Hospital

Field Memorial Community Hospital

Field Memorial Community Hospital in Centreville, MS publishes cash prices for 279 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 Mississippi median for 152 of 275 procedures and above it for 118. By typical cash price it ranks #15 of 36 Mississippi hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

178 HWY 24 E, CENTREVILLE, MS, 39631-4171 Collected Sep 27, 2026 Source price file (601) 890-0500

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 251309 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Field Memorial Community Hospital in Centreville, MS:

Jul 2, 2026 Warning notice
Jul 20, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LEFT COMP 3V MIN	$107.25	$143.00	$0.90–$170.00	11% below	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RIGHT COMP 3V MIN	$107.25	$143.00	$0.90–$170.00	11% below	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE LEFT COMP 3V MIN	$107.25	$143.00	$0.90–$170.00	—	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE RIGHT COMP 3V MIN	$107.25	$143.00	$0.90–$170.00	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI ONLY	$118.50	$158.00	$2.15–$170.00	47% below	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US LOWER LIMB ARTERIAL	$297.00	$396.00	$2.15–$170.00	33% above	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI ONLY	$118.50	$158.00	$2.15–$170.00	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US LOWER LIMB ARTERIAL	$297.00	$396.00	$2.15–$170.00	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM	$192.00	$256.00	$2.24–$170.00	5% below	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM	$192.00	$256.00	$2.24–$170.00	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$690.00	$920.00	$6.98–$170.00	7% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY	$690.00	$920.00	$6.98–$170.00	—	25%
Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE	$204.75	$273.00	$2.28–$170.00	10% above	25%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE	$204.75	$273.00	$2.28–$170.00	—	25%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED	$153.75	$205.00	$1.81–$170.00	21% below	25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED	$153.75	$205.00	$1.81–$170.00	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$1,074.75	$1,433.00	$6.64–$170.00	6% below	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST	$1,074.75	$1,433.00	$6.64–$170.00	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING	$18.75	$25.00	$2.43–$170.00	76% below	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING	$18.75	$25.00	$2.43–$170.00	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENAL STONE	$1,968.75	$2,625.00	$3.75–$170.00	43% above	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS WO CONTRAST	$1,968.75	$2,625.00	$3.75–$170.00	43% above	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS WO CONTRAST	$1,968.75	$2,625.00	$3.75–$170.00	—	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT RENAL STONE	$1,968.75	$2,625.00	$3.75–$170.00	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W CONTRAST	$2,205.00	$2,940.00	$7.25–$170.00	27% above	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT TRAUMA ABDOMEN PELVIS W CONTRAST	$2,205.00	$2,940.00	$7.25–$170.00	27% above	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W CONTRAST	$2,205.00	$2,940.00	$7.25–$170.00	—	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT TRAUMA ABDOMEN PELVIS W CONTRAST	$2,205.00	$2,940.00	$7.25–$170.00	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS WWO CONTRAST	$2,598.75	$3,465.00	$8.15–$170.00	39% above	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS WWO CONTRAST	$2,598.75	$3,465.00	$8.15–$170.00	—	25%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/LOCM	$1,096.50	$1,462.00	$5.67–$170.00	14% above	25%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$1,111.50	$1,482.00	$5.67–$170.00	16% above	25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/LOCM	$1,096.50	$1,462.00	$5.67–$170.00	—	25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$1,111.50	$1,482.00	$5.67–$170.00	—	25%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$851.25	$1,135.00	$2.90–$170.00	at median	25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$851.25	$1,135.00	$2.90–$170.00	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$793.50	$1,058.00	$3.00–$170.00	13% above	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT TRAUMA MAXILLOFACIAL WO CONTRAST	$793.50	$1,058.00	$3.00–$170.00	13% above	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT TRAUMA MAXILLOFACIAL WO CONTRAST	$793.50	$1,058.00	$3.00–$170.00	—	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$793.50	$1,058.00	$3.00–$170.00	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD OR BRAIN WO CONTRAST	$793.50	$1,058.00	$2.35–$170.00	6% above	25%
CT scan of the head or brain, no contrast dye CPT 70450 CT TRAUMA HEAD WO CONTRAST	$793.50	$1,058.00	$2.35–$170.00	6% above	25%
CT scan of the head or brain, no contrast dye CPT 70450 CT STROKE PROTOCOL HEAD W/O CONTRAST	$793.50	$1,058.00	$2.35–$170.00	6% above	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT TRAUMA HEAD WO CONTRAST	$793.50	$1,058.00	$2.35–$170.00	—	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT STROKE PROTOCOL HEAD W/O CONTRAST	$793.50	$1,058.00	$2.35–$170.00	—	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD OR BRAIN WO CONTRAST	$793.50	$1,058.00	$2.35–$170.00	—	25%
CT scan of the head with contrast CPT 70460 CT HEAD OR BRAIN W LOCM	$1,056.00	$1,408.00	$3.32–$170.00	16% above	25%
CT scan of the head with contrast CPT 70460 CT HEAD OR BRAIN W CONTRAST	$1,077.75	$1,437.00	$3.32–$170.00	19% above	25%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD OR BRAIN W LOCM	$1,056.00	$1,408.00	$3.32–$170.00	—	25%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD OR BRAIN W CONTRAST	$1,077.75	$1,437.00	$3.32–$170.00	—	25%
CT scan of the head without and with contrast CPT 70470 CT HEAD OR BRAIN WWO LOCM	$1,119.75	$1,493.00	$3.93–$170.00	8% above	25%
CT scan of the head without and with contrast CPT 70470 CT HEAD OR BRAIN WWO CONTRAST	$1,132.50	$1,510.00	$3.93–$170.00	9% above	25%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD OR BRAIN WWO LOCM	$1,119.75	$1,493.00	$3.93–$170.00	—	25%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD OR BRAIN WWO CONTRAST	$1,132.50	$1,510.00	$3.93–$170.00	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTRAST	$980.25	$1,307.00	$2.89–$170.00	10% above	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST	$980.25	$1,307.00	$2.89–$170.00	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTRAST	$829.50	$1,106.00	$2.91–$170.00	6% below	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT TRAUMA SPINE CERVICAL WO CONTRAST	$829.50	$1,106.00	$2.91–$170.00	6% below	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST	$829.50	$1,106.00	$2.91–$170.00	—	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT TRAUMA SPINE CERVICAL WO CONTRAST	$829.50	$1,106.00	$2.91–$170.00	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W LOCM	$998.25	$1,331.00	$5.67–$170.00	2% above	25%
CT scan of the pelvis, with contrast dye CPT 72193 CT TRAUMA PELVIS W CONTRAST	$1,027.50	$1,370.00	$5.67–$170.00	5% above	25%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,027.50	$1,370.00	$5.67–$170.00	5% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W LOCM	$998.25	$1,331.00	$5.67–$170.00	—	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT TRAUMA PELVIS W CONTRAST	$1,027.50	$1,370.00	$5.67–$170.00	—	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,027.50	$1,370.00	$5.67–$170.00	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID BILATERAL	$363.75	$485.00	$4.73–$170.00	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID BILATERAL	$363.75	$485.00	$4.73–$170.00	—	25%
Chest X-ray, 2 views CPT 71046 CHEST TWO VIEWS	$138.00	$184.00	$0.77–$170.00	3% above	25%
Chest X-ray, 2 views inpatient CPT 71046 CHEST TWO VIEWS	$138.00	$184.00	$0.77–$170.00	—	25%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$108.00	$144.00	$0.58–$170.00	2% above	25%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW	$108.00	$144.00	$0.58–$170.00	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTIC DOPPLER	$293.25	$391.00	$2.43–$170.00	14% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMP	$293.25	$391.00	$2.43–$170.00	14% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMP	$293.25	$391.00	$2.43–$170.00	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US AORTIC DOPPLER	$293.25	$391.00	$2.43–$170.00	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY DUAL ENERGY XRAY	$192.75	$257.00	$0.96–$170.00	19% below	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY DUAL ENERGY XRAY	$192.75	$257.00	$0.96–$170.00	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY APPENDICULAR SKELETON	$68.25	$91.00	$0.74–$170.00	26% below	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY APPENDICULAR SKELETON	$68.25	$91.00	$0.74–$170.00	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$833.25	$1,111.00	$2.91–$170.00	at median	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$833.25	$1,111.00	$2.91–$170.00	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W LOCM	$1,096.50	$1,462.00	$3.85–$170.00	10% above	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT TRAUMA CHEST W CONTRAST	$1,111.50	$1,482.00	$3.85–$170.00	11% above	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST	$1,111.50	$1,482.00	$3.85–$170.00	11% above	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W LOCM	$1,096.50	$1,462.00	$3.85–$170.00	—	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT TRAUMA CHEST W CONTRAST	$1,111.50	$1,482.00	$3.85–$170.00	—	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST	$1,111.50	$1,482.00	$3.85–$170.00	—	25%
Diagnostic mammogram, both breasts both sides CPT 77066 MA MAMMO BILATERAL DIAGNOSTIC	$254.25	$339.00	$3.69–$170.00	—	25%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA MAMMO BILATERAL DIAGNOSTIC	$254.25	$339.00	$3.69–$170.00	—	25%
