36%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE;ASP AMINO(SGOT,AST	$38.40	$60.00	$60.00	—	36%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$350.72	$548.00	$548.00	50% above	36%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$350.72	$548.00	$548.00	—	36%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SINGLE	$39.04	$61.00	$61.00	157% above	36%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IgE; QUANT	$39.04	$61.00	$61.00	157% above	36%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IgE; QUANT	$39.04	$61.00	$61.00	—	36%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SINGLE	$39.04	$61.00	$61.00	—	36%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$60.80	$95.00	$95.00	45% above	36%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$60.80	$95.00	$95.00	—	36%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY (ANA)	$56.96	$89.00	$89.00–$140.00	27% above	36%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Ab, W/REFLEX	$56.96	$89.00	$89.00–$140.00	27% above	36%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY	$89.60	$140.00	$89.00–$140.00	99% above	36%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Ab, W/REFLEX	$56.96	$89.00	$89.00–$140.00	—	36%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY (ANA)	$56.96	$89.00	$89.00–$140.00	—	36%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY	$89.60	$140.00	$89.00–$140.00	—	36%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$289.28	$452.00	$452.00	115% above	36%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$289.28	$452.00	$452.00	—	36%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$62.72	$98.00	$98.00	30% below	36%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$62.72	$98.00	$98.00	—	36%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL IV;GROSS/MICRO	$136.32	$213.00	$213.00	30% above	36%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL IV;GROSS/MICRO	$136.32	$213.00	$213.00	—	36%
Blood culture for bacteria CPT 87040 BACTERIAL CULTURE BC AEROBIC	$48.64	$76.00	$76.00–$119.00	56% below	36%
Blood culture for bacteria CPT 87040 BAC CULTURE BLOOD	$76.16	$119.00	$76.00–$119.00	31% below	36%
Blood culture for bacteria inpatient CPT 87040 BACTERIAL CULTURE BC AEROBIC	$48.64	$76.00	$76.00–$119.00	—	36%
Blood culture for bacteria inpatient CPT 87040 BAC CULTURE BLOOD	$76.16	$119.00	$76.00–$119.00	—	36%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$46.72	$73.00	$73.00	125% above	36%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$46.72	$73.00	$73.00	125% above	36%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$46.72	$73.00	$73.00	—	36%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$46.72	$73.00	$73.00	—	36%
Blood glucose (sugar) test CPT 82947 GLUCOSE;QUANT, BLOOD	$29.44	$46.00	$46.00	34% below	36%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE;QUANT, BLOOD	$29.44	$46.00	$46.00	—	36%
Blood lead test CPT 83655 LEAD, BLOOD	$56.96	$89.00	$89.00–$140.00	83% above	36%
Blood lead test CPT 83655 LEAD, URINE	$89.60	$140.00	$89.00–$140.00	187% above	36%
Blood lead test inpatient CPT 83655 LEAD, BLOOD	$56.96	$89.00	$89.00–$140.00	—	36%
Blood lead test inpatient CPT 83655 LEAD, URINE	$89.60	$140.00	$89.00–$140.00	—	36%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN,CHORIONIC;QUALITA	$55.68	$87.00	$87.00	20% below	36%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN,CHORIONIC;QUALITA	$55.68	$87.00	$87.00	—	36%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO	$14.08	$22.00	$22.00–$35.00	73% below	36%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPING	$22.40	$35.00	$22.00–$35.00	58% below	36%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO	$14.08	$22.00	$22.00–$35.00	—	36%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPING	$22.40	$35.00	$22.00–$35.00	—	36%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$38.40	$60.00	$60.00	30% below	36%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$38.40	$60.00	$60.00	—	36%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF CONFIRM	$174.72	$273.00	$273.00	32% above	36%
C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF PCR	$174.72	$273.00	$273.00	32% above	36%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF CONFIRM	$174.72	$273.00	$273.00	—	36%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDIFF PCR	$174.72	$273.00	$273.00	—	36%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN	$153.60	$240.00	$240.00	51% above	36%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN	$153.60	$240.00	$240.00	—	36%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN	$153.60	$240.00	$240.00	51% above	36%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN	$153.60	$240.00	$240.00	—	36%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 LAB TEST,PCR(INHOUSE)	$240.00	$375.00	$375.00–$591.00	100% above	36%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 LAB TEST,PCR(SENDOUT)	$378.24	$591.00	$375.00–$591.00	215% above	36%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 LAB TEST,PCR(INHOUSE)	$240.00	$375.00	$375.00–$591.00	—	36%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 LAB TEST,PCR(SENDOUT)	$378.24	$591.00	$375.00–$591.00	—	36%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA SCREEN	$61.76	$96.50	$96.50	34% below	36%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS	$61.76	$96.50	$96.50	34% below	36%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS	$61.76	$96.50	$96.50	—	36%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA SCREEN	$61.76	$96.50	$96.50	—	36%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$98.56	$154.00	$154.00	7% above	36%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$98.56	$154.00	$154.00	—	36%
Complete blood count (CBC) with differential CPT 85025 CBC W/MANUAL DIFF	$36.48	$57.00	$57.00–$90.00	56% below	36%
Complete blood count (CBC) with differential CPT 85025 CBC	$57.60	$90.00	$57.00–$90.00	31% below	36%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/MANUAL DIFF	$36.48	$57.00	$57.00–$90.00	—	36%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC	$57.60	$90.00	$57.00–$90.00	—	36%
Complete blood count (CBC), no differential CPT 85027 CBC, NO DIFF	$48.00	$75.00	$75.00	27% below	36%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC, NO DIFF	$48.00	$75.00	$75.00	—	36%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$78.08	$122.00	$122.00	17% below	36%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$78.08	$122.00	$122.00	—	36%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$75.52	$118.00	$118.00	24% below	36%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$75.52	$118.00	$118.00	—	36%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$104.32	$163.00	$163.00	81% above	36%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$104.32	$163.00	$163.00	—	36%
Estradiol blood test CPT 82670 ESTRIDIAL	$49.20	$76.88	$76.88	26% below	36%
Estradiol blood test inpatient CPT 82670 ESTRIDIAL	$49.20	$76.88	$76.88	—	36%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORMONE	$32.72	$51.13	$51.13	54% below	36%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM HORMONE	$32.72	$51.13	$51.13	—	36%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN; FECAL	$144.64	$226.00	$226.00	72% above	36%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN; FECAL	$144.64	$226.00	$226.00	—	36%
Ferritin blood test (iron stores) CPT 82728 FERRITIN,SERUM	$100.48	$157.00	$157.00	12% above	36%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN,SERUM	$100.48	$157.00	$157.00	—	36%
Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM	$108.80	$170.00	$170.00	36% above	36%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID; SERUM	$108.80	$170.00	$170.00	—	36%
Free T3 thyroid hormone test CPT 84481 T3 - FREE	$124.80	$195.00	$195.00	22% above	36%
Free T3 thyroid hormone test inpatient CPT 84481 T3 - FREE	$124.80	$195.00	$195.00	—	36%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE-FREE (T4)	$66.56	$104.00	$104.00	2% below	36%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE-FREE (T4)	$66.56	$104.00	$104.00	—	36%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$187.52	$293.00	$293.00	200% above	36%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$187.52	$293.00	$293.00	—	36%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 METABOLIC PANEL, CBC, TSH	$558.08	$872.00	$872.00	125% above	36%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 METABOLIC PANEL, CBC, TSH	$558.08	$872.00	$872.00	—	36%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE TEST - 1 HR	$35.20	$55.00	$55.00	16% below	36%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE TEST - 1 HR	$35.20	$55.00	$55.00	—	36%
Glucose tolerance test, 3 samples CPT 82951 GTT - 2HRS (3 SPECIMENS)	$95.36	$149.00	$149.00	1% below	36%
Glucose tolerance test, 3 samples CPT 82951 GTT - 3HRS (4 SPECIMENS)	$95.36	$149.00	$149.00	1% below	36%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT - 3HRS (4 SPECIMENS)	$95.36	$149.00	$149.00	—	36%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT - 2HRS (3 SPECIMENS)	$95.36	$149.00	$149.00	—	36%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA PROBE	$61.76	$96.50	$96.50	27% below	36%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE	$61.76	$96.50	$96.50	27% below	36%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE	$61.76	$96.50	$96.50	—	36%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA PROBE	$61.76	$96.50	$96.50	—	36%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI, STOOL	$106.24	$166.00	$166.00	2% below	36%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI, STOOL	$106.24	$166.00	$166.00	—	36%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTIFICATION	$398.08	$622.00	$622.00	246% above	36%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANTIFICATION	$398.08	$622.00	$622.00	—	36%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB COMBO	$112.64	$176.00	$176.00–$277.00	78% above	36%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1,2, SINGLE ASSAY	$177.28	$277.00	$176.00–$277.00	180% above	36%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB COMBO	$112.64	$176.00	$176.00–$277.00	—	36%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1,2, SINGLE ASSAY	$177.28	$277.00	$176.00–$277.00	—	36%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS HIGH RISK	$258.56	$404.00	$404.00	100% above	36%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMAVIRUS HIGH RISK	$258.56	$404.00	$404.00	—	36%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C)	$71.68	$112.00	$112.00	24% above	36%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C)	$71.68	$112.00	$112.00	—	36%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$50.56	$79.00	$79.00	23% below	36%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$50.56	$79.00	$79.00	—	36%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$76.16	$119.00	$119.00	43% above	36%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$76.16	$119.00	$119.00	—	36%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$105.60	$165.00	$165.00	32% above	36%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$105.60	$165.00	$165.00	—	36%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV, RNA, QUANT 9902N	$315.52	$493.00	$493.00	154% above	36%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RIA QUANT	$315.52	$493.00	$493.00	154% above	36%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV, RNA, QUANT 9902N	$315.52	$493.00	$493.00	—	36%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RIA QUANT	$315.52	$493.00	$493.00	—	36%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$97.28	$152.00	$152.00	110% above	36%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1	$97.28	$152.00	$152.00	—	36%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$90.88	$142.00	$142.00	58% above	36%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$90.88	$142.00	$142.00	—	36%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP***	$95.36	$149.00	$149.00	34% above	36%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP***	$95.36	$149.00	$149.00	—	36%
Homocysteine blood test CPT 83090 HOMOCYSTEINE SERUM	$132.48	$207.00	$207.00	48% above	36%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE SERUM	$132.48	$207.00	$207.00	—	36%
Insulin blood test CPT 83525 SERUM INSULIN; TOTAL	$84.48	$132.00	$132.00	54% above	36%
Insulin blood test inpatient CPT 83525 SERUM INSULIN; TOTAL	$84.48	$132.00	$132.00	—	36%
Iron blood test (serum iron) CPT 83540 IRON	$48.00	$75.00	$75.00	7% below	36%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$48.00	$75.00	$75.00	—	36%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$64.64	$101.00	$101.00	at median	36%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$64.64	$101.00	$101.00	—	36%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$64.00	$100.00	$100.00	39% below	36%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$64.00	$100.00	$100.00	—	36%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$136.32	$213.00	$213.00	68% above	36%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$136.32	$213.00	$213.00	—	36%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$51.20	$80.00	$80.00	13% below	36%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$51.20	$80.00	$80.00	—	36%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$60.16	$94.00	$94.00	41% below	36%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$60.16	$94.00	$94.00	—	36%
Lyme disease antibody test CPT 86618 TICKS LYME DIS SERO, S	$80.00	$125.00	$125.00–$196.00	24% above	36%
Lyme disease antibody test CPT 86618 LYME DISEASE-IgG IgM Ab W/RFLX	$125.44	$196.00	$125.00–$196.00	94% above	36%
Lyme disease antibody test inpatient CPT 86618 TICKS LYME DIS SERO, S	$80.00	$125.00	$125.00–$196.00	—	36%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE-IgG IgM Ab W/RFLX	$125.44	$196.00	$125.00–$196.00	—	36%
Magnesium blood test CPT 83735 MAGNESIUM	$49.92	$78.00	$78.00	60% above	36%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$49.92	$78.00	$78.00	—	36%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$95.36	$149.00	$149.00	161% above	36%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$95.36	$149.00	$149.00	—	36%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES; SCREEN	$38.40	$60.00	$60.00	25% below	36%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES; SCREEN	$38.40	$60.00	$60.00	—	36%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN,FREE	$135.68	$212.00	$212.00	277% above	36%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE SPECIFIC ANTIGEN,FREE	$135.68	$212.00	$212.00	—	36%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPEC. ANTIGEN, TOTAL	$135.68	$212.00	$212.00	68% above	36%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE	$135.68	$212.00	$212.00	68% above	36%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASENSITIVE	$135.68	$212.00	$212.00	—	36%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPEC. ANTIGEN, TOTAL	$135.68	$212.00	$212.00	—	36%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR THIN PREP	$94.72	$148.00	$148.00	23% above	36%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR THIN PREP	$94.72	$148.00	$148.00	—	36%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$72.64	$113.50	$113.50	38% below	36%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$72.64	$113.50	$113.50	—	36%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TIME,PARTL (RAD)	$44.80	$70.00	$70.00	24% below	36%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME,PARTI(PTT)	$44.80	$70.00	$70.00	24% below	36%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TIME,PARTL (RAD)	$44.80	$70.00	$70.00	—	36%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME,PARTI(PTT)	$44.80	$70.00	$70.00	—	36%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NIPS CELL-FREE DNA PRENAT SCRN	$3,546.88	$5,542.00	$5,542.00	158% above	36%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NIPS CELL-FREE DNA PRENAT SCRN	$3,546.88	$5,542.00	$5,542.00	—	36%
Progesterone blood test CPT 84144 PROGESTERONE	$36.72	$57.38	$57.38	55% below	36%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$36.72	$57.38	$57.38	—	36%
Prolactin blood test CPT 84146 PROLACTIN SERUM	$34.08	$53.25	$53.25	48% below	36%
Prolactin blood test inpatient CPT 84146 PROLACTIN SERUM	$34.08	$53.25	$53.25	—	36%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$32.00	$50.00	$50.00	6% above	36%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/INR(RAD ONLY)	$32.00	$50.00	$50.00	6% above	36%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/INR(RAD ONLY)	$32.00	$50.00	$50.00	—	36%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$32.00	$50.00	$50.00	—	36%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUALITATIVE	$42.24	$66.00	$66.00	13% below	36%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUALITATIVE	$42.24	$66.00	$66.00	—	36%
Rubella antibody test (immunity check) CPT 86762 IMMUNOASSAY FOR INFAGENT;NOS	$67.84	$106.00	$106.00	43% above	36%
Rubella antibody test (immunity check) inpatient CPT 86762 IMMUNOASSAY FOR INFAGENT;NOS	$67.84	$106.00	$106.00	—	36%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE; AUTOMAT	$20.48	$32.00	$32.00	46% below	36%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE; AUTOMAT	$20.48	$32.00	$32.00	—	36%
Stool ova and parasites exam CPT 87177 OVA & PARASITE MICRO	$41.60	$65.00	$65.00–$103.00	18% above	36%
Stool ova and parasites exam CPT 87177 OVA & PARASITES MICRO, 1 1099T	$65.92	$103.00	$65.00–$103.00	87% above	36%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE MICRO	$41.60	$65.00	$65.00–$103.00	—	36%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES MICRO, 1 1099T	$65.92	$103.00	$65.00–$103.00	—	36%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD, IMMUNOCHEM	$74.88	$117.00	$117.00	30% above	36%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL OCCULT BLOOD, IMMUNOCHEM	$74.88	$117.00	$117.00	—	36%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF	$32.00	$50.00	$50.00	8% above	36%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST; QUALITATIVE	$32.00	$50.00	$50.00	8% above	36%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF	$32.00	$50.00	$50.00	—	36%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST; QUALITATIVE	$32.00	$50.00	$50.00	—	36%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD TB	$109.12	$170.50	$170.50	12% below	36%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON GOLD TB	$109.12	$170.50	$170.50	—	36%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$120.96	$189.00	$189.00	93% above	36%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$120.96	$189.00	$189.00	—	36%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODS;THY,LIV	$107.52	$168.00	$168.00	104% above	36%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES	$107.52	$168.00	$168.00	104% above	36%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODS;THY,LIV	$107.52	$168.00	$168.00	—	36%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES	$107.52	$168.00	$168.00	—	36%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE NEWBORN	$78.72	$123.00	$123.00–$194.00	16% below	36%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATION HORM;(TSH)	$124.16	$194.00	$123.00–$194.00	32% above	36%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE NEWBORN	$78.72	$123.00	$123.00–$194.00	—	36%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATION HORM;(TSH)	$124.16	$194.00	$123.00–$194.00	—	36%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS,AMPLIFIE	$164.48	$257.00	$257.00	228% above	36%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS	$164.48	$257.00	$257.00	228% above	36%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS	$164.48	$257.00	$257.00	—	36%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS,AMPLIFIE	$164.48	$257.00	$257.00	—	36%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$33.28	$52.00	$52.00	24% below	36%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$33.28	$52.00	$52.00	—	36%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, MICROSCOPIC	$23.68	$37.00	$37.00	52% below	36%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, FOR UROLOGIST	$23.68	$37.00	$37.00	52% below	36%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, FOR UROLOGIST	$23.68	$37.00	$37.00	—	36%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, MICROSCOPIC	$23.68	$37.00	$37.00	—	36%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS, NONAUTO, W/SCOPE	$30.08	$47.00	$47.00	22% below	36%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS, NONAUTO, W/SCOPE	$30.08	$47.00	$47.00	—	36%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED;W/O MICRO	$16.64	$26.00	$26.00	35% below	36%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS;AUTOMATED;W/O MIC	$16.64	$26.00	$26.00	35% below	36%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS;AUTOMATED;W/O MIC	$16.64	$26.00	$26.00	—	36%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED;W/O MICRO	$16.64	$26.00	$26.00	—	36%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, NON-AUTO,W/O MICRO	$26.24	$41.00	$41.00	18% above	36%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS, NON-AUTO,W/O MICRO	$26.24	$41.00	$41.00	—	36%
