Donalsonville Hospital
Donalsonville Hospital in Donalsonville, GA publishes cash prices for 254 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 Georgia median for 130 of 251 procedures and above it for 118. By typical cash price it ranks #24 of 61 Georgia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
102 Hospital Circle, Donalsonville, GA, 39845 Collected Sep 27, 2026 Source price file (229) 524-5217
Acute care hospital No emergency department CCN 110194 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Donalsonville Hospital in Donalsonville, GA:
- Sep 20, 2024 Warning notice
- Dec 27, 2024 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE BILATERAL MIN 3 VIEWS | $216.75 | $255.00 | $130.00–$140.00 | — | 15% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE BILATERAL | $284.75 | $335.00 | $130.00–$140.00 | — | 15% |
| Ankle X-ray, complete, 3 or more views CPT 73610 CHEST COMPLETE 4 VIEWS WOTH FLUOROSCOPY | $34.00 | $40.00 | $130.00–$140.00 | 87% below | 15% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE BILATERAL MIN 3 VIEWS | $216.75 | $255.00 | $130.00–$140.00 | — | 15% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE BILATERAL | $284.75 | $335.00 | $130.00–$140.00 | — | 15% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 CHEST COMPLETE 4 VIEWS WOTH FLUOROSCOPY | $34.00 | $40.00 | $130.00–$140.00 | — | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI NON INVAS PHYSIO STUDY | $201.45 | $237.00 | $130.00–$140.00 | 64% below | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NIPS LIMITED | $1,025.10 | $1,206.00 | $130.00–$140.00 | 83% above | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI NON INVAS PHYSIO STUDY | $201.45 | $237.00 | $130.00–$140.00 | — | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NIPS LIMITED | $1,025.10 | $1,206.00 | $130.00–$140.00 | — | 15% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW | $525.30 | $618.00 | $130.00–$140.00 | 67% above | 15% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BARIUM SWALLOW | $525.30 | $618.00 | $130.00–$140.00 | — | 15% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE IMAGING WHOLE BODY | $946.90 | $1,114.00 | $130.00–$140.00 | 13% below | 15% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE IMAGING WHOLE BODY | $946.90 | $1,114.00 | $130.00–$140.00 | — | 15% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST UNILATRAL COMPLETE | $684.25 | $805.00 | $130.00–$140.00 | 79% above | 15% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COMPLETE | $559.30 | $658.00 | $130.00–$140.00 | 46% above | 15% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST UNILATRAL COMPLETE | $684.25 | $805.00 | $130.00–$140.00 | — | 15% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT COMPLETE | $559.30 | $658.00 | $130.00–$140.00 | — | 15% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED | $559.30 | $658.00 | $130.00–$140.00 | 46% above | 15% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT LIMITED | $634.95 | $747.00 | $130.00–$140.00 | 66% above | 15% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED | $559.30 | $658.00 | $130.00–$140.00 | — | 15% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT LIMITED | $634.95 | $747.00 | $130.00–$140.00 | — | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W & W/0 | $2,550.00 | $3,000.00 | $130.00–$140.00 | 37% above | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W CONTRAST | $4,317.15 | $5,079.00 | $130.00–$140.00 | 132% above | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST W & W/0 | $2,550.00 | $3,000.00 | $130.00–$140.00 | — | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W CONTRAST | $4,317.15 | $5,079.00 | $130.00–$140.00 | — | 15% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $1,671.95 | $1,967.00 | $130.00–$140.00 | 25% below | 15% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST | $1,671.95 | $1,967.00 | $130.00–$140.00 | — | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W CONTRAST | $1,894.65 | $2,229.00 | $130.00–$140.00 | 40% below | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W CONTRAST | $1,894.65 | $2,229.00 | $130.00–$140.00 | — | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS W & W/O | $2,571.25 | $3,025.00 | $130.00–$140.00 | 18% below | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $2,765.90 | $3,254.00 | $130.00–$140.00 | 12% below | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PELVIS W & W/O | $2,571.25 | $3,025.00 | $130.00–$140.00 | — | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM | $2,765.90 | $3,254.00 | $130.00–$140.00 | — | 15% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST | $2,841.55 | $3,343.00 | $130.00–$140.00 | 66% above | 15% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST | $2,841.55 | $3,343.00 | $130.00–$140.00 | — | 15% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $1,875.10 | $2,206.00 | $130.00–$140.00 | 38% above | 15% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST | $1,875.10 | $2,206.00 | $130.00–$140.00 | — | 15% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST | $2,345.15 | $2,759.00 | $130.00–$140.00 | 98% above | 15% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLO FACIAL W/0 CONTRAST | $2,345.15 | $2,759.00 | $130.00–$140.00 | 98% above | 15% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST | $2,345.15 | $2,759.00 | $130.00–$140.00 | — | 15% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLO FACIAL W/0 CONTRAST | $2,345.15 | $2,759.00 | $130.00–$140.00 | — | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CON POSS STROKE | $1,377.00 | $1,620.00 | $130.00–$140.00 | at median | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST | $1,377.00 | $1,620.00 | $130.00–$140.00 | at median | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT OUTSIDE FACILITY | $2,200.65 | $2,589.00 | $130.00–$140.00 | 60% above | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CON POSS STROKE | $1,377.00 | $1,620.00 | $130.00–$140.00 | — | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST | $1,377.00 | $1,620.00 | $130.00–$140.00 | — | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT OUTSIDE FACILITY | $2,200.65 | $2,589.00 | $130.00–$140.00 | — | 15% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST | $1,710.20 | $2,012.00 | $130.00–$140.00 | 8% above | 15% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST | $1,710.20 | $2,012.00 | $130.00–$140.00 | — | 15% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W & W/O CONTRAST | $2,191.30 | $2,578.00 | $130.00–$140.00 | 16% above | 15% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W & W/O CONTRAST | $2,191.30 | $2,578.00 | $130.00–$140.00 | — | 15% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE W/O CONTRAST | $1,960.95 | $2,307.00 | $130.00–$140.00 | 27% above | 15% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE W/O CONTRAST | $1,960.95 | $2,307.00 | $130.00–$140.00 | — | 15% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 TOMOGRAPHY C SPINE W/O CONTRAST | $1,521.50 | $1,790.00 | $130.00–$140.00 | 18% above | 15% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C SPINE W/O CONTR | $1,902.30 | $2,238.00 | $130.00–$140.00 | 48% above | 15% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 TOMOGRAPHY C SPINE W/O CONTRAST | $1,521.50 | $1,790.00 | $130.00–$140.00 | — | 15% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C SPINE W/O CONTR | $1,902.30 | $2,238.00 | $130.00–$140.00 | — | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST | $2,669.00 | $3,140.00 | $130.00–$140.00 | 64% above | 15% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST | $2,669.00 | $3,140.00 | $130.00–$140.00 | — | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US DUPLEX CAROTID BILATERAL | $596.70 | $702.00 | $130.00–$140.00 | — | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US DUPLEX CAROTID BILATERAL | $596.70 | $702.00 | $130.00–$140.00 | — | 15% |
| Chest X-ray, 2 views CPT 71046 CHEST APICAL LORDOTIC AP & LATERAL | $243.10 | $286.00 | $130.00–$140.00 | 16% below | 15% |
| Chest X-ray, 2 views CPT 71046 CHEST AP SINGLE VIEW FRONTAL | $351.05 | $413.00 | $130.00–$140.00 | 21% above | 15% |
| Chest X-ray, 2 views CPT 71046 CHEST PA AND LATERAL 2 VIEWS | $380.80 | $448.00 | $130.00–$140.00 | 32% above | 15% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS WITH FLUOROSCOPY | $516.80 | $608.00 | $130.00–$140.00 | 79% above | 15% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST APICAL LORDOTIC AP & LATERAL | $243.10 | $286.00 | $130.00–$140.00 | — | 15% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST AP SINGLE VIEW FRONTAL | $351.05 | $413.00 | $130.00–$140.00 | — | 15% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST PA AND LATERAL 2 VIEWS | $380.80 | $448.00 | $130.00–$140.00 | — | 15% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS WITH FLUOROSCOPY | $516.80 | $608.00 | $130.00–$140.00 | — | 15% |
| Chest X-ray, single view CPT 71045 CHEST-PORTABLE | $266.90 | $314.00 | $130.00–$140.00 | 24% above | 15% |
| Chest X-ray, single view CPT 71045 CHEST PA ONLY | $266.90 | $314.00 | $130.00–$140.00 | 24% above | 15% |
| Chest X-ray, single view inpatient CPT 71045 CHEST-PORTABLE | $266.90 | $314.00 | $130.00–$140.00 | — | 15% |
| Chest X-ray, single view inpatient CPT 71045 CHEST PA ONLY | $266.90 | $314.00 | $130.00–$140.00 | — | 15% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL COMPLETE | $467.50 | $550.00 | $130.00–$140.00 | 23% below | 15% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL COMPLETE | $1,147.50 | $1,350.00 | $130.00–$140.00 | 89% above | 15% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RENAL COMPLETE | $467.50 | $550.00 | $130.00–$140.00 | — | 15% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL COMPLETE | $1,147.50 | $1,350.00 | $130.00–$140.00 | — | 15% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY STUDY 1/> SITE AXIAL SK | $391.00 | $460.00 | $130.00–$140.00 | 4% below | 15% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY STUDY 1/> SITE AXIAL SK | $391.00 | $460.00 | $130.00–$140.00 | — | 15% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY 1/> SITES APPENDICLR SK | $204.85 | $241.00 | $130.00–$140.00 | 14% below | 15% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY 1/> SITES APPENDICLR SK | $204.85 | $241.00 | $130.00–$140.00 | — | 15% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREGNANT UTERUS FETAL DETAIL EXAM | $697.00 | $820.00 | $130.00–$140.00 | 29% above | 15% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREGNANT UTERUS FETAL DETAIL EXAM | $697.00 | $820.00 | $130.00–$140.00 | — | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/0 CONTRAST | $125.80 | $148.00 | $130.00–$140.00 | 90% below | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABD & PELVIS W/O | $1,313.25 | $1,545.00 | $130.00–$140.00 | 2% above | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABD PELVIS W/O CONTRAST | $1,985.60 | $2,336.00 | $130.00–$140.00 | 54% above | 15% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/0 CONTRAST | $125.80 | $148.00 | $130.00–$140.00 | — | 15% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST ABD & PELVIS W/O | $1,313.25 | $1,545.00 | $130.00–$140.00 | — | 15% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST ABD PELVIS W/O CONTRAST | $1,985.60 | $2,336.00 | $130.00–$140.00 | — | 15% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/ABD/PELVIS W CONTRAST | $735.25 | $865.00 | $130.00–$140.00 | 53% below | 15% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST | $2,975.00 | $3,500.00 | $130.00–$140.00 | 90% above | 15% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST/ABD/PELVIS W CONTRAST | $735.25 | $865.00 | $130.00–$140.00 | — | 15% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST | $2,975.00 | $3,500.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILAT DIAG | $680.85 | $801.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILATERAL D | $707.20 | $832.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILAT DIAG 3D + 2D | $758.20 | $892.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILAT DIAG | $680.85 | $801.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILATERAL D | $707.20 | $832.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILAT DIAG 3D + 2D | $758.20 | $892.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO SCR UNILA 3D + 2D | $243.10 | $286.00 | $130.00–$140.00 | 30% below | 15% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO UNIL DIAG 3D + 2D | $346.80 | $408.00 | $130.00–$140.00 | 1% below | 15% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO SCREENING BIL 3D + 2D | $538.05 | $633.00 | $130.00–$140.00 | 54% above | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT L D | $353.60 | $416.00 | $130.00–$140.00 | 1% above | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT R D | $353.60 | $416.00 | $130.00–$140.00 | 1% above | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNILAT | $368.05 | $433.00 | $130.00–$140.00 | 5% above | 15% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO SCR UNILA 3D + 2D | $243.10 | $286.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO UNIL DIAG 3D + 2D | $346.80 | $408.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO SCREENING BIL 3D + 2D | $538.05 | $633.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT L D | $353.60 | $416.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT R D | $353.60 | $416.00 | $130.00–$140.00 | — | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNILAT | $368.05 | $433.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US ARTERIAL BIL LOWER EXTREMITY | $935.00 | $1,100.00 | $130.00–$140.00 | 70% above | 15% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ARTERIAL BIL LOWER EXTREMITY | $935.00 | $1,100.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DOPPLER BILATERAL DUPLEX | $456.45 | $537.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX VENOUS EXTR. BILATERAL | $1,320.90 | $1,554.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 BILATERAL VEIN ULTRASOUND | $1,672.80 | $1,968.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DOPPLER BILATERAL DUPLEX | $456.45 | $537.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX VENOUS EXTR. BILATERAL | $1,320.90 | $1,554.00 | $130.00–$140.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 BILATERAL VEIN ULTRASOUND | $1,672.80 | $1,968.00 | $130.00–$140.00 | — | 15% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO CARDIO TRANS W DOPPLER/COLORFLOW | $1,399.95 | $1,647.00 | $130.00–$140.00 | 24% below | 15% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO CARDIO TRANS W DOPPLER/COLORFLOW | $1,399.95 | $1,647.00 | $130.00–$140.00 | — | 15% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY INCLUDIN GALL BLADDER | $3,235.10 | $3,806.00 | $130.00–$140.00 | 179% above | 15% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY INCLUDIN GALL BLADDER | $3,235.10 | $3,806.00 | $130.00–$140.00 | — | 15% |
| Knee X-ray, 3 views CPT 73562 KNEE MIN 3 VW AP LAT W/ OBLIQUE | $29.75 | $35.00 | $130.00–$140.00 | 89% below | 15% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE MIN 3 VW AP LAT W/ OBLIQUE | $29.75 | $35.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PANCREAS ULTRA SOUND | $63.75 | $75.00 | $130.00–$140.00 | 87% below | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 GALL BLADDER ULTRA SOUND | $63.75 | $75.00 | $130.00–$140.00 | 87% below | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 COMMON BILE DUCT | $66.30 | $78.00 | $130.00–$140.00 | 86% below | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 GALL BLADDER/PANCREAS US | $102.85 | $121.00 | $130.00–$140.00 | 79% below | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US APPENDIX/ABDOMEN | $488.75 | $575.00 | $130.00–$140.00 | at median | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US COMMON BILE DUCT | $831.30 | $978.00 | $130.00–$140.00 | 69% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS | $831.30 | $978.00 | $130.00–$140.00 | 69% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN | $831.30 | $978.00 | $130.00–$140.00 | 69% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER | $831.30 | $978.00 | $130.00–$140.00 | 69% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALL BLADDER | $831.30 | $978.00 | $130.00–$140.00 | 69% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED SINGLE ORGAN (RUQ/LIVE/GB | $1,038.70 | $1,222.00 | $130.00–$140.00 | 112% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 GALL BLADDER ULTRA SOUND | $63.75 | $75.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PANCREAS ULTRA SOUND | $63.75 | $75.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 COMMON BILE DUCT | $66.30 | $78.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 GALL BLADDER/PANCREAS US | $102.85 | $121.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US APPENDIX/ABDOMEN | $488.75 | $575.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN | $831.30 | $978.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US COMMON BILE DUCT | $831.30 | $978.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALL BLADDER | $831.30 | $978.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER | $831.30 | $978.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS | $831.30 | $978.00 | $130.00–$140.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED SINGLE ORGAN (RUQ/LIVE/GB | $1,038.70 | $1,222.00 | $130.00–$140.00 | — | 15% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LUNG CANCER SCRN LOW DOSE | $415.65 | $489.00 | $130.00–$140.00 | 57% above | 15% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LUNG CANCER SCRN LOW DOSE | $415.65 | $489.00 | $130.00–$140.00 | — | 15% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI ANY JOINT LOWER EXTREMITY WO | $4,169.25 | $4,905.00 | $130.00–$140.00 | 133% above | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI ANY JOINT LOWER EXTREMITY WO | $4,169.25 | $4,905.00 | $130.00–$140.00 | — | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXTREMITY W& W/O CONTRAST | $4,660.55 | $5,483.00 | $130.00–$140.00 | 71% above | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXTREMITY W& W/O CONTRAST | $4,660.55 | $5,483.00 | $130.00–$140.00 | — | 15% |