Diagnostic mammogram, one breast one side CPT 77065 MA MAMMO UNILATERAL DIAGNOSTIC	$182.25	$243.00	$2.90–$170.00	41% above	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMMO UNILATERAL DIAGNOSTIC	$182.25	$243.00	$2.90–$170.00	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUPLEX LOW EXT ARTERY BILATERAL	$295.50	$394.00	$6.18–$170.00	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US DUPLEX LOW EXT ARTERY BILATERAL	$295.50	$394.00	$6.18–$170.00	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL	$585.75	$781.00	$4.75–$170.00	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL	$585.75	$781.00	$4.75–$170.00	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM	$976.50	$1,302.00	$4.28–$170.00	3% above	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAM	$976.50	$1,302.00	$4.28–$170.00	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SCAN HIDA DELAYED	$299.25	$399.00	$7.88–$170.00	54% below	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HIDA SCAN W/O EJECTION FRACTION	$600.00	$800.00	$7.88–$170.00	7% below	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SCAN HIDA	$699.00	$932.00	$7.88–$170.00	8% above	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SCAN HIDA DELAYED	$299.25	$399.00	$7.88–$170.00	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HIDA SCAN W/O EJECTION FRACTION	$600.00	$800.00	$7.88–$170.00	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SCAN HIDA	$699.00	$932.00	$7.88–$170.00	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$277.50	$370.00	$1.97–$170.00	4% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$277.50	$370.00	$1.97–$170.00	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG SCREEN	$178.50	$238.00	$3.04–$170.00	138% above	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG SCREEN	$178.50	$238.00	$3.04–$170.00	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM 1 PHASE R OR S CARDIAC PERFUSION SCA	$1,024.50	$1,366.00	$10.90–$170.00	47% below	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERFUSION IMAGING	$1,556.25	$2,075.00	$10.90–$170.00	20% below	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM 1 PHASE R OR S CARDIAC PERFUSION SCA	$1,024.50	$1,366.00	$10.90–$170.00	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERFUSION IMAGING	$1,556.25	$2,075.00	$10.90–$170.00	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$168.00	$224.00	$0.97–$170.00	20% below	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$168.00	$224.00	$0.97–$170.00	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE/ TRANSABD	$261.00	$348.00	$2.40–$170.00	3% below	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE/ TRANSABD	$261.00	$348.00	$2.40–$170.00	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US FETAL COMPLETE STUDY	$343.50	$458.00	$2.97–$170.00	at median	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US FETAL COMPLETE STUDY	$343.50	$458.00	$2.97–$170.00	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US FETAL LIMITED STUDY	$225.00	$300.00	$1.73–$170.00	12% above	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US FETAL LIMITED STUDY	$225.00	$300.00	$1.73–$170.00	—	25%
Screening mammogram, both breasts both sides CPT 77067 MA SCREENING BILATERAL MAMMOGRAPHY	$211.50	$282.00	$3.04–$170.00	—	25%
Screening mammogram, both breasts one side CPT 77067 MA SCREENING UNILATERAL MAMMOGRAPHY	$211.50	$282.00	$3.04–$170.00	at median	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 MA SCREENING BILATERAL MAMMOGRAPHY	$211.50	$282.00	$3.04–$170.00	—	25%
Screening mammogram, both breasts inpatient one side CPT 77067 MA SCREENING UNILATERAL MAMMOGRAPHY	$211.50	$282.00	$3.04–$170.00	—	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT MIN 2 VIEWS	$106.50	$142.00	$0.84–$170.00	15% below	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT MIN 2 VIEWS	$106.50	$142.00	$0.84–$170.00	15% below	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT MIN 2 VIEWS	$106.50	$142.00	$0.84–$170.00	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT MIN 2 VIEWS	$106.50	$142.00	$0.84–$170.00	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 EVAL SWALLOW WITH FLUORO	$244.50	$326.00	$3.08–$170.00	5% above	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 EVAL SWALLOW WITH FLUORO	$244.50	$326.00	$3.08–$170.00	—	25%
Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANSVAGINAL	$198.75	$265.00	$2.79–$170.00	34% below	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC TRANSVAGINAL	$198.75	$265.00	$2.79–$170.00	—	25%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$319.50	$426.00	$2.59–$170.00	11% below	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$319.50	$426.00	$2.59–$170.00	—	25%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$204.75	$273.00	$2.30–$170.00	24% below	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$204.75	$273.00	$2.30–$170.00	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUES	$234.75	$313.00	$2.67–$170.00	12% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUES	$234.75	$313.00	$2.67–$170.00	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI WITHOUT KUB	$219.75	$293.00	$2.77–$170.00	23% below	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI WITHOUT KUB	$219.75	$293.00	$2.77–$170.00	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VEINS UNILATERAL LIMITED	$258.75	$345.00	$3.04–$170.00	11% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX VEINS UNILATERAL LIMITED	$258.75	$345.00	$3.04–$170.00	—	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT COMPLETE MIN 3 VIEWS	$102.75	$137.00	$1.05–$170.00	15% below	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT COMPLETE MIN 3 VIEWS	$102.75	$137.00	$1.05–$170.00	15% below	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT COMPLETE MIN 3 VIEWS	$102.75	$137.00	$1.05–$170.00	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT COMPLETE MIN 3 VIEWS	$102.75	$137.00	$1.05–$170.00	—	25%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SINGLE VIEW	$102.75	$137.00	$0.70–$170.00	13% below	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SINGLE VIEW	$102.75	$137.00	$0.70–$170.00	—	25%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEWS	$93.00	$124.00	$0.78–$170.00	at median	25%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEWS	$93.00	$124.00	$0.78–$170.00	at median	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEWS	$93.00	$124.00	$0.78–$170.00	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEWS	$93.00	$124.00	$0.78–$170.00	—	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER LEFT MINIMUM 2 VIEWS	$81.75	$109.00	$1.00–$170.00	23% below	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER RIGHT MINIMUM 2 VIEWS	$81.75	$109.00	$1.00–$170.00	23% below	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER LEFT MINIMUM 2 VIEWS	$81.75	$109.00	$1.00–$170.00	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER RIGHT MINIMUM 2 VIEWS	$81.75	$109.00	$1.00–$170.00	—	25%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 1 VIEW	$72.75	$97.00	$0.67–$170.00	31% below	25%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 1 VIEW	$72.75	$97.00	$0.67–$170.00	31% below	25%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT AP LATERAL	$93.00	$124.00	$0.67–$170.00	11% below	25%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT AP LATERAL	$93.00	$124.00	$0.67–$170.00	11% below	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 1 VIEW	$72.75	$97.00	$0.67–$170.00	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 1 VIEW	$72.75	$97.00	$0.67–$170.00	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT AP LATERAL	$93.00	$124.00	$0.67–$170.00	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT AP LATERAL	$93.00	$124.00	$0.67–$170.00	—	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LEFT COMP 3V MIN	$110.25	$147.00	$0.83–$170.00	6% below	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RIGHT COMP 3V MIN	$110.25	$147.00	$0.83–$170.00	6% below	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT LEFT COMP 3V MIN	$110.25	$147.00	$0.83–$170.00	—	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT RIGHT COMP 3V MIN	$110.25	$147.00	$0.83–$170.00	—	25%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT 3V MIN	$102.75	$137.00	$0.93–$170.00	16% below	25%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT 3V MIN	$102.75	$137.00	$0.93–$170.00	16% below	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT 3V MIN	$102.75	$137.00	$0.93–$170.00	—	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT 3V MIN	$102.75	$137.00	$0.93–$170.00	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBOSACRAL AP LAT	$129.75	$173.00	$0.95–$170.00	2% below	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBOSACRAL AP LAT	$129.75	$173.00	$0.95–$170.00	—	25%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LS WITH OBLIQUES	$203.25	$271.00	$1.28–$170.00	10% above	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LS WITH OBLIQUES	$203.25	$271.00	$1.28–$170.00	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC AP LAT	$129.75	$173.00	$0.77–$170.00	5% above	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC AP LAT	$129.75	$173.00	$0.77–$170.00	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS	$116.25	$155.00	$0.94–$170.00	12% below	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 VIEWS	$116.25	$155.00	$0.94–$170.00	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL AP LAT	$134.25	$179.00	$0.95–$170.00	2% above	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL AP LAT	$134.25	$179.00	$0.95–$170.00	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP ONLY	$102.75	$137.00	$0.65–$170.00	17% below	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP ONLY	$102.75	$137.00	$0.65–$170.00	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX MIN 2 VIEWS	$116.25	$155.00	$0.79–$170.00	6% below	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX MIN 2 VIEWS	$116.25	$155.00	$0.79–$170.00	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$69.75	$93.00	$170.00	85% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$69.75	$93.00	$170.00	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$69.75	$93.00	$170.00	90% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$69.75	$93.00	$170.00	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$129.75	$173.00	$170.00	17% below	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$129.75	$173.00	$170.00	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 SRACHYBOTRYS ATRA	$9.00	$12.00	$170.00	43% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGEN	$54.00	$72.00	$170.00	243% above	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SRACHYBOTRYS ATRA	$9.00	$12.00	$170.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGEN	$54.00	$72.00	$170.00	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB IGG/IGA	$26.25	$35.00	$170.00	43% below	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB IGG/IGA	$26.25	$35.00	$170.00	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$65.25	$87.00	$170.00	10% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN IFA	$65.25	$87.00	$170.00	10% below	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$65.25	$87.00	$170.00	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN IFA	$65.25	$87.00	$170.00	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP - HOSPITAL	$144.75	$193.00	$170.00	4% above	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP - HOSPITAL	$144.75	$193.00	$170.00	—	25%
Basic metabolic panel (blood test) CPT 80048 REF BASIC METABOLIC PANEL	$106.50	$142.00	$170.00	45% above	25%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$106.50	$142.00	$170.00	45% above	25%
Basic metabolic panel (blood test) inpatient CPT 80048 REF BASIC METABOLIC PANEL	$106.50	$142.00	$170.00	—	25%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$106.50	$142.00	$170.00	—	25%