Urine culture for bacteria, with colony count CPT 87086 SLH URINE CX/COLONY COUNT	$37.76	$59.00	$59.00–$93.00	31% below	36%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL CULTURE URINE	$59.52	$93.00	$59.00–$93.00	8% above	36%
Urine culture for bacteria, with colony count inpatient CPT 87086 SLH URINE CX/COLONY COUNT	$37.76	$59.00	$59.00–$93.00	—	36%
Urine culture for bacteria, with colony count inpatient CPT 87086 BACTERIAL CULTURE URINE	$59.52	$93.00	$59.00–$93.00	—	36%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$64.00	$100.00	$100.00	65% above	36%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$64.00	$100.00	$100.00	—	36%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$111.36	$174.00	$174.00	25% above	36%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$111.36	$174.00	$174.00	—	36%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VIT.D-3)	$52.08	$81.38	$81.38–$217.00	46% below	36%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXYVITAMIN D2 AND D3, S	$138.88	$217.00	$81.38–$217.00	43% above	36%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VIT.D-3)	$52.08	$81.38	$81.38–$217.00	—	36%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXYVITAMIN D2 AND D3, S	$138.88	$217.00	$81.38–$217.00	—	36%
Zinc blood test CPT 84630 ZINC	$83.84	$131.00	$131.00	179% above	36%
Zinc blood test inpatient CPT 84630 ZINC	$83.84	$131.00	$131.00	—	36%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN;(hCG)QUANTITATIVE	$111.36	$174.00	$174.00	21% above	36%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHOR GONADOTROPIN-LOW	$111.36	$174.00	$174.00	21% above	36%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT (WHOLE MOLECULE)	$111.36	$174.00	$174.00	21% above	36%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN;(hCG)QUANTITATIVE	$111.36	$174.00	$174.00	—	36%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT (WHOLE MOLECULE)	$111.36	$174.00	$174.00	—	36%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHOR GONADOTROPIN-LOW	$111.36	$174.00	$174.00	—	36%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ENT-ADENOIDECTOMY >12YRS	$268.16	$419.00	$419.00	57% below	36%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ENT-ADENOIDECTOMY >12YRS	$268.16	$419.00	$419.00	—	36%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 SPINE-ARTH ANTERI APPROACH	$2,320.00	$3,625.00	$3,625.00	68% below	36%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 SPINE-ARTH ANTERI APPROACH	$2,320.00	$3,625.00	$3,625.00	—	36%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 GS APPENDECTOMY, RUPTURED	$1,303.68	$2,037.00	$2,037.00	20% below	36%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 GS APPENDECTOMY, RUPTURED	$1,303.68	$2,037.00	$2,037.00	—	36%
Appendectomy, open surgery CPT 44950 GS APPENDECTOMY	$1,061.12	$1,658.00	$1,658.00	15% below	36%
Appendectomy, open surgery inpatient CPT 44950 GS APPENDECTOMY	$1,061.12	$1,658.00	$1,658.00	—	36%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ORTHO ARTHROSCOPIC ACL	$2,937.60	$4,590.00	$4,590.00	13% below	36%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ORTHO ARTHROSCOPIC ACL	$2,937.60	$4,590.00	$4,590.00	—	36%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ORTHO ARTHRO SHLDR W/RTR CUFF	$1,939.20	$3,030.00	$3,030.00	24% below	36%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ORTHO ARTHRO SHLDR W/RTR CUFF	$1,939.20	$3,030.00	$3,030.00	—	36%
Botox injections for chronic migraine CPT 64615 MDA-CHEMODENERV MUSCL;BIL	$54.64	$85.37	$85.37–$341.50	91% below	36%
Botox injections for chronic migraine CPT 64615 MDA-CHEMODENERV MUSC;BIL W/FC	$163.92	$256.13	$85.37–$341.50	73% below	36%
Botox injections for chronic migraine CPT 64615 MDA-CHEMODENERV MUSCL;BILATERL	$218.56	$341.50	$85.37–$341.50	64% below	36%
Botox injections for chronic migraine inpatient CPT 64615 MDA-CHEMODENERV MUSCL;BIL	$54.64	$85.37	$85.37–$341.50	—	36%
Botox injections for chronic migraine inpatient CPT 64615 MDA-CHEMODENERV MUSC;BIL W/FC	$163.92	$256.13	$85.37–$341.50	—	36%
Botox injections for chronic migraine inpatient CPT 64615 MDA-CHEMODENERV MUSCL;BILATERL	$218.56	$341.50	$85.37–$341.50	—	36%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 RAD-BPSY BRST W/PLC;1ST LES,ST	$678.40	$1,060.00	$1,060.00	60% below	36%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 RAD-BPSY BRST W/PLC;1ST LES,ST	$678.40	$1,060.00	$1,060.00	—	36%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ORTHO CLS TX DISTAL FIB WO MAN	$377.60	$590.00	$590.00–$605.00	19% below	36%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TRMT OF DISTAL FIB FRAC	$387.20	$605.00	$590.00–$605.00	17% below	36%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ORTHO CLS TX DISTAL FIB WO MAN	$377.60	$590.00	$590.00–$605.00	—	36%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TRMT OF DISTAL FIB FRAC	$387.20	$605.00	$590.00–$605.00	—	36%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ORTHO CLSD TRMNT METATARSAL	$335.04	$523.50	$523.50	10% below	36%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ORTHO CLSD TRMNT METATARSAL	$335.04	$523.50	$523.50	—	36%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 ORTHO CORRECTION OF BUNION	$1,209.60	$1,890.00	$1,890.00	26% below	36%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 ORTHO CORRECTION OF BUNION	$1,209.60	$1,890.00	$1,890.00	—	36%
Bunion correction with removal of part of the big toe joint CPT 28292 ORTHO CORRJ HALLUX VALGUS-KELL	$1,244.48	$1,944.50	$1,944.50	14% below	36%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 ORTHO CORRJ HALLUX VALGUS-KELL	$1,244.48	$1,944.50	$1,944.50	—	36%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION;ELECTIVE,EXT. ER	$412.16	$644.00	$644.00–$645.00	60% below	36%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ER-CARDIOVERSION,ELECTV,EXTRNL	$412.80	$645.00	$644.00–$645.00	60% below	36%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION;ELECTIVE,EXT. ER	$412.16	$644.00	$644.00–$645.00	—	36%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ER-CARDIOVERSION,ELECTV,EXTRNL	$412.80	$645.00	$644.00–$645.00	—	36%
Carpal tunnel release, open surgery CPT 64721 ORT-NEURO/TRANSP MED NERV CARP	$770.88	$1,204.50	$1,204.50	47% below	36%
Carpal tunnel release, open surgery CPT 64721 GS CARPAL TUNNEL RELEASE	$770.88	$1,204.50	$1,204.50	47% below	36%
Carpal tunnel release, open surgery inpatient CPT 64721 ORT-NEURO/TRANSP MED NERV CARP	$770.88	$1,204.50	$1,204.50	—	36%
Carpal tunnel release, open surgery inpatient CPT 64721 GS CARPAL TUNNEL RELEASE	$770.88	$1,204.50	$1,204.50	—	36%
Cervical biopsy CPT 57500 FP-BIOPSY OF CERVIX	$274.56	$429.00	$429.00	36% below	36%
Cervical biopsy CPT 57500 WHS-BIOPSY OF CERVIX	$274.56	$429.00	$429.00	36% below	36%
Cervical biopsy inpatient CPT 57500 WHS-BIOPSY OF CERVIX	$274.56	$429.00	$429.00	—	36%
Cervical biopsy inpatient CPT 57500 FP-BIOPSY OF CERVIX	$274.56	$429.00	$429.00	—	36%
Cesarean delivery, including prenatal and postpartum care CPT 59510 FP-CESAREAN DELIVERY & POSTPRT	$3,011.20	$4,705.00	$4,705.00	17% below	36%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 FP-CESAREAN DELIVERY & POSTPRT	$3,011.20	$4,705.00	$4,705.00	—	36%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 FP-CIRCUMCISION W/REGIONL BLCK	$179.20	$280.00	$280.00	27% below	36%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 FP-CIRCUMCISION W/REGIONL BLCK	$179.20	$280.00	$280.00	—	36%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ORTHO DISTAL RADIUS,CLSD TRMT	$492.48	$769.50	$769.50	at median	36%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ORTHO DISTAL RADIUS,CLSD TRMT	$492.48	$769.50	$769.50	—	36%
Colonoscopy with polyp removal CPT 45385 GS LESION REMOVAL COLONOSCOPY	$947.20	$1,480.00	$1,480.00	24% below	36%
Colonoscopy with polyp removal inpatient CPT 45385 GS LESION REMOVAL COLONOSCOPY	$947.20	$1,480.00	$1,480.00	—	36%
Colonoscopy with tissue sample CPT 45380 GS COLONOSCOPY W/BIOPSY	$769.28	$1,202.00	$1,202.00	39% below	36%
Colonoscopy with tissue sample inpatient CPT 45380 GS COLONOSCOPY W/BIOPSY	$769.28	$1,202.00	$1,202.00	—	36%
Colonoscopy, diagnostic CPT 45378 GS DIAGNOSTIC COLONOSCOPY	$723.20	$1,130.00	$1,130.00	40% below	36%
Colonoscopy, diagnostic inpatient CPT 45378 GS DIAGNOSTIC COLONOSCOPY	$723.20	$1,130.00	$1,130.00	—	36%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 WHS COLPOSC W/LOOP BIOPSY-LEEP	$1,059.20	$1,655.00	$1,655.00	47% above	36%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 WHS COLPOSC W/LOOP BIOPSY-LEEP	$1,059.20	$1,655.00	$1,655.00	—	36%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 WHS COLPOSCOPY CERV W/BIOP ECC	$373.12	$583.00	$583.00	32% below	36%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 FP-COLPOSCOPY CERVIX W/BIOPSY	$373.12	$583.00	$583.00	32% below	36%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 WHS COLPOSCOPY CERV W/BIOP ECC	$373.12	$583.00	$583.00	—	36%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 FP-COLPOSCOPY CERVIX W/BIOPSY	$373.12	$583.00	$583.00	—	36%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 GS SCOPE OF BLADDER/URETHRA	$312.96	$489.00	$489.00–$690.50	58% below	36%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 WHS CYSTOURETHROSCOPY	$441.92	$690.50	$489.00–$690.50	41% below	36%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 GS SCOPE OF BLADDER/URETHRA	$312.96	$489.00	$489.00–$690.50	—	36%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 WHS CYSTOURETHROSCOPY	$441.92	$690.50	$489.00–$690.50	—	36%
D&C (dilation and curettage), not related to pregnancy CPT 58120 GS DILATION/CURETTAGE NON OB	$464.96	$726.50	$726.50–$1,298.00	68% below	36%
D&C (dilation and curettage), not related to pregnancy CPT 58120 WHS D&C NONOBSTETRICAL	$830.72	$1,298.00	$726.50–$1,298.00	43% below	36%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 GS DILATION/CURETTAGE NON OB	$464.96	$726.50	$726.50–$1,298.00	—	36%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 WHS D&C NONOBSTETRICAL	$830.72	$1,298.00	$726.50–$1,298.00	—	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 FP-SC FC,DESTRT PREMALG LESION	$21.04	$32.87	$32.87–$131.50	88% below	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 FP-DESTRT PREMALIGNT LSN W/FC	$63.12	$98.63	$32.87–$131.50	65% below	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 FP-DESTRUCT PREMALIGNT LESION	$84.16	$131.50	$32.87–$131.50	53% below	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 UC DISTRUCT PREMALIGNT LESION	$84.16	$131.50	$32.87–$131.50	53% below	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 GS DESTRUCT BENIGN LESION	$84.16	$131.50	$32.87–$131.50	53% below	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 ENT-DESTRUCT BENIGN LESION	$84.16	$131.50	$32.87–$131.50	53% below	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 FP-SC FC,DESTRT PREMALG LESION	$21.04	$32.87	$32.87–$131.50	—	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 FP-DESTRT PREMALIGNT LSN W/FC	$63.12	$98.63	$32.87–$131.50	—	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 ENT-DESTRUCT BENIGN LESION	$84.16	$131.50	$32.87–$131.50	—	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 FP-DESTRUCT PREMALIGNT LESION	$84.16	$131.50	$32.87–$131.50	—	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 GS DESTRUCT BENIGN LESION	$84.16	$131.50	$32.87–$131.50	—	36%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 UC DISTRUCT PREMALIGNT LESION	$84.16	$131.50	$32.87–$131.50	—	36%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 ENT-TYMPANOSTOMY,GENERL ANESTH	$329.60	$515.00	$515.00	62% below	36%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 ENT-TYMPANOSTOMY,GENERL ANESTH	$329.60	$515.00	$515.00	—	36%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 ENT-SC FC,TYMPANOSTOMY	$66.40	$103.75	$103.75–$415.00	84% below	36%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 ENT-TYMPANOSTOMY W/FC	$199.20	$311.25	$103.75–$415.00	53% below	36%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 ENT-TYMPANOSTOMY,LOCAL ANESTH	$265.60	$415.00	$103.75–$415.00	38% below	36%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 ENT-SC FC,TYMPANOSTOMY	$66.40	$103.75	$103.75–$415.00	—	36%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 ENT-TYMPANOSTOMY W/FC	$199.20	$311.25	$103.75–$415.00	—	36%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 ENT-TYMPANOSTOMY,LOCAL ANESTH	$265.60	$415.00	$103.75–$415.00	—	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 FP-REMV IMPCT CERUM,IRRIG W/FC	$20.16	$31.50	$10.50–$176.00	74% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ER-RMVL IMPCTD CERUMN,IRRIG	$26.88	$42.00	$10.50–$176.00	65% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 FP-REMOV IMPACTD CERUMEN,IRRIG	$26.88	$42.00	$10.50–$176.00	65% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ENT-REMOV IMPACT CERUMEN,IRRIG	$26.88	$42.00	$10.50–$176.00	65% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 UC-REMOV IMPACTD CERUMEN,IRRIG	$26.88	$42.00	$10.50–$176.00	65% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ENT-REMV IMPACT CERUMEN,IRR,FC	$26.88	$42.00	$10.50–$176.00	65% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 WC PC-REMV IMPACT CERUMN,IRRIG	$28.80	$45.00	$10.50–$176.00	63% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 WC TC-REMOV IMPCT CERUMN,IRRIG	$112.64	$176.00	$10.50–$176.00	46% above	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 FP-REMV IMPCT CERUM,IRRIG W/FC	$20.16	$31.50	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 UC-REMOV IMPACTD CERUMEN,IRRIG	$26.88	$42.00	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ENT-REMV IMPACT CERUMEN,IRR,FC	$26.88	$42.00	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ENT-REMOV IMPACT CERUMEN,IRRIG	$26.88	$42.00	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ER-RMVL IMPCTD CERUMN,IRRIG	$26.88	$42.00	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 FP-REMOV IMPACTD CERUMEN,IRRIG	$26.88	$42.00	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 WC PC-REMV IMPACT CERUMN,IRRIG	$28.80	$45.00	$10.50–$176.00	—	36%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 WC TC-REMOV IMPCT CERUMN,IRRIG	$112.64	$176.00	$10.50–$176.00	—	36%
Earwax removal with instruments, one ear CPT 69210 ENT-SC,REMV IMPCTD CERUMEN,UNI	$16.96	$26.50	$26.50–$176.00	86% below	36%
Earwax removal with instruments, one ear CPT 69210 ENT-REMOV IMPANTD CERUMEN,W/FC	$50.88	$79.50	$26.50–$176.00	59% below	36%
Earwax removal with instruments, one ear CPT 69210 ER-REMOV IMPACTED CERUMEN,UNIL	$67.84	$106.00	$26.50–$176.00	45% below	36%
Earwax removal with instruments, one ear CPT 69210 UC-REMOV IMPACTED CERUMEN,UNIL	$67.84	$106.00	$26.50–$176.00	45% below	36%
Earwax removal with instruments, one ear CPT 69210 ENT-REMOV IMPACTD CERUMEN,UNIL	$67.84	$106.00	$26.50–$176.00	45% below	36%
Earwax removal with instruments, one ear CPT 69210 WC PC-REMOV IMPACTD CERUMN,UNI	$72.32	$113.00	$26.50–$176.00	41% below	36%
Earwax removal with instruments, one ear CPT 69210 WC TC-REMOV IMPACT CERUMN,INST	$112.64	$176.00	$26.50–$176.00	9% below	36%
Earwax removal with instruments, one ear one side CPT 69210 FP SC-REMV IMPACT CERUM,UNILAT	$16.96	$26.50	$26.50–$176.00	86% below	36%
Earwax removal with instruments, one ear one side CPT 69210 FP-REMOV IMPACT CERUMEN,UNILAT	$67.84	$106.00	$26.50–$176.00	45% below	36%
Earwax removal with instruments, one ear inpatient CPT 69210 ENT-SC,REMV IMPCTD CERUMEN,UNI	$16.96	$26.50	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient CPT 69210 ENT-REMOV IMPANTD CERUMEN,W/FC	$50.88	$79.50	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient CPT 69210 ER-REMOV IMPACTED CERUMEN,UNIL	$67.84	$106.00	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient CPT 69210 UC-REMOV IMPACTED CERUMEN,UNIL	$67.84	$106.00	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient CPT 69210 ENT-REMOV IMPACTD CERUMEN,UNIL	$67.84	$106.00	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient CPT 69210 WC PC-REMOV IMPACTD CERUMN,UNI	$72.32	$113.00	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient CPT 69210 WC TC-REMOV IMPACT CERUMN,INST	$112.64	$176.00	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient one side CPT 69210 FP SC-REMV IMPACT CERUM,UNILAT	$16.96	$26.50	$26.50–$176.00	—	36%
Earwax removal with instruments, one ear inpatient one side CPT 69210 FP-REMOV IMPACT CERUMEN,UNILAT	$67.84	$106.00	$26.50–$176.00	—	36%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 FP-BIOPSY, ENDOMETRIAL	$248.32	$388.00	$388.00	at median	36%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 WHS-BIOPSY, ENDOMETRIAL	$248.32	$388.00	$388.00	at median	36%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 WHS-BIOPSY, ENDOMETRIAL	$248.32	$388.00	$388.00	—	36%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 FP-BIOPSY, ENDOMETRIAL	$248.32	$388.00	$388.00	—	36%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 ENT-ENDOSC MAXILLARY SINUS	$272.00	$425.00	$425.00	58% below	36%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 ENT-ENDOSC MAXILLARY SINUS	$272.00	$425.00	$425.00	—	36%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENT-NASAL ENDOSCOPY W/.OSTOMY	$464.00	$725.00	$725.00	71% below	36%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 ENT-NASAL ENDOSCOPY W/.OSTOMY	$464.00	$725.00	$725.00	—	36%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 MDA-INJ CERV/THOR; W/IMAG GUID	$588.80	$920.00	$920.00	40% below	36%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 MDA-INJ CERV/THOR; W/IMAG GUID	$588.80	$920.00	$920.00	—	36%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MDA SINGLE INJ LMB/SACR W/FLUO	$450.24	$703.50	$703.50–$747.00	68% below	36%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CRNA ANES/STER LUMB/SACRAL	$478.08	$747.00	$703.50–$747.00	66% below	36%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MDA SINGLE INJ LMB/SACR W/FLUO	$450.24	$703.50	$703.50–$747.00	—	36%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CRNA ANES/STER LUMB/SACRAL	$478.08	$747.00	$703.50–$747.00	—	36%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 GS-RPR AA HRNIA 1ST;3-10CM RDC	$1,152.00	$1,800.00	$1,800.00	26% below	36%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 GS-RPR AA HRNIA 1ST;3-10CM RDC	$1,152.00	$1,800.00	$1,800.00	—	36%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 GS-RPR AA HERNIA 1ST;>10CM RDC	$1,216.00	$1,900.00	$1,900.00	30% below	36%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 GS-RPR AA HERNIA 1ST;>10CM RDC	$1,216.00	$1,900.00	$1,900.00	—	36%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 GS-RPR AA HERNIA 1ST; <3CM RDC	$1,088.00	$1,700.00	$1,700.00	29% below	36%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 GS-RPR AA HERNIA 1ST; <3CM RDC	$1,088.00	$1,700.00	$1,700.00	—	36%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 GS SIGMOIDOSCOPY FLEX	$187.84	$293.50	$293.50–$1,629.00	78% below	36%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$1,042.56	$1,629.00	$293.50–$1,629.00	22% above	36%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 GS SIGMOIDOSCOPY FLEX	$187.84	$293.50	$293.50–$1,629.00	—	36%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY	$1,042.56	$1,629.00	$293.50–$1,629.00	—	36%
Gallbladder removal, laparoscopic CPT 47562 GS LAPROSCOPIC CHOLECYSTECTOMY	$1,320.32	$2,063.00	$2,063.00	20% below	36%
Gallbladder removal, laparoscopic inpatient CPT 47562 GS LAPROSCOPIC CHOLECYSTECTOMY	$1,320.32	$2,063.00	$2,063.00	—	36%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 GS LAPRO CHOLECYSTECTOMY/GRAPH	$1,423.04	$2,223.50	$2,223.50	29% below	36%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 GS LAPRO CHOLECYSTECTOMY/GRAPH	$1,423.04	$2,223.50	$2,223.50	—	36%
Gallbladder removal, open surgery through a larger incision CPT 47600 GS CHOLECYSTECTOMY	$1,397.76	$2,184.00	$2,184.00	19% below	36%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 GS CHOLECYSTECTOMY	$1,397.76	$2,184.00	$2,184.00	—	36%
Hammertoe correction surgery CPT 28285 ORTHO REPAIR HAMMERTOE	$709.44	$1,108.50	$1,108.50	70% below	36%