| MRI of the abdomen without contrast CPT 74181 MRCP W/O CONTRAST | $2,326.45 | $2,737.00 | $130.00–$140.00 | 24% above | 15% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO | $4,312.05 | $5,073.00 | $130.00–$140.00 | 129% above | 15% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP W/O CONTRAST | $2,326.45 | $2,737.00 | $130.00–$140.00 | — | 15% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO | $4,312.05 | $5,073.00 | $130.00–$140.00 | — | 15% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRCP W/O & W CONTRAST | $3,324.35 | $3,911.00 | $130.00–$140.00 | 15% above | 15% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & W/O CONTRAST | $4,438.70 | $5,222.00 | $130.00–$140.00 | 54% above | 15% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRCP W/O & W CONTRAST | $3,324.35 | $3,911.00 | $130.00–$140.00 | — | 15% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & W/O CONTRAST | $4,438.70 | $5,222.00 | $130.00–$140.00 | — | 15% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN | $1,870.00 | $2,200.00 | $130.00–$140.00 | 12% above | 15% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $4,122.50 | $4,850.00 | $130.00–$140.00 | 146% above | 15% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN | $1,870.00 | $2,200.00 | $130.00–$140.00 | — | 15% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST | $4,122.50 | $4,850.00 | $130.00–$140.00 | — | 15% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & W/O | $5,999.30 | $7,058.00 | $130.00–$140.00 | 114% above | 15% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & W/O | $5,999.30 | $7,058.00 | $130.00–$140.00 | — | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE W/O CONTRAST | $2,125.00 | $2,500.00 | $130.00–$140.00 | 20% above | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MRI BASIC LUMBAR W/O CONTRAST | $4,000.10 | $4,706.00 | $130.00–$140.00 | 125% above | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MRI COCCYX W/O | $4,159.90 | $4,894.00 | $130.00–$140.00 | 134% above | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE W/O | $4,326.50 | $5,090.00 | $130.00–$140.00 | 144% above | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE W/O CONTRAST | $2,125.00 | $2,500.00 | $130.00–$140.00 | — | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI BASIC LUMBAR W/O CONTRAST | $4,000.10 | $4,706.00 | $130.00–$140.00 | — | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI COCCYX W/O | $4,159.90 | $4,894.00 | $130.00–$140.00 | — | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE W/O | $4,326.50 | $5,090.00 | $130.00–$140.00 | — | 15% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W & W/O | $5,666.10 | $6,666.00 | $130.00–$140.00 | 96% above | 15% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE W&W/O | $5,893.05 | $6,933.00 | $130.00–$140.00 | 104% above | 15% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W & W/O | $5,666.10 | $6,666.00 | $130.00–$140.00 | — | 15% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE W&W/O | $5,893.05 | $6,933.00 | $130.00–$140.00 | — | 15% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE W/O SC | $4,254.25 | $5,005.00 | $130.00–$140.00 | 139% above | 15% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE W/O SC | $4,254.25 | $5,005.00 | $130.00–$140.00 | — | 15% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W & W/O | $4,648.65 | $5,469.00 | $130.00–$140.00 | 76% above | 15% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W & W/O | $4,648.65 | $5,469.00 | $130.00–$140.00 | — | 15% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE | $267.75 | $315.00 | $130.00–$140.00 | 85% below | 15% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O SC | $1,823.25 | $2,145.00 | $130.00–$140.00 | 4% above | 15% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL WO | $4,227.90 | $4,974.00 | $130.00–$140.00 | 140% above | 15% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE | $267.75 | $315.00 | $130.00–$140.00 | — | 15% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O SC | $1,823.25 | $2,145.00 | $130.00–$140.00 | — | 15% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL WO | $4,227.90 | $4,974.00 | $130.00–$140.00 | — | 15% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W & W/O CONTRAST | $5,440.85 | $6,401.00 | $130.00–$140.00 | 88% above | 15% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W & W/O CONTRAST | $5,440.85 | $6,401.00 | $130.00–$140.00 | — | 15% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O | $4,181.15 | $4,919.00 | $130.00–$140.00 | 131% above | 15% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O | $4,181.15 | $4,919.00 | $130.00–$140.00 | — | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI ANY JOINT UPPER EXTRE WO | $1,666.00 | $1,960.00 | $130.00–$140.00 | 8% above | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SHOULDER | $1,666.00 | $1,960.00 | $130.00–$140.00 | 8% above | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI ANY JOINT UPPER EXTREMITY WO | $3,673.70 | $4,322.00 | $130.00–$140.00 | 137% above | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI ANY JOINT UPPER EXTRE WO | $1,666.00 | $1,960.00 | $130.00–$140.00 | — | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI SHOULDER | $1,666.00 | $1,960.00 | $130.00–$140.00 | — | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI ANY JOINT UPPER EXTREMITY WO | $3,673.70 | $4,322.00 | $130.00–$140.00 | — | 15% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED (IUD LOCALIZATION) | $567.80 | $668.00 | $130.00–$140.00 | 44% above | 15% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED (IUD LOCALIZATION) | $567.80 | $668.00 | $130.00–$140.00 | — | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIS US | $68.00 | $80.00 | $130.00–$140.00 | 89% below | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON OBS COMPLETE | $1,237.60 | $1,456.00 | $130.00–$140.00 | 104% above | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIS US | $68.00 | $80.00 | $130.00–$140.00 | — | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NON OBS COMPLETE | $1,237.60 | $1,456.00 | $130.00–$140.00 | — | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PELVIS OB | $68.00 | $80.00 | $130.00–$140.00 | 88% below | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG >/=14 WEEKS,SNGL FETUS | $442.00 | $520.00 | $130.00–$140.00 | 23% below | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS >/=14 WEEKS, SNGL FETUS | $601.80 | $708.00 | $130.00–$140.00 | 5% above | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PELVIS OB | $68.00 | $80.00 | $130.00–$140.00 | — | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG >/=14 WEEKS,SNGL FETUS | $442.00 | $520.00 | $130.00–$140.00 | — | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS >/=14 WEEKS, SNGL FETUS | $601.80 | $708.00 | $130.00–$140.00 | — | 15% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMESTER <14WKS 1 GESTATION | $485.35 | $571.00 | $130.00–$140.00 | 10% below | 15% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1ST TRIMESTER <14WKS 1 GESTATION | $485.35 | $571.00 | $130.00–$140.00 | — | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT LIMITED | $323.00 | $380.00 | $130.00–$140.00 | 6% below | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTERUS LIMITED 1 OR MORE FETUS | $606.90 | $714.00 | $130.00–$140.00 | 77% above | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT LIMITED | $323.00 | $380.00 | $130.00–$140.00 | — | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTERUS LIMITED 1 OR MORE FETUS | $606.90 | $714.00 | $130.00–$140.00 | — | 15% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO BILATERAL SCREENING 2 VW | $569.50 | $670.00 | $130.00–$140.00 | — | 15% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR BILAT 3D + 2D | $650.25 | $765.00 | $130.00–$140.00 | — | 15% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO UNI RT S | $526.15 | $619.00 | $130.00–$140.00 | 122% above | 15% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO UNILAT 2 VW | $526.15 | $619.00 | $130.00–$140.00 | 122% above | 15% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO BILATERAL SCREENING 2 VW | $569.50 | $670.00 | $130.00–$140.00 | — | 15% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCR BILAT 3D + 2D | $650.25 | $765.00 | $130.00–$140.00 | — | 15% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO UNI RT S | $526.15 | $619.00 | $130.00–$140.00 | — | 15% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO UNILAT 2 VW | $526.15 | $619.00 | $130.00–$140.00 | — | 15% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION | $369.75 | $435.00 | $130.00–$140.00 | 50% below | 15% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW,MODIFIED | $485.35 | $571.00 | $130.00–$140.00 | 34% below | 15% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW | $525.30 | $618.00 | $130.00–$140.00 | 28% below | 15% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION | $369.75 | $435.00 | $130.00–$140.00 | — | 15% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW,MODIFIED | $485.35 | $571.00 | $130.00–$140.00 | — | 15% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW | $525.30 | $618.00 | $130.00–$140.00 | — | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL PELVIC NON OBSTETRICAL | $1,097.35 | $1,291.00 | $130.00–$140.00 | 115% above | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL PELVIC NON OBSTETRICAL | $1,097.35 | $1,291.00 | $130.00–$140.00 | — | 15% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANT UTERUS TRANSVAGINAL | $358.70 | $422.00 | $130.00–$140.00 | 11% below | 15% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT UTERUS TRANSVAGINAL | $358.70 | $422.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMPLETE UPPER REAL TIME U/S | $68.00 | $80.00 | $130.00–$140.00 | 91% below | 15% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $1,237.60 | $1,456.00 | $130.00–$140.00 | 55% above | 15% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMPLETE UPPER REAL TIME U/S | $68.00 | $80.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $1,237.60 | $1,456.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR | $651.95 | $767.00 | $130.00–$140.00 | 18% above | 15% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR | $651.95 | $767.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID US | $63.75 | $75.00 | $130.00–$140.00 | 90% below | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID HEAD & NECK | $967.30 | $1,138.00 | $130.00–$140.00 | 59% above | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID/PARATHYROID/PARATID | $967.30 | $1,138.00 | $130.00–$140.00 | 59% above | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK | $967.30 | $1,138.00 | $130.00–$140.00 | 59% above | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 THYROID US | $63.75 | $75.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID HEAD & NECK | $967.30 | $1,138.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID/PARATHYROID/PARATID | $967.30 | $1,138.00 | $130.00–$140.00 | — | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK | $967.30 | $1,138.00 | $130.00–$140.00 | — | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W KUB NHD | $731.00 | $860.00 | $130.00–$140.00 | 49% above | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI SERIES W/O KUB NHD | $799.00 | $940.00 | $130.00–$140.00 | 63% above | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI AIR CONTRAST W SMALL BOWEL HD | $1,598.85 | $1,881.00 | $130.00–$140.00 | 226% above | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W KUB NHD | $731.00 | $860.00 | $130.00–$140.00 | — | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI SERIES W/O KUB NHD | $799.00 | $940.00 | $130.00–$140.00 | — | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI AIR CONTRAST W SMALL BOWEL HD | $1,598.85 | $1,881.00 | $130.00–$140.00 | — | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER UNILATERAL DUPLEX | $304.30 | $358.00 | $130.00–$140.00 | 52% below | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UNILATERAL VEIN ULTRASOUND | $1,134.75 | $1,335.00 | $130.00–$140.00 | 79% above | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER UNILATERAL DUPLEX | $304.30 | $358.00 | $130.00–$140.00 | — | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UNILATERAL VEIN ULTRASOUND | $1,134.75 | $1,335.00 | $130.00–$140.00 | — | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP/PELVIS PEDIATRIC MIN 2 VIEWS | $389.30 | $458.00 | $130.00–$140.00 | 80% above | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP UNILATERAL 2-3 VIEWS LEFT | $389.30 | $458.00 | $130.00–$140.00 | 80% above | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP UNILATERAL 2-3 VIEWS RIGHT | $389.30 | $458.00 | $130.00–$140.00 | 80% above | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP/PELVIS PEDIATRIC MIN 2 VIEWS | $389.30 | $458.00 | $130.00–$140.00 | — | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP UNILATERAL 2-3 VIEWS RIGHT | $389.30 | $458.00 | $130.00–$140.00 | — | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP UNILATERAL 2-3 VIEWS LEFT | $389.30 | $458.00 | $130.00–$140.00 | — | 15% |
| X-ray of the abdomen, 1 view CPT 74018 KUB | $383.35 | $451.00 | $130.00–$140.00 | 34% above | 15% |
| X-ray of the abdomen, 1 view CPT 74018 KUB PORTABLE | $383.35 | $451.00 | $130.00–$140.00 | 34% above | 15% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 KUB | $383.35 | $451.00 | $130.00–$140.00 | — | 15% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 KUB PORTABLE | $383.35 | $451.00 | $130.00–$140.00 | — | 15% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS | $119.00 | $140.00 | $130.00–$140.00 | 41% below | 15% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS | $119.00 | $140.00 | $130.00–$140.00 | — | 15% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 FINGERS 2 OR MORE DIGITS BILATERAL | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGERS MIN 2 VIEWS MORE THAN 1 DIGIT | $351.90 | $414.00 | $130.00–$140.00 | 92% above | 15% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGERS MIN 2 VWS SAME HAND | $351.90 | $414.00 | $130.00–$140.00 | 92% above | 15% |
| X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 FINGERS 2 OR MORE DIGITS BILATERAL | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS MIN 2 VWS SAME HAND | $351.90 | $414.00 | $130.00–$140.00 | — | 15% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS MIN 2 VIEWS MORE THAN 1 DIGIT | $351.90 | $414.00 | $130.00–$140.00 | — | 15% |
| X-ray of the hand, 3 or more views CPT 73130 HAND COMPLETE MIN 3 VW | $26.35 | $31.00 | $130.00–$140.00 | 90% below | 15% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND COMPLETE MIN 3 VW | $26.35 | $31.00 | $130.00–$140.00 | — | 15% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 VW LEFT | $182.75 | $215.00 | $130.00–$140.00 | 1% below | 15% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1 VW LEFT | $182.75 | $215.00 | $130.00–$140.00 | — | 15% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBO SACRAL SPINE AP/LAT | $623.90 | $734.00 | $130.00–$140.00 | 83% above | 15% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBO SACRAL SPINE AP/LAT | $623.90 | $734.00 | $130.00–$140.00 | — | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 4 OR MORE VIEWS | $849.15 | $999.00 | $130.00–$140.00 | 68% above | 15% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 4 OR MORE VIEWS | $849.15 | $999.00 | $130.00–$140.00 | — | 15% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS | $427.55 | $503.00 | $130.00–$140.00 | 32% above | 15% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS | $427.55 | $503.00 | $130.00–$140.00 | — | 15% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES | $468.35 | $551.00 | $130.00–$140.00 | 116% above | 15% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES | $468.35 | $551.00 | $130.00–$140.00 | — | 15% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE AP & LATERAL | $604.35 | $711.00 | $130.00–$140.00 | 44% above | 15% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE AP & LATERAL | $604.35 | $711.00 | $130.00–$140.00 | — | 15% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP 1 - 2 VIEWS | $284.75 | $335.00 | $130.00–$140.00 | 17% above | 15% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP 1 - 2 VIEWS | $284.75 | $335.00 | $130.00–$140.00 | — | 15% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX MIN 2 VWS | $284.75 | $335.00 | $130.00–$140.00 | 1% below | 15% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX MIN 2 VWS | $284.75 | $335.00 | $130.00–$140.00 | — | 15% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $115.60 | $136.00 | $130.00–$140.00 | 162% above | 15% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) | $115.60 | $136.00 | $130.00–$140.00 | — | 15% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 FIB-4 | $21.25 | $25.00 | $130.00–$140.00 | 41% below | 15% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (LABCORP) | $27.20 | $32.00 | $130.00–$140.00 | 24% below | 15% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $115.60 | $136.00 | $130.00–$140.00 | 221% above | 15% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 FIB-4 | $21.25 | $25.00 | $130.00–$140.00 | — | 15% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (LABCORP) | $27.20 | $32.00 | $130.00–$140.00 | — | 15% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) | $115.60 | $136.00 | $130.00–$140.00 | — | 15% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS B PROFILE | $250.75 | $295.00 | $130.00–$140.00 | 30% below | 15% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL 4 | $493.00 | $580.00 | $130.00–$140.00 | 37% above | 15% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE VIRAL HEPATITIS PROFILE(LABCORP) | $493.85 | $581.00 | $130.00–$140.00 | 37% above | 15% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE (LABCORP) | $533.80 | $628.00 | $130.00–$140.00 | 48% above | 15% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS B PROFILE | $250.75 | $295.00 | $130.00–$140.00 | — | 15% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL 4 | $493.00 | $580.00 | $130.00–$140.00 | — | 15% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE VIRAL HEPATITIS PROFILE(LABCORP) | $493.85 | $581.00 | $130.00–$140.00 | — | 15% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE (LABCORP) | $533.80 | $628.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HOUSE DUST (GREER LABS) | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WILLOW (BLACK) | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WILLOW (PUSSY) | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LEMON | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CATFISH | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TILAPIA | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CASHEW | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GREEN BEAN | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BAHIA GRASS | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BERMUDA GRASS | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RAGWEED FALSE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RAGWEED SHORT | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MARSHELDER ROUGH | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, DOCKWEED YELLOW | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PIGWEED | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ALTERNARIA ATERNATA | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CLADOSPORIUM HERBARUM | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MUCOR RACEMOSUS | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ASPERGILLUS FUMIGATUS | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WORMWOOD | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, Setomelanomma rostrat | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PECAN | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN YEAST | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WALNUT | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BARLEY | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, Curvularia lunata | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HOP | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, Epicoccum purpurasce | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MACADAMIA NUT | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RYE GRASS | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SQUID IgE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PECAN TREE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SALMON IgE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN NUTMEG IgE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MUSSEL IgE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HICKORY WHITE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TUNA IgE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CODFISH IgE | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HOUSE DUST (HOLLISTER) | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, POTATO | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, TURKEY | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ALMOND | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PISTACHIO NUT | $13.60 | $16.00 | $130.00–$140.00 | 63% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIUM CHRYSOGENUM | $31.45 | $37.00 | $130.00–$140.00 | 15% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCONUT | $31.45 | $37.00 | $130.00–$140.00 | 15% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MILK | $31.45 | $37.00 | $130.00–$140.00 | 15% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE, WHITE | $31.45 | $37.00 | $130.00–$140.00 | 15% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MUGWORT | $34.00 | $40.00 | $130.00–$140.00 | 8% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FUSARIUM PROLIFERATUM | $34.00 | $40.00 | $130.00–$140.00 | 8% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS ATRA | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Ige WHEY | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN AVACADO | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Ige RICE | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CEDAR, MOUNTAIN | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LIME | $35.70 | $42.00 | $130.00–$140.00 | 4% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ASPERGILLUS FLAVUS IGE | $36.55 | $43.00 | $130.00–$140.00 | 1% below | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FEATHER MIX IGE | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NECTARINE | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GUM SWEET | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CYPRESS BALD | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SYCAMORE, MAPLE LEAF | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PINE NUT, PIGNOLES | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC LIME | $37.40 | $44.00 | $130.00–$140.00 | 1% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OCTOPUS IgE | $38.25 | $45.00 | $130.00–$140.00 | 3% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER | $39.10 | $46.00 | $130.00–$140.00 | 6% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE FOOD ALLERGEN | $39.10 | $46.00 | $130.00–$140.00 | 6% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEACH | $39.10 | $46.00 | $130.00–$140.00 | 6% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED | $39.10 | $46.00 | $130.00–$140.00 | 6% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SQUASH SUMMER (CUCURBITA SPP) IGE | $41.65 | $49.00 | $130.00–$140.00 | 12% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FIRE ANT (INVICTA) | $42.50 | $50.00 | $130.00–$140.00 | 15% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, REGIONAL ZONE 2 | $46.75 | $55.00 | $130.00–$140.00 | 26% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HORSE DANDER | $48.45 | $57.00 | $130.00–$140.00 | 31% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LAMB/MUTTON | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CANOLA/RAPE SEED IgE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SUNFLOWER SEED | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SAFFLOWER, IgE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ONION | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ASPERGILLUS NIGER | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BUCKWHEAT | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SWEET POTATO | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PINEAPPLE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COFFEE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WATERMELON | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BANANA | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHOCOLATE/CACAO | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TROUT | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CASEIN | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN APPLE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHEEP SORRELL | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LETTUCE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CELERY | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAULIFLOWER | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CARROT | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GREEN PEA | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BRAZIL NUT | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HAZELNUT(FILBERT) | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GRAPE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEAR | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEY | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN , HICKORY | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NETTLE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON SILVER BIRCH | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DOG DANDER | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TIMOTHY GRASS | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DERMATOPHAGOIDES FARINAE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAT HAIR/DANDER | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COMMON SILVER BIRCH | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CEDAR MOUNTAIN | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCKROACH GERMAN | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK, WHITE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CEDAR(RED) | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRY | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ORANGE | $50.15 | $59.00 | $130.00–$140.00 | 35% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE W/ IgE -AREA 3 | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CRAB | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAYFISH, FRESHWATER | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUSSEL | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COTTONWOOD | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EPICOCCUM PURPUR | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN FEATHERS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GOOSE FEATHERS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HOUSE DUST MIX | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GOLDENROD | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DUCK FEATHERS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD (602989) 12 FOODS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHITE ASH | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHRIMP | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-BASIC 6 FOODS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PINE LONGLEAF | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ENGLISH PLANTAIN | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HELMINTHOSPORIUM SATIVUM | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG WHITE | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCKLEBUR | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG YOLK | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LAMB'S QUARTER | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, JOHNSON GRASS | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RICE | $54.40 | $64.00 | $130.00–$140.00 | 47% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN | $54.40 | $64.00 | $130.00–$140.00 | 47% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEEF | $54.40 | $64.00 | $130.00–$140.00 | 47% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE PEANUT IGE WITH COMP/RF | $54.40 | $64.00 | $130.00–$140.00 | 47% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LATEX | $56.10 | $66.00 | $130.00–$140.00 | 51% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TEST 1 ANTIGEN | $56.95 | $67.00 | $130.00–$140.00 | 54% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-MEAT | $60.35 | $71.00 | $130.00–$140.00 | 63% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE BASIC FOOD 9 FOODS | $83.30 | $98.00 | $130.00–$140.00 | 125% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-LEGUME | $83.30 | $98.00 | $130.00–$140.00 | 125% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, SUMMER-GRASS | $97.75 | $115.00 | $130.00–$140.00 | 164% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, SPRING TREE SEASONAL | $102.00 | $120.00 | $130.00–$140.00 | 175% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-SHELLFISH | $107.10 | $126.00 | $130.00–$140.00 | 189% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FALL WEED SEASONAL | $114.75 | $135.00 | $130.00–$140.00 | 210% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-VEGETABLE 1 | $117.30 | $138.00 | $130.00–$140.00 | 217% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FALL-WEED | $117.30 | $138.00 | $130.00–$140.00 | 217% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-FISH | $117.30 | $138.00 | $130.00–$140.00 | 217% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS, FALL-WEED | $117.30 | $138.00 | $130.00–$140.00 | 217% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, MOLD | $117.30 | $138.00 | $130.00–$140.00 | 217% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-VEGETABLE II | $123.25 | $145.00 | $130.00–$140.00 | 233% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD (NUTS) | $158.10 | $186.00 | $130.00–$140.00 | 327% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROF - FOOD-MILK | $175.95 | $207.00 | $130.00–$140.00 | 375% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, PERENNIAL ALLERGEN | $204.85 | $241.00 | $130.00–$140.00 | 453% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE PEANUT, IgE WITH COMPON | $219.30 | $258.00 | $130.00–$140.00 | 492% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD-GRAIN | $227.80 | $268.00 | $130.00–$140.00 | 515% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE HYMENOPTERA PROFILE 2 | $232.05 | $273.00 | $130.00–$140.00 | 526% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS (10) TREE | $369.75 | $435.00 | $130.00–$140.00 | 898% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD IGE W/RFKS(608005) | $390.15 | $459.00 | $130.00–$140.00 | 953% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, REGIONAL ZONE 2 | $395.25 | $465.00 | $130.00–$140.00 | 967% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, MINI PROFILE | $454.75 | $535.00 | $130.00–$140.00 | 1127% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD PROFILE W/ REFLEX (603587) | $595.85 | $701.00 | $130.00–$140.00 | 1508% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD IGE II/COMP REFLE | $700.40 | $824.00 | $130.00–$140.00 | 1790% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS 14 | $772.65 | $909.00 | $130.00–$140.00 | 1985% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS TWENTY THREE | $820.25 | $965.00 | $130.00–$140.00 | 2114% above | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL (96) | $1,360.85 | $1,601.00 | $130.00–$140.00 | 3573% above | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WILLOW (PUSSY) | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TILAPIA | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CATFISH | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HOUSE DUST (GREER LABS) | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LEMON | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HOUSE DUST (HOLLISTER) | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HICKORY WHITE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CODFISH IgE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TUNA IgE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MUSSEL IgE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN NUTMEG IgE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SALMON IgE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SQUID IgE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PECAN TREE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, RYE GRASS | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, Epicoccum purpurasce | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, Curvularia lunata | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WALNUT | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PECAN | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, POTATO | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MACADAMIA NUT | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HOP | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BARLEY | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YEAST | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, Setomelanomma rostrat | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WORMWOOD | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ASPERGILLUS FUMIGATUS | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MUCOR RACEMOSUS | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CLADOSPORIUM HERBARUM | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ALTERNARIA ATERNATA | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PIGWEED | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, DOCKWEED YELLOW | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MARSHELDER ROUGH | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, RAGWEED SHORT | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, RAGWEED FALSE | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BERMUDA GRASS | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BAHIA GRASS | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PISTACHIO NUT | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ALMOND | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CASHEW | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, TURKEY | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, GREEN BEAN | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WILLOW (BLACK) | $13.60 | $16.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE, WHITE | $31.45 | $37.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK | $31.45 | $37.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCONUT | $31.45 | $37.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIUM CHRYSOGENUM | $31.45 | $37.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MUGWORT | $34.00 | $40.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FUSARIUM PROLIFERATUM | $34.00 | $40.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige WHEY | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige RICE | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STACHYBOTRYS ATRA | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CEDAR, MOUNTAIN | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AVACADO | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LIME | $35.70 | $42.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ASPERGILLUS FLAVUS IGE | $36.55 | $43.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PINE NUT, PIGNOLES | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FEATHER MIX IGE | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CYPRESS BALD | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC LIME | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NECTARINE | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SYCAMORE, MAPLE LEAF | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GUM SWEET | $37.40 | $44.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OCTOPUS IgE | $38.25 | $45.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE FOOD ALLERGEN | $39.10 | $46.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH | $39.10 | $46.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER | $39.10 | $46.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED | $39.10 | $46.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SQUASH SUMMER (CUCURBITA SPP) IGE | $41.65 | $49.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIRE ANT (INVICTA) | $42.50 | $50.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, REGIONAL ZONE 2 | $46.75 | $55.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HORSE DANDER | $48.45 | $57.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ORANGE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CEDAR MOUNTAIN | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKROACH GERMAN | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK, WHITE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CEDAR(RED) | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEBERRY | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COMMON SILVER BIRCH | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LETTUCE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASEIN | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON SILVER BIRCH | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TROUT | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHOCOLATE/CACAO | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BANANA | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEY | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WATERMELON | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NETTLE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN , HICKORY | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LAMB/MUTTON | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COFFEE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CELERY | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PINEAPPLE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SWEET POTATO | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BUCKWHEAT | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BRAZIL NUT | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ASPERGILLUS NIGER | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAULIFLOWER | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEAR | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CARROT | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GREEN PEA | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GRAPE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ONION | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHEEP SORRELL | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SAFFLOWER, IgE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN APPLE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SUNFLOWER SEED | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DOG DANDER | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAZELNUT(FILBERT) | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TIMOTHY GRASS | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DERMATOPHAGOIDES FARINAE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANOLA/RAPE SEED IgE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAT HAIR/DANDER | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE W/ IgE -AREA 3 | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD (602989) 12 FOODS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSSEL | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE ASH | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG YOLK | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CRAB | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKLEBUR | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ENGLISH PLANTAIN | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DUCK FEATHERS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PINE LONGLEAF | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-BASIC 6 FOODS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHRIMP | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HELMINTHOSPORIUM SATIVUM | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, JOHNSON GRASS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAYFISH, FRESHWATER | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LAMB'S QUARTER | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN FEATHERS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOOSE FEATHERS | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, GOLDENROD | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COTTONWOOD | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HOUSE DUST MIX | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EPICOCCUM PURPUR | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN | $54.40 | $64.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF | $54.40 | $64.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RICE | $54.40 | $64.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE PEANUT IGE WITH COMP/RF | $54.40 | $64.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LATEX | $56.10 | $66.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TEST 1 ANTIGEN | $56.95 | $67.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-MEAT | $60.35 | $71.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-LEGUME | $83.30 | $98.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE BASIC FOOD 9 FOODS | $83.30 | $98.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, SUMMER-GRASS | $97.75 | $115.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, SPRING TREE SEASONAL | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-SHELLFISH | $107.10 | $126.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FALL WEED SEASONAL | $114.75 | $135.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS, FALL-WEED | $117.30 | $138.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-VEGETABLE 1 | $117.30 | $138.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, MOLD | $117.30 | $138.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FALL-WEED | $117.30 | $138.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-FISH | $117.30 | $138.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-VEGETABLE II | $123.25 | $145.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD (NUTS) | $158.10 | $186.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROF - FOOD-MILK | $175.95 | $207.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, PERENNIAL ALLERGEN | $204.85 | $241.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE PEANUT, IgE WITH COMPON | $219.30 | $258.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD-GRAIN | $227.80 | $268.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE HYMENOPTERA PROFILE 2 | $232.05 | $273.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS (10) TREE | $369.75 | $435.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD IGE W/RFKS(608005) | $390.15 | $459.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, REGIONAL ZONE 2 | $395.25 | $465.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, MINI PROFILE | $454.75 | $535.