Hospital

Eastern Oklahoma Medical Center

Listed in its price file as “Leflore County Hospital Authority”.

Eastern Oklahoma Medical Center in Poteau, OK publishes cash prices for 199 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 Oklahoma median for 100 of 198 procedures and above it for 96. By typical cash price it ranks #19 of 43 Oklahoma hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

105 WALL STREET, POTEAU, OK, 74953-4433 Collected Sep 27, 2026 Source price file (918) 647-8167

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 371337 · CMS hospital register

The price file shows no self-pay discount

For 866 of the 904 prices listed here, the cash price in Eastern Oklahoma Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$1,069.21	$1,069.21	$365.00	16% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE WHOLE BODY	$1,069.21	$1,069.21	$365.00	—	—
Breast ultrasound, limited (one breast or one area) CPT 76642 US TAKE CHARGE - US EXAM BREAST(S)	$68.88	$68.88	$365.00	79% below	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNI RT LIMITED	$250.00	$313.51	$365.00	25% below	20%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US TAKE CHARGE - US EXAM BREAST(S)	$68.88	$68.88	$365.00	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNI RT LIMITED	$250.00	$313.51	$365.00	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONT PNL	$500.00	$2,387.80	$365.00	63% below	79%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS ORAL CONTRAST ONLY	$650.00	$2,387.80	$365.00	51% below	73%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONT PNL	$500.00	$2,387.80	$365.00	—	79%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS ORAL CONTRAST ONLY	$650.00	$2,387.80	$365.00	—	73%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W/CONT PNL	$650.00	$3,398.37	$365.00	60% below	81%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W/CONT PNL	$650.00	$3,398.37	$365.00	—	81%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVS W/WO CONT PNL	$650.00	$3,483.25	$365.00	66% below	81%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVS W/WO CONT PNL	$650.00	$3,483.25	$365.00	—	81%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX EXTRACRAN/CAROTID BIL	$250.00	$987.14	$365.00	49% below	75%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DOPPLER EXTRACRAN/CAROTID BLT	$250.00	$614.25	$365.00	49% below	59%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US DOPPLER EXTRACRAN/CAROTID BLT	$250.00	$614.25	$365.00	—	59%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US DUPLEX EXTRACRAN/CAROTID BIL	$250.00	$987.14	$365.00	—	75%
Chest X-ray, 2 views CPT 71046 XR CHEST HEALTH DEPT	$50.00	$50.00	$365.00	58% below	—
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST HEALTH DEPT	$50.00	$50.00	$365.00	—	—
Diagnostic mammogram, both breasts CPT 77066 MM PROJECT WOMAN MAMMO DIGITAL DIAG BIL	$108.96	$108.96	$365.00	37% below	—
Diagnostic mammogram, both breasts CPT 77066 MM TC DIGITAL DIAG PLUS UNI SCREENING	$111.32	$111.32	$365.00	35% below	—
Diagnostic mammogram, both breasts CPT 77066 MM TAKE CHARGE MAMMO DIGITAL DIAG BIL	$122.44	$122.44	$365.00	29% below	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MM PROJECT WOMAN MAMMO DIGITAL DIAG BIL	$108.96	$108.96	$365.00	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MM TC DIGITAL DIAG PLUS UNI SCREENING	$111.32	$111.32	$365.00	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MM TAKE CHARGE MAMMO DIGITAL DIAG BIL	$122.44	$122.44	$365.00	—	—
Diagnostic mammogram, one breast one side CPT 77065 MM TAKE CHARGE -MAMMO DIAG LT OR RT	$96.62	$96.62	$365.00	47% below	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM TAKE CHARGE -MAMMO DIAG LT OR RT	$96.62	$96.62	$365.00	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DUPLEX ART LOW EXT BIL	$250.00	$687.66	$365.00	37% below	64%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DUPLEX ART POPLITEAL BLT	$250.00	$756.42	$365.00	37% below	67%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US DUPLEX ART POPLITEAL BLT	$250.00	$756.42	$365.00	—	67%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US DUPLEX ART LOW EXT BIL	$250.00	$687.66	$365.00	—	64%
Duplex ultrasound of the leg veins, both legs CPT 93970 US DUPLEX VENOUS EXT BIL	$250.00	$759.24	$365.00	59% below	67%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US DUPLEX VENOUS EXT BIL	$250.00	$759.24	$365.00	—	67%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO 2D W/ OR W/O M-MODE COMPLETE	$1,538.94	$1,538.94	$365.00	42% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO 2D W/ OR W/O M-MODE COMPLETE	$1,538.94	$1,538.94	$365.00	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SPLIT NIGHT	$3,150.00	$3,150.00	$365.00	1% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 C-PAP TITRATION	$3,465.00	$3,465.00	$365.00	11% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SPLIT NIGHT	$3,150.00	$3,150.00	$365.00	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 C-PAP TITRATION	$3,465.00	$3,465.00	$365.00	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WITH AND WITHOUT CONTRAST	$800.00	$3,889.74	$365.00	59% below	79%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WITH AND WITHOUT CONTRAST	$800.00	$3,889.74	$365.00	—	79%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC SPECT MULTI	$2,374.81	$2,374.81	$365.00	8% below	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIAC SPECT MULTI	$2,374.81	$2,374.81	$365.00	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 14-40 WKS TRANSABDL	$250.00	$656.60	$365.00	41% below	62%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG 14-40 WKS TRANSABDL	$250.00	$656.60	$365.00	—	62%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1-14WKS TRANSABDL	$250.00	$560.82	$365.00	41% below	55%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1-14WKS TRANSABDL	$250.00	$560.82	$365.00	—	55%
Screening mammogram, both breasts CPT 77067 MM PROJECT WOMAN - SCREENING DIGIT MAMMO	$91.05	$91.05	$365.00	43% below	—
Screening mammogram, both breasts CPT 77067 MM TAKE CHARGE SCREENING DIGITAL MAMMO	$100.52	$100.52	$365.00	37% below	—
Screening mammogram, both breasts CPT 77067 MM SCREEN DIGITAL MAMMO W/IMPLANTS BLT	$156.75	$156.75	$365.00	1% below	—
Screening mammogram, both breasts inpatient CPT 77067 MM PROJECT WOMAN - SCREENING DIGIT MAMMO	$91.05	$91.05	$365.00	—	—
Screening mammogram, both breasts inpatient CPT 77067 MM TAKE CHARGE SCREENING DIGITAL MAMMO	$100.52	$100.52	$365.00	—	—
Screening mammogram, both breasts inpatient CPT 77067 MM SCREEN DIGITAL MAMMO W/IMPLANTS BLT	$156.75	$156.75	$365.00	—	—
Sleep study in a lab (polysomnography) CPT 95810 DIAGNOSTIC PSG	$3,150.00	$3,150.00	$365.00	14% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 DIAGNOSTIC PSG	$3,150.00	$3,150.00	$365.00	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF SWALLOW FUNCT W/ CINE/VIDEO	$331.50	$331.50	$365.00	6% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF SWALLOW FUNCT W/ CINE/VIDEO	$331.50	$331.50	$365.00	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB	$250.00	$358.31	$365.00	12% below	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB	$250.00	$358.31	$365.00	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VENOUS EXT UNI RT	$250.00	$556.80	$365.00	50% below	55%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VENOUS EXT UNI LT	$250.00	$506.18	$365.00	50% below	51%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX VENOUS EXT UNI RT	$250.00	$556.80	$365.00	—	55%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX VENOUS EXT UNI LT	$250.00	$506.18	$365.00	—	51%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$53.36	$53.36	$365.00	64% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NAFLD FIBROSIS SCORE	$187.62	$187.62	$365.00	477% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$53.36	$53.36	$365.00	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NAFLD FIBROSIS SCORE	$187.62	$187.62	$365.00	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$89.95	$89.95	$365.00	137% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 NAFLD FIBROSIS SCORE	$187.62	$187.62	$365.00	395% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$89.95	$89.95	$365.00	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 NAFLD FIBROSIS SCORE	$187.62	$187.62	$365.00	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS A AB TOTAL REFLEX IGM	$173.49	$173.49	$365.00	7% below	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE DLO	$285.92	$285.92	$365.00	54% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ZZHEPATITIS PANEL	$285.92	$285.92	$365.00	54% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS A AB TOTAL REFLEX IGM	$173.49	$173.49	$365.00	—	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE DLO	$285.92	$285.92	$365.00	—	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ZZHEPATITIS PANEL	$285.92	$285.92	$365.00	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MILK	$18.12	$18.12	$365.00	27% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGGWHITES	$18.12	$18.12	$365.00	27% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN	$18.12	$18.12	$365.00	27% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OAT	$18.12	$18.12	$365.00	27% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT	$18.12	$18.12	$365.00	27% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN MEAT (F86) IGE	$18.21	$18.21	$365.00	27% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX (k82) lgE	$20.56	$20.56	$365.00	17% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHITE PINE	$22.60	$22.60	$365.00	9% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GOAT EPITHELIA	$22.60	$22.60	$365.00	9% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHEEP EPITHELIA	$22.60	$22.60	$365.00	9% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HORSE DANDER	$22.60	$22.60	$365.00	9% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PERENNIAL RYE GRASS (G5) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CLADOSPIRIUM HERBARUM	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CURVULARIA LUNATA (M16) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHEESE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DUCK FEATHERS (E86) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SESAME SEED	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 86003 FOOD ALLERGY	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCKLEBUR W13 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN FEATHERS (E85) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE WITH REFLEXES	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ENGLISH PLANTAIN (W9) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ANALYZER ANA IFA W REFLEX TITER PATTERN	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PAPER WASP IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN YELLOW JACKET IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HONEY BEE IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HICKORY/PECAN TREE IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MOSQUITO IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SYCAMORE IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DANDELION IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ASPERGILLUS FUNGITAS	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FIRE ANT IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DERMATOPHAGORDES PTERONYSSINUS	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DERMATOPHAGORDES FARINAE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ROUGH MARSH ELDER	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAT DANDER	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COMMON RAGWEED	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DOG DANDER	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BERMUDA GRASS	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN STEMPHYLIUM BOTRYOSUM (M10) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GOOSE FEATHERS (E86) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WALNUT	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN JUNE GRASS	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ELM	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN JOHNSON GRASS	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OAK	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCKROACH	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MOUNTAIN CEDAR	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LAMBS QUARTERS (GOOSE FOOT)	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MUCOR RACEMOSUS (MR) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALTERNARIA ALTERNATA	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COW DANDER (E4) 1GE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RUSSIAN THISTLE (W11) IGE	$23.28	$23.28	$365.00	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN YEAST	$25.08	$25.08	$365.00	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEY	$25.08	$25.08	$365.00	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GLUTEN	$25.08	$25.08	$365.00	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MALT	$27.13	$27.13	$365.00	9% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ROUGH PIGWEED	$27.13	$27.13	$365.00	9% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BARLEY	$27.13	$27.13	$365.00	9% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHRIMP	$27.13	$27.13	$365.00	9% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RYE	$27.13	$27.13	$365.00	9% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM (M1) IGE	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHERRY	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TUNA	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PORK	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEEF	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CASHEW	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN STRAWBERRY	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RICE	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TOMATO	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALMOND	$78.26	$78.26	$365.00	216% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PANEL	$339.09	$339.09	$365.00	1268% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY ALLERGY PROFILE OK,TX	$638.20	$638.20	$365.00	2474% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 CHILDHOOD ALLERGY (FOOD&ENVIRONMENTAL) P	$1,345.72	$1,345.72	$365.00	5328% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGGWHITES	$18.12	$18.12	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OAT	$18.12	$18.12	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN	$18.12	$18.12	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT	$18.12	$18.12	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK	$18.12	$18.12	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN MEAT (F86) IGE	$18.21	$18.21	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX (k82) lgE	$20.56	$20.56	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE PINE	$22.60	$22.60	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HORSE DANDER	$22.60	$22.60	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHEEP EPITHELIA	$22.60	$22.60	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOAT EPITHELIA	$22.60	$22.60	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN STEMPHYLIUM BOTRYOSUM (M10) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ENGLISH PLANTAIN (W9) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ANALYZER ANA IFA W REFLEX TITER PATTERN	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKROACH	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MUCOR RACEMOSUS (MR) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PERENNIAL RYE GRASS (G5) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LAMBS QUARTERS (GOOSE FOOT)	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALTERNARIA ALTERNATA	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 FOOD ALLERGY	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MOUNTAIN CEDAR	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN JOHNSON GRASS	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OAK	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN JUNE GRASS	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ELM	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOOSE FEATHERS (E86) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BERMUDA GRASS	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DOG DANDER	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAT DANDER	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COMMON RAGWEED	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DERMATOPHAGORDES FARINAE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ROUGH MARSH ELDER	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FIRE ANT IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DERMATOPHAGORDES PTERONYSSINUS	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DANDELION IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ASPERGILLUS FUNGITAS	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SYCAMORE IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MOSQUITO IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HICKORY/PECAN TREE IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HONEY BEE IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YELLOW JACKET IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PAPER WASP IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DUCK FEATHERS (E86) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SESAME SEED	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CURVULARIA LUNATA (M16) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHEESE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COW DANDER (E4) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKLEBUR W13 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN FEATHERS (E85) 1GE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE WITH REFLEXES	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RUSSIAN THISTLE (W11) IGE	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLADOSPIRIUM HERBARUM	$23.28	$23.28	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEY	$25.08	$25.08	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YEAST	$25.08	$25.08	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GLUTEN	$25.08	$25.08	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MALT	$27.13	$27.13	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHRIMP	$27.13	$27.13	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ROUGH PIGWEED	$27.13	$27.13	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BARLEY	$27.13	$27.13	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RYE	$27.13	$27.13	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RICE	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PORK	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHERRY	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASHEW	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM NOTATUM (M1) IGE	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN STRAWBERRY	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TOMATO	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TUNA	$78.26	$78.26	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PANEL	$339.09	$339.09	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESPIRATORY ALLERGY PROFILE OK,TX	$638.20	$638.20	$365.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILDHOOD ALLERGY (FOOD&ENVIRONMENTAL) P	$1,345.72	$1,345.72	$365.00	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE CCP	$98.16	$98.16	$365.00	40% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 RHEUMATOID ARTHRITIS DIAGNOSTIC PANE	$137.95	$137.95	$365.00	96% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANA WITH REFLEX TO RHEUMATOID ARTHRITIS	$615.91	$615.91	$365.00	777% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE CCP	$98.16	$98.16	$365.00	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 RHEUMATOID ARTHRITIS DIAGNOSTIC PANE	$137.95	$137.95	$365.00	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANA WITH REFLEX TO RHEUMATOID ARTHRITIS	$615.91	$615.91	$365.00	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANALYZER ANA IFA W REFLEX TITER PATTERN	$23.28	$23.28	$365.00	46% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANACHOICE (R) SPECIFIC AB CASCADING	$123.86	$123.86	$365.00	189% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN IFA W REFLEX TO TITER AND PAT	$136.24	$136.24	$365.00	218% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 LUPUS SLE 12 PANEL	$335.70	$335.70	$365.00	683% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH REFLEX TO RHEUMATOID ARTHRITIS	$615.91	$615.91	$365.00	1336% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 AUTOIMMUNE HEP DIAG PANEL	$1,140.66	$1,140.66	$365.00	2559% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANALYZER ANA IFA W REFLEX TITER PATTERN	$23.28	$23.28	$365.00	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANACHOICE (R) SPECIFIC AB CASCADING	$123.86	$123.86	$365.00	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN IFA W REFLEX TO TITER AND PAT	$136.24	$136.24	$365.00	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LUPUS SLE 12 PANEL	$335.70	$335.70	$365.00	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH REFLEX TO RHEUMATOID ARTHRITIS	$615.91	$615.91	$365.00	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 AUTOIMMUNE HEP DIAG PANEL	$1,140.66	$1,140.66	$365.00	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 STRATUS BNP (BRAIN NATRIURETIC PEPTIDE)	$169.18	$169.18	$365.00	51% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP	$169.18	$169.18	$365.00	51% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 STRATUS BNP (BRAIN NATRIURETIC PEPTIDE)	$169.18	$169.18	$365.00	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PRO BNP	$169.18	$169.18	$365.00	—	—