Hammertoe correction surgery inpatient CPT 28285 ORTHO REPAIR HAMMERTOE	$709.44	$1,108.50	$1,108.50	—	36%
Hemorrhoid banding (rubber band ligation) CPT 46221 GS-SC,LIGATION HEMORRHOID W/FC	$218.64	$341.63	$113.87–$455.50	73% below	36%
Hemorrhoid banding (rubber band ligation) CPT 46221 GS LIGATION OF HEMORRHOID(S)	$291.52	$455.50	$113.87–$455.50	64% below	36%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 GS-SC,LIGATION HEMORRHOID W/FC	$218.64	$341.63	$113.87–$455.50	—	36%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 GS LIGATION OF HEMORRHOID(S)	$291.52	$455.50	$113.87–$455.50	—	36%
Hemorrhoidectomy (internal and external), one area CPT 46255 GS HEMORRHOIDECTOMY	$845.44	$1,321.00	$1,321.00	55% below	36%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 GS HEMORRHOIDECTOMY	$845.44	$1,321.00	$1,321.00	—	36%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 ORTHO TOTAL HIP ARTHROPLASTY	$7,310.72	$11,423.00	$11,423.00	57% above	36%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 ORTHO TOTAL HIP ARTHROPLASTY	$7,310.72	$11,423.00	$11,423.00	—	36%
Hysterectomy through an abdominal incision (total) CPT 58150 WHS TOTAL ABDOM HYSTERECTOMY	$3,115.84	$4,868.50	$4,868.50	42% above	36%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 WHS TOTAL ABDOM HYSTERECTOMY	$3,115.84	$4,868.50	$4,868.50	—	36%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 WHS CATHETER FOR HYSTEROGRAPHY	$300.16	$469.00	$469.00–$490.00	1% below	36%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 RAD-CATHETER FOR HYSTEROGRAPHY	$300.16	$469.00	$469.00–$490.00	1% below	36%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INTRO CONTRAST HYSTEROSAL	$313.60	$490.00	$469.00–$490.00	4% above	36%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 RAD-CATHETER FOR HYSTEROGRAPHY	$300.16	$469.00	$469.00–$490.00	—	36%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 WHS CATHETER FOR HYSTEROGRAPHY	$300.16	$469.00	$469.00–$490.00	—	36%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INTRO CONTRAST HYSTEROSAL	$313.60	$490.00	$469.00–$490.00	—	36%
Hysteroscopy with endometrial ablation CPT 58563 GS HYSTEROSCOPY ABLATION	$1,610.88	$2,517.00	$2,517.00–$3,802.50	52% below	36%
Hysteroscopy with endometrial ablation CPT 58563 WHS HYSTEROS W/ENDOM ABLATION	$2,433.60	$3,802.50	$2,517.00–$3,802.50	27% below	36%
Hysteroscopy with endometrial ablation inpatient CPT 58563 GS HYSTEROSCOPY ABLATION	$1,610.88	$2,517.00	$2,517.00–$3,802.50	—	36%
Hysteroscopy with endometrial ablation inpatient CPT 58563 WHS HYSTEROS W/ENDOM ABLATION	$2,433.60	$3,802.50	$2,517.00–$3,802.50	—	36%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 WHS HYSTEROSCOPY W/SAMPLING	$1,382.72	$2,160.50	$2,160.50	37% below	36%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 WHS HYSTEROSCOPY W/SAMPLING	$1,382.72	$2,160.50	$2,160.50	—	36%
IUD insertion (the device itself billed separately) CPT 58300 FP-INSERT INTRAUTERINE DEVICE	$369.60	$577.50	$577.50	46% above	36%
IUD insertion (the device itself billed separately) CPT 58300 WHS IUD INSERTION	$369.60	$577.50	$577.50	46% above	36%
IUD insertion (the device itself billed separately) inpatient CPT 58300 WHS IUD INSERTION	$369.60	$577.50	$577.50	—	36%
IUD insertion (the device itself billed separately) inpatient CPT 58300 FP-INSERT INTRAUTERINE DEVICE	$369.60	$577.50	$577.50	—	36%
Incision and drainage of a simple or single skin abscess CPT 10060 GS-SC FC,I&D ABSCESS, SINGLE	$42.64	$66.62	$66.62–$421.00	85% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 GS-I&D ABSCESS,SINGLE W/FC	$127.92	$199.88	$66.62–$421.00	56% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 ER-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	41% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 FP-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	41% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 UC-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	41% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 ORT-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	41% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 GS-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	41% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 WHS-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	41% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 WC PC-I&D ABSCESS,SINGLE/SIMPL	$181.76	$284.00	$66.62–$421.00	37% below	36%
Incision and drainage of a simple or single skin abscess CPT 10060 WC TC-I&D ABSCESS,SINGLE/SIMPL	$269.44	$421.00	$66.62–$421.00	7% below	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 GS-SC FC,I&D ABSCESS, SINGLE	$42.64	$66.62	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 GS-I&D ABSCESS,SINGLE W/FC	$127.92	$199.88	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WHS-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ORT-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ER-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 FP-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 GS-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 UC-I&D ABSCESS, SINGLE/SIMPLE	$170.56	$266.50	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC PC-I&D ABSCESS,SINGLE/SIMPL	$181.76	$284.00	$66.62–$421.00	—	36%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC TC-I&D ABSCESS,SINGLE/SIMPL	$269.44	$421.00	$66.62–$421.00	—	36%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 GS REPAIR INGUINAL HERNIA	$835.20	$1,305.00	$1,305.00	52% below	36%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 GS REPAIR INGUINAL HERNIA	$835.20	$1,305.00	$1,305.00	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ORT-INJ TEND SHEATH/LIG,W/FC	$85.20	$133.13	$44.37–$186.50	77% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PAIN-INJ TEND SHE/LIG,AP, W/FC	$89.52	$139.88	$44.37–$186.50	76% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 UC INJ TEND SHEATH/LIG,APONEUR	$113.60	$177.50	$44.37–$186.50	69% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ORT-INJ TEND SHEATH/LIG,APONEU	$113.60	$177.50	$44.37–$186.50	69% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 RAD-INJ TEND SHEATH/LIG,APONEU	$113.60	$177.50	$44.37–$186.50	69% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ER-INJ TEND SHEATH/LIG,APONEUR	$113.60	$177.50	$44.37–$186.50	69% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 MDA INJ TEND SHEATH/LIG,APONEU	$119.36	$186.50	$44.37–$186.50	68% below	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ORT-INJ TEND SHEATH/LIG,W/FC	$85.20	$133.13	$44.37–$186.50	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PAIN-INJ TEND SHE/LIG,AP, W/FC	$89.52	$139.88	$44.37–$186.50	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 RAD-INJ TEND SHEATH/LIG,APONEU	$113.60	$177.50	$44.37–$186.50	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 UC INJ TEND SHEATH/LIG,APONEUR	$113.60	$177.50	$44.37–$186.50	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ER-INJ TEND SHEATH/LIG,APONEUR	$113.60	$177.50	$44.37–$186.50	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ORT-INJ TEND SHEATH/LIG,APONEU	$113.60	$177.50	$44.37–$186.50	—	36%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 MDA INJ TEND SHEATH/LIG,APONEU	$119.36	$186.50	$44.37–$186.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ORT-DRAIN/INJ MAJOR JNT W/FC	$87.60	$136.88	$45.62–$182.50	76% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MDA-DRAIN/INJ MAJ JNT/BUR W/FC	$87.60	$136.88	$45.62–$182.50	76% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FP-DRAIN/INJ MAJOR JOINT/BURSA	$116.80	$182.50	$45.62–$182.50	68% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 RAD-DRAIN/INJ MAJOR JNT/BURSA	$116.80	$182.50	$45.62–$182.50	68% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER-DRAIN/INJ MAJOR JOINT/BURSA	$116.80	$182.50	$45.62–$182.50	68% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MDA-DRAIN/INJ MAJOR JNT/BURSA	$116.80	$182.50	$45.62–$182.50	68% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ORT-DRAIN/INJ MAJOR JNT/BURSA	$116.80	$182.50	$45.62–$182.50	68% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 UC-DRAIN/INJ MAJOR JOINT/BURSA	$116.80	$182.50	$45.62–$182.50	68% below	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MDA-DRAIN/INJ MAJ JNT/BUR W/FC	$87.60	$136.88	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ORT-DRAIN/INJ MAJOR JNT W/FC	$87.60	$136.88	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ER-DRAIN/INJ MAJOR JOINT/BURSA	$116.80	$182.50	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MDA-DRAIN/INJ MAJOR JNT/BURSA	$116.80	$182.50	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 UC-DRAIN/INJ MAJOR JOINT/BURSA	$116.80	$182.50	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 RAD-DRAIN/INJ MAJOR JNT/BURSA	$116.80	$182.50	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 FP-DRAIN/INJ MAJOR JOINT/BURSA	$116.80	$182.50	$45.62–$182.50	—	36%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ORT-DRAIN/INJ MAJOR JNT/BURSA	$116.80	$182.50	$45.62–$182.50	—	36%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 WHS INSERT DRUG DELIVRY IMPLNT	$128.00	$200.00	$200.00	54% below	36%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 ORT-INSERT DRUG DELIVRY IMPLNT	$128.00	$200.00	$200.00	54% below	36%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 FP-INSERT DRUG DELIVERY IMPLNT	$128.00	$200.00	$200.00	54% below	36%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 WHS INSERT DRUG DELIVRY IMPLNT	$128.00	$200.00	$200.00	—	36%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 FP-INSERT DRUG DELIVERY IMPLNT	$128.00	$200.00	$200.00	—	36%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 ORT-INSERT DRUG DELIVRY IMPLNT	$128.00	$200.00	$200.00	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ORT-ARTH/ASP/INJ,JNT/BUR, W/FC	$93.36	$145.88	$48.62–$194.50	69% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ORT-ARTH/ASP/INJ;INTER JNT/BUR	$124.48	$194.50	$48.62–$194.50	59% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER-ARTH/ASP/INJ;INTER JNT/BURS	$124.48	$194.50	$48.62–$194.50	59% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 MDA-ARTH/ASP/INJ;INTER JNT/BUR	$124.48	$194.50	$48.62–$194.50	59% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HOSPITALIST-ARTH/ASP/INJ;JNT/B	$124.48	$194.50	$48.62–$194.50	59% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 UC-ARTHR/ASPR/INJ;INTERM JOINT	$124.48	$194.50	$48.62–$194.50	59% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 FP-ARTH/ASP/INJ;INTER JNT/BURS	$124.48	$194.50	$48.62–$194.50	59% below	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ORT-ARTH/ASP/INJ,JNT/BUR, W/FC	$93.36	$145.88	$48.62–$194.50	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ORT-ARTH/ASP/INJ;INTER JNT/BUR	$124.48	$194.50	$48.62–$194.50	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 FP-ARTH/ASP/INJ;INTER JNT/BURS	$124.48	$194.50	$48.62–$194.50	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 MDA-ARTH/ASP/INJ;INTER JNT/BUR	$124.48	$194.50	$48.62–$194.50	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HOSPITALIST-ARTH/ASP/INJ;JNT/B	$124.48	$194.50	$48.62–$194.50	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 UC-ARTHR/ASPR/INJ;INTERM JOINT	$124.48	$194.50	$48.62–$194.50	—	36%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ER-ARTH/ASP/INJ;INTER JNT/BURS	$124.48	$194.50	$48.62–$194.50	—	36%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ORT-ARTHRO,ASP/INJ,SM JT, W/FC	$91.20	$142.50	$47.50–$199.50	72% below	36%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 UC-ARTHROCENT,ASP/INJ;SM JOINT	$121.60	$190.00	$47.50–$199.50	62% below	36%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ORT-ARTHROCNT,ASP/INJ SM JOINT	$121.60	$190.00	$47.50–$199.50	62% below	36%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 GS-ARTHROCNT,SMALL JNT;W/O US	$121.60	$190.00	$47.50–$199.50	62% below	36%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ER-ARTHROCENT,ASP/INJ;SM JOINT	$126.72	$198.00	$47.50–$199.50	61% below	36%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 MDA-ARTHROCNT,ASP/INJ;SM JOINT	$127.68	$199.50	$47.50–$199.50	61% below	36%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ORT-ARTHRO,ASP/INJ,SM JT, W/FC	$91.20	$142.50	$47.50–$199.50	—	36%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ORT-ARTHROCNT,ASP/INJ SM JOINT	$121.60	$190.00	$47.50–$199.50	—	36%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 GS-ARTHROCNT,SMALL JNT;W/O US	$121.60	$190.00	$47.50–$199.50	—	36%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 UC-ARTHROCENT,ASP/INJ;SM JOINT	$121.60	$190.00	$47.50–$199.50	—	36%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ER-ARTHROCENT,ASP/INJ;SM JOINT	$126.72	$198.00	$47.50–$199.50	—	36%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 MDA-ARTHROCNT,ASP/INJ;SM JOINT	$127.68	$199.50	$47.50–$199.50	—	36%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ORTHO ARTHRO KNEE W/MENISC REP	$1,835.20	$2,867.50	$2,867.50	24% below	36%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ORTHO ARTHRO KNEE W/MENISC REP	$1,835.20	$2,867.50	$2,867.50	—	36%
Knee arthroscopy with meniscus trim CPT 29881 ORT-ARTHROSC KNEE W/MENISCETOM	$1,247.68	$1,949.50	$1,949.50	36% below	36%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ORT-ARTHROSC KNEE W/MENISCETOM	$1,247.68	$1,949.50	$1,949.50	—	36%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ORTHO ARTHRO KNEE W/MENISCECTO	$1,612.80	$2,520.00	$2,520.00	32% below	36%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ORTHO ARTHRO KNEE W/MENISCECTO	$1,612.80	$2,520.00	$2,520.00	—	36%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ORTHO ARTHRO KNEE DEBR CARTIL	$1,247.68	$1,949.50	$1,949.50	30% below	36%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ORTHO ARTHRO KNEE DEBR CARTIL	$1,247.68	$1,949.50	$1,949.50	—	36%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 GS APPENDECTOMY, LAPAROSCOPY	$1,027.84	$1,606.00	$1,606.00	22% below	36%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 GS APPENDECTOMY, LAPAROSCOPY	$1,027.84	$1,606.00	$1,606.00	—	36%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 GS LAPAROSCOPY ESO FUNDOPLASTY	$1,571.20	$2,455.00	$2,455.00	42% below	36%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 GS LAPAROSCOPY ESO FUNDOPLASTY	$1,571.20	$2,455.00	$2,455.00	—	36%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 GS LAPS SURG RPR 1ST INGUN HRN	$1,192.00	$1,862.50	$1,862.50	at median	36%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 GS LAPS SURG RPR 1ST INGUN HRN	$1,192.00	$1,862.50	$1,862.50	—	36%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 GS LPRSCPY RPR RCURRNT ING HER	$1,300.16	$2,031.50	$2,031.50	8% below	36%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 GS LPRSCPY RPR RCURRNT ING HER	$1,300.16	$2,031.50	$2,031.50	—	36%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 GS LAP RMVL ADNEXAL STRUXS	$1,612.16	$2,519.00	$2,519.00–$3,727.00	6% below	36%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 WHS LAPAROS W/REMOV ADNEX STRU	$2,385.28	$3,727.00	$2,519.00–$3,727.00	39% above	36%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 GS LAP RMVL ADNEXAL STRUXS	$1,612.16	$2,519.00	$2,519.00–$3,727.00	—	36%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 WHS LAPAROS W/REMOV ADNEX STRU	$2,385.28	$3,727.00	$2,519.00–$3,727.00	—	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ORT-INTRM REPR,SCLP/TR;2.5CM/<	$206.08	$322.00	$322.00	54% below	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 GS-INTRM REPR,SCLP/TRN;2.5CM/<	$206.08	$322.00	$322.00	54% below	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ER-INTRM REPR SCLP/TRN;2.5CM/<	$206.08	$322.00	$322.00	54% below	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 UC-INTRM REPR SCLP/TRN;2.5CM/<	$206.08	$322.00	$322.00	54% below	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ORT-INTRM REPR,SCLP/TR;2.5CM/<	$206.08	$322.00	$322.00	—	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 UC-INTRM REPR SCLP/TRN;2.5CM/<	$206.08	$322.00	$322.00	—	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ER-INTRM REPR SCLP/TRN;2.5CM/<	$206.08	$322.00	$322.00	—	36%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 GS-INTRM REPR,SCLP/TRN;2.5CM/<	$206.08	$322.00	$322.00	—	36%
Lower-back epidural injection, with imaging guidance CPT 62323 MDA-INJ CAUDAL;W/IMAG GUIDANC	$572.80	$895.00	$895.00	40% below	36%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 MDA-INJ CAUDAL;W/IMAG GUIDANC	$572.80	$895.00	$895.00	—	36%
Lower-back epidural injection, without imaging guidance CPT 62322 GS-INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	49% below	36%
Lower-back epidural injection, without imaging guidance CPT 62322 MDA-E/S INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	49% below	36%
Lower-back epidural injection, without imaging guidance CPT 62322 ORT-INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	49% below	36%
Lower-back epidural injection, without imaging guidance CPT 62322 ER-INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	49% below	36%
Lower-back epidural injection, without imaging guidance CPT 62322 CRNA-E/S INJ CAUDAL; W/O IMAG	$523.52	$818.00	$770.00–$818.00	46% below	36%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ER-INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	—	36%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ORT-INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	—	36%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 MDA-E/S INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	—	36%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 GS-INJ CAUDAL; W/O IMAG	$492.80	$770.00	$770.00–$818.00	—	36%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 CRNA-E/S INJ CAUDAL; W/O IMAG	$523.52	$818.00	$770.00–$818.00	—	36%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 MDA INJ FORAMEN EPIDURAL L/S	$1,270.08	$1,984.50	$1,984.50	1% below	36%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 MDA INJ FORAMEN EPIDURAL L/S	$1,270.08	$1,984.50	$1,984.50	—	36%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 SPINE-LAMINOTOMY LUMB 1 SPACE	$1,552.00	$2,425.00	$2,425.00	68% below	36%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 SPINE-LAMINOTOMY LUMB 1 SPACE	$1,552.00	$2,425.00	$2,425.00	—	36%
Lumbar laminectomy (spinal decompression), one level CPT 63047 SPINE-LAMINECTOMY LUMBAR FAC	$1,808.00	$2,825.00	$2,825.00	67% below	36%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 SPINE-LAMINECTOMY LUMBAR FAC	$1,808.00	$2,825.00	$2,825.00	—	36%
Lumbar spinal fusion (posterior), one level CPT 22612 SPINE-ARTHRD 1 INTSPC LUMB	$2,166.40	$3,385.00	$3,385.00	—	36%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 SPINE-ARTHRD 1 INTSPC LUMB	$2,166.40	$3,385.00	$3,385.00	—	36%
Lumpectomy (partial mastectomy) CPT 19301 GS PARTIAL MASTECTOMY	$693.44	$1,083.50	$1,083.50	53% below	36%
Lumpectomy (partial mastectomy) inpatient CPT 19301 GS PARTIAL MASTECTOMY	$693.44	$1,083.50	$1,083.50	—	36%
Mastectomy (total removal of the breast) CPT 19303 GS MASTECTOMY, SIMPLE COMPLETE	$1,712.32	$2,675.50	$2,675.50	36% below	36%
Mastectomy (total removal of the breast) inpatient CPT 19303 GS MASTECTOMY, SIMPLE COMPLETE	$1,712.32	$2,675.50	$2,675.50	—	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 UC EXCIS BENIGN LES MAGN SK TG	$144.00	$225.00	$56.25–$225.00	64% below	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 ORTHO EXCISION 0.5 CM OR LESS	$144.00	$225.00	$56.25–$225.00	64% below	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 WHS EXC BENIGN LES MAGN SK TG	$144.00	$225.00	$56.25–$225.00	64% below	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 GS-EXCIS BENIGN LES <0.5	$144.00	$225.00	$56.25–$225.00	64% below	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCIS BENIGN LES MAGN SK TG	$144.00	$225.00	$56.25–$225.00	64% below	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 GS-EXCIS BENIGN LES <0.5	$144.00	$225.00	$56.25–$225.00	—	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 WHS EXC BENIGN LES MAGN SK TG	$144.00	$225.00	$56.25–$225.00	—	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 ORTHO EXCISION 0.5 CM OR LESS	$144.00	$225.00	$56.25–$225.00	—	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCIS BENIGN LES MAGN SK TG	$144.00	$225.00	$56.25–$225.00	—	36%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 UC EXCIS BENIGN LES MAGN SK TG	$144.00	$225.00	$56.25–$225.00	—	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 GS-SC FC EXCIS BENIGN LES 0.5<	$61.04	$95.37	$95.37–$381.50	88% below	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 GS-EXCIS BENIGN LES 0.5< W/FC	$183.12	$286.13	$95.37–$381.50	65% below	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 GS-EXCISION BENIGN LES;0.5CM/<	$244.16	$381.50	$95.37–$381.50	54% below	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 ENT-EXCISN BENIGN LES; 0.5CM/<	$244.16	$381.50	$95.37–$381.50	54% below	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 GS-SC FC EXCIS BENIGN LES 0.5<	$61.04	$95.37	$95.37–$381.50	—	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 GS-EXCIS BENIGN LES 0.5< W/FC	$183.12	$286.13	$95.37–$381.50	—	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 ENT-EXCISN BENIGN LES; 0.5CM/<	$244.16	$381.50	$95.37–$381.50	—	36%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 GS-EXCISION BENIGN LES;0.5CM/<	$244.16	$381.50	$95.37–$381.50	—	36%