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD PROFILE W/ REFLEX (603587) | $595.85 | $701.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD IGE II/COMP REFLE | $700.40 | $824.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS 14 | $772.65 | $909.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS TWENTY THREE | $820.25 | $965.00 | $130.00–$140.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL (96) | $1,360.85 | $1,601.00 | $130.00–$140.00 | — | 15% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 RHEUMATOID ARTHRITIS PROFILE | $210.80 | $248.00 | $130.00–$140.00 | 64% above | 15% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE IgG/IgA | $210.80 | $248.00 | $130.00–$140.00 | 64% above | 15% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 RHEUMATOID ARTHRITIS PROFILE | $210.80 | $248.00 | $130.00–$140.00 | — | 15% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE IgG/IgA | $210.80 | $248.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA FELX TO 11 BIOMARKERS | $69.70 | $82.00 | $130.00–$140.00 | 25% below | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 AUTOIMMUNE PROFILE | $73.95 | $87.00 | $130.00–$140.00 | 21% below | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA REFLEX TO TITER AND PATTERN | $102.00 | $120.00 | $130.00–$140.00 | 9% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB DIRECT | $128.35 | $151.00 | $130.00–$140.00 | 37% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/REFLEX | $128.35 | $151.00 | $130.00–$140.00 | 37% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA WITH REFLEX | $128.35 | $151.00 | $130.00–$140.00 | 37% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/ REFLEX TO 5 BIOMARKERS | $128.35 | $151.00 | $130.00–$140.00 | 37% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA MULTIPLEX PANEL 1 W/REFLEXES QUEST | $878.90 | $1,034.00 | $130.00–$140.00 | 840% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LUPUS DIAGNOSTIC PROFILE | $1,031.05 | $1,213.00 | $130.00–$140.00 | 1003% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA 12 PROFILE, DO ALL (RDL) | $1,582.70 | $1,862.00 | $130.00–$140.00 | 1593% above | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA FELX TO 11 BIOMARKERS | $69.70 | $82.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 AUTOIMMUNE PROFILE | $73.95 | $87.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA REFLEX TO TITER AND PATTERN | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA WITH REFLEX | $128.35 | $151.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB DIRECT | $128.35 | $151.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/ REFLEX TO 5 BIOMARKERS | $128.35 | $151.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/REFLEX | $128.35 | $151.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA MULTIPLEX PANEL 1 W/REFLEXES QUEST | $878.90 | $1,034.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LUPUS DIAGNOSTIC PROFILE | $1,031.05 | $1,213.00 | $130.00–$140.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA 12 PROFILE, DO ALL (RDL) | $1,582.70 | $1,862.00 | $130.00–$140.00 | — | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $153.85 | $181.00 | $130.00–$140.00 | 14% above | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP(LABCORP) | $153.85 | $181.00 | $130.00–$140.00 | 14% above | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ProBNP | $192.95 | $227.00 | $130.00–$140.00 | 42% above | 15% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP(LABCORP) | $153.85 | $181.00 | $130.00–$140.00 | — | 15% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP | $153.85 | $181.00 | $130.00–$140.00 | — | 15% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ProBNP | $192.95 | $227.00 | $130.00–$140.00 | — | 15% |
| Basic metabolic panel (blood test) CPT 80048 MET I (LABCORP | $22.10 | $26.00 | $130.00–$140.00 | 73% below | 15% |
| Basic metabolic panel (blood test) CPT 80048 MET 1 (500) | $168.30 | $198.00 | $130.00–$140.00 | 105% above | 15% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC I BASIC PANEL | $175.10 | $206.00 | $130.00–$140.00 | 114% above | 15% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC BASIC (LABCORP | $175.10 | $206.00 | $130.00–$140.00 | 114% above | 15% |
| Basic metabolic panel (blood test) inpatient CPT 80048 MET I (LABCORP | $22.10 | $26.00 | $130.00–$140.00 | — | 15% |
| Basic metabolic panel (blood test) inpatient CPT 80048 MET 1 (500) | $168.30 | $198.00 | $130.00–$140.00 | — | 15% |
| Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC BASIC (LABCORP | $175.10 | $206.00 | $130.00–$140.00 | — | 15% |
| Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC I BASIC PANEL | $175.10 | $206.00 | $130.00–$140.00 | — | 15% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM LEVEL 4 | $294.95 | $347.00 | $130.00–$140.00 | 211% above | 15% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM LEVEL 4 | $294.95 | $347.00 | $130.00–$140.00 | — | 15% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD-TEST | $95.20 | $112.00 | $130.00–$140.00 | 19% above | 15% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $232.05 | $273.00 | $130.00–$140.00 | 190% above | 15% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD-TEST | $95.20 | $112.00 | $130.00–$140.00 | — | 15% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD | $232.05 | $273.00 | $130.00–$140.00 | — | 15% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $39.95 | $47.00 | $130.00–$140.00 | 220% above | 15% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $39.95 | $47.00 | $130.00–$140.00 | — | 15% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE(LABCORP) | $31.45 | $37.00 | $130.00–$140.00 | 14% below | 15% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE TOLERANCE 2 HR | $50.15 | $59.00 | $130.00–$140.00 | 37% above | 15% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE CSF | $50.15 | $59.00 | $130.00–$140.00 | 37% above | 15% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BODY FLUID | $50.15 | $59.00 | $130.00–$140.00 | 37% above | 15% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $50.15 | $59.00 | $130.00–$140.00 | 37% above | 15% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE TOLERANCE 2 HR(Oral WHO Protocol | $76.50 | $90.00 | $130.00–$140.00 | 109% above | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE(LABCORP) | $31.45 | $37.00 | $130.00–$140.00 | — | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE CSF | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOLERANCE 2 HR | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BODY FLUID | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $50.15 | $59.00 | $130.00–$140.00 | — | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOLERANCE 2 HR(Oral WHO Protocol | $76.50 | $90.00 | $130.00–$140.00 | — | 15% |
| Blood lead test CPT 83655 LEAD BLOOD FILTER PAPER | $59.50 | $70.00 | $130.00–$140.00 | 14% below | 15% |
| Blood lead test CPT 83655 LEAD, URINE | $130.05 | $153.00 | $130.00–$140.00 | 87% above | 15% |
| Blood lead test CPT 83655 HAIR ANALYSIS LEAD | $141.10 | $166.00 | $130.00–$140.00 | 103% above | 15% |
| Blood lead test CPT 83655 LEAD BLOOD FILTER PAPAR | $180.20 | $212.00 | $130.00–$140.00 | 159% above | 15% |
| Blood lead test CPT 83655 LEAD, BLOOD (ADULT) | $202.30 | $238.00 | $130.00–$140.00 | 191% above | 15% |
| Blood lead test CPT 83655 LEAD CAPILLARY FINGERSTICK PEDIATRIC | $202.30 | $238.00 | $130.00–$140.00 | 191% above | 15% |
| Blood lead test CPT 83655 LEAD, BLOOD (PEDIATRIC) | $202.30 | $238.00 | $130.00–$140.00 | 191% above | 15% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD FILTER PAPER | $59.50 | $70.00 | $130.00–$140.00 | — | 15% |
| Blood lead test inpatient CPT 83655 LEAD, URINE | $130.05 | $153.00 | $130.00–$140.00 | — | 15% |
| Blood lead test inpatient CPT 83655 HAIR ANALYSIS LEAD | $141.10 | $166.00 | $130.00–$140.00 | — | 15% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD FILTER PAPAR | $180.20 | $212.00 | $130.00–$140.00 | — | 15% |
| Blood lead test inpatient CPT 83655 LEAD, BLOOD (PEDIATRIC) | $202.30 | $238.00 | $130.00–$140.00 | — | 15% |
| Blood lead test inpatient CPT 83655 LEAD CAPILLARY FINGERSTICK PEDIATRIC | $202.30 | $238.00 | $130.00–$140.00 | — | 15% |
| Blood lead test inpatient CPT 83655 LEAD, BLOOD (ADULT) | $202.30 | $238.00 | $130.00–$140.00 | — | 15% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST | $97.75 | $115.00 | $130.00–$140.00 | 28% below | 15% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST | $97.75 | $115.00 | $130.00–$140.00 | — | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO | $85.00 | $100.00 | $130.00–$140.00 | 28% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE | $118.15 | $139.00 | $130.00–$140.00 | 78% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE & SCREEN - ONE BLOOD | $118.15 | $139.00 | $130.00–$140.00 | 78% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO | $85.00 | $100.00 | $130.00–$140.00 | — | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE & SCREEN - ONE BLOOD | $118.15 | $139.00 | $130.00–$140.00 | — | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE | $118.15 | $139.00 | $130.00–$140.00 | — | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP QUANT (LABCORP) | $51.85 | $61.00 | $130.00–$140.00 | 63% below | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP SENDOUT | $68.00 | $80.00 | $130.00–$140.00 | 51% below | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $138.55 | $163.00 | $130.00–$140.00 | at median | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP QUANT (LABCORP) | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP SENDOUT | $68.00 | $80.00 | $130.00–$140.00 | — | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $138.55 | $163.00 | $130.00–$140.00 | — | 15% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE PCR (DIATHERIX) | $154.70 | $182.00 | $130.00–$140.00 | 74% above | 15% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIN GENE, NAA | $192.95 | $227.00 | $130.00–$140.00 | 117% above | 15% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE PCR (DIATHERIX) | $154.70 | $182.00 | $130.00–$140.00 | — | 15% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE TOXIN GENE, NAA | $192.95 | $227.00 | $130.00–$140.00 | — | 15% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $145.35 | $171.00 | $130.00–$140.00 | 66% above | 15% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 (SENDOUT) | $173.40 | $204.00 | $130.00–$140.00 | 98% above | 15% |
| CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN 19-9 | $181.90 | $214.00 | $130.00–$140.00 | 107% above | 15% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $145.35 | $171.00 | $130.00–$140.00 | — | 15% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 (SENDOUT) | $173.40 | $204.00 | $130.00–$140.00 | — | 15% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN 19-9 | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN (CA) 125 SERIAL (480061 | $168.30 | $198.00 | $130.00–$140.00 | 20% above | 15% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 (SENDOUT) | $168.30 | $198.00 | $130.00–$140.00 | 20% above | 15% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 | $236.30 | $278.00 | $130.00–$140.00 | 68% above | 15% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 (SENDOUT) | $168.30 | $198.00 | $130.00–$140.00 | — | 15% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN (CA) 125 SERIAL (480061 | $168.30 | $198.00 | $130.00–$140.00 | — | 15% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 | $236.30 | $278.00 | $130.00–$140.00 | — | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2, NAA | $188.70 | $222.00 | $130.00–$140.00 | 53% above | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV-2 (DIATHERIX) | $204.85 | $241.00 | $130.00–$140.00 | 67% above | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2, NAA | $188.70 | $222.00 | $130.00–$140.00 | — | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COV-2 (DIATHERIX) | $204.85 | $241.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA GONOCOCCUS NAA W CONFIRMATION | $84.15 | $99.00 | $130.00–$140.00 | 12% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .DNA CHL LCR | $102.00 | $120.00 | $130.00–$140.00 | 36% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/ TRACH | $102.00 | $120.00 | $130.00–$140.00 | 36% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, NAA | $144.50 | $170.00 | $130.00–$140.00 | 93% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DIATHERIX CT+NG+THICH VAGINALIS-GNT | $236.30 | $278.00 | $130.00–$140.00 | 215% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC DNA PROBE (NAAT) | $260.95 | $307.00 | $130.00–$140.00 | 248% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GONOCOCCUS, PHARYNGEAL SWAB NA | $260.95 | $307.00 | $130.00–$140.00 | 248% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC AMPLIFICATION | $260.95 | $307.00 | $130.00–$140.00 | 248% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC,MYCO GEN NAA (180049) | $360.40 | $424.00 | $130.00–$140.00 | 381% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS, N GONORRHOEAE, AND T VAGI | $476.85 | $561.00 | $130.00–$140.00 | 536% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT/GC/TV NAA+M GENITALIUM URINE (180045) | $552.50 | $650.00 | $130.00–$140.00 | 637% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CONJUCTIVITIS PANEL DIATHERIX | $731.00 | $860.00 | $130.00–$140.00 | 875% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA GONOCOCCUS NAA W CONFIRMATION | $84.15 | $99.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/ TRACH | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .DNA CHL LCR | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS, NAA | $144.50 | $170.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 DIATHERIX CT+NG+THICH VAGINALIS-GNT | $236.30 | $278.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC AMPLIFICATION | $260.95 | $307.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GONOCOCCUS, PHARYNGEAL SWAB NA | $260.95 | $307.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC DNA PROBE (NAAT) | $260.95 | $307.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC,MYCO GEN NAA (180049) | $360.40 | $424.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS, N GONORRHOEAE, AND T VAGI | $476.85 | $561.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT/GC/TV NAA+M GENITALIUM URINE (180045) | $552.50 | $650.00 | $130.00–$140.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CONJUCTIVITIS PANEL DIATHERIX | $731.00 | $860.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID RFLX DLDL CARDIO IQ | $98.60 | $116.00 | $130.00–$140.00 | 17% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID CASCADE REFLEX TO APO B | $130.05 | $153.00 | $130.00–$140.00 | 55% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID(LABCORP) | $145.35 | $171.00 | $130.00–$140.00 | 73% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ ADVANCED LIPID PANEL | $162.35 | $191.00 | $130.00–$140.00 | 93% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL WITH LDL/HDL RATIO(235010 | $174.25 | $205.00 | $130.00–$140.00 | 107% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL WITH APOLIPOPROTEIN (APOB) | $176.80 | $208.00 | $130.00–$140.00 | 110% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPOPROFILE | $181.90 | $214.00 | $130.00–$140.00 | 117% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL, CARDIO IQ (QUEST) | $181.90 | $214.00 | $130.00–$140.00 | 117% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE WITH NON-HDL CHOLESTEROL | $181.90 | $214.00 | $130.00–$140.00 | 117% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPOPROFILE W/LIPID WITHOUT GRAPH | $181.90 | $214.00 | $130.00–$140.00 | 117% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $181.90 | $214.00 | $130.00–$140.00 | 117% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR W/LIPIDS AND IRM WITHOUT GRAPH | $273.70 | $322.00 | $130.00–$140.00 | 226% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 ADVANCED LIPID PANEL CARDIO IQ | $496.40 | $584.00 | $130.00–$140.00 | 491% above | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID RFLX DLDL CARDIO IQ | $98.60 | $116.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID CASCADE REFLEX TO APO B | $130.05 | $153.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID(LABCORP) | $145.35 | $171.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ ADVANCED LIPID PANEL | $162.35 | $191.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL WITH LDL/HDL RATIO(235010 | $174.25 | $205.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL WITH APOLIPOPROTEIN (APOB) | $176.80 | $208.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE WITH NON-HDL CHOLESTEROL | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LIPOPROFILE | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL, CARDIO IQ (QUEST) | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LIPOPROFILE W/LIPID WITHOUT GRAPH | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR W/LIPIDS AND IRM WITHOUT GRAPH | $273.70 | $322.00 | $130.00–$140.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 ADVANCED LIPID PANEL CARDIO IQ | $496.40 | $584.00 | $130.00–$140.00 | — | 15% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/ AUTOMATED DIFF | $69.70 | $82.00 | $130.00–$140.00 | 7% above | 15% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO & MANUAL DIFF | $86.70 | $102.00 | $130.00–$140.00 | 33% above | 15% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ AUTOMATED DIFF | $69.70 | $82.00 | $130.00–$140.00 | — | 15% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO & MANUAL DIFF | $86.70 | $102.00 | $130.00–$140.00 | — | 15% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $47.60 | $56.00 | $130.00–$140.00 | at median | 15% |
| Complete blood count (CBC), no differential CPT 85027 CBC | $66.30 | $78.00 | $130.00–$140.00 | 39% above | 15% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $47.60 | $56.00 | $130.00–$140.00 | — | 15% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC | $66.30 | $78.00 | $130.00–$140.00 | — | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 MET II (LABCORP) | $22.10 | $26.00 | $130.00–$140.00 | 79% below | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 MET 2 (500) | $303.45 | $357.00 | $130.00–$140.00 | 188% above | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 METABOLIC II COMPREHENSIVE PANEL | $316.20 | $372.00 | $130.00–$140.00 | 200% above | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 METABOLIC PANEL 2 (LABCORP) | $316.20 | $372.00 | $130.00–$140.00 | 200% above | 15% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 MET II (LABCORP) | $22.10 | $26.00 | $130.00–$140.00 | — | 15% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 MET 2 (500) | $303.45 | $357.00 | $130.00–$140.00 | — | 15% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 METABOLIC PANEL 2 (LABCORP) | $316.20 | $372.00 | $130.00–$140.00 | — | 15% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 METABOLIC II COMPREHENSIVE PANEL | $316.20 | $372.00 | $130.00–$140.00 | — | 15% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (IN HOUSE) | $209.95 | $247.00 | $130.00–$140.00 | 98% above | 15% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER | $277.10 | $326.00 | $130.00–$140.00 | 161% above | 15% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (IN HOUSE) | $209.95 | $247.00 | $130.00–$140.00 | — | 15% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER | $277.10 | $326.00 | $130.00–$140.00 | — | 15% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $192.95 | $227.00 | $130.00–$140.00 | 12% above | 15% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEAS(LABCORP) | $215.05 | $253.00 | $130.00–$140.00 | 25% above | 15% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $192.95 | $227.00 | $130.00–$140.00 | — | 15% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEAS(LABCORP) | $215.05 | $253.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test CPT 82670 ESTROGEN FRACTIONATED LC/MS | $102.85 | $121.00 | $130.00–$140.00 | 4% below | 15% |
| Estradiol blood test CPT 82670 ESTRADIOL SENSITIVE LC/MS | $218.45 | $257.00 | $130.00–$140.00 | 104% above | 15% |
| Estradiol blood test CPT 82670 ESTRADIOL LC/MS (ENDOCRINE SCIENCES) | $227.80 | $268.00 | $130.00–$140.00 | 113% above | 15% |
| Estradiol blood test CPT 82670 ESTRADIOL, SENSITIVE,LC/MS | $230.35 | $271.00 | $130.00–$140.00 | 115% above | 15% |
| Estradiol blood test CPT 82670 ESTRADIOL FREE | $239.70 | $282.00 | $130.00–$140.00 | 124% above | 15% |