Basic metabolic panel (blood test) CPT 80048 DLO BASIC METABOLIC PANEL/ eGFR	$32.69	$32.69	$365.00	2% above	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE (BMP)	$45.82	$45.82	$365.00	44% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 DLO BASIC METABOLIC PANEL/ eGFR	$32.69	$32.69	$365.00	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE (BMP)	$45.82	$45.82	$365.00	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 XPATH - TISSUE EXAM BY PATHOLOGIST	$163.81	$163.81	$365.00	29% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 XPATH - TISSUE EXAM BY PATHOLOGIST	$163.81	$163.81	$365.00	—	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD MANUAL DLO	$39.88	$39.88	$365.00	35% below	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD 1ST SET	$131.04	$131.04	$365.00	112% above	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD 2ND SET	$131.04	$131.04	$365.00	112% above	—
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD MANUAL DLO	$39.88	$39.88	$365.00	—	—
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD 2ND SET	$131.04	$131.04	$365.00	—	—
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD 1ST SET	$131.04	$131.04	$365.00	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VHI COLLI CAPILLARY BLD SPEC	$7.19	$7.19	$365.00	24% below	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LHI COLLI VEN BLD VNPNXR	$7.19	$7.19	$365.00	24% below	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DLO VENI DRAW FEE/ SITE CODE	$11.74	$11.74	$365.00	24% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$12.09	$12.09	$365.00	28% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VHI COLLI CAPILLARY BLD SPEC	$7.19	$7.19	$365.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LHI COLLI VEN BLD VNPNXR	$7.19	$7.19	$365.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DLO VENI DRAW FEE/ SITE CODE	$11.74	$11.74	$365.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$12.09	$12.09	$365.00	—	—
Blood glucose (sugar) test CPT 82947 DLO GLUCOSE	$15.15	$15.15	$365.00	40% below	—
Blood glucose (sugar) test CPT 82947 GLUCOSE	$30.36	$30.36	$365.00	20% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE PERITONEAL FLUID	$52.96	$52.96	$365.00	109% above	—
Blood glucose (sugar) test CPT 82947 NAFLD FIBROSIS SCORE	$187.62	$187.62	$365.00	640% above	—
Blood glucose (sugar) test inpatient CPT 82947 DLO GLUCOSE	$15.15	$15.15	$365.00	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$30.36	$30.36	$365.00	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE PERITONEAL FLUID	$52.96	$52.96	$365.00	—	—
Blood glucose (sugar) test inpatient CPT 82947 NAFLD FIBROSIS SCORE	$187.62	$187.62	$365.00	—	—
Blood lead test CPT 83655 LEAD, CAPILLARY	$8.50	$8.50	$365.00	80% below	—
Blood lead test CPT 83655 HEAVY METALS LEAD	$88.18	$88.18	$365.00	109% above	—
Blood lead test CPT 83655 LEAD BLOOD	$88.18	$88.18	$365.00	109% above	—
Blood lead test CPT 83655 HEAVY METAL EVAL BLOOD	$99.46	$99.46	$365.00	135% above	—
Blood lead test inpatient CPT 83655 LEAD, CAPILLARY	$8.50	$8.50	$365.00	—	—
Blood lead test inpatient CPT 83655 LEAD BLOOD	$88.18	$88.18	$365.00	—	—
Blood lead test inpatient CPT 83655 HEAVY METALS LEAD	$88.18	$88.18	$365.00	—	—
Blood lead test inpatient CPT 83655 HEAVY METAL EVAL BLOOD	$99.46	$99.46	$365.00	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 DCSERUMHCGQL	$92.71	$92.71	$365.00	131% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 DCSERUMHCGQL	$92.71	$92.71	$365.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 DLO ABO GROUP & RH TYPE	$15.40	$15.40	$365.00	73% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB TYPING ABO	$43.16	$43.16	$365.00	24% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABI ABO/RH	$108.92	$108.92	$365.00	91% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 DLO ABO GROUP & RH TYPE	$15.40	$15.40	$365.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB TYPING ABO	$43.16	$43.16	$365.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABI ABO/RH	$108.92	$108.92	$365.00	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$66.29	$66.29	$365.00	144% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$66.29	$66.29	$365.00	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 DLO C DIFF TOXIN B PCR SEND OUT	$107.57	$107.57	$365.00	19% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 DLO CLOSTRIDIUM DNA & TOXIN B GENE, PCR	$1,058.65	$1,058.65	$365.00	1075% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 DLO C DIFF TOXIN B PCR SEND OUT	$107.57	$107.57	$365.00	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 DLO CLOSTRIDIUM DNA & TOXIN B GENE, PCR	$1,058.65	$1,058.65	$365.00	—	—
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNO TUMOR AG CA 19-9	$155.05	$155.05	$365.00	70% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNO TUMOR AG CA 19-9	$155.05	$155.05	$365.00	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MOLECULAR	$80.00	$80.00	$365.00	9% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 PRIORITY SARS CORONAVIRUS COV-2 RT-PCR	$100.00	$100.00	$365.00	37% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS CORONAVIRUS COV-2 RT-PCR	$100.00	$100.00	$365.00	37% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MOLECULAR	$80.00	$80.00	$365.00	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS CORONAVIRUS COV-2 RT-PCR	$100.00	$100.00	$365.00	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 PRIORITY SARS CORONAVIRUS COV-2 RT-PCR	$100.00	$100.00	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ZZ NUC ACID PROBE AMP CHLAMYD T	$79.31	$79.31	$365.00	1% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMONATIS, URINE RNA	$134.57	$134.57	$365.00	72% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DLO CHLAMYDIA/ N. GONRRHOEAE (17618)	$157.80	$157.80	$365.00	102% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 STI PANEL, DLO	$181.43	$181.43	$365.00	132% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRAC NEISS/GONO RNA TMA	$181.43	$181.43	$365.00	132% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA /NEISS GONO RNA TMA THROAT	$181.43	$181.43	$365.00	132% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 WOMEN'S HEALTH PANEL 15:1	$1,120.58	$1,120.58	$365.00	1334% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ZZ NUC ACID PROBE AMP CHLAMYD T	$79.31	$79.31	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMONATIS, URINE RNA	$134.57	$134.57	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 DLO CHLAMYDIA/ N. GONRRHOEAE (17618)	$157.80	$157.80	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 STI PANEL, DLO	$181.43	$181.43	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRAC NEISS/GONO RNA TMA	$181.43	$181.43	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA /NEISS GONO RNA TMA THROAT	$181.43	$181.43	$365.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 WOMEN'S HEALTH PANEL 15:1	$1,120.58	$1,120.58	$365.00	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 DLO LIPID PANEL	$112.31	$112.31	$365.00	72% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$129.60	$129.60	$365.00	98% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ (R) LIPID PANEL	$134.78	$134.78	$365.00	106% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPOPROTEIN FRACTIONATION NMR WITH LIPID	$197.34	$197.34	$365.00	202% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ(R) ADV LIPID PAN & INFLAM PANE	$781.39	$781.39	$365.00	1096% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 DLO LIPID PANEL	$112.31	$112.31	$365.00	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$129.60	$129.60	$365.00	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ (R) LIPID PANEL	$134.78	$134.78	$365.00	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPOPROTEIN FRACTIONATION NMR WITH LIPID	$197.34	$197.34	$365.00	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ(R) ADV LIPID PAN & INFLAM PANE	$781.39	$781.39	$365.00	—	—
Complete blood count (CBC) with differential CPT 85025 CBC AUTO W/AUTO DIFF	$43.28	$43.28	$365.00	5% below	—
Complete blood count (CBC) with differential CPT 85025 CBC W/ DIFF/ PLT	$47.00	$47.00	$365.00	4% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO W/AUTO DIFF	$43.28	$43.28	$365.00	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ DIFF/ PLT	$47.00	$47.00	$365.00	—	—
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF	$37.11	$37.11	$365.00	25% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF	$37.11	$37.11	$365.00	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$66.79	$66.79	$365.00	47% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$66.79	$66.79	$365.00	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER DLO	$80.86	$80.86	$365.00	11% below	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER DLO	$80.86	$80.86	$365.00	—	—
Estradiol blood test CPT 82670 ESTRADIOL ULTRASENSITIVE	$45.06	$45.06	$365.00	40% below	—
Estradiol blood test CPT 82670 ESTRONE	$95.73	$95.73	$365.00	28% above	—
Estradiol blood test CPT 82670 ESTRADIOL FREE	$97.40	$97.40	$365.00	30% above	—
Estradiol blood test CPT 82670 ESTRADIOL	$138.59	$138.59	$365.00	85% above	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL ULTRASENSITIVE	$45.06	$45.06	$365.00	—	—