Nail removal (partial or complete), one nail CPT 11730 ORTHO ABLSN OF NAIL BED-SINGLE	$138.88	$217.00	$217.00–$461.00	50% below	36%
Nail removal (partial or complete), one nail CPT 11730 UC-AVULSION, NAIL PLATE;SINGLE	$138.88	$217.00	$217.00–$461.00	50% below	36%
Nail removal (partial or complete), one nail CPT 11730 GS-AVULSION NAIL PLATE;SINGLE	$138.88	$217.00	$217.00–$461.00	50% below	36%
Nail removal (partial or complete), one nail CPT 11730 FP-AVULSION NAIL PLATE; SINGLE	$138.88	$217.00	$217.00–$461.00	50% below	36%
Nail removal (partial or complete), one nail CPT 11730 ER-AVULSION,NAIL PLATE; SINGLE	$138.88	$217.00	$217.00–$461.00	50% below	36%
Nail removal (partial or complete), one nail CPT 11730 WC PC-AVULSN NAIL PLATE;SINGL	$148.48	$232.00	$217.00–$461.00	47% below	36%
Nail removal (partial or complete), one nail CPT 11730 WC TC-AVULSN NAIL PLATE;SINGLE	$295.04	$461.00	$217.00–$461.00	6% above	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 GS-AVULSION NAIL PLATE;SINGLE	$138.88	$217.00	$217.00–$461.00	—	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 ER-AVULSION,NAIL PLATE; SINGLE	$138.88	$217.00	$217.00–$461.00	—	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 UC-AVULSION, NAIL PLATE;SINGLE	$138.88	$217.00	$217.00–$461.00	—	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 FP-AVULSION NAIL PLATE; SINGLE	$138.88	$217.00	$217.00–$461.00	—	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 ORTHO ABLSN OF NAIL BED-SINGLE	$138.88	$217.00	$217.00–$461.00	—	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 WC PC-AVULSN NAIL PLATE;SINGL	$148.48	$232.00	$217.00–$461.00	—	36%
Nail removal (partial or complete), one nail inpatient CPT 11730 WC TC-AVULSN NAIL PLATE;SINGLE	$295.04	$461.00	$217.00–$461.00	—	36%
Occipital nerve block (injection for headaches) CPT 64405 UC INJ ANES NERVE BLOCK SOMATI	$75.52	$118.00	$118.00–$612.50	88% below	36%
Occipital nerve block (injection for headaches) CPT 64405 MDA-INJ,ANESTH;OCCIP NERVE	$98.00	$153.12	$118.00–$612.50	84% below	36%
Occipital nerve block (injection for headaches) CPT 64405 MDA-SC,INJ,ANES,OCIP NERV,W/FC	$294.00	$459.38	$118.00–$612.50	51% below	36%
Occipital nerve block (injection for headaches) CPT 64405 MDA-INJ,ANESTH;OCCIPITAL NERVE	$392.00	$612.50	$118.00–$612.50	35% below	36%
Occipital nerve block (injection for headaches) CPT 64405 ER-INJ,ANESTH; OCCIPITAL NERVE	$392.00	$612.50	$118.00–$612.50	35% below	36%
Occipital nerve block (injection for headaches) inpatient CPT 64405 UC INJ ANES NERVE BLOCK SOMATI	$75.52	$118.00	$118.00–$612.50	—	36%
Occipital nerve block (injection for headaches) inpatient CPT 64405 MDA-INJ,ANESTH;OCCIP NERVE	$98.00	$153.12	$118.00–$612.50	—	36%
Occipital nerve block (injection for headaches) inpatient CPT 64405 MDA-SC,INJ,ANES,OCIP NERV,W/FC	$294.00	$459.38	$118.00–$612.50	—	36%
Occipital nerve block (injection for headaches) inpatient CPT 64405 MDA-INJ,ANESTH;OCCIPITAL NERVE	$392.00	$612.50	$118.00–$612.50	—	36%
Occipital nerve block (injection for headaches) inpatient CPT 64405 ER-INJ,ANESTH; OCCIPITAL NERVE	$392.00	$612.50	$118.00–$612.50	—	36%
Paracentesis with imaging guidance CPT 49083 ER-ABDOMN PARACENTESIS;W/IMAG	$492.80	$770.00	$770.00	44% below	36%
Paracentesis with imaging guidance CPT 49083 GS-ABDOMN PARACENTESIS;W/IMAG	$492.80	$770.00	$770.00	44% below	36%
Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS W/ IMAGE GU	$492.80	$770.00	$770.00	44% below	36%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS W/ IMAGE GU	$492.80	$770.00	$770.00	—	36%
Paracentesis with imaging guidance inpatient CPT 49083 ER-ABDOMN PARACENTESIS;W/IMAG	$492.80	$770.00	$770.00	—	36%
Paracentesis with imaging guidance inpatient CPT 49083 GS-ABDOMN PARACENTESIS;W/IMAG	$492.80	$770.00	$770.00	—	36%
Partial knee replacement (one compartment) CPT 27446 ORTHO ARTHOPLASTY KNEE	$3,367.36	$5,261.50	$5,261.50	1% below	36%
Partial knee replacement (one compartment) inpatient CPT 27446 ORTHO ARTHOPLASTY KNEE	$3,367.36	$5,261.50	$5,261.50	—	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ORT-EXCISION OF NAIL,PERMANENT	$207.68	$324.50	$324.50–$764.00	59% below	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ER-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	59% below	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 GS-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	59% below	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 UC-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	59% below	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 FP-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	59% below	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 WC PC-EXCSN OF NAIL, PERMANENT	$215.04	$336.00	$324.50–$764.00	57% below	36%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 WC TC-EXCSN OF NAIL, PERMANENT	$488.96	$764.00	$324.50–$764.00	3% below	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 GS-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	—	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ORT-EXCISION OF NAIL,PERMANENT	$207.68	$324.50	$324.50–$764.00	—	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 FP-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	—	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ER-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	—	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 UC-EXCISION OF NAIL, PERMANENT	$207.68	$324.50	$324.50–$764.00	—	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 WC PC-EXCSN OF NAIL, PERMANENT	$215.04	$336.00	$324.50–$764.00	—	36%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 WC TC-EXCSN OF NAIL, PERMANENT	$488.96	$764.00	$324.50–$764.00	—	36%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 MDA PRAVERTEBRAL FACET JOINT	$346.24	$541.00	$541.00	84% below	36%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 MDA PRAVERTEBRAL FACET JOINT	$346.24	$541.00	$541.00	—	36%
Removal of a breast lump, open surgery CPT 19120 GS EXCISION BREAST CYST LUMPEC	$743.36	$1,161.50	$1,161.50	50% below	36%
Removal of a breast lump, open surgery inpatient CPT 19120 GS EXCISION BREAST CYST LUMPEC	$743.36	$1,161.50	$1,161.50	—	36%
Removal of a foreign object under the skin, simple CPT 10120 GS REMOVAL F/B SIMPLE SUBQ	$200.96	$314.00	$314.00–$421.00	50% below	36%
Removal of a foreign object under the skin, simple CPT 10120 UC-INCIS/REMV,FORGN BDY;SIMPLE	$200.96	$314.00	$314.00–$421.00	50% below	36%
Removal of a foreign object under the skin, simple CPT 10120 ER-INCIS/REMV,FORGN BDY;SIMPLE	$200.96	$314.00	$314.00–$421.00	50% below	36%
Removal of a foreign object under the skin, simple CPT 10120 ORTHO REMOVAL FOREIGN BODY	$200.96	$314.00	$314.00–$421.00	50% below	36%
Removal of a foreign object under the skin, simple CPT 10120 WC PC-INCIS/RMV,FORGN BDY;SIMP	$214.40	$335.00	$314.00–$421.00	46% below	36%
Removal of a foreign object under the skin, simple CPT 10120 WC TC-INCIS/RMV,FORGN BDY;SIMP	$269.44	$421.00	$314.00–$421.00	33% below	36%
Removal of a foreign object under the skin, simple inpatient CPT 10120 GS REMOVAL F/B SIMPLE SUBQ	$200.96	$314.00	$314.00–$421.00	—	36%
Removal of a foreign object under the skin, simple inpatient CPT 10120 UC-INCIS/REMV,FORGN BDY;SIMPLE	$200.96	$314.00	$314.00–$421.00	—	36%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ORTHO REMOVAL FOREIGN BODY	$200.96	$314.00	$314.00–$421.00	—	36%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ER-INCIS/REMV,FORGN BDY;SIMPLE	$200.96	$314.00	$314.00–$421.00	—	36%
Removal of a foreign object under the skin, simple inpatient CPT 10120 WC PC-INCIS/RMV,FORGN BDY;SIMP	$214.40	$335.00	$314.00–$421.00	—	36%
Removal of a foreign object under the skin, simple inpatient CPT 10120 WC TC-INCIS/RMV,FORGN BDY;SIMP	$269.44	$421.00	$314.00–$421.00	—	36%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 GS TOTAL THYROID LOBECTOMY	$1,363.84	$2,131.00	$2,131.00	at median	36%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 GS TOTAL THYROID LOBECTOMY	$1,363.84	$2,131.00	$2,131.00	—	36%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 GS SCREENING COLONOSCOPY	$723.20	$1,130.00	$1,130.00	34% below	36%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 GS SCREENING COLONOSCOPY	$723.20	$1,130.00	$1,130.00	34% below	36%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 GS SCREENING COLONOSCOPY	$723.20	$1,130.00	$1,130.00	—	36%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 GS SCREENING COLONOSCOPY	$723.20	$1,130.00	$1,130.00	—	36%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 GS-SCREEN COLONOSCOPY HIGH RIS	$723.20	$1,130.00	$1,130.00	39% below	36%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 GS-SCREEN COLONOSCOPY HIGH RIS	$723.20	$1,130.00	$1,130.00	39% below	36%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 GS-SCREEN COLONOSCOPY HIGH RIS	$723.20	$1,130.00	$1,130.00	—	36%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 GS-SCREEN COLONOSCOPY HIGH RIS	$723.20	$1,130.00	$1,130.00	—	36%
Septoplasty to straighten the nasal septum CPT 30520 ENT-REPAIR OF NASAL SEPTUM	$851.20	$1,330.00	$1,330.00	38% below	36%
Septoplasty to straighten the nasal septum inpatient CPT 30520 ENT-REPAIR OF NASAL SEPTUM	$851.20	$1,330.00	$1,330.00	—	36%
Short arm cast (elbow to hand) CPT 29075 OR-APPL CAST SHORT ARM W/FC	$72.96	$114.00	$38.00–$185.00	69% below	36%
Short arm cast (elbow to hand) CPT 29075 ORTHO APPLICAT CAST SHORT ARM	$97.28	$152.00	$38.00–$185.00	59% below	36%
Short arm cast (elbow to hand) CPT 29075 APPL. OF CAST ELBOW TO FINGER	$115.20	$180.00	$38.00–$185.00	51% below	36%
Short arm cast (elbow to hand) CPT 29075 UC APP OF CAST ELBOW TO FINGER	$118.40	$185.00	$38.00–$185.00	50% below	36%
Short arm cast (elbow to hand) inpatient CPT 29075 OR-APPL CAST SHORT ARM W/FC	$72.96	$114.00	$38.00–$185.00	—	36%
Short arm cast (elbow to hand) inpatient CPT 29075 ORTHO APPLICAT CAST SHORT ARM	$97.28	$152.00	$38.00–$185.00	—	36%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL. OF CAST ELBOW TO FINGER	$115.20	$180.00	$38.00–$185.00	—	36%
Short arm cast (elbow to hand) inpatient CPT 29075 UC APP OF CAST ELBOW TO FINGER	$118.40	$185.00	$38.00–$185.00	—	36%
Short arm splint (forearm and hand) CPT 29125 ORT-FAC CHG,APPLY ARM SPLINT	$31.04	$48.50	$48.50–$194.00	84% below	36%
Short arm splint (forearm and hand) CPT 29125 ORT-SC,ORT APY ARM SPLINT W/FC	$93.12	$145.50	$48.50–$194.00	53% below	36%
Short arm splint (forearm and hand) CPT 29125 UC-APPL SHORT ARM SPLINT;STATC	$124.16	$194.00	$48.50–$194.00	38% below	36%
Short arm splint (forearm and hand) CPT 29125 ORTHO APPLY FOREARM SPLINT	$124.16	$194.00	$48.50–$194.00	38% below	36%
Short arm splint (forearm and hand) CPT 29125 ER-APPL SHORT ARM SPLINT;STATC	$124.16	$194.00	$48.50–$194.00	38% below	36%
Short arm splint (forearm and hand) inpatient CPT 29125 ORT-FAC CHG,APPLY ARM SPLINT	$31.04	$48.50	$48.50–$194.00	—	36%
Short arm splint (forearm and hand) inpatient CPT 29125 ORT-SC,ORT APY ARM SPLINT W/FC	$93.12	$145.50	$48.50–$194.00	—	36%
Short arm splint (forearm and hand) inpatient CPT 29125 ER-APPL SHORT ARM SPLINT;STATC	$124.16	$194.00	$48.50–$194.00	—	36%
Short arm splint (forearm and hand) inpatient CPT 29125 ORTHO APPLY FOREARM SPLINT	$124.16	$194.00	$48.50–$194.00	—	36%
Short arm splint (forearm and hand) inpatient CPT 29125 UC-APPL SHORT ARM SPLINT;STATC	$124.16	$194.00	$48.50–$194.00	—	36%
Short leg cast (below the knee) CPT 29405 ORT-SC,APPL SHT LEG CAST,W/FC	$78.72	$123.00	$41.00–$180.00	71% below	36%
Short leg cast (below the knee) CPT 29405 ORTHO APPLICAT SHORT LEG CAST	$104.96	$164.00	$41.00–$180.00	61% below	36%
Short leg cast (below the knee) CPT 29405 ER-APPLY SHORT LOWER LEG CAST	$115.20	$180.00	$41.00–$180.00	58% below	36%
Short leg cast (below the knee) inpatient CPT 29405 ORT-SC,APPL SHT LEG CAST,W/FC	$78.72	$123.00	$41.00–$180.00	—	36%
Short leg cast (below the knee) inpatient CPT 29405 ORTHO APPLICAT SHORT LEG CAST	$104.96	$164.00	$41.00–$180.00	—	36%
Short leg cast (below the knee) inpatient CPT 29405 ER-APPLY SHORT LOWER LEG CAST	$115.20	$180.00	$41.00–$180.00	—	36%
Short leg splint (calf to foot) CPT 29515 ORT-APPL SHORT LEG SPLINT W/FC	$62.16	$97.13	$32.37–$203.50	72% below	36%
Short leg splint (calf to foot) CPT 29515 ORTHO APPL SHORT LEG SPLINT	$82.88	$129.50	$32.37–$203.50	63% below	36%
Short leg splint (calf to foot) CPT 29515 ER-APPLIC SHORT LEG SPLINT	$130.24	$203.50	$32.37–$203.50	42% below	36%
Short leg splint (calf to foot) CPT 29515 UC-APPLIC SHORT LEG SPLINT	$130.24	$203.50	$32.37–$203.50	42% below	36%
Short leg splint (calf to foot) inpatient CPT 29515 ORT-APPL SHORT LEG SPLINT W/FC	$62.16	$97.13	$32.37–$203.50	—	36%
Short leg splint (calf to foot) inpatient CPT 29515 ORTHO APPL SHORT LEG SPLINT	$82.88	$129.50	$32.37–$203.50	—	36%
Short leg splint (calf to foot) inpatient CPT 29515 ER-APPLIC SHORT LEG SPLINT	$130.24	$203.50	$32.37–$203.50	—	36%
Short leg splint (calf to foot) inpatient CPT 29515 UC-APPLIC SHORT LEG SPLINT	$130.24	$203.50	$32.37–$203.50	—	36%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ORTHO DISTAL CLAVICULECTOMY	$1,372.80	$2,145.00	$2,145.00	36% below	36%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ORTHO DISTAL CLAVICULECTOMY	$1,372.80	$2,145.00	$2,145.00	—	36%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ORT-ARTHR SHOULDR,BONE SHAVE	$736.00	$1,150.00	$1,150.00	33% below	36%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ORT-ARTHR SHOULDR,BONE SHAVE	$736.00	$1,150.00	$1,150.00	—	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ORTHO SIMPLE RPR WOUNDS <2.5CM	$173.76	$271.50	$271.50–$423.00	36% below	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER-SIMPL REPAIR EXTREM;2.5CM/<	$186.88	$292.00	$271.50–$423.00	31% below	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 UC-SIMPL REPAIR EXTREM;2.5CM/<	$186.88	$292.00	$271.50–$423.00	31% below	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WHS SMPL RPR WNDS 2.5CM OR <	$206.72	$323.00	$271.50–$423.00	24% below	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 GS LACERATION REPAIR SIMPLE	$270.72	$423.00	$271.50–$423.00	at median	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ORTHO SIMPLE RPR WOUNDS <2.5CM	$173.76	$271.50	$271.50–$423.00	—	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 UC-SIMPL REPAIR EXTREM;2.5CM/<	$186.88	$292.00	$271.50–$423.00	—	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ER-SIMPL REPAIR EXTREM;2.5CM/<	$186.88	$292.00	$271.50–$423.00	—	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 WHS SMPL RPR WNDS 2.5CM OR <	$206.72	$323.00	$271.50–$423.00	—	36%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 GS LACERATION REPAIR SIMPLE	$270.72	$423.00	$271.50–$423.00	—	36%
Skin biopsy, punch, one lesion CPT 11104 FP SC-PUNCH BIOPSY-SINGLE LESI	$39.20	$61.25	$61.25–$442.00	86% below	36%
Skin biopsy, punch, one lesion CPT 11104 GS-SC FC,PUNCH SKIN BIOP,1 LES	$39.20	$61.25	$61.25–$442.00	86% below	36%
Skin biopsy, punch, one lesion CPT 11104 GS-PUNCH SKIN BIOP;1 LES,W/FC	$117.60	$183.75	$61.25–$442.00	59% below	36%
Skin biopsy, punch, one lesion CPT 11104 FP-PUNCH BIOPSY-SINGLE LESION	$117.60	$183.75	$61.25–$442.00	59% below	36%
Skin biopsy, punch, one lesion CPT 11104 WC PC-PUNCH SKIN BIOPSY;SINGL	$140.16	$219.00	$61.25–$442.00	51% below	36%
Skin biopsy, punch, one lesion CPT 11104 ER-PUNCH SKIN BIOPSY;SINGL LES	$156.80	$245.00	$61.25–$442.00	46% below	36%
Skin biopsy, punch, one lesion CPT 11104 GS-PUNCH SKIN BIOPSY;SINGL LES	$156.80	$245.00	$61.25–$442.00	46% below	36%
Skin biopsy, punch, one lesion CPT 11104 FP-PUNCH BIOPSY; SINGLE LESION	$156.80	$245.00	$61.25–$442.00	46% below	36%
Skin biopsy, punch, one lesion CPT 11104 WHS-PUNCH SKIN BIOPSY;SING LES	$156.80	$245.00	$61.25–$442.00	46% below	36%
Skin biopsy, punch, one lesion CPT 11104 ENT-PUNCH SKIN BIOPSY;SINGL LE	$156.80	$245.00	$61.25–$442.00	46% below	36%
Skin biopsy, punch, one lesion CPT 11104 WC TC-PUNCH SKIN BIOPSY;SINGLE	$282.88	$442.00	$61.25–$442.00	2% below	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 GS-SC FC,PUNCH SKIN BIOP,1 LES	$39.20	$61.25	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 FP SC-PUNCH BIOPSY-SINGLE LESI	$39.20	$61.25	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 FP-PUNCH BIOPSY-SINGLE LESION	$117.60	$183.75	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 GS-PUNCH SKIN BIOP;1 LES,W/FC	$117.60	$183.75	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 WC PC-PUNCH SKIN BIOPSY;SINGL	$140.16	$219.00	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 FP-PUNCH BIOPSY; SINGLE LESION	$156.80	$245.00	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 ENT-PUNCH SKIN BIOPSY;SINGL LE	$156.80	$245.00	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 ER-PUNCH SKIN BIOPSY;SINGL LES	$156.80	$245.00	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 GS-PUNCH SKIN BIOPSY;SINGL LES	$156.80	$245.00	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 WHS-PUNCH SKIN BIOPSY;SING LES	$156.80	$245.00	$61.25–$442.00	—	36%
Skin biopsy, punch, one lesion inpatient CPT 11104 WC TC-PUNCH SKIN BIOPSY;SINGLE	$282.88	$442.00	$61.25–$442.00	—	36%
Skin tag removal, up to 15 tags CPT 11200 FP-SC,REMOVAL OF SKIN TAGS(1-1	$32.00	$50.00	$50.00–$213.00	84% below	36%
Skin tag removal, up to 15 tags CPT 11200 FP-REMOVAL OF SKIN TAGS(1-15)	$96.00	$150.00	$50.00–$213.00	51% below	36%
Skin tag removal, up to 15 tags CPT 11200 WHS-REMOVAL SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	35% below	36%
Skin tag removal, up to 15 tags CPT 11200 FP-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	35% below	36%
Skin tag removal, up to 15 tags CPT 11200 UC-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	35% below	36%
Skin tag removal, up to 15 tags CPT 11200 GS-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	35% below	36%
Skin tag removal, up to 15 tags CPT 11200 ER-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	35% below	36%
Skin tag removal, up to 15 tags CPT 11200 WC PC-REMOVAL SKIN TAGS (1-15)	$136.32	$213.00	$50.00–$213.00	30% below	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 FP-SC,REMOVAL OF SKIN TAGS(1-1	$32.00	$50.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 FP-REMOVAL OF SKIN TAGS(1-15)	$96.00	$150.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 FP-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 ER-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 GS-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 WHS-REMOVAL SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 UC-REMOVAL OF SKIN TAGS (1-15)	$128.00	$200.00	$50.00–$213.00	—	36%
Skin tag removal, up to 15 tags inpatient CPT 11200 WC PC-REMOVAL SKIN TAGS (1-15)	$136.32	$213.00	$50.00–$213.00	—	36%
Spinal tap (lumbar puncture), diagnostic CPT 62270 RAD-SPINAL PUNCTR, LUMBAR,DIAG	$244.80	$382.50	$382.50–$428.00	66% below	36%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ER-SPINAL LUMBAR PUNCTURE,DIAG	$244.80	$382.50	$382.50–$428.00	66% below	36%
Spinal tap (lumbar puncture), diagnostic CPT 62270 MDA-LUMBAR PUNCTURE DIAGNOSTIC	$257.28	$402.00	$382.50–$428.00	65% below	36%