Blood culture for bacteria CPT 87040 CULT BLOOD	$145.50	$194.00	$170.00	65% above	25%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD	$145.50	$194.00	$170.00	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$9.00	$12.00	$170.00	5% below	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$9.00	$12.00	$170.00	—	25%
Blood glucose (sugar) test CPT 82947 URINE GLUCOSE	$4.50	$6.00	$170.00	86% below	25%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$45.75	$61.00	$170.00	42% above	25%
Blood glucose (sugar) test inpatient CPT 82947 URINE GLUCOSE	$4.50	$6.00	$170.00	—	25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$45.75	$61.00	$170.00	—	25%
Blood lead test CPT 83655 LEAD BLOOD PEDIATRIC	$48.75	$65.00	$170.00	3% below	25%
Blood lead test CPT 83655 .URINE LEAD QNT	$48.75	$65.00	$170.00	3% below	25%
Blood lead test CPT 83655 LEAD BLOOD ADULT	$48.75	$65.00	$170.00	3% below	25%
Blood lead test inpatient CPT 83655 .URINE LEAD QNT	$48.75	$65.00	$170.00	—	25%
Blood lead test inpatient CPT 83655 LEAD BLOOD ADULT	$48.75	$65.00	$170.00	—	25%
Blood lead test inpatient CPT 83655 LEAD BLOOD PEDIATRIC	$48.75	$65.00	$170.00	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM	$53.25	$71.00	$170.00	11% above	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM	$53.25	$71.00	$170.00	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .BB ABO GROUP	$67.50	$90.00	$170.00	44% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .BB ABO GROUP	$67.50	$90.00	$170.00	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$51.75	$69.00	$170.00	55% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$51.75	$69.00	$170.00	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIN GENE NAA	$120.00	$160.00	$170.00	60% above	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE TOXIN GENE NAA	$120.00	$160.00	$170.00	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$56.25	$75.00	$170.00	34% below	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$56.25	$75.00	$170.00	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$56.25	$75.00	$170.00	49% below	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$56.25	$75.00	$170.00	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INHOUSE COVID-19 TEST	$96.21	$128.28	$170.00	54% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INHOUSE COVID-19 TEST	$96.21	$128.28	$170.00	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INHOUSE CHLAMYIDA TRACH AND N.GONORRHEA	$52.50	$70.00	$170.00	32% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NAA	$64.50	$86.00	$170.00	17% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INHOUSE CT/NG/TV PANEL	$157.50	$210.00	$170.00	104% above	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INHOUSE CHLAMYIDA TRACH AND N.GONORRHEA	$52.50	$70.00	$170.00	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NAA	$64.50	$86.00	$170.00	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INHOUSE CT/NG/TV PANEL	$157.50	$210.00	$170.00	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 REF LIPID PANEL	$56.25	$75.00	$170.00	24% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$56.25	$75.00	$170.00	24% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIAC ENZYMES	$124.50	$166.00	$170.00	69% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 REF LIPID PANEL	$56.25	$75.00	$170.00	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$56.25	$75.00	$170.00	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIAC ENZYMES	$124.50	$166.00	$170.00	—	25%
Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFF	$67.50	$90.00	$170.00	63% above	25%
Complete blood count (CBC) with differential CPT 85025 .CBC PL AUTO DIFF	$67.50	$90.00	$170.00	63% above	25%
Complete blood count (CBC) with differential CPT 85025 REF CBC WITH AUTO DIFF	$67.50	$90.00	$170.00	63% above	25%
Complete blood count (CBC) with differential inpatient CPT 85025 .CBC PL AUTO DIFF	$67.50	$90.00	$170.00	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTO DIFF	$67.50	$90.00	$170.00	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 REF CBC WITH AUTO DIFF	$67.50	$90.00	$170.00	—	25%
Complete blood count (CBC), no differential CPT 85027 CBC WITH MANUAL DIFF	$67.50	$90.00	$170.00	91% above	25%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH MANUAL DIFF	$67.50	$90.00	$170.00	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$158.25	$211.00	$170.00	51% above	25%
Comprehensive metabolic panel (blood test) CPT 80053 REF COMPREHENSIVE METABOLIC PANEL	$158.25	$211.00	$170.00	51% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$158.25	$211.00	$170.00	—	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 REF COMPREHENSIVE METABOLIC PANEL	$158.25	$211.00	$170.00	—	25%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$144.75	$193.00	$170.00	87% above	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$144.75	$193.00	$170.00	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$51.75	$69.00	$170.00	46% below	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$51.75	$69.00	$170.00	—	25%
Estradiol blood test CPT 82670 ESTRADIOL	$124.50	$166.00	$170.00	23% above	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$124.50	$166.00	$170.00	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$86.25	$115.00	$170.00	17% below	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$86.25	$115.00	$170.00	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$243.00	$324.00	$170.00	53% above	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$243.00	$324.00	$170.00	—	25%
Ferritin blood test (iron stores) CPT 82728 FERRITIN - HOSPITAL	$114.00	$152.00	$170.00	48% above	25%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN - HOSPITAL	$114.00	$152.00	$170.00	—	25%
Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID SERUM)	$51.75	$69.00	$170.00	28% below	25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE (FOLIC ACID SERUM)	$51.75	$69.00	$170.00	—	25%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$48.75	$65.00	$170.00	47% below	25%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$48.75	$65.00	$170.00	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 REF T4 FREE	$51.00	$68.00	$170.00	2% above	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$51.00	$68.00	$170.00	2% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$51.00	$68.00	$170.00	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 REF T4 FREE	$51.00	$68.00	$170.00	—	25%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$74.25	$99.00	$170.00	9% below	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$74.25	$99.00	$170.00	—	25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$62.25	$83.00	$170.00	69% below	25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$62.25	$83.00	$170.00	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE 1 HR	$45.75	$61.00	$170.00	19% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE 1 HR	$45.75	$61.00	$170.00	—	25%
Glucose tolerance test, 3 samples CPT 82951 .GLUCOSE TOL FIRST 3 SPEC	$86.25	$115.00	$170.00	17% above	25%
Glucose tolerance test, 3 samples CPT 82951 .LACTOSE TOL FIRST 3 SPEC	$86.25	$115.00	$170.00	17% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GLUCOSE TOL FIRST 3 SPEC	$86.25	$115.00	$170.00	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 .LACTOSE TOL FIRST 3 SPEC	$86.25	$115.00	$170.00	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INHOUSE NEISSERIA GONORRHEA	$52.50	$70.00	$170.00	5% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC NAA	$64.50	$86.00	$170.00	17% above	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INHOUSE NEISSERIA GONORRHEA	$52.50	$70.00	$170.00	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC NAA	$64.50	$86.00	$170.00	—	25%
H. pylori antibody blood test CPT 86677 H. PYLORI IGG	$79.50	$106.00	$170.00	40% above	25%
H. pylori antibody blood test CPT 86677 .H. PYLORI IGA	$79.50	$106.00	$170.00	40% above	25%
H. pylori antibody blood test CPT 86677 .H. PYLORI IGM	$79.50	$106.00	$170.00	40% above	25%
H. pylori antibody blood test inpatient CPT 86677 .H. PYLORI IGA	$79.50	$106.00	$170.00	—	25%
H. pylori antibody blood test inpatient CPT 86677 .H. PYLORI IGM	$79.50	$106.00	$170.00	—	25%
H. pylori antibody blood test inpatient CPT 86677 H. PYLORI IGG	$79.50	$106.00	$170.00	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR QNT	$106.50	$142.00	$170.00	49% below	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA PCR QNT	$106.50	$142.00	$170.00	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCREEN	$72.75	$97.00	$170.00	46% above	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV SCREEN	$72.75	$97.00	$170.00	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$56.25	$75.00	$170.00	5% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$56.25	$75.00	$170.00	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B S AB	$117.00	$156.00	$170.00	107% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B S AB	$117.00	$156.00	$170.00	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B S AG	$119.25	$159.00	$170.00	137% above	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B S AG	$119.25	$159.00	$170.00	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$57.00	$76.00	$170.00	18% below	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB	$57.00	$76.00	$170.00	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QNT RNA	$320.25	$427.00	$170.00	86% above	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QNT RNA	$320.25	$427.00	$170.00	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGG AB	$70.50	$94.00	$170.00	84% above	25%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGM AB	$70.50	$94.00	$170.00	84% above	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGG AB	$70.50	$94.00	$170.00	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGM AB	$70.50	$94.00	$170.00	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGG AB	$70.50	$94.00	$170.00	51% above	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGM AB	$70.50	$94.00	$170.00	51% above	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGG AB	$70.50	$94.00	$170.00	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGM AB	$70.50	$94.00	$170.00	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENS	$48.75	$65.00	$170.00	23% above	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENS	$48.75	$65.00	$170.00	—	25%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$189.00	$252.00	$170.00	133% above	25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$189.00	$252.00	$170.00	—	25%
Insulin blood test CPT 83525 INSULIN TOTAL	$47.25	$63.00	$170.00	13% below	25%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$47.25	$63.00	$170.00	—	25%
Iron blood test (serum iron) CPT 83540 IRON	$53.25	$71.00	$170.00	41% above	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$53.25	$71.00	$170.00	—	25%