Estradiol blood test inpatient CPT 82670 ESTRONE	$95.73	$95.73	$365.00	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL FREE	$97.40	$97.40	$365.00	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$138.59	$138.59	$365.00	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH, PEDIATRICS	$78.73	$78.73	$365.00	15% above	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$151.25	$151.25	$365.00	121% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, PEDIATRICS	$78.73	$78.73	$365.00	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$151.25	$151.25	$365.00	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$384.20	$384.20	$365.00	220% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$384.20	$384.20	$365.00	—	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$98.94	$98.94	$365.00	103% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$98.94	$98.94	$365.00	—	—
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$103.89	$103.89	$365.00	78% above	—
Folate (folic acid) blood test CPT 82746 DLO FOLIC ACID SERUM	$113.96	$113.96	$365.00	96% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$103.89	$103.89	$365.00	—	—
Folate (folic acid) blood test inpatient CPT 82746 DLO FOLIC ACID SERUM	$113.96	$113.96	$365.00	—	—
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE FREE	$92.86	$92.86	$365.00	3% above	—
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE FREE	$92.86	$92.86	$365.00	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$107.18	$107.18	$365.00	75% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE direct dialysis	$107.18	$107.18	$365.00	75% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$107.18	$107.18	$365.00	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE direct dialysis	$107.18	$107.18	$365.00	—	—
Free testosterone test CPT 84402 TESTOSTERONE FREE	$25.20	$25.20	$365.00	71% below	—
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$188.11	$188.11	$365.00	119% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$25.20	$25.20	$365.00	—	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$188.11	$188.11	$365.00	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$146.76	$146.76	$365.00	9% below	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$146.76	$146.76	$365.00	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 ONE HOUR GLUCOSE TOLERANCE	$55.20	$55.20	$365.00	89% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 ONE HOUR GLUCOSE TOLERANCE	$55.20	$55.20	$365.00	—	—
Glucose tolerance test, 3 samples CPT 82951 2HR NON- PREG GLUCOSE TOL TEST	$109.48	$109.48	$365.00	68% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 2HR NON- PREG GLUCOSE TOL TEST	$109.48	$109.48	$365.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ZZ NUC ACID PROBE AMP GC	$64.95	$64.95	$365.00	16% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 PROBE GC NEISSERIA GONORRHOEAE, DNA	$134.57	$134.57	$365.00	75% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DLO CHLAMYDIA/ N. GONRRHOEAE (17618)	$157.80	$157.80	$365.00	105% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, URINOGENITAL RNA	$227.57	$227.57	$365.00	195% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 WOMEN'S HEALTH PANEL 15:1	$1,120.58	$1,120.58	$365.00	1355% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ZZ NUC ACID PROBE AMP GC	$64.95	$64.95	$365.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 PROBE GC NEISSERIA GONORRHOEAE, DNA	$134.57	$134.57	$365.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 DLO CHLAMYDIA/ N. GONRRHOEAE (17618)	$157.80	$157.80	$365.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, URINOGENITAL RNA	$227.57	$227.57	$365.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 WOMEN'S HEALTH PANEL 15:1	$1,120.58	$1,120.58	$365.00	—	—
H. pylori antibody blood test CPT 86677 TEST UNAVAILABLE	$56.03	$56.03	$365.00	18% below	—
H. pylori antibody blood test CPT 86677 ZZH PYLORI	$109.77	$109.77	$365.00	60% above	—
H. pylori antibody blood test inpatient CPT 86677 TEST UNAVAILABLE	$56.03	$56.03	$365.00	—	—
H. pylori antibody blood test inpatient CPT 86677 ZZH PYLORI	$109.77	$109.77	$365.00	—	—
H. pylori stool antigen test CPT 87338 ZZH PYLOR	$110.83	$110.83	$365.00	2% below	—
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN DETECTION STOOL	$152.62	$152.62	$365.00	35% above	—
H. pylori stool antigen test inpatient CPT 87338 ZZH PYLOR	$110.83	$110.83	$365.00	—	—
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN DETECTION STOOL	$152.62	$152.62	$365.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QN	$162.83	$162.83	$365.00	16% below	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QN REFLEX GENOTYPE	$282.19	$282.19	$365.00	45% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QN	$162.83	$162.83	$365.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QN REFLEX GENOTYPE	$282.19	$282.19	$365.00	—	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV AG AND AB 1/2 EIA W/REFLEX DLO	$66.57	$66.57	$365.00	46% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV AG AND AB 1/2 EIA W/REFLEX DLO	$66.57	$66.57	$365.00	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 RECTAL	$105.27	$105.27	$365.00	at median	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV mRNA E6/E7	$108.00	$108.00	$365.00	3% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 RECTAL	$105.27	$105.27	$365.00	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV mRNA E6/E7	$108.00	$108.00	$365.00	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 DLO HEMOGLOBIN A1C	$83.96	$83.96	$365.00	95% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED	$83.96	$83.96	$365.00	95% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 DLO HEMOGLOBIN A1C	$83.96	$83.96	$365.00	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED	$83.96	$83.96	$365.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$20.80	$20.80	$365.00	52% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUAL	$43.06	$43.06	$365.00	1% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 ZZHEPBSURFACEAB(QUAL)	$43.06	$43.06	$365.00	1% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE QUANT	$101.26	$101.26	$365.00	133% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$20.80	$20.80	$365.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 ZZHEPBSURFACEAB(QUAL)	$43.06	$43.06	$365.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB QUAL	$43.06	$43.06	$365.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE QUANT	$101.26	$101.26	$365.00	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$20.80	$20.80	$365.00	47% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG W/ REFLEX CONFIRM	$41.39	$41.39	$365.00	6% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 ZZHEP B SURFACE AG W/ REFLEX CONFIRM	$41.39	$41.39	$365.00	6% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$20.80	$20.80	$365.00	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG W/ REFLEX CONFIRM	$41.39	$41.39	$365.00	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 ZZHEP B SURFACE AG W/ REFLEX CONFIRM	$41.39	$41.39	$365.00	—	—
Hepatitis C antibody blood test (screening) CPT 86803 ZZHEPC AB TEST	$20.80	$20.80	$365.00	58% below	—
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB DLO	$107.22	$107.22	$365.00	118% above	—
Hepatitis C antibody blood test (screening) CPT 86803 ZZHEP C AB	$107.22	$107.22	$365.00	118% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 ZZHEPC AB TEST	$20.80	$20.80	$365.00	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB DLO	$107.22	$107.22	$365.00	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 ZZHEP C AB	$107.22	$107.22	$365.00	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HLA-B27 ANTIGEN	$228.69	$228.69	$365.00	3% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA QN	$343.03	$343.03	$365.00	54% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA QUANT W/ REFLEX GENO	$360.19	$360.19	$365.00	62% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA QN (PCR)	$381.15	$381.15	$365.00	71% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HLA-B27 ANTIGEN	$228.69	$228.69	$365.00	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RNA QN	$343.03	$343.03	$365.00	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RNA QUANT W/ REFLEX GENO	$360.19	$360.19	$365.00	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RNA QN (PCR)	$381.15	$381.15	$365.00	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IGG, HERPESELECT W/REFLEX	$74.73	$74.73	$365.00	22% above	—
Herpes blood test, HSV-1 antibody CPT 86695 TORCH PANEL, ACUTE	$673.87	$673.87	$365.00	998% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 IGG, HERPESELECT W/REFLEX	$74.73	$74.73	$365.00	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 TORCH PANEL, ACUTE	$673.87	$673.87	$365.00	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV 1/2 IGG, HERPESELECT W/REFLEX	$74.73	$74.73	$365.00	15% above	—
Herpes blood test, HSV-2 antibody CPT 86696 DLO HERPES SIMPLEX TYPE 2 TEST	$420.00	$420.00	$365.00	545% above	—
Herpes blood test, HSV-2 antibody CPT 86696 TORCH PANEL, ACUTE	$673.87	$673.87	$365.00	935% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1/2 IGG, HERPESELECT W/REFLEX	$74.73	$74.73	$365.00	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 DLO HERPES SIMPLEX TYPE 2 TEST	$420.00	$420.00	$365.00	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 TORCH PANEL, ACUTE	$673.87	$673.87	$365.00	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO IQ hs-CRP	$50.00	$50.00	$365.00	2% below	—
High-sensitivity CRP (hs-CRP) test CPT 86141 HSCRP HIGH SENSITIVITY CRP (CARDIO)	$58.21	$58.21	$365.00	14% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CSF C REACTIVE PROTEIN, HIGH SENSITIVITY	$166.41	$166.41	$365.00	225% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO IQ(R) ADV LIPID PAN & INFLAM PANE	$781.39	$781.39	$365.00	1426% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO IQ hs-CRP	$50.00	$50.00	$365.00	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HSCRP HIGH SENSITIVITY CRP (CARDIO)	$58.21	$58.21	$365.00	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CSF C REACTIVE PROTEIN, HIGH SENSITIVITY	$166.41	$166.41	$365.00	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO IQ(R) ADV LIPID PAN & INFLAM PANE	$781.39	$781.39	$365.00	—	—
Homocysteine blood test CPT 83090 HOMOCYSTINE TOTAL	$110.05	$110.05	$365.00	12% below	—
Homocysteine blood test CPT 83090 METHYLMALONIC ACID AND HOMOCYSTEINE	$454.52	$454.52	$365.00	265% above	—
Homocysteine blood test CPT 83090 CARDIO IQ(R) HOMOCYSTINE	$499.64	$499.64	$365.00	301% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE TOTAL	$110.05	$110.05	$365.00	—	—
Homocysteine blood test inpatient CPT 83090 METHYLMALONIC ACID AND HOMOCYSTEINE	$454.52	$454.52	$365.00	—	—
Homocysteine blood test inpatient CPT 83090 CARDIO IQ(R) HOMOCYSTINE	$499.64	$499.64	$365.00	—	—