Spinal tap (lumbar puncture), diagnostic CPT 62270 CRNA-LUMBAR PUNCTURE DIAGNOSTI	$273.92	$428.00	$382.50–$428.00	62% below	36%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 RAD-SPINAL PUNCTR, LUMBAR,DIAG	$244.80	$382.50	$382.50–$428.00	—	36%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ER-SPINAL LUMBAR PUNCTURE,DIAG	$244.80	$382.50	$382.50–$428.00	—	36%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 MDA-LUMBAR PUNCTURE DIAGNOSTIC	$257.28	$402.00	$382.50–$428.00	—	36%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CRNA-LUMBAR PUNCTURE DIAGNOSTI	$273.92	$428.00	$382.50–$428.00	—	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 GS REPAIR WOUND 2.6CM = 7.5CM	$176.64	$276.00	$276.00–$361.50	42% below	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ENT-WOUND REPAIR 2.6-7.5	$176.64	$276.00	$276.00–$361.50	42% below	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ORT-SURGICAL REPAIR 2.6=7.5	$176.64	$276.00	$276.00–$361.50	42% below	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER-SIMPL REPAIR EXTR;2.6-7.5CM	$231.36	$361.50	$276.00–$361.50	25% below	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 UC-SIMPL REPAIR EXTR;2.6-7.5CM	$231.36	$361.50	$276.00–$361.50	25% below	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ORT-SURGICAL REPAIR 2.6=7.5	$176.64	$276.00	$276.00–$361.50	—	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ENT-WOUND REPAIR 2.6-7.5	$176.64	$276.00	$276.00–$361.50	—	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 GS REPAIR WOUND 2.6CM = 7.5CM	$176.64	$276.00	$276.00–$361.50	—	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ER-SIMPL REPAIR EXTR;2.6-7.5CM	$231.36	$361.50	$276.00–$361.50	—	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 UC-SIMPL REPAIR EXTR;2.6-7.5CM	$231.36	$361.50	$276.00–$361.50	—	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 FP-SIMPL REPR FACE/EAR;2.5CM/<	$216.96	$339.00	$339.00	21% below	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 UC-SIMPL REPR FACE/EAR;2.5CM/<	$216.96	$339.00	$339.00	21% below	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 GS SMPLE RPR SPRFCL WNDS FACE	$216.96	$339.00	$339.00	21% below	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER-SIMPL REPR FACE/EAR;2.5CM/<	$216.96	$339.00	$339.00	21% below	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 UC-SIMPL REPR FACE/EAR;2.5CM/<	$216.96	$339.00	$339.00	—	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 FP-SIMPL REPR FACE/EAR;2.5CM/<	$216.96	$339.00	$339.00	—	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ER-SIMPL REPR FACE/EAR;2.5CM/<	$216.96	$339.00	$339.00	—	36%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 GS SMPLE RPR SPRFCL WNDS FACE	$216.96	$339.00	$339.00	—	36%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 ENT-SC,TANG SKIN BIOP SGL	$27.20	$42.50	$42.50–$170.00	89% below	36%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 ENT-TANG SKIN BIOPSY;SINGLE LS	$81.60	$127.50	$42.50–$170.00	67% below	36%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 GS-TANG SKIN BIOPSY;SINGL LESN	$108.80	$170.00	$42.50–$170.00	56% below	36%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 ENT-TANG SKIN BIOPSY;SINGL LES	$108.80	$170.00	$42.50–$170.00	56% below	36%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 ORT-TANG SKIN BIOPSY;SINGL LES	$108.80	$170.00	$42.50–$170.00	56% below	36%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 FP-TANG SKIN BIOPSY;SINGL LESN	$108.80	$170.00	$42.50–$170.00	56% below	36%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 ENT-SC,TANG SKIN BIOP SGL	$27.20	$42.50	$42.50–$170.00	—	36%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 ENT-TANG SKIN BIOPSY;SINGLE LS	$81.60	$127.50	$42.50–$170.00	—	36%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 FP-TANG SKIN BIOPSY;SINGL LESN	$108.80	$170.00	$42.50–$170.00	—	36%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 GS-TANG SKIN BIOPSY;SINGL LESN	$108.80	$170.00	$42.50–$170.00	—	36%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 ENT-TANG SKIN BIOPSY;SINGL LES	$108.80	$170.00	$42.50–$170.00	—	36%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 ORT-TANG SKIN BIOPSY;SINGL LES	$108.80	$170.00	$42.50–$170.00	—	36%
Thoracentesis with imaging guidance CPT 32555 GS THORACENTESIS PUNCTURE/GUID	$280.96	$439.00	$439.00–$2,295.00	69% below	36%
Thoracentesis with imaging guidance CPT 32555 ER W/ OPEN INTRAPLEURAL W/GUID	$473.60	$740.00	$439.00–$2,295.00	47% below	36%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS OF PLUERAL W/GUI	$480.00	$750.00	$439.00–$2,295.00	46% below	36%
Thoracentesis with imaging guidance CPT 32555 INJ PROCEDUR BY MD W/ULTRASOUN	$1,468.80	$2,295.00	$439.00–$2,295.00	64% above	36%
Thoracentesis with imaging guidance inpatient CPT 32555 GS THORACENTESIS PUNCTURE/GUID	$280.96	$439.00	$439.00–$2,295.00	—	36%
Thoracentesis with imaging guidance inpatient CPT 32555 ER W/ OPEN INTRAPLEURAL W/GUID	$473.60	$740.00	$439.00–$2,295.00	—	36%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS OF PLUERAL W/GUI	$480.00	$750.00	$439.00–$2,295.00	—	36%
Thoracentesis with imaging guidance inpatient CPT 32555 INJ PROCEDUR BY MD W/ULTRASOUN	$1,468.80	$2,295.00	$439.00–$2,295.00	—	36%
Tonsil and adenoid removal, child under 12 CPT 42820 ENT-TONSILLECTMY/ADENOID,<12YR	$585.60	$915.00	$915.00	21% below	36%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 ENT-TONSILLECTMY/ADENOID,<12YR	$585.60	$915.00	$915.00	—	36%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 ENT-TONSILLECTMY;AGE 12 & OVER	$595.20	$930.00	$930.00	18% below	36%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 ENT-TONSILLECTMY;AGE 12 & OVER	$595.20	$930.00	$930.00	—	36%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 ENT-TONSILLECTOMY, < AGE 12	$563.20	$880.00	$880.00	32% below	36%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 ENT-TONSILLECTOMY, < AGE 12	$563.20	$880.00	$880.00	—	36%
Total hip replacement CPT 27130 ORT-TOTAL HIP ARTHROPLASTY	$3,133.44	$4,896.00	$4,896.00	20% below	36%
Total hip replacement inpatient CPT 27130 ORT-TOTAL HIP ARTHROPLASTY	$3,133.44	$4,896.00	$4,896.00	—	36%
Total knee replacement CPT 27447 ORT-TOTAL KNEE ARTHROPLASTY	$3,561.28	$5,564.50	$5,564.50	5% below	36%
Total knee replacement inpatient CPT 27447 ORT-TOTAL KNEE ARTHROPLASTY	$3,561.28	$5,564.50	$5,564.50	—	36%
Total shoulder replacement CPT 23472 ORT-ARTHROPLSTY,TOTAL SHOULDER	$3,036.80	$4,745.00	$4,745.00	26% below	36%
Total shoulder replacement inpatient CPT 23472 ORT-ARTHROPLSTY,TOTAL SHOULDER	$3,036.80	$4,745.00	$4,745.00	—	36%
Total thyroid removal (thyroidectomy) CPT 60240 GS THYROIDECTOMY, TOTAL	$2,582.40	$4,035.00	$4,035.00	18% above	36%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 GS THYROIDECTOMY, TOTAL	$2,582.40	$4,035.00	$4,035.00	—	36%
Trigger finger release surgery CPT 26055 ORTHO TENDON SHEATH INCISION	$680.00	$1,062.50	$1,062.50	48% below	36%
Trigger finger release surgery inpatient CPT 26055 ORTHO TENDON SHEATH INCISION	$680.00	$1,062.50	$1,062.50	—	36%
Trigger point injections, 1 or 2 muscles CPT 20552 ORT-INJ TRIGGER POINTS,W/FC	$90.72	$141.75	$47.25–$198.50	71% below	36%
Trigger point injections, 1 or 2 muscles CPT 20552 PAIN-SC,TRIG PNT INJ 12- W/FC	$95.28	$148.88	$47.25–$198.50	69% below	36%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE\MULT. TRIGGER PNTS	$112.00	$175.00	$47.25–$198.50	64% below	36%
Trigger point injections, 1 or 2 muscles CPT 20552 GS INJ SINGLE OR MULT TRIGGER	$115.20	$180.00	$47.25–$198.50	63% below	36%
Trigger point injections, 1 or 2 muscles CPT 20552 ORTHO INJECTION TRIGGER POINTS	$120.96	$189.00	$47.25–$198.50	61% below	36%
Trigger point injections, 1 or 2 muscles CPT 20552 UC INJ SINGLE/MULT TRIGGER PNT	$120.96	$189.00	$47.25–$198.50	61% below	36%
Trigger point injections, 1 or 2 muscles CPT 20552 MDA TRIGGER POINT INJ 1-2 MUSC	$127.04	$198.50	$47.25–$198.50	59% below	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ORT-INJ TRIGGER POINTS,W/FC	$90.72	$141.75	$47.25–$198.50	—	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PAIN-SC,TRIG PNT INJ 12- W/FC	$95.28	$148.88	$47.25–$198.50	—	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE\MULT. TRIGGER PNTS	$112.00	$175.00	$47.25–$198.50	—	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 GS INJ SINGLE OR MULT TRIGGER	$115.20	$180.00	$47.25–$198.50	—	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 UC INJ SINGLE/MULT TRIGGER PNT	$120.96	$189.00	$47.25–$198.50	—	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ORTHO INJECTION TRIGGER POINTS	$120.96	$189.00	$47.25–$198.50	—	36%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 MDA TRIGGER POINT INJ 1-2 MUSC	$127.04	$198.50	$47.25–$198.50	—	36%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 GS LAP TUBAL FULGUR OVIDUCTS	$731.20	$1,142.50	$1,142.50–$2,787.50	6% below	36%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 WHS LAPAROSCOPY W/FULGUR OVIDU	$1,784.00	$2,787.50	$1,142.50–$2,787.50	129% above	36%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 GS LAP TUBAL FULGUR OVIDUCTS	$731.20	$1,142.50	$1,142.50–$2,787.50	—	36%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 WHS LAPAROSCOPY W/FULGUR OVIDU	$1,784.00	$2,787.50	$1,142.50–$2,787.50	—	36%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 RAD-BPSY BRST W/PLC;1ST LES,US	$636.80	$995.00	$995.00–$1,640.00	61% below	36%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US-BPSY BRST W/PLC;1ST LESION	$1,049.60	$1,640.00	$995.00–$1,640.00	36% below	36%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 RAD-BPSY BRST W/PLC;1ST LES,US	$636.80	$995.00	$995.00–$1,640.00	—	36%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US-BPSY BRST W/PLC;1ST LESION	$1,049.60	$1,640.00	$995.00–$1,640.00	—	36%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 GS UPR GI NDSC BALO DIL ESOPH	$629.12	$983.00	$983.00	65% below	36%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 GS UPR GI NDSC BALO DIL ESOPH	$629.12	$983.00	$983.00	—	36%
Upper endoscopy (EGD) with biopsy CPT 43239 GS UPPER GI ENDOSCOPY W/BIOPSY	$543.68	$849.50	$849.50	48% below	36%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 GS UPPER GI ENDOSCOPY W/BIOPSY	$543.68	$849.50	$849.50	—	36%
Upper endoscopy (EGD) with injection into the lining CPT 43236 GS UPPER GASTRO ENDO W. DIRCT	$781.76	$1,221.50	$1,221.50	39% below	36%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 GS UPPER GASTRO ENDO W. DIRCT	$781.76	$1,221.50	$1,221.50	—	36%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 GS UPPER GI ENDOSCOPY	$451.20	$705.00	$705.00	74% below	36%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 GS UPPER GI ENDOSCOPY	$451.20	$705.00	$705.00	—	36%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 GS UPPER GASTR ENDO W/GUIDE WI	$391.04	$611.00	$611.00	72% below	36%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 GS UPPER GASTR ENDO W/GUIDE WI	$391.04	$611.00	$611.00	—	36%
Upper endoscopy (EGD), diagnostic CPT 43235 GS UPPER GI ENDOSCOPY	$505.92	$790.50	$790.50	47% below	36%
Upper endoscopy (EGD), diagnostic CPT 43235 ENT- UPPER GI ENDOSCOPY	$505.92	$790.50	$790.50	47% below	36%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 GS UPPER GI ENDOSCOPY	$505.92	$790.50	$790.50	—	36%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENT- UPPER GI ENDOSCOPY	$505.92	$790.50	$790.50	—	36%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 FP-VAG DELIVRY,PREVIOUS CESAR	$2,848.00	$4,450.00	$4,450.00	15% below	36%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 FP-VAG DELIVRY,PREVIOUS CESAR	$2,848.00	$4,450.00	$4,450.00	—	36%
Vaginal delivery, including prenatal and postpartum care CPT 59400 FP-OBSTETRICAL CARE	$2,400.00	$3,750.00	$3,750.00	23% below	36%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 FP-OBSTETRICAL CARE	$2,400.00	$3,750.00	$3,750.00	—	36%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 GS VASECTOMY, UNILATERAL OR BI	$560.00	$875.00	$875.00	—	36%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 GS VASECTOMY, UNILATERAL OR BI	$560.00	$875.00	$875.00	—	36%
Wart removal, up to 14 warts CPT 17110 FP-SC FC,DESTRUCTION LES >14	$47.84	$74.75	$74.75–$299.00	76% below	36%
Wart removal, up to 14 warts CPT 17110 UC-DESTRUCTION,LESION;UP TO 14	$115.20	$180.00	$74.75–$299.00	41% below	36%
Wart removal, up to 14 warts CPT 17110 ER-DESTRUCTION,LESION,UP TO 14	$115.20	$180.00	$74.75–$299.00	41% below	36%
Wart removal, up to 14 warts CPT 17110 FP-DESTRUCTION LESION >14 W/FC	$143.52	$224.25	$74.75–$299.00	27% below	36%
Wart removal, up to 14 warts CPT 17110 ORT-DESTRUCTN, LESION,UP TO 14	$191.36	$299.00	$74.75–$299.00	2% below	36%
Wart removal, up to 14 warts CPT 17110 FP-DESTRUCTION,LESION,UP TO 14	$191.36	$299.00	$74.75–$299.00	2% below	36%
Wart removal, up to 14 warts CPT 17110 WHS-DESTRUCTN,LESION, UP TO 14	$191.36	$299.00	$74.75–$299.00	2% below	36%
Wart removal, up to 14 warts CPT 17110 ENT-DESTRUCTION,LESION,TO 14	$191.36	$299.00	$74.75–$299.00	2% below	36%
Wart removal, up to 14 warts CPT 17110 GS-DESTRUCTION,LESION,UP TO 14	$191.36	$299.00	$74.75–$299.00	2% below	36%
Wart removal, up to 14 warts inpatient CPT 17110 FP-SC FC,DESTRUCTION LES >14	$47.84	$74.75	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 ER-DESTRUCTION,LESION,UP TO 14	$115.20	$180.00	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 UC-DESTRUCTION,LESION;UP TO 14	$115.20	$180.00	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 FP-DESTRUCTION LESION >14 W/FC	$143.52	$224.25	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 ENT-DESTRUCTION,LESION,TO 14	$191.36	$299.00	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 GS-DESTRUCTION,LESION,UP TO 14	$191.36	$299.00	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 WHS-DESTRUCTN,LESION, UP TO 14	$191.36	$299.00	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 FP-DESTRUCTION,LESION,UP TO 14	$191.36	$299.00	$74.75–$299.00	—	36%
Wart removal, up to 14 warts inpatient CPT 17110 ORT-DESTRUCTN, LESION,UP TO 14	$191.36	$299.00	$74.75–$299.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 GS-DEBRID,SUBC,1ST 20CM,W/FC	$132.48	$207.00	$69.00–$871.00	70% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 GS-DEBRID,SUBC, FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	60% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER-DEBRID,SUBC, FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	60% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WHS-DEBRID,SUBC,FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	60% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ORTHO-DEBRID,SUBC,FIRST 20SQCM	$176.64	$276.00	$69.00–$871.00	60% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 UC-DEBRID,SUBC, FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	60% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 FP-DEBRID, SUB, 1ST 20SQ CM/<	$176.64	$276.00	$69.00–$871.00	60% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC PC-DEBRID,SUB,1ST 20SQ CM/<	$188.16	$294.00	$69.00–$871.00	58% below	36%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC TC-DEBRID,SUB,1ST 20SQ CM/<	$557.44	$871.00	$69.00–$871.00	25% above	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 GS-DEBRID,SUBC,1ST 20CM,W/FC	$132.48	$207.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 FP-DEBRID, SUB, 1ST 20SQ CM/<	$176.64	$276.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ORTHO-DEBRID,SUBC,FIRST 20SQCM	$176.64	$276.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ER-DEBRID,SUBC, FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WHS-DEBRID,SUBC,FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 GS-DEBRID,SUBC, FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 UC-DEBRID,SUBC, FIRST 20 SQ CM	$176.64	$276.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC PC-DEBRID,SUB,1ST 20SQ CM/<	$188.16	$294.00	$69.00–$871.00	—	36%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC TC-DEBRID,SUB,1ST 20SQ CM/<	$557.44	$871.00	$69.00–$871.00	—	36%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 ORTHO OPTX RADL X-ARTIC FX/EPI	$1,126.08	$1,759.50	$1,759.50	53% below	36%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 ORTHO OPTX RADL X-ARTIC FX/EPI	$1,126.08	$1,759.50	$1,759.50	—	36%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION, BLOOD OR COMPONEN	$232.96	$364.00	$364.00	67% below	36%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION, BLOOD OR COMPONEN	$232.96	$364.00	$364.00	—	36%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 FP-AIRWAY INHALATION TREATMENT	$35.20	$55.00	$55.00–$226.00	70% below	36%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBUL TREAT/EZ PAP(PAT AIRW PR	$144.64	$226.00	$55.00–$226.00	23% above	36%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 FP-AIRWAY INHALATION TREATMENT	$35.20	$55.00	$55.00–$226.00	—	36%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBUL TREAT/EZ PAP(PAT AIRW PR	$144.64	$226.00	$55.00–$226.00	—	36%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INFUS, FIRST HR	$641.92	$1,003.00	$1,003.00	25% above	36%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN IV INFUS, FIRST HR	$641.92	$1,003.00	$1,003.00	—	36%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 ENT-COMP EVAL/SPEECH RECOG	$23.04	$36.00	$12.00–$48.00	85% below	36%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 ENT-COMP EVAL/SPEECH RECOG	$23.04	$36.00	$12.00–$48.00	—	36%
Critical care, first 30 to 74 minutes CPT 99291 ER-CRITICAL CARE, 1ST 30-74MIN	$485.12	$758.00	$758.00–$2,251.00	69% below	36%
Critical care, first 30 to 74 minutes CPT 99291 HOSPITLST-CRIT CARE,1ST 30-74	$485.12	$758.00	$758.00–$2,251.00	69% below	36%
Critical care, first 30 to 74 minutes CPT 99291 FP-CRITICAL CARE,1ST 30-74 MIN	$485.12	$758.00	$758.00–$2,251.00	69% below	36%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE 30-74 MINUTES	$1,440.64	$2,251.00	$758.00–$2,251.00	7% below	36%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HOSPITLST-CRIT CARE,1ST 30-74	$485.12	$758.00	$758.00–$2,251.00	—	36%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER-CRITICAL CARE, 1ST 30-74MIN	$485.12	$758.00	$758.00–$2,251.00	—	36%
Critical care, first 30 to 74 minutes inpatient CPT 99291 FP-CRITICAL CARE,1ST 30-74 MIN	$485.12	$758.00	$758.00–$2,251.00	—	36%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER CRITICAL CARE 30-74 MINUTES	$1,440.64	$2,251.00	$758.00–$2,251.00	—	36%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 FP RC-EKG COMPLETE	$215.68	$337.00	$337.00	65% above	36%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 FP RC-EKG COMPLETE	$215.68	$337.00	$337.00	—	36%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ECG ONLY IN ICU	$232.96	$364.00	$364.00–$676.00	35% above	36%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ECG ONLY	$432.64	$676.00	$364.00–$676.00	151% above	36%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ECG ONLY IN ICU	$232.96	$364.00	$364.00–$676.00	—	36%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ECG ONLY	$432.64	$676.00	$364.00–$676.00	—	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER TRIAGE/NURSING FEE ONLY	$76.80	$120.00	$120.00–$271.00	60% below	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 MINOR SERVICE THROUGH ER	$104.32	$163.00	$120.00–$271.00	46% below	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER-EVAL & MGMT, LEVEL 1	$104.64	$163.50	$120.00–$271.00	46% below	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL I	$173.44	$271.00	$120.00–$271.00	10% below	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER TRIAGE/NURSING FEE ONLY	$76.80	$120.00	$120.00–$271.00	—	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 MINOR SERVICE THROUGH ER	$104.32	$163.00	$120.00–$271.00	—	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER-EVAL & MGMT, LEVEL 1	$104.64	$163.50	$120.00–$271.00	—	36%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM LEVEL I	$173.44	$271.00	$120.00–$271.00	—	36%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER-EVAL & MGMT, LEVEL 2	$127.04	$198.50	$198.50–$397.00	49% below	36%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL II	$254.08	$397.00	$198.50–$397.00	3% above	36%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER-EVAL & MGMT, LEVEL 2	$127.04	$198.50	$198.50–$397.00	—	36%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY ROOM LEVEL II	$254.08	$397.00	$198.50–$397.00	—	36%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER-EVAL & MGMT, LEVEL 3	$158.72	$248.00	$248.00–$626.00	60% below	36%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL III	$400.64	$626.00	$248.00–$626.00	1% above	36%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER-EVAL & MGMT, LEVEL 3	$158.72	$248.00	$248.00–$626.00	—	36%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM LEVEL III	$400.64	$626.00	$248.00–$626.00	—	36%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER-EVAL & MGMT, LEVEL 4	$236.16	$369.00	$369.00–$1,005.00	63% below	36%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL IV	$643.20	$1,005.00	$369.00–$1,005.00	1% above	36%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER-EVAL & MGMT, LEVEL 4	$236.16	$369.00	$369.00–$1,005.00	—	36%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM LEVEL IV	$643.20	$1,005.00	$369.00–$1,005.00	—	36%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER-EVAL & MGMT, LEVEL 5	$381.76	$596.50	$596.50–$1,467.00	60% below	36%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL V	$938.88	$1,467.00	$596.50–$1,467.00	1% below	36%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER-EVAL & MGMT, LEVEL 5	$381.76	$596.50	$596.50–$1,467.00	—	36%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM LEVEL V	$938.88	$1,467.00	$596.50–$1,467.00	—	36%