| Estradiol blood test CPT 82670 ESTRONE LC/MS(ENDOCRINE SCIENCES) | $239.70 | $282.00 | $130.00–$140.00 | 124% above | 15% |
| Estradiol blood test CPT 82670 ESTRADIOL | $239.70 | $282.00 | $130.00–$140.00 | 124% above | 15% |
| Estradiol blood test CPT 82670 HRT FEMALE POST PELLET | $384.20 | $452.00 | $130.00–$140.00 | 259% above | 15% |
| Estradiol blood test inpatient CPT 82670 ESTROGEN FRACTIONATED LC/MS | $102.85 | $121.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL SENSITIVE LC/MS | $218.45 | $257.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL LC/MS (ENDOCRINE SCIENCES) | $227.80 | $268.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL, SENSITIVE,LC/MS | $230.35 | $271.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL FREE | $239.70 | $282.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $239.70 | $282.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 ESTRONE LC/MS(ENDOCRINE SCIENCES) | $239.70 | $282.00 | $130.00–$140.00 | — | 15% |
| Estradiol blood test inpatient CPT 82670 HRT FEMALE POST PELLET | $384.20 | $452.00 | $130.00–$140.00 | — | 15% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH (ACCESS) | $198.90 | $234.00 | $130.00–$140.00 | 29% above | 15% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $198.90 | $234.00 | $130.00–$140.00 | 29% above | 15% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (ACCESS) | $198.90 | $234.00 | $130.00–$140.00 | — | 15% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $198.90 | $234.00 | $130.00–$140.00 | — | 15% |
| Fecal calprotectin (stool inflammation test) CPT 83993 FECAL CALPROTECTIN | $243.95 | $287.00 | $130.00–$140.00 | 34% below | 15% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $365.50 | $430.00 | $130.00–$140.00 | 1% below | 15% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 FECAL CALPROTECTIN | $243.95 | $287.00 | $130.00–$140.00 | — | 15% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL | $365.50 | $430.00 | $130.00–$140.00 | — | 15% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $183.60 | $216.00 | $130.00–$140.00 | 26% above | 15% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (LABCORP) | $183.60 | $216.00 | $130.00–$140.00 | 26% above | 15% |
| Ferritin blood test (iron stores) CPT 82728 HGB FRAC CASCADE W/ RFLX TO ALPHA THALAS | $261.80 | $308.00 | $130.00–$140.00 | 79% above | 15% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (LABCORP) | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HGB FRAC CASCADE W/ RFLX TO ALPHA THALAS | $261.80 | $308.00 | $130.00–$140.00 | — | 15% |
| Folate (folic acid) blood test CPT 82746 B12/FOLATE | $96.90 | $114.00 | $130.00–$140.00 | 42% below | 15% |
| Folate (folic acid) blood test CPT 82746 FOLATE (LABCORP) | $113.90 | $134.00 | $130.00–$140.00 | 32% below | 15% |
| Folate (folic acid) blood test CPT 82746 FOLATE | $155.55 | $183.00 | $130.00–$140.00 | 7% below | 15% |
| Folate (folic acid) blood test inpatient CPT 82746 B12/FOLATE | $96.90 | $114.00 | $130.00–$140.00 | — | 15% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE (LABCORP) | $113.90 | $134.00 | $130.00–$140.00 | — | 15% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE | $155.55 | $183.00 | $130.00–$140.00 | — | 15% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE (LABCORP) | $201.45 | $237.00 | $130.00–$140.00 | 11% above | 15% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE FREE | $201.45 | $237.00 | $130.00–$140.00 | 11% above | 15% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE (LABCORP) | $201.45 | $237.00 | $130.00–$140.00 | — | 15% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE FREE | $201.45 | $237.00 | $130.00–$140.00 | — | 15% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE (SENDOUT) | $75.65 | $89.00 | $130.00–$140.00 | 45% below | 15% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE (LABCORP) | $85.85 | $101.00 | $130.00–$140.00 | 38% below | 15% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE(T4) ENDOCRINE SCIENCES | $100.30 | $118.00 | $130.00–$140.00 | 27% below | 15% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $125.80 | $148.00 | $130.00–$140.00 | 9% below | 15% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE (SENDOUT) | $75.65 | $89.00 | $130.00–$140.00 | — | 15% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE (LABCORP) | $85.85 | $101.00 | $130.00–$140.00 | — | 15% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE(T4) ENDOCRINE SCIENCES | $100.30 | $118.00 | $130.00–$140.00 | — | 15% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE | $125.80 | $148.00 | $130.00–$140.00 | — | 15% |
| Free testosterone test CPT 84402 TESTOSTERONE BIOVAILABLE + FREE (502338) | $275.40 | $324.00 | $130.00–$140.00 | 19% above | 15% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE & TOTAL | $311.10 | $366.00 | $130.00–$140.00 | 35% above | 15% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE (DIRECT) | $323.85 | $381.00 | $130.00–$140.00 | 40% above | 15% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE AND TOTAL EQUILIBRIUM | $340.85 | $401.00 | $130.00–$140.00 | 48% above | 15% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE W/TOTAL LC/MS-MS | $374.85 | $441.00 | $130.00–$140.00 | 62% above | 15% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE BIOVAILABLE + FREE (502338) | $275.40 | $324.00 | $130.00–$140.00 | — | 15% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE & TOTAL | $311.10 | $366.00 | $130.00–$140.00 | — | 15% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE (DIRECT) | $323.85 | $381.00 | $130.00–$140.00 | — | 15% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE AND TOTAL EQUILIBRIUM | $340.85 | $401.00 | $130.00–$140.00 | — | 15% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE W/TOTAL LC/MS-MS | $374.85 | $441.00 | $130.00–$140.00 | — | 15% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GHP MANUAL WBC DIFFERENTIAL | $255.00 | $300.00 | $130.00–$140.00 | 23% below | 15% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GHP MANUAL DIFF BUFFY COAT | $255.00 | $300.00 | $130.00–$140.00 | 23% below | 15% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GHP CBC NO DIFF | $255.00 | $300.00 | $130.00–$140.00 | 23% below | 15% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GHP CBC WITH DIFF | $306.85 | $361.00 | $130.00–$140.00 | 7% below | 15% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GHP MANUAL WBC DIFFERENTIAL | $255.00 | $300.00 | $130.00–$140.00 | — | 15% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GHP CBC NO DIFF | $255.00 | $300.00 | $130.00–$140.00 | — | 15% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GHP MANUAL DIFF BUFFY COAT | $255.00 | $300.00 | $130.00–$140.00 | — | 15% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GHP CBC WITH DIFF | $306.85 | $361.00 | $130.00–$140.00 | — | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR PP | $62.05 | $73.00 | $130.00–$140.00 | 20% below | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GESTATIONAL DIABETES 1-HR SCREEN | $66.30 | $78.00 | $130.00–$140.00 | 15% below | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR PP | $90.95 | $107.00 | $130.00–$140.00 | 17% above | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR PP | $62.05 | $73.00 | $130.00–$140.00 | — | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GESTATIONAL DIABETES 1-HR SCREEN | $66.30 | $78.00 | $130.00–$140.00 | — | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 HR PP | $90.95 | $107.00 | $130.00–$140.00 | — | 15% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HOUR | $348.50 | $410.00 | $130.00–$140.00 | 244% above | 15% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HOUR | $348.50 | $410.00 | $130.00–$140.00 | — | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC NAA PHARYNGEAL | $170.85 | $201.00 | $130.00–$140.00 | 128% above | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, NAA | $184.45 | $217.00 | $130.00–$140.00 | 146% above | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC NAA PHARYNGEAL | $170.85 | $201.00 | $130.00–$140.00 | — | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, NAA | $184.45 | $217.00 | $130.00–$140.00 | — | 15% |
| H. pylori antibody blood test CPT 86677 H. pylori, IgG Abs (SEND-OUT) | $26.35 | $31.00 | $130.00–$140.00 | 71% below | 15% |
| H. pylori antibody blood test CPT 86677 H PYLORI IgM,A,G (QUANT) SEND-OUT | $100.30 | $118.00 | $130.00–$140.00 | 12% above | 15% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB IGM (SENDOUT) | $109.65 | $129.00 | $130.00–$140.00 | 22% above | 15% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGG (SENDOUT) | $109.65 | $129.00 | $130.00–$140.00 | 22% above | 15% |
| H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODIES | $201.45 | $237.00 | $130.00–$140.00 | 125% above | 15% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGM IGG IGA AB | $315.35 | $371.00 | $130.00–$140.00 | 252% above | 15% |
| H. pylori antibody blood test inpatient CPT 86677 H. pylori, IgG Abs (SEND-OUT) | $26.35 | $31.00 | $130.00–$140.00 | — | 15% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IgM,A,G (QUANT) SEND-OUT | $100.30 | $118.00 | $130.00–$140.00 | — | 15% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG (SENDOUT) | $109.65 | $129.00 | $130.00–$140.00 | — | 15% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB IGM (SENDOUT) | $109.65 | $129.00 | $130.00–$140.00 | — | 15% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODIES | $201.45 | $237.00 | $130.00–$140.00 | — | 15% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM IGG IGA AB | $315.35 | $371.00 | $130.00–$140.00 | — | 15% |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL AG | $122.40 | $144.00 | $130.00–$140.00 | 29% below | 15% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL AG | $122.40 | $144.00 | $130.00–$140.00 | — | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT PCR (GRAPHICAL) | $314.50 | $370.00 | $130.00–$140.00 | 22% above | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT PCR (NONGRAPHICAL) | $317.05 | $373.00 | $130.00–$140.00 | 23% above | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA QUANTITATIVE PCR | $505.75 | $595.00 | $130.00–$140.00 | 96% above | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT PCR ULTRA-SENSITIVE | $747.15 | $879.00 | $130.00–$140.00 | 189% above | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA BY bDNA | $1,131.35 | $1,331.00 | $130.00–$140.00 | 338% above | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT PCR (GRAPHICAL) | $314.50 | $370.00 | $130.00–$140.00 | — | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT PCR (NONGRAPHICAL) | $317.05 | $373.00 | $130.00–$140.00 | — | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA QUANTITATIVE PCR | $505.75 | $595.00 | $130.00–$140.00 | — | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT PCR ULTRA-SENSITIVE | $747.15 | $879.00 | $130.00–$140.00 | — | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA BY bDNA | $1,131.35 | $1,331.00 | $130.00–$140.00 | — | 15% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2 (RL) | $73.10 | $86.00 | $130.00–$140.00 | 9% above | 15% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 AND 2 (RL) | $73.10 | $86.00 | $130.00–$140.00 | — | 15% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV COMBO 4TH GENERATION (NPC ONLY) | $139.40 | $164.00 | $130.00–$140.00 | 33% above | 15% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCREEN 4TH GEN WITH Rfx | $139.40 | $164.00 | $130.00–$140.00 | 33% above | 15% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV SCREEN 4TH GEN WITH Rfx | $139.40 | $164.00 | $130.00–$140.00 | — | 15% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV COMBO 4TH GENERATION (NPC ONLY) | $139.40 | $164.00 | $130.00–$140.00 | — | 15% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 GYNECOLOGIC PAP TEST LIQUID BASED | $267.75 | $315.00 | $130.00–$140.00 | 137% above | 15% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 GYNECOLOGIC PAP TEST LIQUID BASED | $267.75 | $315.00 | $130.00–$140.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C (SENDOUT) | $85.85 | $101.00 | $130.00–$140.00 | 14% below | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $124.95 | $147.00 | $130.00–$140.00 | 25% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGBA1C WITH eAG (LABCORP) | $124.95 | $147.00 | $130.00–$140.00 | 25% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGBA1C WITH eAG ESTIMATION | $124.95 | $147.00 | $130.00–$140.00 | 25% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C (SENDOUT) | $124.95 | $147.00 | $130.00–$140.00 | 25% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C REFLEX TO GLYCOMARK | $204.85 | $241.00 | $130.00–$140.00 | 105% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C (SENDOUT) | $85.85 | $101.00 | $130.00–$140.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGBA1C WITH eAG (LABCORP) | $124.95 | $147.00 | $130.00–$140.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGBA1C WITH eAG ESTIMATION | $124.95 | $147.00 | $130.00–$140.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $124.95 | $147.00 | $130.00–$140.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C (SENDOUT) | $124.95 | $147.00 | $130.00–$140.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C REFLEX TO GLYCOMARK | $204.85 | $241.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB QUAL(006395) | $107.10 | $126.00 | $130.00–$140.00 | 32% above | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB, QUAL | $194.65 | $229.00 | $130.00–$140.00 | 140% above | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB QUAL(006395) | $107.10 | $126.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB, QUAL | $194.65 | $229.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAg CONFIRMATION | $81.60 | $96.00 | $130.00–$140.00 | 40% above | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG (SENDOUT) | $82.45 | $97.00 | $130.00–$140.00 | 41% above | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $82.45 | $97.00 | $130.00–$140.00 | 41% above | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 LABCORP HEPATITIS B SURFACE ANTIGEN | $90.10 | $106.00 | $130.00–$140.00 | 54% above | 15% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAg CONFIRMATION | $81.60 | $96.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG (SENDOUT) | $82.45 | $97.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN | $82.45 | $97.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 LABCORP HEPATITIS B SURFACE ANTIGEN | $90.10 | $106.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV ANTIBODY W REFLEX TO QUANT REAL TIME | $106.25 | $125.00 | $130.00–$140.00 | 24% below | 15% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV AB (LABCORP) | $127.50 | $150.00 | $130.00–$140.00 | 9% below | 15% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV AB WITH REFLEX TO RIBA | $133.45 | $157.00 | $130.00–$140.00 | 5% below | 15% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV AB | $232.05 | $273.00 | $130.00–$140.00 | 66% above | 15% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV ANTIBODY W REFLEX TO QUANT REAL TIME | $106.25 | $125.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB (LABCORP) | $127.50 | $150.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB WITH REFLEX TO RIBA | $133.45 | $157.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB | $232.05 | $273.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV QUANT, REAL TIME PCR (NONGRAPHICAL) | $323.00 | $380.00 | $130.00–$140.00 | 64% above | 15% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA REFLEX TO GENOTYPING | $495.55 | $583.00 | $130.00–$140.00 | 151% above | 15% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT/REFLEX TO GENOTYPE | $711.45 | $837.00 | $130.00–$140.00 | 261% above | 15% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-RNA PCR QUANT (GRAPH) | $171.70 | $202.00 | $130.00–$140.00 | 13% below | 15% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV QUANT, REAL TIME PCR (NONGRAPHICAL) | $323.00 | $380.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA REFLEX TO GENOTYPING | $495.55 | $583.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT/REFLEX TO GENOTYPE | $711.45 | $837.00 | $130.00–$140.00 | — | 15% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-RNA PCR QUANT (GRAPH) | $171.70 | $202.00 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I/II IgG | $81.60 | $96.00 | $130.00–$140.00 | 15% below | 15% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 AND 2 IGG WTH RFX TO HSV 2 INHIBIT | $119.72 | $140.85 | $130.00–$140.00 | 24% above | 15% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I & II -SPEC IgG | $130.05 | $153.00 | $130.00–$140.00 | 35% above | 15% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 SPECIFIC IGG | $130.05 | $153.00 | $130.00–$140.00 | 35% above | 15% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 TYPE 1 AND/OR 2 ABS IGM ELISA | $255.00 | $300.00 | $130.00–$140.00 | 165% above | 15% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I/II IgG | $81.60 | $96.00 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 AND 2 IGG WTH RFX TO HSV 2 INHIBIT | $119.72 | $140.85 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I & II -SPEC IgG | $130.05 | $153.00 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 SPECIFIC IGG | $130.05 | $153.00 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 TYPE 1 AND/OR 2 ABS IGM ELISA | $255.00 | $300.00 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV I/II IgM INDIRECT | $119.00 | $140.00 | $130.00–$140.00 | 24% above | 15% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE II SPEC IgG | $138.55 | $163.00 | $130.00–$140.00 | 44% above | 15% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV I/II IgM INDIRECT | $119.00 | $140.00 | $130.00–$140.00 | — | 15% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE II SPEC IgG | $138.55 | $163.00 | $130.00–$140.00 | — | 15% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN (CARDIAC) | $139.40 | $164.00 | $130.00–$140.00 | 52% above | 15% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN CARDIAC | $344.25 | $405.00 | $130.00–$140.00 | 276% above | 15% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN (CARDIAC) | $139.40 | $164.00 | $130.00–$140.00 | — | 15% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN CARDIAC | $344.25 | $405.00 | $130.00–$140.00 | — | 15% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE URINE | $168.30 | $198.00 | $130.00–$140.00 | 41% below | 15% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $303.45 | $357.00 | $130.00–$140.00 | 6% above | 15% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE URINE | $168.30 | $198.00 | $130.00–$140.00 | — | 15% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $303.45 | $357.00 | $130.00–$140.00 | — | 15% |
| Insulin blood test CPT 83525 INSULIN (3 SPEC) | $142.80 | $168.00 | $130.00–$140.00 | 119% above | 15% |
| Insulin blood test CPT 83525 INSULIN | $187.85 | $221.00 | $130.00–$140.00 | 188% above | 15% |
| Insulin blood test CPT 83525 INSULIN (LABCORP) | $204.00 | $240.00 | $130.00–$140.00 | 213% above | 15% |
| Insulin blood test CPT 83525 INSULIN 2 HOUR (LABCORP) | $204.00 | $240.00 | $130.00–$140.00 | 213% above | 15% |
| Insulin blood test CPT 83525 INSULIN FREE AND TOTAL | $293.25 | $345.00 | $130.00–$140.00 | 349% above | 15% |
| Insulin blood test inpatient CPT 83525 INSULIN (3 SPEC) | $142.80 | $168.00 | $130.00–$140.00 | — | 15% |
| Insulin blood test inpatient CPT 83525 INSULIN | $187.85 | $221.00 | $130.00–$140.00 | — | 15% |
| Insulin blood test inpatient CPT 83525 INSULIN 2 HOUR (LABCORP) | $204.00 | $240.00 | $130.00–$140.00 | — | 15% |
| Insulin blood test inpatient CPT 83525 INSULIN (LABCORP) | $204.00 | $240.00 | $130.00–$140.00 | — | 15% |
| Insulin blood test inpatient CPT 83525 INSULIN FREE AND TOTAL | $293.25 | $345.00 | $130.00–$140.00 | — | 15% |
| Iron blood test (serum iron) CPT 83540 IRON(LABCORP) | $46.75 | $55.00 | $130.00–$140.00 | at median | 15% |
| Iron blood test (serum iron) CPT 83540 IRON/TIBC (AU 500) | $58.65 | $69.00 | $130.00–$140.00 | 25% above | 15% |
| Iron blood test (serum iron) CPT 83540 IRON/TIBC(LABCORP) | $58.65 | $69.00 | $130.00–$140.00 | 25% above | 15% |
| Iron blood test (serum iron) CPT 83540 IRON/TIBC | $58.65 | $69.00 | $130.00–$140.00 | 25% above | 15% |
| Iron blood test (serum iron) CPT 83540 IRON | $58.65 | $69.00 | $130.00–$140.00 | 25% above | 15% |