Iron-binding capacity (TIBC) test CPT 83550 IBC	$78.00	$104.00	$170.00	77% above	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IBC	$78.00	$104.00	$170.00	—	25%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$138.75	$185.00	$170.00	77% above	25%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$138.75	$185.00	$170.00	—	25%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$93.00	$124.00	$170.00	at median	25%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$93.00	$124.00	$170.00	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$56.25	$75.00	$170.00	40% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$56.25	$75.00	$170.00	—	25%
Liver function blood test panel CPT 80076 LIVER PROFILE	$81.00	$108.00	$170.00	2% below	25%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$89.25	$119.00	$170.00	8% above	25%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE	$81.00	$108.00	$170.00	—	25%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$89.25	$119.00	$170.00	—	25%
Lyme disease antibody test CPT 86618 LYME AB TOTAL	$83.25	$111.00	$170.00	5% above	25%
Lyme disease antibody test CPT 86618 LYME AB TOTAL, IGM, REFLEX	$83.25	$111.00	$170.00	5% above	25%
Lyme disease antibody test inpatient CPT 86618 LYME AB TOTAL, IGM, REFLEX	$83.25	$111.00	$170.00	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME AB TOTAL	$83.25	$111.00	$170.00	—	25%
Magnesium blood test CPT 83735 MAGNESIUM	$48.75	$65.00	$170.00	43% above	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$48.75	$65.00	$170.00	—	25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG	$73.50	$98.00	$170.00	76% above	25%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG	$73.50	$98.00	$170.00	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$45.75	$61.00	$170.00	22% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$45.75	$61.00	$170.00	—	25%
Obstetric blood test panel CPT 80055 PRENATAL PANEL	$372.00	$496.00	$170.00	138% above	25%
Obstetric blood test panel inpatient CPT 80055 PRENATAL PANEL	$372.00	$496.00	$170.00	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE/TOTAL	$80.25	$107.00	$170.00	27% above	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE/TOTAL	$80.25	$107.00	$170.00	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$84.75	$113.00	$170.00	2% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREEN - LAB	$84.75	$113.00	$170.00	2% below	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$84.75	$113.00	$170.00	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREEN - LAB	$84.75	$113.00	$170.00	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$159.75	$213.00	$170.00	at median	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$159.75	$213.00	$170.00	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$51.00	$68.00	$170.00	30% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$51.00	$68.00	$170.00	—	25%
Progesterone blood test CPT 84144 PROGESTERONE	$93.00	$124.00	$170.00	1% above	25%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$93.00	$124.00	$170.00	—	25%
Prolactin blood test CPT 84146 PROLACTIN	$74.25	$99.00	$170.00	33% below	25%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$74.25	$99.00	$170.00	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 REF PT/INR	$51.00	$68.00	$170.00	44% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR	$60.00	$80.00	$170.00	69% above	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 REF PT/INR	$51.00	$68.00	$170.00	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR	$60.00	$80.00	$170.00	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 IN-HOUSE FENTANYL	$18.90	$25.20	$170.00	48% below	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 IN-HOUSE FENTANYL	$18.90	$25.20	$170.00	—	25%
Rapid flu test (influenza antigen) CPT 87804 .INFLUENZA TYPE A	$18.75	$25.00	$170.00	56% below	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 .INFLUENZA TYPE A	$18.75	$25.00	$170.00	—	25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A RAPID	$52.50	$70.00	$170.00	2% above	25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A RAPID	$52.50	$70.00	$170.00	—	25%
Rheumatoid factor (RF) test CPT 86431 RA QUANT	$31.50	$42.00	$170.00	19% below	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RA QUANT	$31.50	$42.00	$170.00	—	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$64.50	$86.00	$170.00	28% above	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$64.50	$86.00	$170.00	28% above	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM	$64.50	$86.00	$170.00	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$64.50	$86.00	$170.00	—	25%
Stool ova and parasites exam CPT 87177 OVA + PARASITES	$57.75	$77.00	$170.00	12% above	25%
Stool ova and parasites exam inpatient CPT 87177 OVA + PARASITES	$57.75	$77.00	$170.00	—	25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$27.00	$36.00	$170.00	50% above	25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$27.00	$36.00	$170.00	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF VDRL	$45.75	$61.00	$170.00	78% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CSF VDRL	$45.75	$61.00	$170.00	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$97.50	$130.00	$170.00	28% below	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$97.50	$130.00	$170.00	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$125.25	$167.00	$170.00	5% above	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$125.25	$167.00	$170.00	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$24.75	$33.00	$170.00	30% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$51.00	$68.00	$170.00	45% above	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$24.75	$33.00	$170.00	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$51.00	$68.00	$170.00	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEONATAL TSH	$54.00	$72.00	$170.00	25% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 REF TSH (THYROID STIM.HOR.)	$69.00	$92.00	$170.00	4% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (THYROID STIM.HOR.)	$69.00	$92.00	$170.00	4% below	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NEONATAL TSH	$54.00	$72.00	$170.00	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (THYROID STIM.HOR.)	$69.00	$92.00	$170.00	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 REF TSH (THYROID STIM.HOR.)	$69.00	$92.00	$170.00	—	25%
Trichomonas test (NAAT) CPT 87661 INHOUSE TRICHOMONAS VAGINALIS	$52.50	$70.00	$170.00	9% above	25%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS, AMP PROBE	$64.50	$86.00	$170.00	34% above	25%
Trichomonas test (NAAT) inpatient CPT 87661 INHOUSE TRICHOMONAS VAGINALIS	$52.50	$70.00	$170.00	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS, AMP PROBE	$64.50	$86.00	$170.00	—	25%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$45.75	$61.00	$170.00	31% above	25%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$45.75	$61.00	$170.00	—	25%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/MIC	$44.25	$59.00	$170.00	32% above	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/MIC	$44.25	$59.00	$170.00	—	25%
Urinalysis without microscope exam, automated CPT 81003 URINE BILIRUBIN QUAL	$9.75	$13.00	$170.00	36% below	25%
Urinalysis without microscope exam, automated CPT 81003 URINE BLOOD QUAL	$9.75	$13.00	$170.00	36% below	25%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICROSCOPY	$37.50	$50.00	$170.00	148% above	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE BLOOD QUAL	$9.75	$13.00	$170.00	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE BILIRUBIN QUAL	$9.75	$13.00	$170.00	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICROSCOPY	$37.50	$50.00	$170.00	—	25%
Urinalysis without microscope exam, manual CPT 81002 QUAL URINE CALCIUM	$27.00	$36.00	$170.00	91% above	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 QUAL URINE CALCIUM	$27.00	$36.00	$170.00	—	25%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE QUNT COL CNT	$93.00	$124.00	$170.00	102% above	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE QUNT COL CNT	$93.00	$124.00	$170.00	—	25%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE - LAB	$53.25	$71.00	$170.00	34% above	25%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE - LAB	$53.25	$71.00	$170.00	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 B12	$72.00	$96.00	$170.00	14% below	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12	$72.00	$96.00	$170.00	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D 25 HYDROXY	$159.75	$213.00	$170.00	72% above	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D 25 HYDROXY	$159.75	$213.00	$170.00	—	25%
Zinc blood test CPT 84630 ZINC ROYAL BLUE TOP WHOLE BLOOD	$89.25	$119.00	$170.00	31% above	25%
Zinc blood test inpatient CPT 84630 ZINC ROYAL BLUE TOP WHOLE BLOOD	$89.25	$119.00	$170.00	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 INHOUSE SERUM HCG	$22.58	$30.10	$170.00	72% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE	$74.25	$99.00	$170.00	9% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 INHOUSE SERUM HCG	$22.58	$30.10	$170.00	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE	$74.25	$99.00	$170.00	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 I/P OPEN APPENDECTOMY	$1,980.00	$2,640.00	$8.40–$170.00	9% below	25%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 I/P OPEN APPENDECTOMY	$1,980.00	$2,640.00	$8.40–$170.00	—	25%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$1,912.50	$2,550.00	$6.25–$170.00	5% above	25%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$1,912.50	$2,550.00	$6.25–$170.00	—	25%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE	$4,451.25	$5,935.00	$12.57–$170.00	76% below	25%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE	$4,451.25	$5,935.00	$12.57–$170.00	—	25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED DISTAL FIBULA FX W/O MANIPULATION	$139.50	$186.00	$5.48–$170.00	6% above	25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT OF DISTAL FIBULA OR SHA	$140.25	$187.00	$5.48–$170.00	6% above	25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ER-PHY CLOSED DISTAL FIBULA FX W/O MANIP	$453.75	$605.00	$5.48–$170.00	244% above	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED DISTAL FIBULA FX W/O MANIPULATION	$139.50	$186.00	$5.48–$170.00	—	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREATMENT OF DISTAL FIBULA OR SHA	$140.25	$187.00	$5.48–$170.00	—	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ER-PHY CLOSED DISTAL FIBULA FX W/O MANIP	$453.75	$605.00	$5.48–$170.00	—	25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX OF METATARSAL FX MANIPULATION	$223.50	$298.00	$4.12–$170.00	23% below	25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ER-PHY CLOSED TX OF METATARSAL FX MANIPU	$309.00	$412.00	$4.12–$170.00	6% above	25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX OF METATARSAL FX MANIPULATION	$223.50	$298.00	$4.12–$170.00	—	25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ER-PHY CLOSED TX OF METATARSAL FX MANIPU	$309.00	$412.00	$4.12–$170.00	—	25%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HALLUX VALGUS W/WO SESAMOIDEC W TENDON T	$1,110.75	$1,481.00	$6.67–$170.00	90% below	25%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HALLUX VALGUS W/WO SESAMOIDEC W TENDON T	$1,110.75	$1,481.00	$6.67–$170.00	—	25%