Exercise stress test, tracing only, the hospital charge CPT 93017 EKG TREADMILL	$956.16	$1,494.00	$127.00–$1,494.00	33% above	36%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EKG TREADMILL	$956.16	$1,494.00	$127.00–$1,494.00	—	36%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDRATION; 1ST HR ER	$117.12	$183.00	$183.00–$322.00	57% below	36%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 1ST HR	$206.08	$322.00	$183.00–$322.00	24% below	36%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS HYDRATION; 1ST HR ER	$117.12	$183.00	$183.00–$322.00	—	36%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 1ST HR	$206.08	$322.00	$183.00–$322.00	—	36%
IV infusion of a medicine, first hour CPT 96365 UC-IV INFUS,INITIAL,UP TO 1 HR	$115.20	$180.00	$180.00–$407.00	65% below	36%
IV infusion of a medicine, first hour CPT 96365 IV INFUS THERAPY TO 1 HR, ER	$117.12	$183.00	$180.00–$407.00	64% below	36%
IV infusion of a medicine, first hour CPT 96365 TREATMENT RM IV INFUS TO 1 HR	$260.48	$407.00	$180.00–$407.00	21% below	36%
IV infusion of a medicine, first hour inpatient CPT 96365 UC-IV INFUS,INITIAL,UP TO 1 HR	$115.20	$180.00	$180.00–$407.00	—	36%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS THERAPY TO 1 HR, ER	$117.12	$183.00	$180.00–$407.00	—	36%
IV infusion of a medicine, first hour inpatient CPT 96365 TREATMENT RM IV INFUS TO 1 HR	$260.48	$407.00	$180.00–$407.00	—	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ORT-THERA/PROPH/INJ SB/IM W/FC	$30.00	$46.88	$15.62–$515.00	61% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 UC-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	48% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 FP-THERAP/PROPH/DX INJ SUBC/IM	$40.00	$62.50	$15.62–$515.00	48% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ENT-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	48% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 MDA-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	48% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 WHS-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	48% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 GS-THERAP/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	48% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SUBQ/IM INJECT BY NURSE IN UC	$53.76	$84.00	$15.62–$515.00	30% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PRO/DIAG INJ,SUBCUTANEOUS	$59.52	$93.00	$15.62–$515.00	23% below	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SUBQ/IM INJECT THERAPEUTIC; ER	$88.96	$139.00	$15.62–$515.00	15% above	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 WC TC-INJ, SUBQ OR IM	$108.80	$170.00	$15.62–$515.00	41% above	36%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECT BY MD UNILA	$329.60	$515.00	$15.62–$515.00	327% above	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ORT-THERA/PROPH/INJ SB/IM W/FC	$30.00	$46.88	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 WHS-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 MDA-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 FP-THERAP/PROPH/DX INJ SUBC/IM	$40.00	$62.50	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 UC-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GS-THERAP/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ENT-THERA/PROPH/DX INJ SUBQ/IM	$40.00	$62.50	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SUBQ/IM INJECT BY NURSE IN UC	$53.76	$84.00	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PRO/DIAG INJ,SUBCUTANEOUS	$59.52	$93.00	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SUBQ/IM INJECT THERAPEUTIC; ER	$88.96	$139.00	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 WC TC-INJ, SUBQ OR IM	$108.80	$170.00	$15.62–$515.00	—	36%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECT BY MD UNILA	$329.60	$515.00	$15.62–$515.00	—	36%
New patient office visit, about 30 minutes CPT 99203 ENT-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 ORT-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 PAIN-SC FAC CHG, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 FP RC-FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 WMW-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 SP-SC FAC CHG,NEW,LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 OH-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 GS-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 WHS-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 WC-SC FAC CHG,LEVEL 3	$46.24	$72.25	$72.25–$308.00	60% below	36%
New patient office visit, about 30 minutes CPT 99203 GS-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 WHS-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 ORT-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 WMW-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 OH-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 PAIN-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 SP-OFFICE VST,NEW,LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 FP RC-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 ENT-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	19% above	36%
New patient office visit, about 30 minutes CPT 99203 WC-SC, E&M LEV 3,W/FC	$147.84	$231.00	$72.25–$308.00	27% above	36%
New patient office visit, about 30 minutes CPT 99203 ORT-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 OH-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 FP-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 WMW-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 SP-OFFICE VISIT,NEW,LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 UC-URGENT CARE, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 GS-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 PAIN-OFFICE VISIT, NEW,LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 WHS-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 ENT-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	58% above	36%
New patient office visit, about 30 minutes CPT 99203 WC TC-NEW PATIENT E&M, LEVEL 3	$192.64	$301.00	$72.25–$308.00	65% above	36%
New patient office visit, about 30 minutes CPT 99203 WC PC-NEW PATIENT E&M, LEVEL 3	$197.12	$308.00	$72.25–$308.00	69% above	36%
New patient office visit, about 30 minutes inpatient CPT 99203 ORT-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WMW-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 SP-SC FAC CHG,NEW,LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 OH-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 GS-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WHS-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WC-SC FAC CHG,LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 ENT-SC FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 PAIN-SC FAC CHG, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 FP RC-FAC CHG, NEW, LEVEL 3	$46.24	$72.25	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 GS-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 PAIN-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WHS-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 OH-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 ORT-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WMW-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 SP-OFFICE VST,NEW,LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 FP RC-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 ENT-E&M, NEW, LEVEL 3 W/FC	$138.72	$216.75	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WC-SC, E&M LEV 3,W/FC	$147.84	$231.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 GS-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WHS-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 PAIN-OFFICE VISIT, NEW,LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 UC-URGENT CARE, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 FP-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WMW-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 SP-OFFICE VISIT,NEW,LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 ORT-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 OH-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 ENT-OFFICE VISIT, NEW, LEVEL 3	$184.96	$289.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WC TC-NEW PATIENT E&M, LEVEL 3	$192.64	$301.00	$72.25–$308.00	—	36%
New patient office visit, about 30 minutes inpatient CPT 99203 WC PC-NEW PATIENT E&M, LEVEL 3	$197.12	$308.00	$72.25–$308.00	—	36%
New patient office visit, about 45 minutes CPT 99204 WMW-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 SP-SC FAC CHG,NEW,LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 GS-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 ENT-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 WC-SC,FAC CHG, E&M LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 OH-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 PAIN-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 ORT-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 WHS-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	70% below	36%
New patient office visit, about 45 minutes CPT 99204 FP RC-FAC CHG, NEW, LEVEL 4	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 GS-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 FP RC-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 ENT-E&M,NEW,LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 SP-OFFICE VST,NEW,LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 PN-E&M, NEW PT, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 WMW-E&M,NEW,LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 WHS-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 OH-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 ORT-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	11% below	36%
New patient office visit, about 45 minutes CPT 99204 WC-SC,NEW PT,E&M LEVEL 4 W/FC	$162.56	$254.00	$79.25–$401.00	5% below	36%
New patient office visit, about 45 minutes CPT 99204 WMW-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 OH-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 WHS-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 SP-OFFICE VISIT,NEW,LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 FP-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 ORT-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 GS-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 UC-URGENT CARE, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 PAIN-OFFICE VISIT, NEW,LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 ENT-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	18% above	36%
New patient office visit, about 45 minutes CPT 99204 WC PC-NEW PATIENT E&M, LEVEL 4	$216.32	$338.00	$79.25–$401.00	26% above	36%
New patient office visit, about 45 minutes CPT 99204 WC TC-NEW PATIENT E&M, LEVEL 4	$256.64	$401.00	$79.25–$401.00	50% above	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WHS-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WMW-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 ORT-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 PAIN-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 OH-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WC-SC,FAC CHG, E&M LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 ENT-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 GS-SC FAC CHG, NEW, LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 SP-SC FAC CHG,NEW,LEVEL 4	$50.72	$79.25	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 GS-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WMW-E&M,NEW,LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 SP-OFFICE VST,NEW,LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 ENT-E&M,NEW,LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 OH-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WHS-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 ORT-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 FP RC-FAC CHG, NEW, LEVEL 4	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 FP RC-E&M, NEW, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 PN-E&M, NEW PT, LEVEL 4 W/FC	$152.16	$237.75	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WC-SC,NEW PT,E&M LEVEL 4 W/FC	$162.56	$254.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 ORT-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 SP-OFFICE VISIT,NEW,LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 UC-URGENT CARE, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 ENT-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WMW-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 PAIN-OFFICE VISIT, NEW,LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 OH-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 GS-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WHS-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 FP-OFFICE VISIT, NEW, LEVEL 4	$202.88	$317.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WC PC-NEW PATIENT E&M, LEVEL 4	$216.32	$338.00	$79.25–$401.00	—	36%
New patient office visit, about 45 minutes inpatient CPT 99204 WC TC-NEW PATIENT E&M, LEVEL 4	$256.64	$401.00	$79.25–$401.00	—	36%
New patient office visit, about 60 minutes CPT 99205 OH-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 WHS-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 FP RC-FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 PAIN-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 GS-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 WC-SC,FAC CHG, E&M LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 WMW-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 ENT-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 ORT-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	74% below	36%
New patient office visit, about 60 minutes CPT 99205 WHS-E&M, NEW, LEVEL 5 W/FC	$179.52	$280.50	$96.00–$533.00	24% below	36%
New patient office visit, about 60 minutes CPT 99205 OH-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 ENT-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 GS-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 FP RC-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 ORT-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 WMW-E&M, NEW, LEVEL, 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 PAIN-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 SP-OFFICE VST,NEW,LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	22% below	36%
New patient office visit, about 60 minutes CPT 99205 WC-SC,E&M LEV 5 W/FC	$196.48	$307.00	$96.00–$533.00	16% below	36%
New patient office visit, about 60 minutes CPT 99205 PAIN-OFFICE VISIT,NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 GS-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 SP-OFFICE VISIT,NEW,LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 ORT-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 FP-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 UC-URGENT CARE, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 OH-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 WHS-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 ENT-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 WMW-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	4% above	36%
New patient office visit, about 60 minutes CPT 99205 WC PC-NEW PATIENT E&M, LEVEL 5	$261.76	$409.00	$96.00–$533.00	11% above	36%
New patient office visit, about 60 minutes CPT 99205 WC TC-NEW PATIENT E&M, LEVEL 5	$341.12	$533.00	$96.00–$533.00	45% above	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WMW-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 PAIN-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 ENT-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 ORT-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 OH-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WC-SC,FAC CHG, E&M LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WHS-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 FP RC-FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 GS-SC FAC CHG, NEW, LEVEL 5	$61.44	$96.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WHS-E&M, NEW, LEVEL 5 W/FC	$179.52	$280.50	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 ENT-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 OH-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 SP-OFFICE VST,NEW,LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 ORT-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 PAIN-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 GS-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WMW-E&M, NEW, LEVEL, 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 FP RC-E&M, NEW, LEVEL 5 W/FC	$184.32	$288.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WC-SC,E&M LEV 5 W/FC	$196.48	$307.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 SP-OFFICE VISIT,NEW,LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 ENT-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 GS-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 UC-URGENT CARE, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WHS-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 PAIN-OFFICE VISIT,NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 OH-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WMW-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 FP-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 ORT-OFFICE VISIT, NEW, LEVEL 5	$245.76	$384.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WC PC-NEW PATIENT E&M, LEVEL 5	$261.76	$409.00	$96.00–$533.00	—	36%
New patient office visit, about 60 minutes inpatient CPT 99205 WC TC-NEW PATIENT E&M, LEVEL 5	$341.12	$533.00	$96.00–$533.00	—	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC-SC FAC CHG,LEVEL 2	$15.04	$23.50	$23.50–$234.00	80% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ENT-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 GS-SC FAC CHG, NEW, LEV 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WHS-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PAIN-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WMW-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SP-SC FAC CHG,NEW,LEVEL 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ORT-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	58% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC-SC,E&M LEVEL 2 W/FC	$48.64	$76.00	$23.50–$234.00	36% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC PC-NEW PATIENT E&M, LEVEL 2	$64.64	$101.00	$23.50–$234.00	15% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 GS-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PAIN-E&M,NEW,LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SP-OFFICE VST,NEW,LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 FP RC-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OH-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WHS-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WMW-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ORT-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ENT-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	26% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 UC-URGENT CARE, NEW, LEVEL 2	$100.48	$157.00	$23.50–$234.00	32% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 GS-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WMW-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ORT-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ENT-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 FP-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WHS-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PAIN-OFFICE VISIT, NEW,LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OH-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SP-OFFICE VISIT,NEW,LEVEL 2	$128.00	$200.00	$23.50–$234.00	68% above	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC TC-NEW PATIENT E&M, LEVEL 2	$149.76	$234.00	$23.50–$234.00	97% above	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC-SC FAC CHG,LEVEL 2	$15.04	$23.50	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ENT-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ORT-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GS-SC FAC CHG, NEW, LEV 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PAIN-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SP-SC FAC CHG,NEW,LEVEL 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WHS-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WMW-SC FAC CHG, NEW, LEVEL 2	$32.00	$50.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC-SC,E&M LEVEL 2 W/FC	$48.64	$76.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC PC-NEW PATIENT E&M, LEVEL 2	$64.64	$101.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ENT-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PAIN-E&M,NEW,LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WMW-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ORT-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OH-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WHS-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SP-OFFICE VST,NEW,LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GS-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 FP RC-E&M, NEW, LEVEL 2 W/FC	$96.00	$150.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 UC-URGENT CARE, NEW, LEVEL 2	$100.48	$157.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ENT-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WHS-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PAIN-OFFICE VISIT, NEW,LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OH-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GS-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SP-OFFICE VISIT,NEW,LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 FP-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ORT-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WMW-OFFICE VISIT, NEW, LEVEL 2	$128.00	$200.00	$23.50–$234.00	—	36%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC TC-NEW PATIENT E&M, LEVEL 2	$149.76	$234.00	$23.50–$234.00	—	36%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THER;INTL,DIAB, 15MIN	$83.84	$131.00	$131.00	34% above	36%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THR;INTL,NONDIA,15MIN	$83.84	$131.00	$131.00	34% above	36%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THR;INTL,NONDIA,15MIN	$83.84	$131.00	$131.00	—	36%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THER;INTL,DIAB, 15MIN	$83.84	$131.00	$131.00	—	36%