Insulin blood test CPT 83525 INSULIN	$84.69	$84.69	$365.00	90% above	—
Insulin blood test CPT 83525 CARDIO IQ INSULIN RESIST PANEL WITH SCOR	$114.34	$114.34	$365.00	156% above	—
Insulin blood test CPT 83525 CARDIO IQ(R) INSULIN	$114.34	$114.34	$365.00	156% above	—
Insulin blood test inpatient CPT 83525 INSULIN	$84.69	$84.69	$365.00	—	—
Insulin blood test inpatient CPT 83525 CARDIO IQ(R) INSULIN	$114.34	$114.34	$365.00	—	—
Insulin blood test inpatient CPT 83525 CARDIO IQ INSULIN RESIST PANEL WITH SCOR	$114.34	$114.34	$365.00	—	—
Iron blood test (serum iron) CPT 83540 IRON SERUM	$36.88	$36.88	$365.00	15% above	—
Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM	$36.88	$36.88	$365.00	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$55.80	$55.80	$365.00	42% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$55.80	$55.80	$365.00	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$182.95	$182.95	$365.00	246% above	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$182.95	$182.95	$365.00	—	—
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE, PEDIATRICS	$92.60	$92.60	$365.00	27% above	—
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$156.81	$156.81	$365.00	115% above	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE, PEDIATRICS	$92.60	$92.60	$365.00	—	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$156.81	$156.81	$365.00	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$57.39	$57.39	$365.00	34% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BODY FLUID	$57.86	$57.86	$365.00	35% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE RANDOM URINE (DLO)	$65.72	$65.72	$365.00	53% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$57.39	$57.39	$365.00	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BODY FLUID	$57.86	$57.86	$365.00	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE RANDOM URINE (DLO)	$65.72	$65.72	$365.00	—	—
Liver function blood test panel CPT 80076 Liver Panel (HEPATIC FUNCTION )	$43.88	$43.88	$365.00	1% below	—
Liver function blood test panel CPT 80076 Liver FIBROSIS HFP FIB-4 INDEX DLO	$77.57	$77.57	$365.00	75% above	—
Liver function blood test panel inpatient CPT 80076 Liver Panel (HEPATIC FUNCTION )	$43.88	$43.88	$365.00	—	—
Liver function blood test panel inpatient CPT 80076 Liver FIBROSIS HFP FIB-4 INDEX DLO	$77.57	$77.57	$365.00	—	—
Lyme disease antibody test CPT 86618 LYME DISEASE EIA W/REFLEX IGG IGM WEST B	$118.11	$118.11	$365.00	65% above	—
Lyme disease antibody test CPT 86618 ZZLYME DISEASE ANTIBODY	$245.00	$245.00	$365.00	243% above	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE EIA W/REFLEX IGG IGM WEST B	$118.11	$118.11	$365.00	—	—
Lyme disease antibody test inpatient CPT 86618 ZZLYME DISEASE ANTIBODY	$245.00	$245.00	$365.00	—	—
Magnesium blood test CPT 83735 ASSAY OF URINE CREATININE	$26.80	$26.80	$365.00	4% below	—
Magnesium blood test CPT 83735 MAGNESIUM	$48.48	$48.48	$365.00	73% above	—
Magnesium blood test CPT 83735 MAGNESIUM RBC (REFERENCE LAB)	$67.02	$67.02	$365.00	139% above	—
Magnesium blood test CPT 83735 URO-RISK (R) DIAGNOSTIC PROFILE	$952.31	$952.31	$365.00	3301% above	—
Magnesium blood test CPT 83735 STONERISK DIAGNOSTIC PROFILE	$1,236.75	$1,236.75	$365.00	4317% above	—
Magnesium blood test inpatient CPT 83735 ASSAY OF URINE CREATININE	$26.80	$26.80	$365.00	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$48.48	$48.48	$365.00	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC (REFERENCE LAB)	$67.02	$67.02	$365.00	—	—
Magnesium blood test inpatient CPT 83735 URO-RISK (R) DIAGNOSTIC PROFILE	$952.31	$952.31	$365.00	—	—
Magnesium blood test inpatient CPT 83735 STONERISK DIAGNOSTIC PROFILE	$1,236.75	$1,236.75	$365.00	—	—
Measles (rubeola) antibody test CPT 86765 Measles Rubeola AB Igg	$35.67	$35.67	$365.00	22% below	—
Measles (rubeola) antibody test CPT 86765 MEASLES AB IGM	$53.54	$53.54	$365.00	17% above	—
Measles (rubeola) antibody test inpatient CPT 86765 Measles Rubeola AB Igg	$35.67	$35.67	$365.00	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES AB IGM	$53.54	$53.54	$365.00	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN DLO	$15.12	$15.12	$365.00	54% below	—
Mono test (heterophile antibody, Monospot) CPT 86308 ANALYZER ANA IFA W REFLEX TITER PATTERN	$23.28	$23.28	$365.00	29% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN DLO	$15.12	$15.12	$365.00	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 ANALYZER ANA IFA W REFLEX TITER PATTERN	$23.28	$23.28	$365.00	—	—
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$295.65	$295.65	$365.00	125% above	—
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$295.65	$295.65	$365.00	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA-FREE&TOTAL	$107.74	$107.74	$365.00	7% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA-FREE&TOTAL	$107.74	$107.74	$365.00	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$58.77	$58.77	$365.00	23% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL W/ REFLEX TO PSA FREE DLO	$71.05	$71.05	$365.00	7% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE TUMOR AG	$135.87	$135.87	$365.00	77% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$58.77	$58.77	$365.00	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL W/ REFLEX TO PSA FREE DLO	$71.05	$71.05	$365.00	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE TUMOR AG	$135.87	$135.87	$365.00	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP AND HPV AGES 30-65	$165.00	$165.00	$365.00	131% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP (58315)	$259.72	$259.72	$365.00	263% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 DLO THINPREP IMAGING PAP AND HPV mRNA E6	$559.86	$559.86	$365.00	683% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP REFLEX HPV (21 AND OVER)	$559.86	$559.86	$365.00	683% above	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP AND HPV AGES 30-65	$165.00	$165.00	$365.00	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP (58315)	$259.72	$259.72	$365.00	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 DLO THINPREP IMAGING PAP AND HPV mRNA E6	$559.86	$559.86	$365.00	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP REFLEX HPV (21 AND OVER)	$559.86	$559.86	$365.00	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH RFX HPV	$60.52	$60.52	$365.00	14% below	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH RFX HPV	$60.52	$60.52	$365.00	—	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE INTACT W CA	$177.55	$177.55	$365.00	27% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT WITHOUT CALCIUM	$188.38	$188.38	$365.00	35% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE INTACT W CA	$177.55	$177.55	$365.00	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT WITHOUT CALCIUM	$188.38	$188.38	$365.00	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$45.51	$45.51	$365.00	46% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoagulant Evaluation/ w reflex	$57.86	$57.86	$365.00	85% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 DLO aPTT	$113.78	$113.78	$365.00	265% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 VON WILLEBRAND SCREEN	$1,672.09	$1,672.09	$365.00	5259% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$45.51	$45.51	$365.00	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoagulant Evaluation/ w reflex	$57.86	$57.86	$365.00	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 DLO aPTT	$113.78	$113.78	$365.00	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 VON WILLEBRAND SCREEN	$1,672.09	$1,672.09	$365.00	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 QNATAL ADVANCED	$2,277.15	$2,277.15	$365.00	93% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 QNATAL ADVANCED	$2,277.15	$2,277.15	$365.00	—	—
Progesterone blood test CPT 84144 PROGESTERONE	$138.59	$138.59	$365.00	82% above	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$138.59	$138.59	$365.00	—	—
Prolactin blood test CPT 84146 PROLACTIN	$134.88	$134.88	$365.00	59% above	—
Prolactin blood test inpatient CPT 84146 PROLACTIN	$134.88	$134.88	$365.00	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$32.65	$32.65	$365.00	48% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 DLO PROTHROMBIN TIME-INR	$74.20	$74.20	$365.00	237% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$32.65	$32.65	$365.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 DLO PROTHROMBIN TIME-INR	$74.20	$74.20	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE BARBITUATE	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE OPIATE	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SNGL AMPHETAMINE	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE METHADONE	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCRN SNGL PHENCYCLIDINE	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SNGL CANNABINOID	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE COCAINE	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE BENZO	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE METHAMPHET	$36.98	$36.98	$365.00	5% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCRN SGL TRICYCLIC URINE	$111.26	$111.26	$365.00	185% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SNGL CANNABINOID	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE COCAINE	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE BENZO	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE METHADONE	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE BARBITUATE	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE METHAMPHET	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SNGL AMPHETAMINE	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE OPIATE	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCRN SNGL PHENCYCLIDINE	$36.98	$36.98	$365.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCRN SGL TRICYCLIC URINE	$111.26	$111.26	$365.00	—	—
Rheumatoid factor (RF) test CPT 86431 THYROID PEROXIDASE AB	$22.95	$22.95	$365.00	13% below	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QN	$56.65	$56.65	$365.00	115% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ARTHRITIS DIAGNOSTIC PANE	$137.95	$137.95	$365.00	423% above	—
Rheumatoid factor (RF) test CPT 86431 LUPUS SLE 12 PANEL	$335.70	$335.70	$365.00	1174% above	—