Bunion correction with removal of part of the big toe joint CPT 28292 HALLUX VALGUS KELLER MCBRIDE MAYO TYPE P	$1,110.75	$1,481.00	$6.69–$170.00	89% below	25%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 HALLUX VALGUS KELLER MCBRIDE MAYO TYPE P	$1,110.75	$1,481.00	$6.69–$170.00	—	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$432.75	$577.00	$1.05–$170.00	13% above	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION-ER	$432.75	$577.00	$1.05–$170.00	13% above	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$432.75	$577.00	$1.05–$170.00	—	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION-ER	$432.75	$577.00	$1.05–$170.00	—	25%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE	$2,408.25	$3,211.00	$7.53–$170.00	60% below	25%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE	$2,408.25	$3,211.00	$7.53–$170.00	—	25%
Cataract surgery with lens implant CPT 66984 REMOVAL CATARACT INSERT LENS	$2,011.50	$2,682.00	$8.23–$170.00	41% below	25%
Cataract surgery with lens implant inpatient CPT 66984 REMOVAL CATARACT INSERT LENS	$2,011.50	$2,682.00	$8.23–$170.00	—	25%
Cervical biopsy CPT 57500 BIOPSY SINGLE OR MULTIPLE OR LOCAL EXCIS	$216.00	$288.00	$0.87–$170.00	59% below	25%
Cervical biopsy inpatient CPT 57500 BIOPSY SINGLE OR MULTIPLE OR LOCAL EXCIS	$216.00	$288.00	$0.87–$170.00	—	25%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION SURG EXCISION OTHER THAN CL	$1,339.50	$1,786.00	$2.25–$170.00	65% below	25%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION OTHER THAN CLAMP EXC NEWBOR	$1,339.50	$1,786.00	$2.25–$170.00	65% below	25%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION OTHER THAN CLAMP EXC NEWBOR	$1,339.50	$1,786.00	$2.25–$170.00	—	25%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION SURG EXCISION OTHER THAN CL	$1,339.50	$1,786.00	$2.25–$170.00	—	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCSION USING CLAMP OR OTHER DEVICE	$1,339.50	$1,786.00	$0.73–$170.00	897% above	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCSION USING CLAMP OR PLASTIBELL	$1,339.50	$1,786.00	$0.73–$170.00	897% above	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION	$1,339.50	$1,786.00	$0.73–$170.00	897% above	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP	$1,339.50	$1,786.00	$0.73–$170.00	897% above	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCSION USING CLAMP OR OTHER DEVICE	$1,339.50	$1,786.00	$0.73–$170.00	—	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION	$1,339.50	$1,786.00	$0.73–$170.00	—	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCSION USING CLAMP OR PLASTIBELL	$1,339.50	$1,786.00	$0.73–$170.00	—	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP	$1,339.50	$1,786.00	$0.73–$170.00	—	25%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION SURGICAL EXC OTHER THAN CLA	$1,339.50	$1,786.00	$1.55–$170.00	47% above	25%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCSION SURGICAL EXC OTHER THAN CLAM	$1,339.50	$1,786.00	$1.55–$170.00	47% above	25%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCSION SURGICAL EXC OTHER THAN CLAM	$1,339.50	$1,786.00	$1.55–$170.00	—	25%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION SURGICAL EXC OTHER THAN CLA	$1,339.50	$1,786.00	$1.55–$170.00	—	25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX OF DISTAL RADIAL FRACTURE	$216.00	$288.00	$7.01–$170.00	6% below	25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX DISTAL RADIUS FX W/MANIPULATIO	$223.50	$298.00	$7.01–$170.00	2% below	25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ER-PHY CLOSED TX DISTAL RADIUS FX W/MANI	$405.00	$540.00	$7.01–$170.00	77% above	25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX OF DISTAL RADIAL FRACTURE	$216.00	$288.00	$7.01–$170.00	—	25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX DISTAL RADIUS FX W/MANIPULATIO	$223.50	$298.00	$7.01–$170.00	—	25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ER-PHY CLOSED TX DISTAL RADIUS FX W/MANI	$405.00	$540.00	$7.01–$170.00	—	25%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/REMOVAL TUMOR/POLYP LESION	$953.25	$1,271.00	$2.38–$170.00	43% below	25%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/REMOVAL TUMOR/POLYP LESION	$953.25	$1,271.00	$2.38–$170.00	—	25%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY	$953.25	$1,271.00	$1.93–$170.00	32% below	25%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY	$953.25	$1,271.00	$1.93–$170.00	—	25%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$825.75	$1,101.00	$1.79–$170.00	30% below	25%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$825.75	$1,101.00	$1.79–$170.00	—	25%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY BX OF CERVICX	$247.50	$330.00	$1.30–$170.00	16% below	25%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY BX OF CERVICX	$247.50	$330.00	$1.30–$170.00	—	25%
Complex cataract surgery with lens implant CPT 66982 EXTRACAPSULAR CATARACT REMOVAL WITH INSE	$1,766.25	$2,355.00	$11.05–$170.00	50% below	25%
Complex cataract surgery with lens implant inpatient CPT 66982 EXTRACAPSULAR CATARACT REMOVAL WITH INSE	$1,766.25	$2,355.00	$11.05–$170.00	—	25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$487.50	$650.00	$0.68–$170.00	15% below	25%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$487.50	$650.00	$0.68–$170.00	—	25%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE DIAGNOSTIC AND OR	$1,605.75	$2,141.00	$2.86–$170.00	74% below	25%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE DIAGNOSTIC AND OR	$1,605.75	$2,141.00	$2.86–$170.00	—	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION ELECTROSURGICAL SKIN LESION	$137.25	$183.00	$1.00–$170.00	14% above	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION ELECTROSURGICAL SKIN LESION	$137.25	$183.00	$1.00–$170.00	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ER-PHY REMOVAL IMPACTED CERUMEN LAVAGE	$72.00	$96.00	$0.46–$170.00	63% above	25%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN UNILATERAL	$90.00	$120.00	$0.46–$170.00	104% above	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ER-PHY REMOVAL IMPACTED CERUMEN LAVAGE	$72.00	$96.00	$0.46–$170.00	—	25%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN UNILATERAL	$90.00	$120.00	$0.46–$170.00	—	25%
Earwax removal with instruments, one ear CPT 69210 ER-PHY REMOVAL IMPACTED CERUMEN 1 BOTH E	$72.00	$96.00	$0.28–$170.00	29% above	25%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN 1 BOTH EARS	$84.00	$112.00	$0.28–$170.00	50% above	25%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN ONE OR BOTH EAR	$84.00	$112.00	$0.28–$170.00	50% above	25%
Earwax removal with instruments, one ear inpatient CPT 69210 ER-PHY REMOVAL IMPACTED CERUMEN 1 BOTH E	$72.00	$96.00	$0.28–$170.00	—	25%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN ONE OR BOTH EAR	$84.00	$112.00	$0.28–$170.00	—	25%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN 1 BOTH EARS	$84.00	$112.00	$0.28–$170.00	—	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY W/WO ENDOCERVICAL	$136.50	$182.00	$0.48–$170.00	4% above	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY W/WO ENDOCERVICAL	$136.50	$182.00	$0.48–$170.00	—	25%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR ANTERIOR ABD HERNIA REDUC 3-10 CM	$2,625.00	$3,500.00	$4.44–$170.00	65% below	25%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR ANTERIOR ABD HERNIA REDUC 3-10 CM	$2,625.00	$3,500.00	$4.44–$170.00	—	25%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANTERIOR ABD HERNIA REDUC >3CM RE	$2,025.00	$2,700.00	$2.88–$170.00	66% below	25%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANTERIOR ABD HERNIA REDUC >3CM RE	$2,025.00	$2,700.00	$2.88–$170.00	—	25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$359.25	$479.00	$0.74–$170.00	54% below	25%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$359.25	$479.00	$0.74–$170.00	—	25%
Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY, LAPAROSCOPIC	$2,520.75	$3,361.00	$6.97–$170.00	70% below	25%
Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY, LAPAROSCOPIC	$2,520.75	$3,361.00	$6.97–$170.00	—	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY	$6,251.25	$8,335.00	$7.45–$170.00	14% above	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY	$6,251.25	$8,335.00	$7.45–$170.00	—	25%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$2,517.00	$3,356.00	$10.61–$170.00	2% below	25%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY	$2,517.00	$3,356.00	$10.61–$170.00	—	25%
Hammertoe correction surgery CPT 28285 CORRECT HAMMERTOE	$1,378.50	$1,838.00	$5.66–$170.00	77% below	25%
Hammertoe correction surgery inpatient CPT 28285 CORRECT HAMMERTOE	$1,378.50	$1,838.00	$5.66–$170.00	—	25%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL/EXTERNAL	$1,809.75	$2,413.00	$4.95–$170.00	67% below	25%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL/EXTERNAL SIMPL	$1,809.75	$2,413.00	$4.95–$170.00	67% below	25%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL/EXTERNAL SIMPL	$1,809.75	$2,413.00	$4.95–$170.00	—	25%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL/EXTERNAL	$1,809.75	$2,413.00	$4.95–$170.00	—	25%