Preventive checkup, new patient aged 18–39 CPT 99385 WHS-SC FAC CHG, NEW, WW 18-39	$48.00	$75.00	$75.00–$300.00	71% below	36%
Preventive checkup, new patient aged 18–39 CPT 99385 WHS-NEW, WELL WOMAN 18-39 W/FC	$144.00	$225.00	$75.00–$300.00	12% below	36%
Preventive checkup, new patient aged 18–39 CPT 99385 WHS NEW VISIT WELL WOMAN 18-39	$192.00	$300.00	$75.00–$300.00	18% above	36%
Preventive checkup, new patient aged 18–39 CPT 99385 FP-PREV VISIT, NEW, AGE 18-39	$192.00	$300.00	$75.00–$300.00	18% above	36%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 WHS-SC FAC CHG, NEW, WW 18-39	$48.00	$75.00	$75.00–$300.00	—	36%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 WHS-NEW, WELL WOMAN 18-39 W/FC	$144.00	$225.00	$75.00–$300.00	—	36%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 FP-PREV VISIT, NEW, AGE 18-39	$192.00	$300.00	$75.00–$300.00	—	36%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 WHS NEW VISIT WELL WOMAN 18-39	$192.00	$300.00	$75.00–$300.00	—	36%
Preventive checkup, new patient aged 40–64 CPT 99386 WHS-SC FAC CHG,NEW, WW 40-64	$55.20	$86.25	$86.25–$421.00	75% below	36%
Preventive checkup, new patient aged 40–64 CPT 99386 FP-SC,PREV VISIT,NEW,AGE 40-64	$67.36	$105.25	$86.25–$421.00	69% below	36%
Preventive checkup, new patient aged 40–64 CPT 99386 WHS-NEW, WELL WOMAN 40-64 W/FC	$165.60	$258.75	$86.25–$421.00	25% below	36%
Preventive checkup, new patient aged 40–64 CPT 99386 FP-PREV VISIT,NEW,AGE 40-64	$202.08	$315.75	$86.25–$421.00	8% below	36%
Preventive checkup, new patient aged 40–64 CPT 99386 WHS NEW VISIT WELL WOMAN 40-64	$220.80	$345.00	$86.25–$421.00	at median	36%
Preventive checkup, new patient aged 40–64 CPT 99386 FP-PREV VISIT, NEW, AGE 40-64	$269.44	$421.00	$86.25–$421.00	23% above	36%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 WHS-SC FAC CHG,NEW, WW 40-64	$55.20	$86.25	$86.25–$421.00	—	36%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 FP-SC,PREV VISIT,NEW,AGE 40-64	$67.36	$105.25	$86.25–$421.00	—	36%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 WHS-NEW, WELL WOMAN 40-64 W/FC	$165.60	$258.75	$86.25–$421.00	—	36%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 FP-PREV VISIT,NEW,AGE 40-64	$202.08	$315.75	$86.25–$421.00	—	36%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 WHS NEW VISIT WELL WOMAN 40-64	$220.80	$345.00	$86.25–$421.00	—	36%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 FP-PREV VISIT, NEW, AGE 40-64	$269.44	$421.00	$86.25–$421.00	—	36%
Preventive checkup, new patient aged 65 or older CPT 99387 WHS-SC FAC CHG, NEW, WW 65+	$60.00	$93.75	$93.75–$375.00	77% below	36%
Preventive checkup, new patient aged 65 or older CPT 99387 WHS-NEW, WELL WOMAN 65+ W/FC	$180.00	$281.25	$93.75–$375.00	31% below	36%
Preventive checkup, new patient aged 65 or older CPT 99387 FP-PREV VISIT, NEW, AGE 65+	$240.00	$375.00	$93.75–$375.00	9% below	36%
Preventive checkup, new patient aged 65 or older CPT 99387 WHS NEW VISIT WELL WOMAN 65+	$240.00	$375.00	$93.75–$375.00	9% below	36%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 WHS-SC FAC CHG, NEW, WW 65+	$60.00	$93.75	$93.75–$375.00	—	36%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 WHS-NEW, WELL WOMAN 65+ W/FC	$180.00	$281.25	$93.75–$375.00	—	36%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 WHS NEW VISIT WELL WOMAN 65+	$240.00	$375.00	$93.75–$375.00	—	36%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 FP-PREV VISIT, NEW, AGE 65+	$240.00	$375.00	$93.75–$375.00	—	36%
Preventive checkup, returning patient aged 18–39 CPT 99395 WHS-SC FAC CH,PRDIC MEDS 18-39	$153.60	$240.00	$240.00–$320.00	18% above	36%
Preventive checkup, returning patient aged 18–39 CPT 99395 WHS-PERIODIC MEDI 18-39 W/FC	$153.60	$240.00	$240.00–$320.00	18% above	36%
Preventive checkup, returning patient aged 18–39 CPT 99395 WHS PERIODIC MEDICINE 18-39 YR	$204.80	$320.00	$240.00–$320.00	58% above	36%
Preventive checkup, returning patient aged 18–39 CPT 99395 FP-PREV VISIT, ESTAB,AGE 18-39	$204.80	$320.00	$240.00–$320.00	58% above	36%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 WHS-SC FAC CH,PRDIC MEDS 18-39	$153.60	$240.00	$240.00–$320.00	—	36%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 WHS-PERIODIC MEDI 18-39 W/FC	$153.60	$240.00	$240.00–$320.00	—	36%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 WHS PERIODIC MEDICINE 18-39 YR	$204.80	$320.00	$240.00–$320.00	—	36%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 FP-PREV VISIT, ESTAB,AGE 18-39	$204.80	$320.00	$240.00–$320.00	—	36%
Preventive checkup, returning patient aged 40–64 CPT 99396 FP-SC FC,PREV VST,EST,AGE40-64	$53.44	$83.50	$83.50–$334.00	63% below	36%
Preventive checkup, returning patient aged 40–64 CPT 99396 WHS-SC FAC CH,PRDC MED 40-64	$53.44	$83.50	$83.50–$334.00	63% below	36%
Preventive checkup, returning patient aged 40–64 CPT 99396 WHS-PERIODIC MED 40-64 W/FC	$160.32	$250.50	$83.50–$334.00	10% above	36%
Preventive checkup, returning patient aged 40–64 CPT 99396 FP-PREV VST,ESTB,AGE40-64 W/FC	$160.32	$250.50	$83.50–$334.00	10% above	36%
Preventive checkup, returning patient aged 40–64 CPT 99396 WHS PERIODIC MEDICINE 40-64 YR	$213.76	$334.00	$83.50–$334.00	47% above	36%
Preventive checkup, returning patient aged 40–64 CPT 99396 FP-PREV VISIT, ESTAB,AGE 40-64	$213.76	$334.00	$83.50–$334.00	47% above	36%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 FP-SC FC,PREV VST,EST,AGE40-64	$53.44	$83.50	$83.50–$334.00	—	36%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WHS-SC FAC CH,PRDC MED 40-64	$53.44	$83.50	$83.50–$334.00	—	36%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 FP-PREV VST,ESTB,AGE40-64 W/FC	$160.32	$250.50	$83.50–$334.00	—	36%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WHS-PERIODIC MED 40-64 W/FC	$160.32	$250.50	$83.50–$334.00	—	36%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WHS PERIODIC MEDICINE 40-64 YR	$213.76	$334.00	$83.50–$334.00	—	36%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 FP-PREV VISIT, ESTAB,AGE 40-64	$213.76	$334.00	$83.50–$334.00	—	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 WHS-SC FAC CHG, PERIODIC PRV	$60.00	$93.75	$93.75–$375.00	72% below	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 FP-PREV VISIT,ESTAB,AGE65+	$60.00	$93.75	$93.75–$375.00	72% below	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 FP-PREV VISIT,ESTB,AGE65+ W/FC	$180.00	$281.25	$93.75–$375.00	16% below	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 WHS-PERIODIC PRV W/FC	$180.00	$281.25	$93.75–$375.00	16% below	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 FP-PREV VISIT, ESTAB, AGE 65+	$240.00	$375.00	$93.75–$375.00	11% above	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 WHS PERIODIC PREVENTIVE VISIT	$240.00	$375.00	$93.75–$375.00	11% above	36%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 FP-PREV VISIT,ESTAB,AGE65+	$60.00	$93.75	$93.75–$375.00	—	36%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 WHS-SC FAC CHG, PERIODIC PRV	$60.00	$93.75	$93.75–$375.00	—	36%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 FP-PREV VISIT,ESTB,AGE65+ W/FC	$180.00	$281.25	$93.75–$375.00	—	36%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 WHS-PERIODIC PRV W/FC	$180.00	$281.25	$93.75–$375.00	—	36%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 FP-PREV VISIT, ESTAB, AGE 65+	$240.00	$375.00	$93.75–$375.00	—	36%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 WHS PERIODIC PREVENTIVE VISIT	$240.00	$375.00	$93.75–$375.00	—	36%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 FP-BEHAV CHNG SMOKING; 3-10MIN	$25.60	$40.00	$40.00	23% below	36%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 FP-BEHAV CHNG SMOKING; 3-10MIN	$25.60	$40.00	$40.00	—	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SP-SC FAC CHG,OV,EST,LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 GS-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WMW-SC FAC CHG,ESTB,LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OH-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 FP RC-FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PAIN-SC FAC CHG, ESTAB, LEV 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WHS-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC-SC,FAC CHG,LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ORT-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ENT-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	59% below	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SP-OFFICE VST,EST,LEVEL 5 W/FC	$205.44	$321.00	$107.25–$457.00	21% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WHS-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 GS-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OH-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 FP RC-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WMW-E&M,ESB,LEV 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ORT-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ENT-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PAIN-E&M, ESTAB, LEV 5 W/FC	$205.92	$321.75	$107.25–$457.00	22% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC-SC,E&M LEVEL 5, W/FC	$219.52	$343.00	$107.25–$457.00	30% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC TC-ESTAB PATIENT E&M, LEV 5	$256.64	$401.00	$107.25–$457.00	52% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OH-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WHS-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SP-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 GS-OFFICE VISIT,ESTAB, LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PAIN-OFFICE VISIT,ESTAB,LEV 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WMW-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 UC-URGENT CARE, ESTAB, LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 FP-OFFICE VISIT,ESTAB, LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ENT-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ORT-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	62% above	36%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC PC-ESTAB PATIENT E&M, LEV 5	$292.48	$457.00	$107.25–$457.00	73% above	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GS-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ENT-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ORT-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SP-SC FAC CHG,OV,EST,LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC-SC,FAC CHG,LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WHS-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PAIN-SC FAC CHG, ESTAB, LEV 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 FP RC-FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OH-SC FAC CHG, ESTAB, LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WMW-SC FAC CHG,ESTB,LEVEL 5	$68.64	$107.25	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SP-OFFICE VST,EST,LEVEL 5 W/FC	$205.44	$321.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OH-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PAIN-E&M, ESTAB, LEV 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GS-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ENT-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 FP RC-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ORT-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WMW-E&M,ESB,LEV 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WHS-E&M, ESTAB, LEVEL 5 W/FC	$205.92	$321.75	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC-SC,E&M LEVEL 5, W/FC	$219.52	$343.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC TC-ESTAB PATIENT E&M, LEV 5	$256.64	$401.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OH-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WMW-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 FP-OFFICE VISIT,ESTAB, LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ORT-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PAIN-OFFICE VISIT,ESTAB,LEV 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GS-OFFICE VISIT,ESTAB, LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SP-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ENT-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WHS-OFFICE VISIT,ESTAB,LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 UC-URGENT CARE, ESTAB, LEVEL 5	$274.56	$429.00	$107.25–$457.00	—	36%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC PC-ESTAB PATIENT E&M, LEV 5	$292.48	$457.00	$107.25–$457.00	—	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 FP RC-FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PAIN-SC FAC CHG, ESTAB, LEV 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ENT-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WHS-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP-SC FAC CHG,OV,EST,LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC-SC FAC CHG,EST LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 GS-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WMW-SC FAC CHG,ESTB,LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OH-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ORT-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	67% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 FP RC-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WMW-SC,E&M,ESTB,LEV 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WHS-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ORT-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP-OFFICE VST,EST,LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 GS-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PAIN-E&M, ESTAB, LEV 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OH-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ENT-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	1% below	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC-SC,E&M LEV 3, W/FC	$99.84	$156.00	$48.75–$249.00	6% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC-SC,E&M LEVEL 3 W/FC	$99.84	$156.00	$48.75–$249.00	6% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WMW-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WHS-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PAIN-OFFICE VISIT,ESTAB,LEV 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 FP-OFFICE VISIT,ESTAB, LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 UC-URGENT CARE, ESTAB, LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OH-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ORT-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ENT-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 GS-OFFICE VISIT,ESTAB, LEVEL 3	$124.80	$195.00	$48.75–$249.00	33% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC PC-ESTAB PATIENT E&M, LEV 3	$133.12	$208.00	$48.75–$249.00	41% above	36%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC TC-ESTAB PATIENT E&M, LEV 3	$159.36	$249.00	$48.75–$249.00	69% above	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GS-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC-SC FAC CHG,EST LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WMW-SC FAC CHG,ESTB,LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PAIN-SC FAC CHG, ESTAB, LEV 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 FP RC-FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ENT-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ORT-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WHS-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OH-SC FAC CHG, ESTAB, LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SP-SC FAC CHG,OV,EST,LEVEL 3	$31.20	$48.75	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SP-OFFICE VST,EST,LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 FP RC-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ORT-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ENT-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GS-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PAIN-E&M, ESTAB, LEV 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WHS-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WMW-SC,E&M,ESTB,LEV 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OH-E&M, ESTAB, LEVEL 3 W/FC	$93.60	$146.25	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC-SC,E&M LEV 3, W/FC	$99.84	$156.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC-SC,E&M LEVEL 3 W/FC	$99.84	$156.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WMW-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SP-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ORT-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ENT-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GS-OFFICE VISIT,ESTAB, LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OH-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WHS-OFFICE VISIT,ESTAB,LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PAIN-OFFICE VISIT,ESTAB,LEV 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 UC-URGENT CARE, ESTAB, LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 FP-OFFICE VISIT,ESTAB, LEVEL 3	$124.80	$195.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC PC-ESTAB PATIENT E&M, LEV 3	$133.12	$208.00	$48.75–$249.00	—	36%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC TC-ESTAB PATIENT E&M, LEV 3	$159.36	$249.00	$48.75–$249.