Rheumatoid factor (RF) test CPT 86431 ANA WITH REFLEX TO RHEUMATOID ARTHRITIS	$615.91	$615.91	$365.00	2237% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 THYROID PEROXIDASE AB	$22.95	$22.95	$365.00	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QN	$56.65	$56.65	$365.00	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID ARTHRITIS DIAGNOSTIC PANE	$137.95	$137.95	$365.00	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 LUPUS SLE 12 PANEL	$335.70	$335.70	$365.00	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 ANA WITH REFLEX TO RHEUMATOID ARTHRITIS	$615.91	$615.91	$365.00	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG AB IMMUNE STATUS	$38.93	$38.93	$365.00	24% below	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY (IGM)	$451.97	$451.97	$365.00	779% above	—
Rubella antibody test (immunity check) CPT 86762 TORCH PANEL, ACUTE	$673.87	$673.87	$365.00	1211% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG AB IMMUNE STATUS	$38.93	$38.93	$365.00	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY (IGM)	$451.97	$451.97	$365.00	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH PANEL, ACUTE	$673.87	$673.87	$365.00	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 DLO SED RATE	$10.80	$10.80	$365.00	48% below	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE	$32.65	$32.65	$365.00	57% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 DLO SED RATE	$10.80	$10.80	$365.00	—	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE	$32.65	$32.65	$365.00	—	—
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$81.19	$81.19	$365.00	41% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$81.19	$81.19	$365.00	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD FECES	$61.37	$61.37	$365.00	170% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD FECES	$61.37	$61.37	$365.00	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTRY (INSURE)	$116.99	$116.99	$365.00	101% above	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTRY (INSURE)	$116.99	$116.99	$365.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR MONITOR WITH REFLEX TITER	$12.81	$12.81	$365.00	50% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX TITER AND CONFIRMATION	$44.13	$44.13	$365.00	72% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$70.69	$70.69	$365.00	176% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SERUM	$101.18	$101.18	$365.00	295% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR MONITOR WITH REFLEX TITER	$12.81	$12.81	$365.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX TITER AND CONFIRMATION	$44.13	$44.13	$365.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF	$70.69	$70.69	$365.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, SERUM	$101.18	$101.18	$365.00	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON (R) - TB GOLD	$245.76	$245.76	$365.00	48% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON (R) - TB GOLD	$245.76	$245.76	$365.00	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL, LC/ MS/ MS	$99.70	$99.70	$365.00	22% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE MALE	$181.32	$181.32	$365.00	122% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL, LC/ MS/ MS	$99.70	$99.70	$365.00	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE MALE	$181.32	$181.32	$365.00	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$22.95	$22.95	$365.00	58% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL ANTIBODY (IgG)	$92.95	$92.95	$365.00	68% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LUPUS SLE 12 PANEL	$335.70	$335.70	$365.00	508% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 AUTOIMMUNE HEP DIAG PANEL	$1,140.66	$1,140.66	$365.00	1966% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$22.95	$22.95	$365.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOMAL ANTIBODY (IgG)	$92.95	$92.95	$365.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LUPUS SLE 12 PANEL	$335.70	$335.70	$365.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 AUTOIMMUNE HEP DIAG PANEL	$1,140.66	$1,140.66	$365.00	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 PRIMARY CONGENITAL HYPOTHYROIDISM (CH)	$41.60	$41.60	$365.00	7% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/ HAMA TREATMENT	$64.87	$64.87	$365.00	46% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH DLO	$64.87	$64.87	$365.00	46% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$114.77	$114.77	$365.00	158% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID PROFILE WITH TSH	$507.08	$507.08	$365.00	1040% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 PRIMARY CONGENITAL HYPOTHYROIDISM (CH)	$41.60	$41.60	$365.00	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/ HAMA TREATMENT	$64.87	$64.87	$365.00	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH DLO	$64.87	$64.87	$365.00	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$114.77	$114.77	$365.00	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID PROFILE WITH TSH	$507.08	$507.08	$365.00	—	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS RNA QUALITY MALE	$120.05	$120.05	$365.00	37% above	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA QUAL	$380.93	$380.93	$365.00	335% above	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS RNA QUALITY MALE	$120.05	$120.05	$365.00	—	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS RNA QUAL	$380.93	$380.93	$365.00	—	—
Uric acid blood test CPT 84550 URIC ACID BLOOD	$37.59	$37.59	$365.00	49% above	—
Uric acid blood test CPT 84550 URIC ACID BODY FLUID	$116.60	$116.60	$365.00	362% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$37.59	$37.59	$365.00	—	—
Uric acid blood test inpatient CPT 84550 URIC ACID BODY FLUID	$116.60	$116.60	$365.00	—	—
Urinalysis with microscope exam, automated CPT 81001 UA W/ REFLEX CULTURE	$41.86	$41.86	$365.00	73% above	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPIC	$48.95	$48.95	$365.00	103% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 UA W/ REFLEX CULTURE	$41.86	$41.86	$365.00	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPIC	$48.95	$48.95	$365.00	—	—
Urinalysis without microscope exam, automated CPT 81003 UA AUTO BLD	$31.31	$31.31	$365.00	175% above	—
Urinalysis without microscope exam, automated CPT 81003 URINE PROTEIN DIPSTICK	$36.99	$36.99	$365.00	224% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 UA AUTO BLD	$31.31	$31.31	$365.00	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PROTEIN DIPSTICK	$36.99	$36.99	$365.00	—	—
Urinalysis without microscope exam, manual CPT 81002 KETONES URINE	$9.97	$9.97	$365.00	43% below	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS AUTO	$60.00	$60.00	$365.00	243% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 KETONES URINE	$9.97	$9.97	$365.00	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS AUTO	$60.00	$60.00	$365.00	—	—
Urine culture for bacteria, with colony count CPT 87086 ZCULTURE URINE W/COLONY CNT	$90.72	$90.72	$365.00	90% above	—
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE SPECIAL	$91.36	$91.36	$365.00	91% above	—
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE DLO	$91.36	$91.36	$365.00	91% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 ZCULTURE URINE W/COLONY CNT	$90.72	$90.72	$365.00	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE SPECIAL	$91.36	$91.36	$365.00	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE DLO	$91.36	$91.36	$365.00	—	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY	$51.33	$51.33	$365.00	90% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY	$51.33	$51.33	$365.00	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 DLO VITAMIN B-12 LEVEL	$97.88	$97.88	$365.00	65% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 LEVEL	$105.59	$105.59	$365.00	78% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 DLO VITAMIN B-12 LEVEL	$97.88	$97.88	$365.00	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 LEVEL	$105.59	$105.59	$365.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 INFANT VITAMIN D 25 HYDROXY D2/D3	$88.80	$88.80	$365.00	32% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 IN HOUSE VITAMIN D25 HYDROXY	$118.40	$118.40	$365.00	10% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY DLO	$160.27	$160.27	$365.00	22% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CARDIO IQ(R) VIT D 25, HYDROXY, LC/MS/MS	$184.35	$184.35	$365.00	41% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D (D2, D3) LC/MS/MS	$531.79	$531.79	$365.00	305% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 INFANT VITAMIN D 25 HYDROXY D2/D3	$88.80	$88.80	$365.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 IN HOUSE VITAMIN D25 HYDROXY	$118.40	$118.40	$365.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY DLO	$160.27	$160.27	$365.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CARDIO IQ(R) VIT D 25, HYDROXY, LC/MS/MS	$184.35	$184.35	$365.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D (D2, D3) LC/MS/MS	$531.79	$531.79	$365.00	—	—
Zinc blood test CPT 84630 ZINC RBC (SEND OUT)	$70.94	$70.94	$365.00	23% above	—
Zinc blood test CPT 84630 ZINC (PLASMA)	$77.75	$77.75	$365.00	34% above	—
Zinc blood test inpatient CPT 84630 ZINC RBC (SEND OUT)	$70.94	$70.94	$365.00	—	—
Zinc blood test inpatient CPT 84630 ZINC (PLASMA)	$77.75	$77.75	$365.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TOTAL QN	$128.30	$128.30	$365.00	138% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PENTA SCREEN	$681.04	$681.04	$365.00	1162% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QUAD SCREEN	$1,536.04	$1,536.04	$365.00	2747% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 ZZQUAD SCREEN	$1,536.04	$1,536.04	$365.00	2747% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TOTAL QN	$128.30	$128.30	$365.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PENTA SCREEN	$681.04	$681.04	$365.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 QUAD SCREEN	$1,536.04	$1,536.04	$365.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 ZZQUAD SCREEN	$1,536.04	$1,536.04	$365.00	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DSTL FIB FX WO MANIP	$158.16	$158.16	$365.00	42% below	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX; WO MANIP EACH	$531.00	$531.00	$365.75	87% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATARSAL FX; WO MANIP EACH	$531.00	$531.00	$365.75	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 ER CARDIOVERSION	$554.46	$554.46	$365.00	at median	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TRMT DISTAL RADIUS	$575.47	$575.47	$365.00	64% above	—
Colonoscopy with polyp removal CPT 45385 PROF FEE COLONOSCOPY W REMOVAL BY SNARE	$719.07	$719.07	$365.00	72% below	—