Hysterectomy through an abdominal incision (total) CPT 58150 TAH WITH OR WITHOUT REMOVAL OF TUBES	$2,735.25	$3,647.00	$10.49–$170.00	54% below	25%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TAH WITH OR WITHOUT REMOVAL OF TUBES	$2,735.25	$3,647.00	$10.49–$170.00	—	25%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY SURGICAL W/ENDOMETRIAL ABL	$6,330.00	$8,440.00	$2.15–$170.00	28% below	25%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY SURGICAL W/ENDOMETRIAL ABL	$6,330.00	$8,440.00	$2.15–$170.00	—	25%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$3,173.25	$4,231.00	$2.06–$170.00	56% below	25%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY	$3,173.25	$4,231.00	$2.06–$170.00	—	25%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$113.25	$151.00	$0.40–$170.00	61% below	25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$113.25	$151.00	$0.40–$170.00	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 ER-PHY I&D ABSCESS SIMPLE SINGLE	$130.50	$174.00	$1.89–$170.00	2% below	25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE SINGLE	$194.25	$259.00	$1.89–$170.00	46% above	25%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE OF ABSCESS SIMPLE	$201.75	$269.00	$1.89–$170.00	52% above	25%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$431.25	$575.00	$1.89–$170.00	225% above	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ER-PHY I&D ABSCESS SIMPLE SINGLE	$130.50	$174.00	$1.89–$170.00	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE SINGLE	$194.25	$259.00	$1.89–$170.00	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE OF ABSCESS SIMPLE	$201.75	$269.00	$1.89–$170.00	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS	$431.25	$575.00	$1.89–$170.00	—	25%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INITIAL ING HERNIA REDUCIBLE HALS	$2,569.50	$3,426.00	$5.99–$170.00	5% below	25%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INITIAL ING HERNIA REDUCIBLE HALS	$2,569.50	$3,426.00	$5.99–$170.00	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION(S) SINGLE TENDON SHEATH OR LIG	$207.75	$277.00	$0.32–$170.00	29% above	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION(S) SINGLE TENDON SHEATH OR LIG	$207.75	$277.00	$0.32–$170.00	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER-PHY ARTHROCENTESIS INJ MAJOR JOINT	$106.50	$142.00	$0.44–$170.00	31% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS INJ MAJOR JOINT	$178.50	$238.00	$0.44–$170.00	16% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT OR BURSA EG SHOULDER HIP KNE	$207.75	$277.00	$0.44–$170.00	35% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ER-PHY ARTHROCENTESIS INJ MAJOR JOINT	$106.50	$142.00	$0.44–$170.00	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS INJ MAJOR JOINT	$178.50	$238.00	$0.44–$170.00	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT OR BURSA EG SHOULDER HIP KNE	$207.75	$277.00	$0.44–$170.00	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER-PHY ARTHROCENTESIS INTERMEDIATE JOINT	$96.75	$129.00	$0.34–$170.00	20% below	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATION GANGLION CYST	$201.00	$268.00	$0.34–$170.00	65% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMEDIATE JOINT GANGLI	$201.00	$268.00	$0.34–$170.00	65% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ER-PHY ARTHROCENTESIS INTERMEDIATE JOINT	$96.75	$129.00	$0.34–$170.00	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATION GANGLION CYST	$201.00	$268.00	$0.34–$170.00	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMEDIATE JOINT GANGLI	$201.00	$268.00	$0.34–$170.00	—	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATION AND OR INJECTI	$209.25	$279.00	$0.33–$170.00	69% above	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATION AND OR INJECTI	$209.25	$279.00	$0.33–$170.00	—	25%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY OF KNEE W/MENISCUS REPAIR	$2,865.00	$3,820.00	$9.61–$170.00	65% below	25%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY OF KNEE W/MENISCUS REPAIR	$2,865.00	$3,820.00	$9.61–$170.00	—	25%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE WITH MENISCECTOMY	$2,649.75	$3,533.00	$8.22–$170.00	60% below	25%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE WITH MENISCECTOMY	$2,649.75	$3,533.00	$8.22–$170.00	—	25%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY KNEE WITH MENISCECTOMY	$2,435.25	$3,247.00	$8.40–$170.00	71% below	25%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY KNEE WITH MENISCECTOMY	$2,435.25	$3,247.00	$8.40–$170.00	—	25%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 DEBRIDEMENT SHAVING OF ARTICULAR CARTILA	$2,121.75	$2,829.00	$9.12–$170.00	51% below	25%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 DEBRIDEMENT SHAVING OF ARTICULAR CARTILA	$2,121.75	$2,829.00	$9.12–$170.00	—	25%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 CAPSULOTOMY	$621.75	$829.00	$5.57–$170.00	11% below	25%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 CAPSULOTOMY	$621.75	$829.00	$5.57–$170.00	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE SCALP AX TRUNK	$193.50	$258.00	$2.33–$170.00	15% below	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ER-PHY LAYER CLOSURE SCALP AX TRUNK	$235.50	$314.00	$2.33–$170.00	3% above	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUNDS OF SCALP AXILLAE	$263.25	$351.00	$2.33–$170.00	15% above	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE SCALP AX TRUNK	$193.50	$258.00	$2.33–$170.00	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ER-PHY LAYER CLOSURE SCALP AX TRUNK	$235.50	$314.00	$2.33–$170.00	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUNDS OF SCALP AXILLAE	$263.25	$351.00	$2.33–$170.00	—	25%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL QUAD RESECT	$1,744.50	$2,326.00	$7.37–$170.00	20% below	25%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL QUAD RESECT	$1,744.50	$2,326.00	$7.37–$170.00	—	25%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$1,705.50	$2,274.00	$10.33–$170.00	86% below	25%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$1,705.50	$2,274.00	$10.33–$170.00	—	25%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISSED ABORTION COMPLETED S	$1,223.25	$1,631.00	$5.42–$170.00	80% below	25%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREATMENT OF MISSED ABORTION COMPLETED S	$1,223.25	$1,631.00	$5.42–$170.00	—	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION INCLUDING MARGINS	$329.25	$439.00	$1.54–$170.00	58% above	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION INCLUDING MARGINS	$329.25	$439.00	$1.54–$170.00	—	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION OTHER BENIGN LESION INCLUDING M	$309.75	$413.00	$2.09–$170.00	12% above	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION FACE EARS EYELIDS	$375.00	$500.00	$2.09–$170.00	36% above	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION OTHER BENIGN LESION INCLUDING M	$309.75	$413.00	$2.09–$170.00	—	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BENIGN LESION FACE EARS EYELIDS	$375.00	$500.00	$2.09–$170.00	—	25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE SINGLE	$124.50	$166.00	$0.48–$170.00	6% below	25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE PARTIAL OR COMPLE	$124.50	$166.00	$0.48–$170.00	6% below	25%
Nail removal (partial or complete), one nail CPT 11730 ER-PHY AVULSION OF NAIL PLATE PART	$131.25	$175.00	$0.48–$170.00	at median	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE SINGLE	$124.50	$166.00	$0.48–$170.00	—	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE PARTIAL OR COMPLE	$124.50	$166.00	$0.48–$170.00	—	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 ER-PHY AVULSION OF NAIL PLATE PART	$131.25	$175.00	$0.48–$170.00	—	25%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGING GUIDANCE	$834.75	$1,113.00	$0.95–$170.00	52% above	25%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGING GUIDANCE	$834.75	$1,113.00	$0.95–$170.00	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ER-PHY EXCISION NAIL NAIL MATRIX	$309.00	$412.00	$1.36–$170.00	at median	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX PARTIAL	$321.75	$429.00	$1.36–$170.00	4% above	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL NAIL MATRIX	$360.75	$481.00	$1.36–$170.00	17% above	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ER-PHY EXCISION NAIL NAIL MATRIX	$309.00	$412.00	$1.36–$170.00	—	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX PARTIAL	$321.75	$429.00	$1.36–$170.00	—	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL NAIL MATRIX	$360.75	$481.00	$1.36–$170.00	—	25%
Removal of a breast lump, open surgery CPT 19120 EXCISION CYST FIBROADEMOMA OR OTHER BENI	$1,227.00	$1,636.00	$5.38–$170.00	56% below	25%
Removal of a breast lump, open surgery CPT 19120 EXC CYST OR OTHER BEN/MAL TUMOR BREAST	$2,249.25	$2,999.00	$5.38–$170.00	19% below	25%
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION CYST FIBROADEMOMA OR OTHER BENI	$1,227.00	$1,636.00	$5.38–$170.00	—	25%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST OR OTHER BEN/MAL TUMOR BREAST	$2,249.25	$2,999.00	$5.38–$170.00	—	25%
Removal of a foreign object under the skin, simple CPT 10120 ER-PHY INCISION REMOVAL OF FOREIGN BODY	$138.75	$185.00	$1.83–$170.00	25% below	25%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBCUTAN	$193.50	$258.00	$1.83–$170.00	4% above	25%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FOREIGN BODY SUBCUT	$263.25	$351.00	$1.83–$170.00	42% above	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ER-PHY INCISION REMOVAL OF FOREIGN BODY	$138.75	$185.00	$1.83–$170.00	—	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBCUTAN	$193.50	$258.00	$1.83–$170.00	—	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL FOREIGN BODY SUBCUT	$263.25	$351.00	$1.83–$170.00	—	25%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCREENING LOW RISK	$902.25	$1,203.00	$1.79–$170.00	18% below	25%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY SCREENING LOW RISK	$902.25	$1,203.00	$1.79–$170.00	—	25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK	$902.25	$1,203.00	$1.79–$170.00	18% above	25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK	$902.25	$1,203.00	$1.79–$170.00	—	25%
Short arm cast (elbow to hand) CPT 29075 APPLICATION SHORT ARM CAST	$108.75	$145.00	$1.00–$170.00	22% below	25%
Short arm cast (elbow to hand) CPT 29075 ER-PHY APPLICATION SHORT ARM CAST	$116.25	$155.00	$1.00–$170.00	16% below	25%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION SHORT ARM CAST	$108.75	$145.00	$1.00–$170.00	—	25%
Short arm cast (elbow to hand) inpatient CPT 29075 ER-PHY APPLICATION SHORT ARM CAST	$116.25	$155.00	$1.00–$170.00	—	25%
Short arm splint (forearm and hand) CPT 29125 ER-PHY SHORT ARM SPLINT STATIC	$81.75	$109.00	$0.65–$170.00	3% above	25%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT STATIC	$112.50	$150.00	$0.65–$170.00	41% above	25%
Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT STATIC	$112.50	$150.00	$0.65–$170.00	41% above	25%
Short arm splint (forearm and hand) inpatient CPT 29125 ER-PHY SHORT ARM SPLINT STATIC	$81.75	$109.00	$0.65–$170.00	—	25%
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT STATIC	$112.50	$150.00	$0.65–$170.00	—	25%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT STATIC	$112.50	$150.00	$0.65–$170.00	—	25%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST	$112.50	$150.00	$0.86–$170.00	12% below	25%
Short leg cast (below the knee) CPT 29405 ER-PHY APPLICATION SHORT LEG CAST	$144.75	$193.00	$0.86–$170.00	13% above	25%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$198.75	$265.00	$0.86–$170.00	56% above	25%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST	$112.50	$150.00	$0.86–$170.00	—	25%
Short leg cast (below the knee) inpatient CPT 29405 ER-PHY APPLICATION SHORT LEG CAST	$144.75	$193.00	$0.86–$170.00	—	25%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST	$198.75	$265.00	$0.86–$170.00	—	25%
Short leg splint (calf to foot) CPT 29515 ER-PHY SHORT LEG SPLINT CALF TO FOOT	$101.25	$135.00	$0.67–$170.00	1% below	25%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT CALF TO FOOT	$192.00	$256.00	$0.67–$170.00	88% above	25%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT	$192.00	$256.00	$0.67–$170.00	88% above	25%