| Iron blood test (serum iron) CPT 83540 IRON/TIBC (LABCORP) | $58.65 | $69.00 | $130.00–$140.00 | 25% above | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON(LABCORP) | $46.75 | $55.00 | $130.00–$140.00 | — | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON/TIBC(LABCORP) | $58.65 | $69.00 | $130.00–$140.00 | — | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $58.65 | $69.00 | $130.00–$140.00 | — | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON/TIBC | $58.65 | $69.00 | $130.00–$140.00 | — | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON/TIBC (LABCORP) | $58.65 | $69.00 | $130.00–$140.00 | — | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON/TIBC (AU 500) | $58.65 | $69.00 | $130.00–$140.00 | — | 15% |
| Iron-binding capacity (TIBC) test CPT 83550 DIRECT TOTAL IRON BINDING CAPACITY | $27.20 | $32.00 | $130.00–$140.00 | 80% below | 15% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 DIRECT TOTAL IRON BINDING CAPACITY | $27.20 | $32.00 | $130.00–$140.00 | — | 15% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION (LABCORP) | $39.95 | $47.00 | $130.00–$140.00 | 68% below | 15% |
| Kidney function blood test panel CPT 80069 RENAL PROFILE | $60.78 | $71.50 | $130.00–$140.00 | 51% below | 15% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION | $227.80 | $268.00 | $130.00–$140.00 | 83% above | 15% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION (LABCORP) | $39.95 | $47.00 | $130.00–$140.00 | — | 15% |
| Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE | $60.78 | $71.50 | $130.00–$140.00 | — | 15% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION | $227.80 | $268.00 | $130.00–$140.00 | — | 15% |
| LH (luteinizing hormone) test CPT 83002 LH | $220.15 | $259.00 | $130.00–$140.00 | 159% above | 15% |
| LH (luteinizing hormone) test CPT 83002 LH(LABCORP) | $220.15 | $259.00 | $130.00–$140.00 | 159% above | 15% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH(LABCORP) | $220.15 | $259.00 | $130.00–$140.00 | — | 15% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH | $220.15 | $259.00 | $130.00–$140.00 | — | 15% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE(LABCORP) | $96.90 | $114.00 | $130.00–$140.00 | 22% below | 15% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BODY FLUID | $111.35 | $131.00 | $130.00–$140.00 | 11% below | 15% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $200.60 | $236.00 | $130.00–$140.00 | 61% above | 15% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE(LABCORP) | $96.90 | $114.00 | $130.00–$140.00 | — | 15% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BODY FLUID | $111.35 | $131.00 | $130.00–$140.00 | — | 15% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $200.60 | $236.00 | $130.00–$140.00 | — | 15% |
| Liver function blood test panel CPT 80076 LIVER FIBROSIS RISK PROFILE WITH HEPATIC | $118.15 | $139.00 | $130.00–$140.00 | 11% above | 15% |
| Liver function blood test panel CPT 80076 LIVER PROFILE | $119.00 | $140.00 | $130.00–$140.00 | 11% above | 15% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION(LABCORP) | $127.50 | $150.00 | $130.00–$140.00 | 19% above | 15% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION (500) | $208.25 | $245.00 | $130.00–$140.00 | 95% above | 15% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $226.10 | $266.00 | $130.00–$140.00 | 112% above | 15% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION(500) | $226.10 | $266.00 | $130.00–$140.00 | 112% above | 15% |
| Liver function blood test panel inpatient CPT 80076 LIVER FIBROSIS RISK PROFILE WITH HEPATIC | $118.15 | $139.00 | $130.00–$140.00 | — | 15% |
| Liver function blood test panel inpatient CPT 80076 LIVER PROFILE | $119.00 | $140.00 | $130.00–$140.00 | — | 15% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION(LABCORP) | $127.50 | $150.00 | $130.00–$140.00 | — | 15% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION (500) | $208.25 | $245.00 | $130.00–$140.00 | — | 15% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $226.10 | $266.00 | $130.00–$140.00 | — | 15% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION(500) | $226.10 | $266.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB | $68.85 | $81.00 | $130.00–$140.00 | 12% below | 15% |
| Lyme disease antibody test CPT 86618 LYME DISEASE IGM EARLY TEST W/REFLEX | $164.05 | $193.00 | $130.00–$140.00 | 110% above | 15% |
| Lyme disease antibody test CPT 86618 LYME DISEASE IGG/IGM/IGA | $168.30 | $198.00 | $130.00–$140.00 | 116% above | 15% |
| Lyme disease antibody test CPT 86618 TOTAL LYME DISEASE GROUP | $168.30 | $198.00 | $130.00–$140.00 | 116% above | 15% |
| Lyme disease antibody test CPT 86618 LYME, TOTAL Ab TEST/REFLEX | $175.10 | $206.00 | $130.00–$140.00 | 124% above | 15% |
| Lyme disease antibody test CPT 86618 LYME ANTIBODY/LINE BLOT REFLEX | $181.90 | $214.00 | $130.00–$140.00 | 133% above | 15% |
| Lyme disease antibody test CPT 86618 LYME DISEASE IgM Quant | $187.00 | $220.00 | $130.00–$140.00 | 140% above | 15% |
| Lyme disease antibody test CPT 86618 LYME TOTAL AB WITH RFX TO IMMUNOASSAY | $203.15 | $239.00 | $130.00–$140.00 | 160% above | 15% |
| Lyme disease antibody test CPT 86618 LYME ANTIBODIES MODIFIED 2-TIER TESTING | $210.80 | $248.00 | $130.00–$140.00 | 170% above | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB | $68.85 | $81.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGM EARLY TEST W/REFLEX | $164.05 | $193.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 TOTAL LYME DISEASE GROUP | $168.30 | $198.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGG/IGM/IGA | $168.30 | $198.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME, TOTAL Ab TEST/REFLEX | $175.10 | $206.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODY/LINE BLOT REFLEX | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IgM Quant | $187.00 | $220.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME TOTAL AB WITH RFX TO IMMUNOASSAY | $203.15 | $239.00 | $130.00–$140.00 | — | 15% |
| Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODIES MODIFIED 2-TIER TESTING | $210.80 | $248.00 | $130.00–$140.00 | — | 15% |
| Magnesium blood test CPT 83735 MAGNESIUM (LABCORP | $46.75 | $55.00 | $130.00–$140.00 | 26% below | 15% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE, 24 HR | $61.20 | $72.00 | $130.00–$140.00 | 4% below | 15% |
| Magnesium blood test CPT 83735 MAGNESIUM, RBC | $75.65 | $89.00 | $130.00–$140.00 | 19% above | 15% |
| Magnesium blood test CPT 83735 MAGNESIUM | $75.65 | $89.00 | $130.00–$140.00 | 19% above | 15% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM (LABCORP | $46.75 | $55.00 | $130.00–$140.00 | — | 15% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE, 24 HR | $61.20 | $72.00 | $130.00–$140.00 | — | 15% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $75.65 | $89.00 | $130.00–$140.00 | — | 15% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC | $75.65 | $89.00 | $130.00–$140.00 | — | 15% |
| Measles (rubeola) antibody test CPT 86765 MEASLES(RUBEOLA) ANTIBODIES IGG | $153.85 | $181.00 | $130.00–$140.00 | 153% above | 15% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) ANTIBODIES IGM | $153.85 | $181.00 | $130.00–$140.00 | 153% above | 15% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IgM | $186.15 | $219.00 | $130.00–$140.00 | 206% above | 15% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IgG | $210.80 | $248.00 | $130.00–$140.00 | 247% above | 15% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES(RUBEOLA) ANTIBODIES IGG | $153.85 | $181.00 | $130.00–$140.00 | — | 15% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) ANTIBODIES IGM | $153.85 | $181.00 | $130.00–$140.00 | — | 15% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IgM | $186.15 | $219.00 | $130.00–$140.00 | — | 15% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IgG | $210.80 | $248.00 | $130.00–$140.00 | — | 15% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST WITH REFLEX | $49.30 | $58.00 | $130.00–$140.00 | 38% below | 15% |
| Mono test (heterophile antibody, Monospot) CPT 86308 EBVCA(IGG+EBVCA(IGM+EBVEA | $452.20 | $532.00 | $130.00–$140.00 | 468% above | 15% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST WITH REFLEX | $49.30 | $58.00 | $130.00–$140.00 | — | 15% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 EBVCA(IGG+EBVCA(IGM+EBVEA | $452.20 | $532.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $204.85 | $241.00 | $130.00–$140.00 | 55% above | 15% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $204.85 | $241.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL WITH REFLEX TO PSA FREE | $164.05 | $193.00 | $130.00–$140.00 | 4% below | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE | $170.00 | $200.00 | $130.00–$140.00 | 1% below | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $183.60 | $216.00 | $130.00–$140.00 | 7% above | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (REFLEX TO FREE) (SERIAL) | $183.60 | $216.00 | $130.00–$140.00 | 7% above | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ANTIGEN REFLEX FREE SERIAL (480640) | $183.60 | $216.00 | $130.00–$140.00 | 7% above | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE-SPECIFIC ANTIGEN, FREE TOTAL RA | $183.60 | $216.00 | $130.00–$140.00 | 7% above | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL+% FREE | $184.45 | $217.00 | $130.00–$140.00 | 8% above | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA FREE & TOTAL | $211.65 | $249.00 | $130.00–$140.00 | 24% above | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL WITH REFLEX TO PSA FREE | $164.05 | $193.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASENSITIVE | $170.00 | $200.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ANTIGEN REFLEX FREE SERIAL (480640) | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (REFLEX TO FREE) (SERIAL) | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE-SPECIFIC ANTIGEN, FREE TOTAL RA | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL+% FREE | $184.45 | $217.00 | $130.00–$140.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA FREE & TOTAL | $211.65 | $249.00 | $130.00–$140.00 | — | 15% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR LIQUID BASED | $255.85 | $301.00 | $130.00–$140.00 | 228% above | 15% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR LIQUID BASED | $255.85 | $301.00 | $130.00–$140.00 | — | 15% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $200.60 | $236.00 | $130.00–$140.00 | 11% below | 15% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH N TERMINAL | $238.00 | $280.00 | $130.00–$140.00 | 5% above | 15% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH C TERMINAL | $284.75 | $335.00 | $130.00–$140.00 | 26% above | 15% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $200.60 | $236.00 | $130.00–$140.00 | — | 15% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH N TERMINAL | $238.00 | $280.00 | $130.00–$140.00 | — | 15% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH C TERMINAL | $284.75 | $335.00 | $130.00–$140.00 | — | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 DAILY PTT | $57.80 | $68.00 | $130.00–$140.00 | 31% above | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN (PTT) ACTIVATED | $59.50 | $70.00 | $130.00–$140.00 | 35% above | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT MIXING STUDIES | $66.30 | $78.00 | $130.00–$140.00 | 51% above | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $81.60 | $96.00 | $130.00–$140.00 | 85% above | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 DAILY PTT | $57.80 | $68.00 | $130.00–$140.00 | — | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN (PTT) ACTIVATED | $59.50 | $70.00 | $130.00–$140.00 | — | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT MIXING STUDIES | $66.30 | $78.00 | $130.00–$140.00 | — | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $81.60 | $96.00 | $130.00–$140.00 | — | 15% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNI21 PLUS CORE + ESS + SCA(451937) | $3,459.50 | $4,070.00 | $130.00–$140.00 | 258% above | 15% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNIT21 PLUS CORE | $3,995.00 | $4,700.00 | $130.00–$140.00 | 313% above | 15% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNI21 PLUS CORE + ESS + SCA(451937) | $3,459.50 | $4,070.00 | $130.00–$140.00 | — | 15% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNIT21 PLUS CORE | $3,995.00 | $4,700.00 | $130.00–$140.00 | — | 15% |
| Progesterone blood test CPT 84144 PROGESTERONE (LABCORP) | $165.75 | $195.00 | $130.00–$140.00 | at median | 15% |
| Progesterone blood test CPT 84144 PROGESTERONE (ACCESS) | $181.90 | $214.00 | $130.00–$140.00 | 10% above | 15% |
| Progesterone blood test CPT 84144 PROGESTERONE | $197.20 | $232.00 | $130.00–$140.00 | 19% above | 15% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE (LABCORP) | $165.75 | $195.00 | $130.00–$140.00 | — | 15% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE (ACCESS) | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $197.20 | $232.00 | $130.00–$140.00 | — | 15% |
| Prolactin blood test CPT 84146 MACROPROLACTIN | $124.10 | $146.00 | $130.00–$140.00 | 35% below | 15% |
| Prolactin blood test CPT 84146 PROLACTIN | $216.75 | $255.00 | $130.00–$140.00 | 14% above | 15% |
| Prolactin blood test inpatient CPT 84146 MACROPROLACTIN | $124.10 | $146.00 | $130.00–$140.00 | — | 15% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $216.75 | $255.00 | $130.00–$140.00 | — | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT) LABCORP | $44.20 | $52.00 | $130.00–$140.00 | 16% above | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $76.50 | $90.00 | $130.00–$140.00 | 101% above | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/PTT (LABCORP) | $94.35 | $111.00 | $130.00–$140.00 | 148% above | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT) LABCORP | $44.20 | $52.00 | $130.00–$140.00 | — | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME | $76.50 | $90.00 | $130.00–$140.00 | — | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/PTT (LABCORP) | $94.35 | $111.00 | $130.00–$140.00 | — | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN RAPID CITY OF DONALSONVILLE | $8.50 | $10.00 | $130.00–$140.00 | 88% below | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN RAPID CITY OF DONALSONVILLE | $8.50 | $10.00 | $130.00–$140.00 | — | 15% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A SCREEN | $90.95 | $107.00 | $130.00–$140.00 | 20% above | 15% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A SCREEN | $90.95 | $107.00 | $130.00–$140.00 | — | 15% |
| Rheumatoid factor (RF) test CPT 86431 RA FACTOR (LABCORP) | $40.80 | $48.00 | $130.00–$140.00 | 49% below | 15% |
| Rheumatoid factor (RF) test CPT 86431 RA QUANTITATIVE | $43.35 | $51.00 | $130.00–$140.00 | 46% below | 15% |
| Rheumatoid factor (RF) test CPT 86431 RH FACTOR ISOTYPES G, A, AND M | $275.40 | $324.00 | $130.00–$140.00 | 246% above | 15% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR (LABCORP) | $40.80 | $48.00 | $130.00–$140.00 | — | 15% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RA QUANTITATIVE | $43.35 | $51.00 | $130.00–$140.00 | — | 15% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RH FACTOR ISOTYPES G, A, AND M | $275.40 | $324.00 | $130.00–$140.00 | — | 15% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN | $71.40 | $84.00 | $130.00–$140.00 | 1% below | 15% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IgG | $91.80 | $108.00 | $130.00–$140.00 | 27% above | 15% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IgM | $91.80 | $108.00 | $130.00–$140.00 | 27% above | 15% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN | $71.40 | $84.00 | $130.00–$140.00 | — | 15% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgM | $91.80 | $108.00 | $130.00–$140.00 | — | 15% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgG | $91.80 | $108.00 | $130.00–$140.00 | — | 15% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR/SED RATE | $109.65 | $129.00 | $130.00–$140.00 | 181% above | 15% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR/SED RATE | $109.65 | $129.00 | $130.00–$140.00 | — | 15% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES FORMALIN ONLY | $59.50 | $70.00 | $130.00–$140.00 | 39% below | 15% |
| Stool ova and parasites exam CPT 87177 PARASITE ID ARTHROPOD | $88.40 | $104.00 | $130.00–$140.00 | 9% below | 15% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES | $147.05 | $173.00 | $130.00–$140.00 | 52% above | 15% |
| Stool ova and parasites exam CPT 87177 GIARDIA LAMBLIA, EIA AND OVA AND PARASIT | $147.05 | $173.00 | $130.00–$140.00 | 52% above | 15% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES FORMALIN ONLY | $59.50 | $70.00 | $130.00–$140.00 | — | 15% |
| Stool ova and parasites exam inpatient CPT 87177 PARASITE ID ARTHROPOD | $88.40 | $104.00 | $130.00–$140.00 | — | 15% |
| Stool ova and parasites exam inpatient CPT 87177 GIARDIA LAMBLIA, EIA AND OVA AND PARASIT | $147.05 | $173.00 | $130.00–$140.00 | — | 15% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES | $147.05 | $173.00 | $130.00–$140.00 | — | 15% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD DIAGNOSTIC | $68.85 | $81.00 | $130.00–$140.00 | 86% above | 15% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREENING | $146.20 | $172.00 | $130.00–$140.00 | 295% above | 15% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD DIAGNOSTIC | $68.85 | $81.00 | $130.00–$140.00 | — | 15% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREENING | $146.20 | $172.00 | $130.00–$140.00 | — | 15% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECAL IMMUNOASSAY | $74.80 | $88.00 | $130.00–$140.00 | 28% below | 15% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FECAL IMMUNOASSAY | $74.80 | $88.00 | $130.00–$140.00 | — | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM QUEST | $51.85 | $61.00 | $130.00–$140.00 | 40% above | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX CONFIRMATION (TP-PA) | $91.80 | $108.00 | $130.00–$140.00 | 148% above | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX TO TITER AND TREPONEMA | $99.45 | $117.00 | $130.00–$140.00 | 168% above | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $99.45 | $117.00 | $130.00–$140.00 | 168% above | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $105.40 | $124.00 | $130.00–$140.00 | 184% above | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SERUM QUEST | $51.85 | $61.00 | $130.00–$140.00 | — | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX CONFIRMATION (TP-PA) | $91.80 | $108.00 | $130.00–$140.00 | — | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX TO TITER AND TREPONEMA | $99.45 | $117.00 | $130.00–$140.00 | — | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR | $99.45 | $117.00 | $130.00–$140.00 | — | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF | $105.40 | $124.00 | $130.00–$140.00 | — | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD (CLIENT INCUBATED) | $353.60 | $416.00 | $130.00–$140.00 | 99% above | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON IN TUBE | $359.55 | $423.00 | $130.00–$140.00 | 102% above | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD (CLIENT INCUBATED) | $353.60 | $416.00 | $130.00–$140.00 | — | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON IN TUBE | $359.55 | $423.00 | $130.00–$140.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE HYPOGONADAL MALES(070001 | $90.95 | $107.00 | $130.00–$140.00 | 48% below | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOERONE TOTAL (LABCORP) | $94.35 | $111.00 | $130.00–$140.00 | 46% below | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL (LABCORP) MS | $183.60 | $216.00 | $130.00–$140.00 | 6% above | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, WOMEN/CHILD | $183.60 | $216.00 | $130.00–$140.00 | 6% above | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $239.70 | $282.00 | $130.00–$140.00 | 38% above | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE DIALYSIS W/SHBG (QUEST | $474.30 | $558.00 | $130.00–$140.00 | 173% above | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE HYPOGONADAL MALES(070001 | $90.95 | $107.00 | $130.00–$140.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOERONE TOTAL (LABCORP) | $94.35 | $111.00 | $130.00–$140.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, WOMEN/CHILD | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL (LABCORP) MS | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE | $239.70 | $282.00 | $130.00–$140.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE FREE DIALYSIS W/SHBG (QUEST | $474.30 | $558.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB | $42.50 | $50.00 | $130.00–$140.00 | 59% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE TPO AB | $42.50 | $50.00 | $130.00–$140.00 | 59% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID MICROSOMAL | $42.50 | $50.00 | $130.00–$140.00 | 59% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL (LKM) ANTIBODIES | $65.45 | $77.00 | $130.00–$140.00 | 37% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 TPO AB (SENDOUT) | $65.45 | $77.00 | $130.00–$140.00 | 37% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID AB GROUP | $102.00 | $120.00 | $130.00–$140.00 | 2% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO AB (RDL) | $164.05 | $193.00 | $130.00–$140.00 | 57% above | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB | $42.50 | $50.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE TPO AB | $42.50 | $50.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID MICROSOMAL | $42.50 | $50.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO AB (SENDOUT) | $65.45 | $77.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL (LKM) ANTIBODIES | $65.45 | $77.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID AB GROUP | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-TPO AB (RDL) | $164.05 | $193.00 | $130.00–$140.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (LABCORP) | $66.30 | $78.00 | $130.00–$140.00 | 58% below | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH/FREE T4 | $126.65 | $149.00 | $130.00–$140.00 | 19% below | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH E-411 | $131.75 | $155.00 | $130.00–$140.00 | 16% below | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH RFX T4FREE (SENDOUT) | $147.05 | $173.00 | $130.00–$140.00 | 6% below | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/REFLEX TO T4 FREE | $192.95 | $227.00 | $130.00–$140.00 | 23% above | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $192.95 | $227.00 | $130.00–$140.00 | 23% above | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (LABCORP) | $66.30 | $78.00 | $130.00–$140.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH/FREE T4 | $126.65 | $149.00 | $130.00–$140.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH E-411 | $131.75 | $155.00 | $130.00–$140.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH RFX T4FREE (SENDOUT) | $147.05 | $173.00 | $130.00–$140.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $192.95 | $227.00 | $130.00–$140.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/REFLEX TO T4 FREE | $192.95 | $227.00 | $130.00–$140.00 | — | 15% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS, URINE | $45.90 | $54.00 | $130.00–$140.00 | 49% below | 15% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA | $178.50 | $210.00 | $130.00–$140.00 | 97% above | 15% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS, URINE | $45.90 | $54.00 | $130.00–$140.00 | — | 15% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA | $178.50 | $210.00 | $130.00–$140.00 | — | 15% |