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY REMOVAL OF LESIONS WITH SNAR	$2,608.32	$2,608.32	$365.75	1% above	—
Colonoscopy with polyp removal inpatient CPT 45385 PROF FEE COLONOSCOPY W REMOVAL BY SNARE	$719.07	$719.07	$365.00	—	—
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY REMOVAL OF LESIONS WITH SNAR	$2,608.32	$2,608.32	$365.75	—	—
Colonoscopy with tissue sample CPT 45380 PROF FEE COLONOSCOPY W/ BIOPSY	$567.84	$567.84	$365.00	79% below	—
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY SINGLE OR MULTIPLE	$2,608.32	$2,608.32	$365.75	4% below	—
Colonoscopy with tissue sample inpatient CPT 45380 PROF FEE COLONOSCOPY W/ BIOPSY	$567.84	$567.84	$365.00	—	—
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY SINGLE OR MULTIPLE	$2,608.32	$2,608.32	$365.75	—	—
Colonoscopy, diagnostic CPT 45378 PROF FEE COLONOSCOPY NOT HIGH RISK	$522.21	$522.21	$365.00	61% below	—
Colonoscopy, diagnostic CPT 45378 PROF FEE COLONOSCOPY HIGH RISK	$522.21	$522.21	$365.00	61% below	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY SCREENING HIGH RISK	$2,608.32	$2,608.32	$365.75	95% above	—
Colonoscopy, diagnostic inpatient CPT 45378 PROF FEE COLONOSCOPY NOT HIGH RISK	$522.21	$522.21	$365.00	—	—
Colonoscopy, diagnostic inpatient CPT 45378 PROF FEE COLONOSCOPY HIGH RISK	$522.21	$522.21	$365.00	—	—
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY SCREENING HIGH RISK	$2,608.32	$2,608.32	$365.75	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI IRRIG/LAVAGE	$45.79	$45.79	$365.00	26% below	—
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI 1 R BOTH	$52.33	$52.33	$365.00	29% below	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 LAPARASCOP REPAIR VENTRAL HERNIA 3-10 CM	$12,479.50	$12,479.50	$365.75	at median	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 LAPARASCOP REPAIR VENTRAL HERNIA 3-10 CM	$12,479.50	$12,479.50	$365.75	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 LAPROSCOPIC CHOLECYSTECTOMY	$7,058.12	$7,058.12	$365.75	8% below	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 LAPROSCOPIC CHOLECYSTECTOMY	$7,058.12	$7,058.12	$365.75	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$2,484.11	$2,484.11	$365.75	33% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$2,484.11	$2,484.11	$365.75	—	—
Gallbladder removal, laparoscopic CPT 47562 LAPROSCOPIC CHOLECYSTECTOMY	$2,199.04	$2,199.04	$365.75	78% below	—
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPROSCOPIC CHOLECYSTECTOMY	$2,199.04	$2,199.04	$365.75	—	—
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$3,406.68	$3,406.68	$365.75	25% below	—
Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE	$3,406.68	$3,406.68	$365.75	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 XR ZZ INJ SALPINGOGRAM	$100.00	$130.36	$365.00	48% below	23%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 XR ZZ INJ SALPINGOGRAM	$100.00	$130.36	$365.00	—	23%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$281.42	$281.42	$365.00	31% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TRIGGER POINT TENDON SHEATH/LIGAMENT	$659.31	$659.31	$365.00	202% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER ARTHROCENTESIS MAJOR JOINT	$409.20	$409.20	$365.00	72% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER ARTHROCENTESIS INTERMED JOINT	$140.32	$140.32	$365.00	38% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ER ARTHROCENTESIS SM JOINT	$122.79	$122.79	$365.00	31% below	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 PRO FEE LAPAROSCOPY W/RMVL ADNEXAL STRUC	$1,101.39	$1,101.39	$365.00	87% below	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	$11,668.72	$11,668.72	$365.75	42% above	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 PRO FEE LAPAROSCOPY W/RMVL ADNEXAL STRUC	$1,101.39	$1,101.39	$365.00	—	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	$11,668.72	$11,668.72	$365.75	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE 2.5 CM OR LESS	$123.81	$123.81	$365.00	60% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION <.5 CM	$1,407.18	$1,407.18	$365.75	387% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION OF BENIGN LESION <.5 CM	$1,829.33	$1,829.33	$365.75	533% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION <.5 CM	$1,407.18	$1,407.18	$365.75	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION OF BENIGN LESION <.5 CM	$1,829.33	$1,829.33	$365.75	—	—
Nail removal (partial or complete), one nail CPT 11730 SPL AVULSE NP; SGL	$84.44	$84.44	$365.00	46% below	—
Paracentesis with imaging guidance CPT 49083 US ABD PARACENTESIS	$250.00	$1,034.76	$365.00	73% below	76%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$473.17	$473.17	$365.00	49% below	—
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/ IMAGING	$1,104.19	$1,104.19	$365.00	19% above	—
Paracentesis with imaging guidance inpatient CPT 49083 US ABD PARACENTESIS	$250.00	$1,034.76	$365.00	—	76%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$553.10	$553.10	$365.00	53% above	—
Removal of a foreign object under the skin, simple CPT 10120 INC & REM FB SQ; SMPL	$135.56	$135.56	$365.00	45% below	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FOREIGN BODY SIMPLE	$1,198.59	$1,198.59	$365.75	388% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL FOREIGN BODY SIMPLE	$1,198.59	$1,198.59	$365.75	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PROF FEE COLONOSCOPY NOT HIGH RISK	$522.21	$522.21	$365.00	47% below	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCREENING NOT HIGH RISK	$2,608.32	$2,608.32	$365.75	165% above	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PROF FEE COLONOSCOPY NOT HIGH RISK	$522.21	$522.21	$365.00	—	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY SCREENING NOT HIGH RISK	$2,608.32	$2,608.32	$365.75	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PROF FEE COLONOSCOPY HIGH RISK	$522.21	$522.21	$365.00	56% below	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK	$2,608.32	$2,608.32	$365.75	119% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PROF FEE COLONOSCOPY HIGH RISK	$522.21	$522.21	$365.00	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK	$2,608.32	$2,608.32	$365.75	—	—
Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST	$100.42	$100.42	$365.00	48% below	—
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT; STATIC	$110.81	$110.81	$365.00	14% below	—
Short leg cast (below the knee) CPT 29405 ER APPLICATION SHORT LEG CAST	$141.90	$141.90	$365.00	8% below	—
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$132.50	$132.50	$365.00	6% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER REPAIR 2.5 CM OR LESS	$197.11	$197.11	$365.00	1% above	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION	$1,198.59	$1,198.59	$365.75	300% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION	$1,198.59	$1,198.59	$365.75	—	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION <.5 CM	$1,407.18	$1,407.18	$365.75	217% above	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION <.5 CM	$1,407.18	$1,407.18	$365.75	—	—
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS; <=15 LESIONS	$154.01	$154.01	$365.00	1% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 ER LUMBAR SPINAL PUNCTURE DIAG	$564.50	$564.50	$365.00	6% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER REPAIR 2.6-7.5 CM	$225.76	$225.76	$365.00	10% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER REPAIR UP TO 2.5 CM (FACIAL)	$198.43	$198.43	$365.00	6% below	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENT BIOSPY SINGLE SKIN LESION	$596.10	$596.10	$365.75	156% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENT BIOSPY SINGLE SKIN LESION	$596.10	$596.10	$365.75	—	—
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS	$250.00	$1,944.72	$365.00	63% below	87%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS	$250.00	$1,944.72	$365.00	—	87%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES	$483.01	$483.01	$365.00	112% above	—
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 PRO FEE LAPAROSCOPY W/FULGURATION OF OVI	$1,057.47	$1,057.47	$365.00	76% below	—
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 PRO FEE LAPAROSCOPY W/FULGURATION OF OVI	$1,057.47	$1,057.47	$365.00	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PROF FEE EGD W/ DILATION	$390.81	$390.81	$365.00	78% below	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD WITH DILATION	$1,878.98	$1,878.98	$365.75	4% above	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 PROF FEE EGD W/ DILATION	$390.81	$390.81	$365.00	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD WITH DILATION	$1,878.98	$1,878.98	$365.75	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 PROF FEE EGD W/ BIOPSY	$390.81	$390.81	$365.00	44% below	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,651.02	$1,651.02	$365.75	136% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PROF FEE EGD W/ BIOPSY	$390.81	$390.81	$365.00	—	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,651.02	$1,651.02	$365.75	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PROF FEE EGD REMOVE TUMOR POLY/OTHER LES	$534.93	$534.93	$365.00	82% below	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PROF FEE EGD REMOVE TUMOR POLY/OTHER LES	$534.93	$534.93	$365.00	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 PROF FEE EGD	$346.17	$346.17	$365.00	67% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$1,407.71	$1,407.71	$365.75	33% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PROF FEE EGD	$346.17	$346.17	$365.00	—	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$1,407.71	$1,407.71	$365.75	—	—
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 PRO FEE VASECTOMY UNI OR BILATERAL	$650.19	$650.19	$365.00	—	—