Short leg splint (calf to foot) inpatient CPT 29515 ER-PHY SHORT LEG SPLINT CALF TO FOOT	$101.25	$135.00	$0.67–$170.00	—	25%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT CALF TO FOOT	$192.00	$256.00	$0.67–$170.00	—	25%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT	$192.00	$256.00	$0.67–$170.00	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S	$153.00	$204.00	$0.34–$170.00	5% below	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR 2.5 CM OR LESS	$158.25	$211.00	$0.34–$170.00	2% below	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER-PHY REPAIR 2.5CM OR LESS	$186.00	$248.00	$0.34–$170.00	15% above	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S	$153.00	$204.00	$0.34–$170.00	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR 2.5 CM OR LESS	$158.25	$211.00	$0.34–$170.00	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ER-PHY REPAIR 2.5CM OR LESS	$186.00	$248.00	$0.34–$170.00	—	25%
Skin biopsy, punch, one lesion CPT 11104 REMOVAL OF SKIN LESION PUNCH BIOPSY	$275.25	$367.00	$0.47–$170.00	30% above	25%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN, SINGLE LESION	$275.25	$367.00	$0.47–$170.00	30% above	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN, SINGLE LESION	$275.25	$367.00	$0.47–$170.00	—	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 REMOVAL OF SKIN LESION PUNCH BIOPSY	$275.25	$367.00	$0.47–$170.00	—	25%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION INCLUDING MARG	$316.50	$422.00	$1.85–$170.00	8% above	25%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION INCLUDING MARG	$316.50	$422.00	$1.85–$170.00	—	25%
Skin tag removal, up to 15 tags CPT 11200 ER-PHY REMOVAL OF SKIN TAG 15 LESIONS	$107.25	$143.00	$1.43–$170.00	18% above	25%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG, MULT FIBRO TAG UP TO 15	$127.50	$170.00	$1.43–$170.00	40% above	25%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG ANY AREA 15 LESIONS	$138.00	$184.00	$1.43–$170.00	52% above	25%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN	$138.00	$184.00	$1.43–$170.00	52% above	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 ER-PHY REMOVAL OF SKIN TAG 15 LESIONS	$107.25	$143.00	$1.43–$170.00	—	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAG, MULT FIBRO TAG UP TO 15	$127.50	$170.00	$1.43–$170.00	—	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN	$138.00	$184.00	$1.43–$170.00	—	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAG ANY AREA 15 LESIONS	$138.00	$184.00	$1.43–$170.00	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ER-PHY SPINAL PUNCTURE LUMBAR DX	$200.25	$267.00	$0.43–$170.00	36% below	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$243.00	$324.00	$0.43–$170.00	23% below	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DX	$252.75	$337.00	$0.43–$170.00	20% below	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ER-PHY SPINAL PUNCTURE LUMBAR DX	$200.25	$267.00	$0.43–$170.00	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$243.00	$324.00	$0.43–$170.00	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DX	$252.75	$337.00	$0.43–$170.00	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S	$189.75	$253.00	$0.40–$170.00	17% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR 2.6-7.5 CM	$213.75	$285.00	$0.40–$170.00	31% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER-PHY REPAIR 2.6-7CM	$217.50	$290.00	$0.40–$170.00	34% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SUPERFICIAL WOUND SCALP	$222.00	$296.00	$0.40–$170.00	36% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S	$189.75	$253.00	$0.40–$170.00	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR 2.6-7.5 CM	$213.75	$285.00	$0.40–$170.00	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ER-PHY REPAIR 2.6-7CM	$217.50	$290.00	$0.40–$170.00	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR OF SUPERFICIAL WOUND SCALP	$222.00	$296.00	$0.40–$170.00	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR FACE EARS 2.5CM/LESS	$168.00	$224.00	$0.39–$170.00	4% above	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF F	$168.75	$225.00	$0.39–$170.00	4% above	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER-PHY REPAIR FACE EARS 2.5CM OR LESS	$206.25	$275.00	$0.39–$170.00	27% above	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR FACE EARS 2.5CM/LESS	$168.00	$224.00	$0.39–$170.00	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF F	$168.75	$225.00	$0.39–$170.00	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ER-PHY REPAIR FACE EARS 2.5CM OR LESS	$206.25	$275.00	$0.39–$170.00	—	25%
Tonsil and adenoid removal, age 12 or older CPT 42821 T&A OVER 12	$1,932.00	$2,576.00	$4.28–$170.00	60% below	25%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 T&A OVER 12	$1,932.00	$2,576.00	$4.28–$170.00	—	25%
Tonsil and adenoid removal, child under 12 CPT 42820 T&A UNDER 12	$1,932.00	$2,576.00	$4.06–$170.00	57% below	25%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 T&A UNDER 12	$1,932.00	$2,576.00	$4.06–$170.00	—	25%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY PRIMARY OR SECONDARY 12 OL	$2,010.00	$2,680.00	$3.87–$170.00	54% below	25%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY PRIMARY OR SECONDARY 12 OL	$2,010.00	$2,680.00	$3.87–$170.00	—	25%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY ONLY UNDER AGE 12	$2,010.00	$2,680.00	$4.21–$170.00	55% below	25%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY ONLY UNDER AGE 12	$2,010.00	$2,680.00	$4.21–$170.00	—	25%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAP BTL WITH FULGURATION	$2,619.00	$3,492.00	$4.31–$170.00	71% below	25%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAP BTL WITH FULGURATION	$2,619.00	$3,492.00	$4.31–$170.00	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US GUIDED BREAST BX	$1,676.25	$2,235.00	$1.13–$170.00	at median	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US GUIDED BREAST BX	$1,676.25	$2,235.00	$1.13–$170.00	—	25%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY	$953.25	$1,271.00	$1.42–$170.00	20% below	25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH BIOPSY	$953.25	$1,271.00	$1.42–$170.00	—	25%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/REMOVAL TUMOR/POLYP/LESION SNARE	$953.25	$1,271.00	$1.90–$170.00	29% below	25%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/REMOVAL TUMOR/POLYP/LESION SNARE	$953.25	$1,271.00	$1.90–$170.00	—	25%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$744.75	$993.00	$1.29–$170.00	23% below	25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$744.75	$993.00	$1.29–$170.00	—	25%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$1,610.25	$2,147.00	$3.22–$170.00	58% above	25%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$1,610.25	$2,147.00	$3.22–$170.00	—	25%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION WITH CAUTERY	$204.00	$272.00	$1.33–$170.00	73% above	25%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESION WITH CAUTERY	$204.00	$272.00	$1.33–$170.00	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER-PHY DEBRIDEMENT SKIN AND SUBQ	$145.50	$194.00	$0.68–$170.00	32% below	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN SUBQ TISSUE	$261.00	$348.00	$0.68–$170.00	22% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN AND SUB Q	$261.00	$348.00	$0.68–$170.00	22% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PT DEBRIDEMENT SKIN SUBCUTANEOUS TISSUE	$263.25	$351.00	$0.68–$170.00	23% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN /TISSUE	$661.50	$882.00	$0.68–$170.00	208% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ER-PHY DEBRIDEMENT SKIN AND SUBQ	$145.50	$194.00	$0.68–$170.00	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN AND SUB Q	$261.00	$348.00	$0.68–$170.00	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN SUBQ TISSUE	$261.00	$348.00	$0.68–$170.00	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PT DEBRIDEMENT SKIN SUBCUTANEOUS TISSUE	$263.25	$351.00	$0.68–$170.00	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN /TISSUE	$661.50	$882.00	$0.68–$170.00	—	25%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 ORIF RADIAL FRACTURE	$1,118.25	$1,491.00	$11.42–$170.00	90% below	25%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 ORIF RADIAL FRACTURE	$1,118.25	$1,491.00	$11.42–$170.00	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Blood transfusion (giving blood or blood components) CPT 36430 .BB ADMINISTRATION FEE	$318.75	$425.00	$1.26–$170.00	28% below	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 .BB ADMINISTRATION FEE	$318.75	$425.00	$1.26–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TX SUB 1	$76.50	$102.00	$0.23–$170.00	24% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ PAP, SUBSEQUENT	$76.50	$102.00	$0.23–$170.00	24% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TX REPEATED ACUTE	$82.50	$110.00	$0.23–$170.00	34% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB SUBSEQUENT	$106.50	$142.00	$0.23–$170.00	73% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TX SUB 2	$106.50	$142.00	$0.23–$170.00	73% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ACUTE EXACERBATION REPEATED	$106.50	$142.00	$0.23–$170.00	73% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUB TX	$106.50	$142.00	$0.23–$170.00	73% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUB TX 3	$106.50	$142.00	$0.23–$170.00	73% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUB TX 4	$106.50	$142.00	$0.23–$170.00	73% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER, INIT	$136.50	$182.00	$0.23–$170.00	122% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ACAPELLA INT SET UP	$136.50	$182.00	$0.23–$170.00	122% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ PAP, INIT	$136.50	$182.00	$0.23–$170.00	122% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ACAPELLA, INIT	$136.50	$182.00	$0.23–$170.00	122% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX	$224.25	$299.00	$0.23–$170.00	265% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TX SUB 1	$76.50	$102.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ PAP, SUBSEQUENT	$76.50	$102.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TX REPEATED ACUTE	$82.50	$110.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TX SUB 2	$106.50	$142.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUB TX 3	$106.50	$142.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ACUTE EXACERBATION REPEATED	$106.50	$142.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUB TX	$106.50	$142.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB SUBSEQUENT	$106.50	$142.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUB TX 4	$106.50	$142.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ACAPELLA, INIT	$136.50	$182.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER, INIT	$136.50	$182.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ PAP, INIT	$136.50	$182.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ACAPELLA INT SET UP	$136.50	$182.00	$0.23–$170.00	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX	$224.25	$299.00	$0.23–$170.00	—	25%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY ADMINISTRATION INTRAVENOUS	$251.25	$335.00	$3.35–$170.00	31% below	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY ADMINISTRATION INTRAVENOUS	$251.25	$335.00	$3.35–$170.00	—	25%