| Uric acid blood test CPT 84550 URIC ACID | $95.20 | $112.00 | $130.00–$140.00 | 28% above | 15% |
| Uric acid blood test CPT 84550 URIC ACID (LABCORP) | $95.20 | $112.00 | $130.00–$140.00 | 28% above | 15% |
| Uric acid blood test inpatient CPT 84550 URIC ACID (LABCORP) | $95.20 | $112.00 | $130.00–$140.00 | — | 15% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $95.20 | $112.00 | $130.00–$140.00 | — | 15% |
| Urinalysis with microscope exam, automated CPT 81001 ZOLPIDEM SERUM OR PLASMA | $68.85 | $81.00 | $130.00–$140.00 | 67% above | 15% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO | $104.55 | $123.00 | $130.00–$140.00 | 153% above | 15% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO WITH REFLEX CULTURE | $104.55 | $123.00 | $130.00–$140.00 | 153% above | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 ZOLPIDEM SERUM OR PLASMA | $68.85 | $81.00 | $130.00–$140.00 | — | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO | $104.55 | $123.00 | $130.00–$140.00 | — | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO WITH REFLEX CULTURE | $104.55 | $123.00 | $130.00–$140.00 | — | 15% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WITH REFLEX TO MICROSCOPIC | $20.40 | $24.00 | $130.00–$140.00 | 42% below | 15% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO NO MICROSCOPY | $34.85 | $41.00 | $130.00–$140.00 | 1% below | 15% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE | $46.75 | $55.00 | $130.00–$140.00 | 32% above | 15% |
| Urinalysis without microscope exam, automated CPT 81003 KIDNEY STONE URINE TEST COMBINATION | $634.95 | $747.00 | $130.00–$140.00 | 1696% above | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS WITH REFLEX TO MICROSCOPIC | $20.40 | $24.00 | $130.00–$140.00 | — | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO NO MICROSCOPY | $34.85 | $41.00 | $130.00–$140.00 | — | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE | $46.75 | $55.00 | $130.00–$140.00 | — | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 KIDNEY STONE URINE TEST COMBINATION | $634.95 | $747.00 | $130.00–$140.00 | — | 15% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE | $181.90 | $214.00 | $130.00–$140.00 | 168% above | 15% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE | $181.90 | $214.00 | $130.00–$140.00 | — | 15% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $115.60 | $136.00 | $130.00–$140.00 | at median | 15% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12 (SENDOUT) | $115.60 | $136.00 | $130.00–$140.00 | at median | 15% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $115.60 | $136.00 | $130.00–$140.00 | — | 15% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12 (SENDOUT) | $115.60 | $136.00 | $130.00–$140.00 | — | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D HYDROXY TOTAL (LABCORP) | $238.85 | $281.00 | $130.00–$140.00 | 1% below | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 & D3, VIT D 25-HYRDOXY | $267.75 | $315.00 | $130.00–$140.00 | 11% above | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-25 HYDROXY | $267.75 | $315.00 | $130.00–$140.00 | 11% above | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D HYDROXY TOTAL (LABCORP) | $238.85 | $281.00 | $130.00–$140.00 | — | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 & D3, VIT D 25-HYRDOXY | $267.75 | $315.00 | $130.00–$140.00 | — | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D-25 HYDROXY | $267.75 | $315.00 | $130.00–$140.00 | — | 15% |
| Zinc blood test CPT 84630 ZINC PLASMA OR SERUM | $97.75 | $115.00 | $130.00–$140.00 | 8% below | 15% |
| Zinc blood test CPT 84630 ZINC WHOLE BLOOD | $97.75 | $115.00 | $130.00–$140.00 | 8% below | 15% |
| Zinc blood test CPT 84630 ZINC SERUM OR PLASMA | $106.25 | $125.00 | $130.00–$140.00 | at median | 15% |
| Zinc blood test CPT 84630 ZINC, RBC | $115.60 | $136.00 | $130.00–$140.00 | 9% above | 15% |
| Zinc blood test inpatient CPT 84630 ZINC WHOLE BLOOD | $97.75 | $115.00 | $130.00–$140.00 | — | 15% |
| Zinc blood test inpatient CPT 84630 ZINC PLASMA OR SERUM | $97.75 | $115.00 | $130.00–$140.00 | — | 15% |
| Zinc blood test inpatient CPT 84630 ZINC SERUM OR PLASMA | $106.25 | $125.00 | $130.00–$140.00 | — | 15% |
| Zinc blood test inpatient CPT 84630 ZINC, RBC | $115.60 | $136.00 | $130.00–$140.00 | — | 15% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE | $217.60 | $256.00 | $130.00–$140.00 | 37% above | 15% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE | $217.60 | $256.00 | $130.00–$140.00 | — | 15% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W/ STEREOTACTIC GUIDE 1ST LESI | $636.65 | $749.00 | $130.00–$140.00 | 77% below | 15% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST W/ STEREOTACTIC GUIDE 1ST LESI | $636.65 | $749.00 | $130.00–$140.00 | — | 15% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $3,721.30 | $4,378.00 | $130.00–$140.00 | 505% above | 15% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT OF ANKLE FRACTURE | $3,721.30 | $4,378.00 | $130.00–$140.00 | — | 15% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FX | $362.95 | $427.00 | $130.00–$140.00 | 55% below | 15% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT METATARSAL FX | $362.95 | $427.00 | $130.00–$140.00 | — | 15% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EMERGENCY | $863.60 | $1,016.00 | $130.00–$140.00 | 65% below | 15% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EMERGENCY | $863.60 | $1,016.00 | $130.00–$140.00 | — | 15% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRC WITH CLAMP | $200.60 | $236.00 | $130.00–$140.00 | 87% below | 15% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRC WITH CLAMP | $200.60 | $236.00 | $130.00–$140.00 | — | 15% |
| Circumcision, surgical, older than a newborn CPT 54160 CIRC W/O CLAMP | $300.90 | $354.00 | $140.00 | 88% below | 15% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRC W/O CLAMP | $300.90 | $354.00 | $140.00 | — | 15% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX FX RADIUS | $942.65 | $1,109.00 | $130.00–$140.00 | 32% above | 15% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX FX RADIUS | $942.65 | $1,109.00 | $130.00–$140.00 | — | 15% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION BENIGN LESION | $223.55 | $263.00 | $130.00–$140.00 | 87% above | 15% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION BENIGN LESION | $223.55 | $263.00 | $130.00–$140.00 | — | 15% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRI/LVG UNI | $91.80 | $108.00 | $130.00–$140.00 | 39% below | 15% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN IRRI/LVG UNI | $91.80 | $108.00 | $130.00–$140.00 | — | 15% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE CERUMEN | $150.45 | $177.00 | $130.00–$140.00 | 55% below | 15% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN | $150.45 | $177.00 | $130.00–$140.00 | — | 15% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ID SUBQ ABSCESS SIMPLE/SINGLE | $120.70 | $142.00 | $130.00–$140.00 | 80% below | 15% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SUBQ ABSCESS SIMPLE | $298.35 | $351.00 | $130.00–$140.00 | 50% below | 15% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ID SUBQ ABSCESS SIMPLE/SINGLE | $120.70 | $142.00 | $130.00–$140.00 | — | 15% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SUBQ ABSCESS SIMPLE | $298.35 | $351.00 | $130.00–$140.00 | — | 15% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON/LIG/TRIG PT | $102.00 | $120.00 | $130.00–$140.00 | 92% below | 15% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON/LIG/TRIG PT | $102.00 | $120.00 | $130.00–$140.00 | — | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATE/INJECTION LG JOINT | $73.10 | $86.00 | $130.00–$140.00 | 92% below | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JOINT W/O US | $226.95 | $267.00 | $130.00–$140.00 | 75% below | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INKECT SHOULDER | $262.65 | $309.00 | $130.00–$140.00 | 71% below | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATE/INJECTION LG JOINT | $73.10 | $86.00 | $130.00–$140.00 | — | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JOINT W/O US | $226.95 | $267.00 | $130.00–$140.00 | — | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INKECT SHOULDER | $262.65 | $309.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATE/INJECTION SM JOINT | $115.60 | $136.00 | $130.00–$140.00 | 85% below | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT JOINT | $250.75 | $295.00 | $130.00–$140.00 | 67% below | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATE/INJECTION JOINT | $250.75 | $295.00 | $130.00–$140.00 | 67% below | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMEDIATE JOINT W/O US | $461.55 | $543.00 | $130.00–$140.00 | 39% below | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATE/INJECTION SM JOINT | $115.60 | $136.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJECT JOINT | $250.75 | $295.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATE/INJECTION JOINT | $250.75 | $295.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMEDIATE JOINT W/O US | $461.55 | $543.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN /INJECT JOINT | $119.00 | $140.00 | $130.00–$140.00 | 80% below | 15% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATE/INJECTION SMALL JOINT | $223.55 | $263.00 | $130.00–$140.00 | 63% below | 15% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ SMALL JOINT W/O US | $444.55 | $523.00 | $130.00–$140.00 | 26% below | 15% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN /INJECT JOINT | $119.00 | $140.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATE/INJECTION SMALL JOINT | $223.55 | $263.00 | $130.00–$140.00 | — | 15% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ SMALL JOINT W/O US | $444.55 | $523.00 | $130.00–$140.00 | — | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR < 2.5 CM INTERMED S/A/T/E | $215.90 | $254.00 | $130.00–$140.00 | 71% below | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTERMED <2.5CM | $384.20 | $452.00 | $130.00–$140.00 | 48% below | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM /< | $691.05 | $813.00 | $130.00–$140.00 | 7% below | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR < 2.5 CM INTERMED S/A/T/E | $215.90 | $254.00 | $130.00–$140.00 | — | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTERMED <2.5CM | $384.20 | $452.00 | $130.00–$140.00 | — | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM /< | $691.05 | $813.00 | $130.00–$140.00 | — | 15% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION OF LESION 0.5CM | $240.55 | $283.00 | $130.00–$140.00 | 61% below | 15% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION B9 LESION MRGN XCP SK TG T/A/L | $311.95 | $367.00 | $130.00–$140.00 | 50% below | 15% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION OF LESION 0.5CM | $240.55 | $283.00 | $130.00–$140.00 | — | 15% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION B9 LESION MRGN XCP SK TG T/A/L | $311.95 | $367.00 | $130.00–$140.00 | — | 15% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL SKIN LESION | $232.05 | $273.00 | $130.00–$140.00 | 62% below | 15% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION LESION 0.5 CM | $340.00 | $400.00 | $130.00–$140.00 | 44% below | 15% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 REMOVAL SKIN LESION | $232.05 | $273.00 | $130.00–$140.00 | — | 15% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION LESION 0.5 CM | $340.00 | $400.00 | $130.00–$140.00 | — | 15% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL SIMPLE | $113.05 | $133.00 | $130.00–$140.00 | 78% below | 15% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL | $224.40 | $264.00 | $130.00–$140.00 | 56% below | 15% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL SIMPLE | $113.05 | $133.00 | $130.00–$140.00 | — | 15% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL | $224.40 | $264.00 | $130.00–$140.00 | — | 15% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W IMAGING GUIDE | $127.50 | $150.00 | $130.00–$140.00 | 91% below | 15% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DX/THER W IMAGE GUIDNCE | $762.45 | $897.00 | $130.00–$140.00 | 48% below | 15% |
| Paracentesis with imaging guidance CPT 49083 US GUIDED PARACENTESIS | $1,477.30 | $1,738.00 | $130.00–$140.00 | 1% above | 15% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DX/THER W/IMAG GUIDANCE | $1,598.85 | $1,881.00 | $130.00–$140.00 | 9% above | 15% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DX/THER W IMAGING | $1,598.85 | $1,881.00 | $130.00–$140.00 | 9% above | 15% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W IMAGING GUIDE | $127.50 | $150.00 | $130.00–$140.00 | — | 15% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS DX/THER W IMAGE GUIDNCE | $762.45 | $897.00 | $130.00–$140.00 | — | 15% |
| Paracentesis with imaging guidance inpatient CPT 49083 US GUIDED PARACENTESIS | $1,477.30 | $1,738.00 | $130.00–$140.00 | — | 15% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS DX/THER W IMAGING | $1,598.85 | $1,881.00 | $130.00–$140.00 | — | 15% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS DX/THER W/IMAG GUIDANCE | $1,598.85 | $1,881.00 | $130.00–$140.00 | — | 15% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE INGROWN NAIL | $210.80 | $248.00 | $130.00–$140.00 | 72% below | 15% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $708.90 | $834.00 | $130.00–$140.00 | 6% below | 15% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE INGROWN NAIL | $210.80 | $248.00 | $130.00–$140.00 | — | 15% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED | $708.90 | $834.00 | $130.00–$140.00 | — | 15% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FB SUBQ SIMPLE | $405.45 | $477.00 | $130.00–$140.00 | 58% below | 15% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION &REMOVAL FOREIGN BODY SUBQ TISS | $476.00 | $560.00 | $130.00–$140.00 | 51% below | 15% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FB SUBQ SIMPLE | $405.45 | $477.00 | $130.00–$140.00 | — | 15% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION &REMOVAL FOREIGN BODY SUBQ TISS | $476.00 | $560.00 | $130.00–$140.00 | — | 15% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION FOREARM CAST | $290.70 | $342.00 | $130.00–$140.00 | 74% below | 15% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF SHORT ARM CAST | $327.25 | $385.00 | $130.00–$140.00 | 70% below | 15% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION FOREARM CAST | $290.70 | $342.00 | $130.00–$140.00 | — | 15% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF SHORT ARM CAST | $327.25 | $385.00 | $130.00–$140.00 | — | 15% |
| Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT APPLICATION | $123.25 | $145.00 | $130.00–$140.00 | 68% below | 15% |
| Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT | $128.35 | $151.00 | $130.00–$140.00 | 67% below | 15% |
| Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT APPLICATION | $123.25 | $145.00 | $130.00–$140.00 | — | 15% |
| Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT | $128.35 | $151.00 | $130.00–$140.00 | — | 15% |
| Short leg cast (below the knee) CPT 29405 SHORT LEG CAST APPLICATION | $524.45 | $617.00 | $130.00–$140.00 | 36% below | 15% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $524.45 | $617.00 | $130.00–$140.00 | 36% below | 15% |
| Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG CAST APPLICATION | $524.45 | $617.00 | $130.00–$140.00 | — | 15% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST | $524.45 | $617.00 | $130.00–$140.00 | — | 15% |
| Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT | $124.10 | $146.00 | $130.00–$140.00 | 68% below | 15% |
| Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT | $124.10 | $146.00 | $130.00–$140.00 | — | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE < 2.5 CM | $206.55 | $243.00 | $130.00–$140.00 | 40% below | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE <2.5 cm | $215.05 | $253.00 | $130.00–$140.00 | 37% below | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE < 2.5 CM | $206.55 | $243.00 | $130.00–$140.00 | — | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE <2.5 cm | $215.05 | $253.00 | $130.00–$140.00 | — | 15% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION TRUNK 0.5 CM | $589.05 | $693.00 | $130.00–$140.00 | 7% below | 15% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK 0.5 CM | $589.05 | $693.00 | $130.00–$140.00 | — | 15% |
| Skin tag removal, up to 15 tags CPT 11200 EXCISION OF SUPERNUMERARY DIGIT, EXTRA D | $44.20 | $52.00 | $130.00–$140.00 | 89% below | 15% |
| Skin tag removal, up to 15 tags CPT 11200 SKIN TAG LIGATION | $112.20 | $132.00 | $130.00–$140.00 | 72% below | 15% |
| Skin tag removal, up to 15 tags CPT 11200 SKIN TAG LIGATION <15 | $145.35 | $171.00 | $130.00–$140.00 | 64% below | 15% |