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GS-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ENT-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ORT-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OH-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WMW-SC FAC CHG,E&M,ESTB,LEV 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 FP RC-FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PAIN-SC FAC CHG, ESTAB, LEV 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WHS-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC-SC, FAC CHG, E&M LEV 4	$48.64	$76.00	$76.00–$324.00	60% below	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WMW-E&M,ESTB,LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PAIN-E&M, ESTAB, LEV 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 FP RC-E&M, ESTAB, LEVEL 4	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ENT-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ORT-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SP-OFFICE VST,EST,LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WHS-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OH-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GS-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	21% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC-SC, E&M LEVEL 4 W/FC	$155.52	$243.00	$76.00–$324.00	29% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC TC-ESTAB PATIENT E&M, LEV 4	$192.64	$301.00	$76.00–$324.00	60% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OH-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ENT-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WMW-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SP-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 FP-OFFICE VISIT,ESTAB, LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GS-OFFICE VISIT,ESTAB, LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PAIN-OFFICE VISIT,ESTAB,LEV 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ORT-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 UC-URGENT CARE, ESTAB, LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WHS-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	62% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC PC-ESTAB PATIENT E&M, LEV 4	$207.36	$324.00	$76.00–$324.00	72% above	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WHS-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GS-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC-SC, FAC CHG, E&M LEV 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PAIN-SC FAC CHG, ESTAB, LEV 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 FP RC-FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WMW-SC FAC CHG,E&M,ESTB,LEV 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OH-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ENT-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ORT-SC FAC CHG, ESTAB, LEVEL 4	$48.64	$76.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OH-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SP-OFFICE VST,EST,LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WMW-E&M,ESTB,LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GS-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ORT-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WHS-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PAIN-E&M, ESTAB, LEV 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 FP RC-E&M, ESTAB, LEVEL 4	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ENT-E&M, ESTAB, LEVEL 4 W/FC	$145.92	$228.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC-SC, E&M LEVEL 4 W/FC	$155.52	$243.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC TC-ESTAB PATIENT E&M, LEV 4	$192.64	$301.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 FP-OFFICE VISIT,ESTAB, LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ORT-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WMW-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WHS-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 UC-URGENT CARE, ESTAB, LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GS-OFFICE VISIT,ESTAB, LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OH-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PAIN-OFFICE VISIT,ESTAB,LEV 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SP-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ENT-OFFICE VISIT,ESTAB,LEVEL 4	$194.56	$304.00	$76.00–$324.00	—	36%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC PC-ESTAB PATIENT E&M, LEV 4	$207.36	$324.00	$76.00–$324.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ORT-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GS-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ENT-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WMW-SC FAC CHG,E&M,ESTB,LEV 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PAIN-SC FAC CHG, ESTAB, LEV 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 FP RC-FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OH-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SP-SC FAC CHG,OV,EST,LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WHS-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC-SC, FAC CHG, E&M LEVEL 2	$18.56	$29.00	$29.00–$234.00	77% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WHS-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WMW-SC,E&M,ESTB,LEVEL 1 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SP-OFFICE VST,ESTAB,LEV 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OH-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PAIN-E&M, ESTAB, LEV 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ENT-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 FP RC-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ORT-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GS-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	32% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC-SC, E&M LEVEL 2 W/FC	$59.52	$93.00	$29.00–$234.00	27% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SP-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WHS-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WMW-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ORT-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 FP-OFFICE VISIT,ESTAB, LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PAIN-OFFICE VISIT,ESTAB,LEV 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OH-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ENT-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 UC-URGENT CARE, ESTAB, LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GS-OFFICE VISIT,ESTAB, LEVEL 2	$74.24	$116.00	$29.00–$234.00	9% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC PC-ESTAB PATIENT E&M, LEV 2	$79.36	$124.00	$29.00–$234.00	3% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC TC-ESTAB PATIENT E&M, LEV 2	$149.76	$234.00	$29.00–$234.00	84% above	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SP-SC FAC CHG,OV,EST,LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ENT-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC-SC, FAC CHG, E&M LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OH-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WMW-SC FAC CHG,E&M,ESTB,LEV 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ORT-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PAIN-SC FAC CHG, ESTAB, LEV 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 FP RC-FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WHS-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GS-SC FAC CHG, ESTAB, LEVEL 2	$18.56	$29.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ENT-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PAIN-E&M, ESTAB, LEV 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ORT-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GS-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OH-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WMW-SC,E&M,ESTB,LEVEL 1 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WHS-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 FP RC-E&M, ESTAB, LEVEL 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SP-OFFICE VST,ESTAB,LEV 2 W/FC	$55.68	$87.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC-SC, E&M LEVEL 2 W/FC	$59.52	$93.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ORT-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WMW-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PAIN-OFFICE VISIT,ESTAB,LEV 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ENT-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OH-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GS-OFFICE VISIT,ESTAB, LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 UC-URGENT CARE, ESTAB, LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 FP-OFFICE VISIT,ESTAB, LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SP-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WHS-OFFICE VISIT,ESTAB,LEVEL 2	$74.24	$116.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC PC-ESTAB PATIENT E&M, LEV 2	$79.36	$124.00	$29.00–$234.00	—	36%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC TC-ESTAB PATIENT E&M, LEV 2	$149.76	$234.00	$29.00–$234.00	—	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ORT-SC FAC CHG, CONSULT LEV 3	$42.16	$65.87	$65.87–$277.00	77% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 WHS-SC FAC CHG, CONSULT LEV 3	$42.16	$65.87	$65.87–$277.00	77% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ENT-SC FAC CHG W/CONSULT LEV 3	$42.16	$65.87	$65.87–$277.00	77% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OH-SC FAC CHG, CONSULT, LEV 3	$42.16	$65.87	$65.87–$277.00	77% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 GS-SC FAC CHG, CONSULT, LEV 3	$42.16	$65.87	$65.87–$277.00	77% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PAIN-OUTPT CONSULT, LEV 3	$44.32	$69.25	$65.87–$277.00	76% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OH-OUTPT CONSULT, LEV 3 W/FC	$126.48	$197.63	$65.87–$277.00	31% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ENT-OUPT CONSULT, LEVEL 3 W/FC	$126.48	$197.63	$65.87–$277.00	31% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ORT-OUTPT CONSULT, LEV 3 W/FC	$126.48	$197.63	$65.87–$277.00	31% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 WHS-OUTPT CONSULT, LEV 3 W/FC	$126.48	$197.63	$65.87–$277.00	31% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 GS-CONSULT, LEVEL 3 W/FC	$126.48	$197.63	$65.87–$277.00	31% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PAIN-OUTPT CONSULT, LEV 3 W/FC	$132.96	$207.75	$65.87–$277.00	27% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 WHS-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	8% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 GS-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	8% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ORT-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	8% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ENT-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	8% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OH-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	8% below	36%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PAIN-OFFICE/OUTP CONSULT,LEV 3	$177.28	$277.00	$65.87–$277.00	3% below	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 WHS-SC FAC CHG, CONSULT LEV 3	$42.16	$65.87	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ENT-SC FAC CHG W/CONSULT LEV 3	$42.16	$65.87	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ORT-SC FAC CHG, CONSULT LEV 3	$42.16	$65.87	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OH-SC FAC CHG, CONSULT, LEV 3	$42.16	$65.87	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 GS-SC FAC CHG, CONSULT, LEV 3	$42.16	$65.87	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PAIN-OUTPT CONSULT, LEV 3	$44.32	$69.25	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ENT-OUPT CONSULT, LEVEL 3 W/FC	$126.48	$197.63	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 WHS-OUTPT CONSULT, LEV 3 W/FC	$126.48	$197.63	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ORT-OUTPT CONSULT, LEV 3 W/FC	$126.48	$197.63	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 GS-CONSULT, LEVEL 3 W/FC	$126.48	$197.63	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OH-OUTPT CONSULT, LEV 3 W/FC	$126.48	$197.63	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PAIN-OUTPT CONSULT, LEV 3 W/FC	$132.96	$207.75	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ENT-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 GS-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OH-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 WHS-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ORT-OFFICE/OUTP CONSULT, LEV 3	$168.64	$263.50	$65.87–$277.00	—	36%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PAIN-OFFICE/OUTP CONSULT,LEV 3	$177.28	$277.00	$65.87–$277.00	—	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 WHS-SC FAC CHG, CONSULT LEVEL	$60.40	$94.37	$94.37–$396.50	71% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OH-SC FAC CHG, CONSULT, LEV 4	$60.40	$94.37	$94.37–$396.50	71% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ORT-SC FAC CHG, CONSULT LEV 4	$60.40	$94.37	$94.37–$396.50	71% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ENT-SC FAC CHG,W/CONSULT,LEV 4	$60.40	$94.37	$94.37–$396.50	71% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 GS-SC FAC CHG, CONSULT, LEV 4	$60.40	$94.37	$94.37–$396.50	71% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PAIN-SC FAC CHG, CONSULT LEV 4	$63.44	$99.12	$94.37–$396.50	69% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OH-OUTPT CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	12% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ORT-OUTPT CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	12% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 GS-OUTP CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	12% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ENT-OUTPT CONSULT, LEVEL 4 W/F	$181.20	$283.13	$94.37–$396.50	12% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 WHS-OUTPT CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	12% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PAIN-OUTPT CONSULT, LEV 4 W/FC	$190.32	$297.38	$94.37–$396.50	8% below	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ORT-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	17% above	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ENT-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	17% above	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 WHS-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	17% above	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OH-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	17% above	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 GS-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	17% above	36%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PAIN-OFFICE/OUTP CONSULT,LEV 4	$253.76	$396.50	$94.37–$396.50	23% above	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OH-SC FAC CHG, CONSULT, LEV 4	$60.40	$94.37	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ORT-SC FAC CHG, CONSULT LEV 4	$60.40	$94.37	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ENT-SC FAC CHG,W/CONSULT,LEV 4	$60.40	$94.37	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 GS-SC FAC CHG, CONSULT, LEV 4	$60.40	$94.37	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 WHS-SC FAC CHG, CONSULT LEVEL	$60.40	$94.37	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PAIN-SC FAC CHG, CONSULT LEV 4	$63.44	$99.12	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ENT-OUTPT CONSULT, LEVEL 4 W/F	$181.20	$283.13	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 GS-OUTP CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ORT-OUTPT CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 WHS-OUTPT CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OH-OUTPT CONSULT, LEV 4 W/FC	$181.20	$283.13	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PAIN-OUTPT CONSULT, LEV 4 W/FC	$190.32	$297.38	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ENT-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 WHS-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 GS-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ORT-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OH-OFFICE/OUTP CONSULT, LEV 4	$241.60	$377.50	$94.37–$396.50	—	36%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PAIN-OFFICE/OUTP CONSULT,LEV 4	$253.76	$396.50	$94.37–$396.50	—	36%
Spirometry (breathing test) CPT 94010 FP-BREATHING CAPACITY TEST	$41.60	$65.00	$65.00	74% below	36%
Spirometry (breathing test) inpatient CPT 94010 FP-BREATHING CAPACITY TEST	$41.60	$65.00	$65.00	—	36%
Spirometry before and after a bronchodilator CPT 94060 SPIROGRAM W/PRE & POST BRONCHO	$221.44	$346.00	$346.00	24% below	36%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROGRAM W/PRE & POST BRONCHO	$221.44	$346.00	$346.00	—	36%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPEUTIC	$197.12	$308.00	$308.00	7% below	36%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY, THERAPEUTIC	$197.12	$308.00	$308.00	—	36%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 PC-CARD STRESS TST;SUP,INT,REP	$96.00	$150.00	$150.00	17% below	36%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 PC-CARD STRESS TST;SUP,INT,REP	$96.00	$150.00	$150.00	—	36%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE 20 mcg/mL SYR (ENGERIX-B)(ADULT)	$268.62	$419.72	$419.72	139% above	36%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE 20 mcg/mL SYR (ENGERIX-B)(ADULT)	$268.62	$419.72	$419.72	—	36%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE (HD) 0.7 mL INJ (FLUZONE HD)	$272.81	$426.27	$426.27	264% above	36%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VACCINE (HD) 0.7 mL INJ (FLUZONE HD)	$272.81	$426.27	$426.27	—	36%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VACC (MMR-II) 0.5 ML VIAL-OB	$310.40	$485.00	$485.00	149% above	36%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VACC (MMR-II) 0.5 ML VIAL-OB	$310.40	$485.00	$485.00	—	36%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ 0.5 ML SYR (PREVNAR-20)	$810.93	$1,267.08	$1,267.08	102% above	36%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ 0.5 ML SYR (PREVNAR-20)	$810.93	$1,267.08	$1,267.08	—	36%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE 2.5 UNITS/ML SYR (RABAVERT)	$1,185.70	$1,852.65	$1,852.65	115% above	36%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE 2.5 UNITS/ML SYR (RABAVERT)	$1,185.70	$1,852.65	$1,852.65	115% above	36%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE 2.5 UNITS/ML SYR (RABAVERT)	$1,185.70	$1,852.65	$1,852.65	—	36%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE 2.5 UNITS/ML SYR (RABAVERT)	$1,185.70	$1,852.65	$1,852.65	—	36%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOX ADULT 0.5ML	$149.21	$233.14	$233.14	139% above	36%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOX ADULT 0.5ML	$149.21	$233.14	$233.14	139% above	36%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOX ADULT 0.5ML	$149.21	$233.14	$233.14	—	36%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOX ADULT 0.5ML	$149.21	$233.14	$233.14	—	36%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-PERTUS 0.5 ML SYR (BOOSTRIX)(inpt)	$180.19	$281.54	$281.54	130% above	36%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-PERTUS 0.5 ML SYR (BOOSTRIX)(inpt)	$180.19	$281.54	$281.54	—	36%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 WHS-IMMUNIZATN ADMIN;1 VACCINE	$32.00	$50.00	$50.00–$186.00	22% below	36%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FP-IMMUNIZATION ADMIN	$32.00	$50.00	$50.00–$186.00	22% below	36%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GS-IMMUNIZATION ADMIN 1 VACCIN	$32.00	$50.00	$50.00–$186.00	22% below	36%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN BY NURSE-UC	$110.72	$173.00	$50.00–$186.00	171% above	36%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN BY NURSE-ER	$118.40	$185.00	$50.00–$186.00	189% above	36%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN BY NURSE-OP	$119.04	$186.00	$50.00–$186.00	191% above	36%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FP-IMMUNIZATION ADMIN	$32.00	$50.00	$50.00–$186.00	—	36%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 WHS-IMMUNIZATN ADMIN;1 VACCINE	$32.00	$50.00	$50.00–$186.00	—	36%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GS-IMMUNIZATION ADMIN 1 VACCIN	$32.00	$50.00	$50.00–$186.00	—	36%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN BY NURSE-UC	$110.72	$173.00	$50.00–$186.00	—	36%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN BY NURSE-ER	$118.40	$185.00	$50.00–$186.00	—	36%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN BY NURSE-OP	$119.04	$186.00	$50.00–$186.00	—	36%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 FP-IMMUNIZATION ADMIN, EA ADDL	$14.72	$23.00	$23.00–$100.00	42% below	36%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN,EACH ADDL	$64.00	$100.00	$23.00–$100.00	154% above	36%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 FP-IMMUNIZATION ADMIN, EA ADDL	$14.72	$23.00	$23.00–$100.00	—	36%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EACH ADDL	$64.00	$100.00	$23.00–$100.00	—	36%

Source file: https://cloquethospital.com/wp-content/uploads/2026/06/410743546_community-memorial-hospital_standardcharges.csv