Critical care, first 30 to 74 minutes CPT 99291 PHY CRITICAL CARE 1 HR	$433.50	$578.00	$170.00–$1,300.00	28% below	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PHY CRITICAL CARE 1 HR	$433.50	$578.00	$170.00–$1,300.00	—	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 AWAKE AND DROWSY	$89.25	$119.00	$10.46–$170.00	68% below	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$292.50	$390.00	$10.46–$170.00	4% above	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 AWAKE AND DROWSY	$89.25	$119.00	$10.46–$170.00	—	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$292.50	$390.00	$10.46–$170.00	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$102.75	$137.00	$0.18–$170.00	31% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$102.75	$137.00	$0.18–$170.00	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER-PHY LIMITED/MINOR PROC	$75.75	$101.00	$170.00–$350.00	18% below	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER-PHY LIMITED/MINOR PROC	$75.75	$101.00	$170.00–$350.00	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER-PHY LEVEL 2	$109.50	$146.00	$170.00–$350.00	16% below	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER-PHY LEVEL 2	$109.50	$146.00	$170.00–$350.00	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER-PHY LEVEL 3	$161.25	$215.00	$170.00–$600.00	22% below	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER-PHY LEVEL 3	$161.25	$215.00	$170.00–$600.00	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER-PHY LEVEL 4	$243.75	$325.00	$170.00–$850.00	16% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER-PHY LEVEL 4	$243.75	$325.00	$170.00–$850.00	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER-PHY LEVEL 5	$325.50	$434.00	$170.00–$1,250.00	37% below	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER-PHY LEVEL 5	$325.50	$434.00	$170.00–$1,250.00	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 EKG STRESS TEST	$225.00	$300.00	$1.13–$170.00	40% below	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EKG STRESS TEST	$225.00	$300.00	$1.13–$170.00	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF THERAPY HYDRATION 31 MIN TO 1 HOUR	$208.50	$278.00	$0.75–$170.00	8% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS THERAPY HYDRATION TO 1 HR	$209.25	$279.00	$0.75–$170.00	8% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF THERAPY HYDRATION 31 MIN TO 1 HOUR	$208.50	$278.00	$0.75–$170.00	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS THERAPY HYDRATION TO 1 HR	$209.25	$279.00	$0.75–$170.00	—	25%
IV infusion of a medicine, first hour CPT 96365 IV INFUS THERAPY MEDICATION TO 1 HR	$209.25	$279.00	$1.54–$170.00	7% below	25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS THERAPY MEDICATION TO 1 HR	$209.25	$279.00	$1.54–$170.00	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM ANTIBIOTIC	$57.00	$76.00	$0.25–$170.00	3% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SUBCUTANEOUS	$57.00	$76.00	$0.25–$170.00	3% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ OR IM	$57.00	$76.00	$0.25–$170.00	3% below	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBQ OR IM	$57.00	$76.00	$0.25–$170.00	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM ANTIBIOTIC	$57.00	$76.00	$0.25–$170.00	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SUBCUTANEOUS	$57.00	$76.00	$0.25–$170.00	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MINU	$56.25	$75.00	$0.48–$170.00	7% above	25%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED EACH 15 MINUTES	$56.25	$75.00	$0.48–$170.00	7% above	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MINU	$56.25	$75.00	$0.48–$170.00	—	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-ED EACH 15 MINUTES	$56.25	$75.00	$0.48–$170.00	—	25%
New patient office visit, about 45 minutes CPT 99204 HOSPITAL OUTPATIENT CONSULTATION	$239.25	$319.00	$1.15–$170.00	67% above	25%
New patient office visit, about 45 minutes inpatient CPT 99204 HOSPITAL OUTPATIENT CONSULTATION	$239.25	$319.00	$1.15–$170.00	—	25%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION - LOW COMPLEXITY	$76.50	$102.00	$1.53–$170.00	44% below	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION - LOW COMPLEXITY	$76.50	$102.00	$1.53–$170.00	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT INITIAL EVALUATION - HIGH COMPLEXITY	$145.50	$194.00	$1.45–$170.00	1% below	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT INITIAL EVALUATION - HIGH COMPLEXITY	$145.50	$194.00	$1.45–$170.00	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT INITIAL EVALUATION - LOW COMPLEXITY	$76.50	$102.00	$1.45–$170.00	40% below	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT INITIAL EVALUATION - LOW COMPLEXITY	$76.50	$102.00	$1.45–$170.00	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT INITIAL EVALUATION - MOD COMPLEXITY	$111.00	$148.00	$1.45–$170.00	19% below	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT INITIAL EVALUATION - MOD COMPLEXITY	$111.00	$148.00	$1.45–$170.00	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EA 15 MINUTES	$58.50	$78.00	$0.40–$170.00	3% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT JOINT/SOFT TISSUE MOBILIZATION/MANUAL	$58.50	$78.00	$0.40–$170.00	3% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY EA 15 MINUTES	$58.50	$78.00	$0.40–$170.00	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT JOINT/SOFT TISSUE MOBILIZATION/MANUAL	$58.50	$78.00	$0.40–$170.00	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXERCISE 15 MINUTES	$52.50	$70.00	$0.43–$170.00	5% below	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MINUTES	$52.50	$70.00	$0.43–$170.00	5% below	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE 15 MINUTES	$52.50	$70.00	$0.43–$170.00	—	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MINUTES	$52.50	$70.00	$0.43–$170.00	—	25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNSELING 3-10 MINUTES	$24.75	$33.00	$0.09–$170.00	25% below	25%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE/TOBACCO COUNSELING 3-10 MINUTES	$24.75	$33.00	$0.09–$170.00	—	25%
Speech and language evaluation CPT 92523 ST EVAL OF SPEECH LANGUAGE	$174.00	$232.00	$2.97–$170.00	2% below	25%
Speech and language evaluation inpatient CPT 92523 ST EVAL OF SPEECH LANGUAGE	$174.00	$232.00	$2.97–$170.00	—	25%
Speech therapy session, individual CPT 92507 ST TREATMENT OF SPEECH LANGUAGE VOICE	$165.75	$221.00	$0.99–$170.00	5% above	25%
Speech therapy session, individual inpatient CPT 92507 ST TREATMENT OF SPEECH LANGUAGE VOICE	$165.75	$221.00	$0.99–$170.00	—	25%
Spirometry (breathing test) CPT 94010 CARDIOLOGIST PHY FEE	$53.25	$71.00	$0.63–$170.00	58% below	25%
Spirometry (breathing test) CPT 94010 SPIROMETRY W/MVV & FVL	$193.50	$258.00	$0.63–$170.00	54% above	25%
Spirometry (breathing test) CPT 94010 GP SPIROMETRY W/MVV & FVL	$231.75	$309.00	$0.63–$170.00	84% above	25%
Spirometry (breathing test) inpatient CPT 94010 CARDIOLOGIST PHY FEE	$53.25	$71.00	$0.63–$170.00	—	25%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/MVV & FVL	$193.50	$258.00	$0.63–$170.00	—	25%
Spirometry (breathing test) inpatient CPT 94010 GP SPIROMETRY W/MVV & FVL	$231.75	$309.00	$0.63–$170.00	—	25%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE/POST WITH NEB	$300.00	$400.00	$0.93–$170.00	12% above	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE/POST WITH NEB	$300.00	$400.00	$0.93–$170.00	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT KINETIC ACTIVITIES EA 15 MINUTES	$27.75	$37.00	$0.62–$170.00	44% below	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIVITIES DYNAMIC ACTIVI	$51.00	$68.00	$0.62–$170.00	2% above	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MINUTES	$51.75	$69.00	$0.62–$170.00	4% above	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT KINETIC ACTIVITIES 1ST 30 MINUTES	$53.25	$71.00	$0.62–$170.00	7% above	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT KINETIC ACTIVITIES EA 15 MINUTES	$27.75	$37.00	$0.62–$170.00	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES DYNAMIC ACTIVI	$51.00	$68.00	$0.62–$170.00	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MINUTES	$51.75	$69.00	$0.62–$170.00	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT KINETIC ACTIVITIES 1ST 30 MINUTES	$53.25	$71.00	$0.62–$170.00	—	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPEUTIC	$134.25	$179.00	$2.65–$170.00	33% above	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY, THERAPEUTIC	$134.25	$179.00	$2.65–$170.00	—	25%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOLOGIST PHY FEE	$89.25	$119.00	$1.40–$170.00	68% below	25%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 NM CARDIAC STRESS W/PHY SUPERVISION INT	$277.50	$370.00	$1.40–$170.00	1% below	25%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIOLOGIST PHY FEE	$89.25	$119.00	$1.40–$170.00	—	25%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 NM CARDIAC STRESS W/PHY SUPERVISION INT	$277.50	$370.00	$1.40–$170.00	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE 20MCG/1ML, 1ML	$75.00	$100.00	$170.00	at median	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE 20MCG/1ML, 1ML	$75.00	$100.00	$170.00	—	25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU SHOT HIGH-DOSE (+65 YR),0.5ML DOSE	$73.50	$98.00	$170.00	65% above	25%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU SHOT HIGH-DOSE (+65 YR),0.5ML DOSE	$73.50	$98.00	$170.00	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23(PNEUMOCOCCAL) 0.5ML SYRINGE	$189.75	$253.00	$170.00	1% above	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23(PNEUMOCOCCAL) 0.5ML SYRINGE	$189.75	$253.00	$170.00	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPHTHERIA(7YR-ADULT) Td SYRINGE	$75.00	$100.00	$170.00	at median	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPHTHERIA(7YR-ADULT) Td SYRINGE	$75.00	$100.00	$170.00	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap(Tetanus/Diphtheria/Pertussis)SYRING	$90.75	$121.00	$170.00	5% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap(Tetanus/Diphtheria/Pertussis)SYRING	$90.75	$121.00	$170.00	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN FEE - VACCINE,TOXOIDS	$9.00	$12.00	$0.44–$170.00	81% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU SHOT VACCINE ADMINISTRATION FEE	$9.00	$12.00	$0.44–$170.00	81% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS & DIPTHERIA TOXOID 7&OLDER	$80.25	$107.00	$0.44–$170.00	68% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN FEE - VACCINE,TOXOIDS	$9.00	$12.00	$0.44–$170.00	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FLU SHOT VACCINE ADMINISTRATION FEE	$9.00	$12.00	$0.44–$170.00	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TETANUS & DIPTHERIA TOXOID 7&OLDER	$80.25	$107.00	$0.44–$170.00	—	25%

Source file: http://fhsms.org/wp-content/uploads/2026/07/646009174_field-memorial-community-hospital_standardcharges.csv