| Skin tag removal, up to 15 tags CPT 11200 EXCISION OF SUPERNUMERARY DIGIT EXTRA D | $211.65 | $249.00 | $130.00–$140.00 | 47% below | 15% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MLT UPW/15 | $221.00 | $260.00 | $130.00–$140.00 | 45% below | 15% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 EXCISION OF SUPERNUMERARY DIGIT, EXTRA D | $44.20 | $52.00 | $130.00–$140.00 | — | 15% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG LIGATION | $112.20 | $132.00 | $130.00–$140.00 | — | 15% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG LIGATION <15 | $145.35 | $171.00 | $130.00–$140.00 | — | 15% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 EXCISION OF SUPERNUMERARY DIGIT EXTRA D | $211.65 | $249.00 | $130.00–$140.00 | — | 15% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MLT UPW/15 | $221.00 | $260.00 | $130.00–$140.00 | — | 15% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE | $481.95 | $567.00 | $130.00–$140.00 | 76% below | 15% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE | $481.95 | $567.00 | $130.00–$140.00 | — | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE <2.6 - 7.5 CM | $158.95 | $187.00 | $130.00–$140.00 | 58% below | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR SCALP/NECK 2.5 - 7.5 CM | $165.75 | $195.00 | $130.00–$140.00 | 57% below | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE <2.6 - 7.5 CM | $158.95 | $187.00 | $130.00–$140.00 | — | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR SCALP/NECK 2.5 - 7.5 CM | $165.75 | $195.00 | $130.00–$140.00 | — | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE < 2.5 CM | $350.20 | $412.00 | $130.00–$140.00 | 7% below | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR < 2.5 CM SIMPLE F/E/E/N/L/M | $560.15 | $659.00 | $130.00–$140.00 | 48% above | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE < 2.5 CM | $350.20 | $412.00 | $130.00–$140.00 | — | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR < 2.5 CM SIMPLE F/E/E/N/L/M | $560.15 | $659.00 | $130.00–$140.00 | — | 15% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $631.55 | $743.00 | $130.00–$140.00 | 18% above | 15% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $631.55 | $743.00 | $130.00–$140.00 | — | 15% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATHPLEURA W/IMAGE | $1,004.70 | $1,182.00 | $130.00–$140.00 | 66% below | 15% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI | $1,004.70 | $1,182.00 | $130.00–$140.00 | 66% below | 15% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI | $1,004.70 | $1,182.00 | $130.00–$140.00 | — | 15% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATHPLEURA W/IMAGE | $1,004.70 | $1,182.00 | $130.00–$140.00 | — | 15% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BX/ LOCALIZATION 1ST LESION | $731.00 | $860.00 | $130.00–$140.00 | 73% below | 15% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BIOPSY PER NDL CORE W IMAGING | $880.60 | $1,036.00 | $130.00–$140.00 | 68% below | 15% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BX/ LOCALIZATION 1ST LESION | $731.00 | $860.00 | $130.00–$140.00 | — | 15% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BIOPSY PER NDL CORE W IMAGING | $880.60 | $1,036.00 | $130.00–$140.00 | — | 15% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RADIO FREQUENCY ABLATION 1ST | $7,285.35 | $8,571.00 | $130.00–$140.00 | 7% below | 15% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS RADIO FREQUENCY ABLATION 1ST | $7,285.35 | $8,571.00 | $130.00–$140.00 | — | 15% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 | $345.95 | $407.00 | $130.00–$140.00 | 87% below | 15% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 | $345.95 | $407.00 | $130.00–$140.00 | — | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 CLEANSING OF SKIN/TISSUE | $175.95 | $207.00 | $130.00–$140.00 | 81% below | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 CLEANSING OF SKIN TISSUE | $248.20 | $292.00 | $130.00–$140.00 | 73% below | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE INFECTED SKIN | $251.60 | $296.00 | $130.00–$140.00 | 73% below | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE INFECTED SKIN ER | $636.65 | $749.00 | $130.00–$140.00 | 31% below | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 CLEANSING OF SKIN/TISSUE | $175.95 | $207.00 | $130.00–$140.00 | — | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 CLEANSING OF SKIN TISSUE | $248.20 | $292.00 | $130.00–$140.00 | — | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE INFECTED SKIN | $251.60 | $296.00 | $130.00–$140.00 | — | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE INFECTED SKIN ER | $636.65 | $749.00 | $130.00–$140.00 | — | 15% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $109.65 | $129.00 | $130.00–$140.00 | 86% below | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $281.35 | $331.00 | $130.00–$140.00 | 64% below | 15% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $109.65 | $129.00 | $130.00–$140.00 | — | 15% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION | $281.35 | $331.00 | $130.00–$140.00 | — | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO SUBSEQ | $179.35 | $211.00 | $130.00–$140.00 | 5% below | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO SUBSEQ | $179.35 | $211.00 | $130.00–$140.00 | — | 15% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INFUSION CHEMO 1ST HOUR | $821.95 | $967.00 | $130.00–$140.00 | 18% above | 15% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INFUSION CHEMO 1ST HOUR | $821.95 | $967.00 | $130.00–$140.00 | — | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY ROOM | $721.65 | $849.00 | $130.00–$140.00 | 69% below | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, FIRST HOUR | $749.70 | $882.00 | $130.00–$140.00 | 68% below | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST HOUR | $749.70 | $882.00 | $130.00–$140.00 | 68% below | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 OB CRITICAL CARE (CODE BLUE) | $911.20 | $1,072.00 | $130.00–$140.00 | 61% below | 15% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY ROOM | $721.65 | $849.00 | $130.00–$140.00 | — | 15% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST HOUR | $749.70 | $882.00 | $130.00–$140.00 | — | 15% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, FIRST HOUR | $749.70 | $882.00 | $130.00–$140.00 | — | 15% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 OB CRITICAL CARE (CODE BLUE) | $911.20 | $1,072.00 | $130.00–$140.00 | — | 15% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG | $233.75 | $275.00 | $140.00 | 66% below | 15% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG | $233.75 | $275.00 | $140.00 | — | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 DAILY EKG | $65.45 | $77.00 | $130.00–$140.00 | 76% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $77.35 | $91.00 | $130.00–$140.00 | 71% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ER EKG | $94.35 | $111.00 | $130.00–$140.00 | 65% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 DAILY EKG | $65.45 | $77.00 | $130.00–$140.00 | — | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG | $77.35 | $91.00 | $130.00–$140.00 | — | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ER EKG | $94.35 | $111.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM | $262.65 | $309.00 | $130.00–$140.00 | 17% above | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FOC/FOC/STRAIGHT FORWARD | $271.15 | $319.00 | $130.00–$140.00 | 21% above | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM | $262.65 | $309.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FOC/FOC/STRAIGHT FORWARD | $271.15 | $319.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM | $317.90 | $374.00 | $130.00–$140.00 | 7% below | 15% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EXP FOC/EXP FOC/LOW | $328.95 | $387.00 | $130.00–$140.00 | 4% below | 15% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY ROOM | $317.90 | $374.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EXP FOC/EXP FOC/LOW | $328.95 | $387.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM | $385.90 | $454.00 | $130.00–$140.00 | 40% below | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EXP FOC/EXP FOC/LOW-MOD | $400.35 | $471.00 | $130.00–$140.00 | 38% below | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM | $385.90 | $454.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EXP FOC/EXP FOC/LOW-MOD | $400.35 | $471.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM | $466.65 | $549.00 | $130.00–$140.00 | 47% below | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 DETAILED/DETAILED/MOD | $484.50 | $570.00 | $130.00–$140.00 | 45% below | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM | $466.65 | $549.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 DETAILED/DETAILED/MOD | $484.50 | $570.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM | $582.25 | $685.00 | $130.00–$140.00 | 52% below | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPR/COMPR/HIGH | $623.05 | $733.00 | $130.00–$140.00 | 48% below | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM | $582.25 | $685.00 | $130.00–$140.00 | — | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPR/COMPR/HIGH | $623.05 | $733.00 | $130.00–$140.00 | — | 15% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $445.40 | $524.00 | $130.00–$140.00 | 33% below | 15% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST | $445.40 | $524.00 | $130.00–$140.00 | — | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION, HYDRATION, UP TO 1 HR | $96.05 | $113.00 | $130.00–$140.00 | 69% below | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION, HYDRATION, UP TO 1 HR ER | $96.05 | $113.00 | $130.00–$140.00 | 69% below | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION, HYDRATION, UP TO 1 HR ER | $96.05 | $113.00 | $130.00–$140.00 | — | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION, HYDRATION, UP TO 1 HR | $96.05 | $113.00 | $130.00–$140.00 | — | 15% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR THERAPY DX INT 1 H ER | $96.05 | $113.00 | $130.00–$140.00 | 68% below | 15% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR THERAPY DX INT 1 H | $96.05 | $113.00 | $130.00–$140.00 | 68% below | 15% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR THERAPY DX INT 1 H ER | $96.05 | $113.00 | $130.00–$140.00 | — | 15% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR THERAPY DX INT 1 H | $96.05 | $113.00 | $130.00–$140.00 | — | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC DX INJ SUB ER | $173.40 | $204.00 | $130.00–$140.00 | 120% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC DX INJ SUB Q IM | $173.40 | $204.00 | $130.00–$140.00 | 120% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC DX INJ SUB Q IM | $173.40 | $204.00 | $130.00–$140.00 | — | 15% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC DX INJ SUB ER | $173.40 | $204.00 | $130.00–$140.00 | — | 15% |
| Neuromuscular re-education, 15 minutes CPT 97112 POSTERIAL STABILITY | $175.95 | $207.00 | $130.00–$140.00 | 100% above | 15% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEURO RE-EDUCATION X 15 | $178.50 | $210.00 | $130.00–$140.00 | 103% above | 15% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION | $179.35 | $211.00 | $130.00–$140.00 | 103% above | 15% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 POSTERIAL STABILITY | $175.95 | $207.00 | $130.00–$140.00 | — | 15% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEURO RE-EDUCATION X 15 | $178.50 | $210.00 | $130.00–$140.00 | — | 15% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION | $179.35 | $211.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OP NEW 30 MIN | $315.35 | $371.00 | $130.00–$140.00 | 37% above | 15% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT OB TRIAGE 30-44 MIN | $368.90 | $434.00 | $130.00–$140.00 | 60% above | 15% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OP NEW 30 MIN | $315.35 | $371.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT OB TRIAGE 30-44 MIN | $368.90 | $434.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OP NEW 45 MINUTES | $479.40 | $564.00 | $130.00–$140.00 | 129% above | 15% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT OB TRIAGE 45-59 MIN | $1,178.95 | $1,387.00 | $130.00–$140.00 | 464% above | 15% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OP NEW 45 MINUTES | $479.40 | $564.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT OB TRIAGE 45-59 MIN | $1,178.95 | $1,387.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT OB TRIAGE 60-74 MIN | $476.85 | $561.00 | $130.00–$140.00 | 76% above | 15% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE/OP NEW HIGH 60 MINUTES | $601.80 | $708.00 | $130.00–$140.00 | 123% above | 15% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT OB TRIAGE 60-74 MIN | $476.85 | $561.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OP NEW HIGH 60 MINUTES | $601.80 | $708.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OP NEW 15 MINUTES | $204.85 | $241.00 | $130.00–$140.00 | 10% above | 15% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT OB TRIAGE 15-29 MIN | $337.45 | $397.00 | $130.00–$140.00 | 81% above | 15% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OP NEW 15 MINUTES | $204.85 | $241.00 | $130.00–$140.00 | — | 15% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT OB TRIAGE 15-29 MIN | $337.45 | $397.00 | $130.00–$140.00 | — | 15% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $151.30 | $178.00 | $130.00–$140.00 | 1% above | 15% |
| Occupational therapy evaluation, low complexity CPT 97165 OT INITIAL EVAL | $151.30 | $178.00 | $130.00–$140.00 | 1% above | 15% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $151.30 | $178.00 | $130.00–$140.00 | — | 15% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT INITIAL EVAL | $151.30 | $178.00 | $130.00–$140.00 | — | 15% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $175.10 | $206.00 | $130.00–$140.00 | 7% below | 15% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $175.10 | $206.00 | $130.00–$140.00 | — | 15% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $156.40 | $184.00 | $130.00–$140.00 | 9% below | 15% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW COMPLEXITY | $183.60 | $216.00 | $130.00–$140.00 | 7% above | 15% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $156.40 | $184.00 | $130.00–$140.00 | — | 15% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY | $183.60 | $216.00 | $130.00–$140.00 | — | 15% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $159.80 | $188.00 | $130.00–$140.00 | 10% below | 15% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT MOD EVALUATION | $176.80 | $208.00 | $130.00–$140.00 | at median | 15% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $159.80 | $188.00 | $130.00–$140.00 | — | 15% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT MOD EVALUATION | $176.80 | $208.00 | $130.00–$140.00 | — | 15% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THER 1 REGION EACH 15 MINUTES | $73.10 | $86.00 | $130.00–$140.00 | 25% below | 15% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THER 1 REGION EACH 15 MINUTES | $73.10 | $86.00 | $130.00–$140.00 | — | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ST THER PROCEDURE 1 OR MORE EA 15 MIN | $153.00 | $180.00 | $130.00–$140.00 | 74% above | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 STRENGTHENING X 15 | $221.00 | $260.00 | $130.00–$140.00 | 151% above | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ST THER PROCEDURE 1 OR MORE EA 15 MIN | $153.00 | $180.00 | $130.00–$140.00 | — | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 STRENGTHENING X 15 | $221.00 | $260.00 | $130.00–$140.00 | — | 15% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP EST PT 40 MIN | $425.85 | $501.00 | $130.00–$140.00 | 61% above | 15% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OP EST PT 40 MIN | $425.85 | $501.00 | $130.00–$140.00 | — | 15% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP EST PT 20 MIN | $216.75 | $255.00 | $130.00–$140.00 | 2% above | 15% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OP EST PT 20 MIN | $216.75 | $255.00 | $130.00–$140.00 | — | 15% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OP EST PT 30 MIN | $316.20 | $372.00 | $130.00–$140.00 | 88% above | 15% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OP EST PT 30 MIN | $316.20 | $372.00 | $130.00–$140.00 | — | 15% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OP EST SF 10 MIN | $146.20 | $172.00 | $130.00–$140.00 | 15% above | 15% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OP EST SF 10 MIN | $146.20 | $172.00 | $130.00–$140.00 | — | 15% |
| Spirometry (breathing test) CPT 94010 PFS BASIC | $314.50 | $370.00 | $130.00–$140.00 | 24% below | 15% |
| Spirometry (breathing test) inpatient CPT 94010 PFS BASIC | $314.50 | $370.00 | $130.00–$140.00 | — | 15% |
| Spirometry before and after a bronchodilator CPT 94060 PFS COMPLETE | $776.05 | $913.00 | $130.00–$140.00 | 8% above | 15% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFS COMPLETE | $776.05 | $913.00 | $130.00–$140.00 | — | 15% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 ST FUNCTIONAL ACTIVITIES | $82.45 | $97.00 | $130.00–$140.00 | 5% above | 15% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVITY DIRECT | $208.25 | $245.00 | $130.00–$140.00 | 166% above | 15% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 ST FUNCTIONAL ACTIVITIES | $82.45 | $97.00 | $130.00–$140.00 | — | 15% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPUTIC ACTIVITY DIRECT | $208.25 | $245.00 | $130.00–$140.00 | — | 15% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $146.20 | $172.00 | $130.00–$140.00 | 4% below | 15% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY | $146.20 | $172.00 | $130.00–$140.00 | — | 15% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (VARICELLA) VACCINE | $359.55 | $423.00 | $130.00–$140.00 | 21% below | 15% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (VARICELLA) VACCINE | $359.55 | $423.00 | $130.00–$140.00 | — | 15% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A (HAVRIX) VACCINE 1ML INJ | $1,476.45 | $1,737.00 | $130.00–$140.00 | 1086% above | 15% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A (HAVRIX) VACCINE 1ML INJ | $1,476.45 | $1,737.00 | $130.00–$140.00 | — | 15% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS-B (ENGERIX) 20MCG/ML INJ | $319.60 | $376.00 | $130.00–$140.00 | 54% above | 15% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS-B (ENGERIX) 20MCG/ML INJ | $319.60 | $376.00 | $130.00–$140.00 | — | 15% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE/MERUVAX II | $179.35 | $211.00 | $130.00–$140.00 | 47% below | 15% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 RUBELLA (MERUVAX II) VACCINE | $482.80 | $568.00 | $130.00–$140.00 | 41% above | 15% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE/MERUVAX II | $179.35 | $211.00 | $130.00–$140.00 | — | 15% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 RUBELLA (MERUVAX II) VACCINE | $482.80 | $568.00 | $130.00–$140.00 | — | 15% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE | $4,794.85 | $5,641.00 | $130.00–$140.00 | 370% above | 15% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE | $4,794.85 | $5,641.00 | $130.00–$140.00 | — | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS & DIPTHERIA TOXOID INJ | $283.90 | $334.00 | $130.00–$140.00 | 104% above | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIP PERTUSSIN (TDAP) | $345.10 | $406.00 | $130.00–$140.00 | 148% above | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS & DIPTHERIA TOXOID INJ | $283.90 | $334.00 | $130.00–$140.00 | — | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIP PERTUSSIN (TDAP) | $345.10 | $406.00 | $130.00–$140.00 | — | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VAX TT IM | $34.00 | $40.00 | $130.00–$140.00 | 45% below | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VAX TD PED IM | $34.00 | $40.00 | $130.00–$140.00 | 45% below | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM 1 VACCINE | $150.45 | $177.00 | $130.00–$140.00 | 142% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TEX TOX INJ | $210.80 | $248.00 | $130.00–$140.00 | 239% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VAX TD PED IM | $34.00 | $40.00 | $130.00–$140.00 | — | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VAX TT IM | $34.00 | $40.00 | $130.00–$140.00 | — | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM 1 VACCINE | $150.45 | $177.00 | $130.00–$140.00 | — | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TEX TOX INJ | $210.80 | $248.00 | $130.00–$140.00 | — | 15% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM EACH ADDTL VACCINE | $170.00 | $200.00 | $130.00–$140.00 | 352% above | 15% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM EACH ADDTL VACCINE | $170.00 | $200.00 | $130.00–$140.00 | — | 15% |
Source file: https://donalsonvillehospital.org/wp-content/uploads/2025/08/standardcharges.csv