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI OR BILATERAL	$1,164.42	$1,164.42	$365.75	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 PRO FEE VASECTOMY UNI OR BILATERAL	$650.19	$650.19	$365.00	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI OR BILATERAL	$1,164.42	$1,164.42	$365.75	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SUBQ TISSUE	$547.55	$547.55	$365.00	35% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 1-2 BLOOD PROD UNITS	$304.92	$304.92	$365.00	54% below	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPONTS 2H	$307.81	$307.81	$365.00	54% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 3-4 BLOOD PROD UNITS	$457.38	$457.38	$365.00	31% below	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMP	$902.29	$902.29	$365.00	35% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$1,914.50	$1,914.50	$365.00	187% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 1-2 BLOOD PROD UNITS	$304.92	$304.92	$365.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPONTS 2H	$307.81	$307.81	$365.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 3-4 BLOOD PROD UNITS	$457.38	$457.38	$365.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMP	$902.29	$902.29	$365.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE	$1,914.50	$1,914.50	$365.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI WITH SPACER	$78.38	$78.38	$365.00	37% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEBULIZER SUBSEQUENT	$91.44	$91.44	$365.00	26% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB/MDI RX INITIAL	$958.00	$958.00	$365.00	673% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI WITH SPACER	$78.38	$78.38	$365.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEBULIZER SUBSEQUENT	$91.44	$91.44	$365.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB/MDI RX INITIAL	$958.00	$958.00	$365.00	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADM IV INFUSION UP TO 1 HR	$1,441.90	$1,441.90	$365.00	314% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM IV INFUSION UP TO 1 HR	$1,441.90	$1,441.90	$365.00	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE INIT 30-74 MIN	$630.36	$630.36	$365.00	22% below	—
Critical care, first 30 to 74 minutes CPT 99291 111ER CRITICAL CARE 1ST 30-74 MIN	$984.54	$984.54	$365.00	21% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE INIT 30-74 MIN	$630.36	$630.36	$365.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE TRACING ONLY	$173.30	$173.30	$365.00	49% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NURSING EKG TRACING ONLY	$173.30	$173.30	$365.00	49% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RADIOLOGY EKG TRACING ONLY	$173.30	$173.30	$365.00	49% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE TRACING ONLY	$173.30	$173.30	$365.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NURSING EKG TRACING ONLY	$173.30	$173.30	$365.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RADIOLOGY EKG TRACING ONLY	$173.30	$173.30	$365.00	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL STRESS TEST	$410.28	$410.28	$365.00	9% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL STRESS TEST	$410.28	$410.28	$365.00	—	—
Group psychotherapy session CPT 90853 GROUP THERAPY	$198.00	$198.00	$365.00	1% above	—
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY	$198.00	$198.00	$365.00	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT 31-60 MINS	$118.92	$118.92	$365.00	27% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INIT 31M-1HR	$935.90	$935.90	$365.00	474% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INIT 31M-1HR	$935.90	$935.90	$365.00	—	—
IV infusion of a medicine, first hour CPT 96365 ER-KETAMINE HCL 500MG/5ML 100mg/ml	$42.92	$42.92	$365.00	81% below	—
IV infusion of a medicine, first hour CPT 96365 INFUSN THERAP,PROPHYL, DIAGN TO 1 HR	$110.45	$110.45	$365.00	52% below	—
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$157.95	$157.95	$365.00	31% below	—
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$352.97	$352.97	$365.00	54% above	—
IV infusion of a medicine, first hour CPT 96365 IV THERAPUTIC FIRST HR ONCO	$935.90	$935.90	$365.00	308% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$157.95	$157.95	$365.00	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPUTIC FIRST HR ONCO	$935.90	$935.90	$365.00	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER-ETOMIDATE (Amidate) 40mg/20ML INJ	$18.34	$18.34	$365.00	73% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SUBQ/INTRAMUSCULAR	$111.77	$111.77	$365.00	67% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THER/PROPH/DX SUBQ/IM	$298.75	$298.75	$365.00	346% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER-ETOMIDATE (Amidate) 40mg/20ML INJ	$18.34	$18.34	$365.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/INTRAMUSCULAR	$111.77	$111.77	$365.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THER/PROPH/DX SUBQ/IM	$298.75	$298.75	$365.00	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPATIENT VISIT NEW	$55.44	$55.44	$365.00	49% below	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPATIENT VISIT NEW	$55.44	$55.44	$365.00	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EAC	$110.48	$110.48	$365.00	129% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EAC	$110.48	$110.48	$365.00	—	—
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL PSY 20-30 MIN	$222.75	$222.75	$365.00	3% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL PSY 20-30 MIN	$222.75	$222.75	$365.00	—	—
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL PSY 45-50	$350.92	$350.92	$365.00	35% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL PSY 45-50	$350.92	$350.92	$365.00	—	—
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION TEST W/O	$132.51	$132.51	$365.00	8% below	—
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION TEST W/O	$132.51	$132.51	$365.00	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PTA THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	20% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 COTA THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	20% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	20% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	20% below	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 COTA THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PTA THERAPUTIC ACTIVITIES	$43.80	$43.80	$365.00	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$532.40	$532.40	$365.00	325% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$532.40	$532.40	$365.00	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE	$521.67	$521.67	$365.00	24% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE	$521.67	$521.67	$365.00	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU-INFLUENZA VACCI *AGE 6 MO & UP	$39.60	$39.60	$365.00	8% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU-INFLUENZA VACCI *AGE 6 MO & UP	$39.60	$39.60	$365.00	—	—
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE (VAQTA ) IM	$79.20	$79.20	$365.00	47% below	—
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE - PED (HAVRIX ) 0.5ml	$109.25	$109.25	$365.00	27% below	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE (VAQTA ) IM	$79.20	$79.20	$365.00	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE - PED (HAVRIX ) 0.5ml	$109.25	$109.25	$365.00	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluZONE HD 65+	$168.83	$168.83	$365.00	2% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZONE HD 65+	$168.83	$168.83	$365.00	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R Vaccine INJ	$127.36	$127.36	$365.00	10% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II VACCINE SQ	$255.45	$255.45	$365.00	122% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R Vaccine INJ	$127.36	$127.36	$365.00	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II VACCINE SQ	$255.45	$255.45	$365.00	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MCV4 MENACWY VACCINE IM	$704.32	$704.32	$365.00	338% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MCV4 MENACWY VACCINE IM	$704.32	$704.32	$365.00	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 MS-PREVNAR 20 PNEUMOCOCCAL VACCINE	$727.13	$727.13	$365.00	14% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 MS-PREVNAR 20 PNEUMOCOCCAL VACCINE	$727.13	$727.13	$365.00	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23	$298.23	$298.23	$365.00	89% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23(PNEUMOVAX 23) vacc 0.5ml	$328.50	$328.50	$365.00	108% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23	$298.23	$298.23	$365.00	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23(PNEUMOVAX 23) vacc 0.5ml	$328.50	$328.50	$365.00	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS (RSV vaccine) 50mg/0.5ml syrin	$1,434.55	$1,434.55	$365.00	49% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS (RSV vaccine) 50mg/0.5ml syrin	$1,434.55	$1,434.55	$365.00	—	—
Rabies vaccine, one dose CPT 90675 IM RABIES VACCINE	$1,058.14	$1,058.14	$365.00	54% above	—
Rabies vaccine, one dose CPT 90675 INF-RABIES VACCINE (RABAVERT) IM	$1,225.96	$1,225.96	$365.00	78% above	—
Rabies vaccine, one dose CPT 90675 ER-RABIES VACCINE (RABAVERT) IM	$1,225.98	$1,225.98	$365.00	78% above	—
Rabies vaccine, one dose inpatient CPT 90675 IM RABIES VACCINE	$1,058.14	$1,058.14	$365.00	—	—
Rabies vaccine, one dose inpatient CPT 90675 INF-RABIES VACCINE (RABAVERT) IM	$1,225.96	$1,225.96	$365.00	—	—
Rabies vaccine, one dose inpatient CPT 90675 ER-RABIES VACCINE (RABAVERT) IM	$1,225.98	$1,225.98	$365.00	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC 7 YRS IM (Tenivac)	$103.78	$103.78	$365.00	17% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC 7 YRS IM (Tenivac)	$103.78	$103.78	$365.00	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ER-TDAP VACCINE >= 7 YEARS IM (Boostrix)	$136.60	$136.60	$365.00	75% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >= 7 YRS IM	$191.81	$191.81	$365.00	145% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ER-TDAP VACCINE >= 7 YEARS IM (Boostrix)	$136.60	$136.60	$365.00	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >= 7 YRS IM	$191.81	$191.81	$365.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$53.72	$53.72	$365.00	10% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE	$139.00	$139.00	$365.00	132% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION X 1	$298.75	$298.75	$365.00	398% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$53.72	$53.72	$365.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN ONE	$139.00	$139.00	$365.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION X 1	$298.75	$298.75	$365.00	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM; EA ADDTL 1 VACCINE	$41.32	$41.32	$365.00	43% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION INJ EACH ADDITIONAL	$60.84	$60.84	$365.00	111% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM; EA ADDTL 1 VACCINE	$41.32	$41.32	$365.00	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION INJ EACH ADDITIONAL	$60.84	$60.84	$365.00	—	—

Source file: https://eomchospital.com/wp-content/uploads/2026/03/736060835_eastern-oklahoma-medical-center_standardcharges.csv