Artesia General Hospital
Artesia General Hospital in Artesia, NM publishes cash prices for 402 common procedures listed here, from its own machine-readable price file updated Feb 20, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Mexico median for 215 of 367 procedures and above it for 130. By typical cash price it ranks #4 of 11 New Mexico hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
702 North 13th Street, Artesia, NM 88210 Collected Sep 27, 2026 Source price file (575) 748-3333
Acute care hospital Emergency department CCN 320030 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 CB XR ANKLE 3V | $369.60 | $616.00 | $31.38–$585.20 | 12% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE 3V | $369.60 | $616.00 | $31.38–$585.20 | 12% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 UC XR ANKLE 3V | $369.60 | $616.00 | $31.38–$585.20 | 12% above | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3V MIN I/F LEFT | $259.80 | $433.00 | $31.38–$411.35 | 22% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3V MIN I/F RIGHT | $259.80 | $433.00 | $31.38–$411.35 | 22% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 UC XR ANKLE 3V RIGHT | $369.60 | $616.00 | $31.38–$585.20 | 12% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 UC XR ANKLE 3V | $369.60 | $616.00 | $31.38–$585.20 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 CB XR ANKLE 3V | $369.60 | $616.00 | $31.38–$585.20 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE 3V | $369.60 | $616.00 | $31.38–$585.20 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3V MIN I/F RIGHT | $259.80 | $433.00 | $31.38–$411.35 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3V MIN I/F LEFT | $259.80 | $433.00 | $31.38–$411.35 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 UC XR ANKLE 3V RIGHT | $369.60 | $616.00 | $31.38–$585.20 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART | $150.60 | $251.00 | $68.52–$249.80 | 64% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CB US ANKLE BRACHIAL | $499.80 | $833.00 | $78.88–$791.35 | 20% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL | $499.80 | $833.00 | $78.88–$791.35 | 20% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART | $150.60 | $251.00 | $68.52–$238.45 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE BRACHIAL | $499.80 | $833.00 | $227.41–$791.35 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CB US ANKLE BRACHIAL | $499.80 | $833.00 | $227.41–$791.35 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 FL ESOPHAGUS | $555.60 | $926.00 | $84.86–$879.70 | 8% above | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 CB RADEX ESOPHAGUS | $684.00 | $1,140.00 | $84.86–$1,083.00 | 33% above | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL ESOPHAGUS | $555.60 | $926.00 | $84.86–$879.70 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 CB RADEX ESOPHAGUS | $684.00 | $1,140.00 | $84.86–$1,083.00 | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY | $1,723.20 | $2,872.00 | $253.95–$2,728.40 | 38% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE WHOLE BODY | $1,723.20 | $2,872.00 | $253.95–$2,728.40 | — | 40% |
| Breast ultrasound, complete, one breast CPT 76641 CB US BREAST | $546.60 | $911.00 | $87.58–$865.45 | 10% above | 40% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST | $546.60 | $911.00 | $87.58–$865.45 | 10% above | 40% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST | $546.60 | $911.00 | $118.74–$865.45 | — | 40% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 CB US BREAST | $546.60 | $911.00 | $118.74–$865.45 | — | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 CB US BREAST UNI REAL TIME W/IMAGE LIMIT | $411.60 | $686.00 | $72.52–$651.70 | 27% above | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 CB US BREAST LIMITED | $431.40 | $719.00 | $72.52–$683.05 | 33% above | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED | $431.40 | $719.00 | $72.52–$683.05 | 33% above | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 CB US BREAST UNI REAL TIME W/IMAGE LIMIT | $411.60 | $686.00 | $97.65–$651.70 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 CB US BREAST LIMITED | $431.40 | $719.00 | $97.65–$683.05 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED | $431.40 | $719.00 | $97.65–$683.05 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST | $2,653.44 | $4,422.40 | $146.62–$4,201.28 | 16% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PE | $2,653.44 | $4,422.40 | $146.62–$4,201.28 | 16% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST PE | $2,653.44 | $4,422.40 | $317.10–$4,201.28 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST | $2,653.44 | $4,422.40 | $317.10–$4,201.28 | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA ART/GRAPH/MORPH | $2,046.60 | $3,411.00 | $294.14–$3,240.45 | 8% above | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA ART/GRAPH/MORPH | $2,046.60 | $3,411.00 | $428.08–$3,240.45 | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORE | $120.00 | $200.00 | $34.85–$238.53 | 41% below | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORE | $120.00 | $200.00 | $80.00–$238.53 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENAL STONE LOW DOSE | $2,340.60 | $3,901.00 | $178.28–$3,705.95 | 22% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELV W/O | $3,261.00 | $5,435.00 | $178.28–$5,163.25 | 9% above | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT RENAL STONE LOW DOSE | $2,340.60 | $3,901.00 | $178.28–$3,705.95 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELV W/O | $3,261.00 | $5,435.00 | $178.28–$5,163.25 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELV W/CON | $3,941.34 | $6,568.90 | $284.05–$6,240.45 | at median | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELV W/CON | $3,941.34 | $6,568.90 | $284.05–$6,240.45 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELV W/WO | $4,213.80 | $7,023.00 | $294.14–$6,671.85 | 2% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $4,213.80 | $7,023.00 | $294.14–$6,671.85 | 2% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELV W/WO | $4,213.80 | $7,023.00 | $348.06–$6,671.85 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM | $4,213.80 | $7,023.00 | $348.06–$6,671.85 | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W/CON | $2,107.80 | $3,513.00 | $146.62–$3,337.35 | at median | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CON | $2,107.80 | $3,513.00 | $243.38–$3,337.35 | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD W/O | $1,778.40 | $2,964.00 | $87.58–$2,815.80 | at median | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O | $1,778.40 | $2,964.00 | $192.54–$2,815.80 | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O | $1,674.00 | $2,790.00 | $87.58–$2,650.50 | 28% above | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL W/O | $1,674.00 | $2,790.00 | $87.58–$2,650.50 | 28% above | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL W/O | $1,674.00 | $2,790.00 | $196.62–$2,650.50 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O | $1,674.00 | $2,790.00 | $196.62–$2,650.50 | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD STROKE ALERT | $1,739.94 | $2,899.90 | $87.58–$2,754.91 | 16% above | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O | $1,739.94 | $2,899.90 | $87.58–$2,754.91 | 16% above | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O | $1,739.94 | $2,899.90 | $164.35–$2,754.91 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD STROKE ALERT | $1,739.94 | $2,899.90 | $164.35–$2,754.91 | — | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD W/CON | $1,858.20 | $3,097.00 | $146.62–$2,942.15 | at median | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CON | $1,858.20 | $3,097.00 | $203.63–$2,942.15 | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO | $2,252.40 | $3,754.00 | $146.62–$3,566.30 | 10% above | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO | $2,252.40 | $3,754.00 | $242.75–$3,566.30 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O | $1,944.00 | $3,240.00 | $87.58–$3,078.00 | at median | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE W/O | $1,944.00 | $3,240.00 | $205.53–$3,078.00 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O | $2,067.84 | $3,446.40 | $87.58–$3,274.08 | at median | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE W/O | $2,067.84 | $3,446.40 | $206.42–$3,274.08 | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CON | $1,959.00 | $3,265.00 | $146.62–$3,101.75 | at median | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CON | $1,959.00 | $3,265.00 | $236.83–$3,101.75 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CB US CAROTID DOP BILAT | $1,134.60 | $1,891.00 | $184.27–$1,796.45 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DOPP BILAT | $1,134.60 | $1,891.00 | $184.27–$1,796.45 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 93880 DUPLEX SCAN EXTCRANIAL ART COMP | $352.20 | $587.00 | $160.25–$557.65 | 48% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US BIL W/DOP & FLOW VEL | $1,134.60 | $1,891.00 | $184.27–$1,796.45 | 67% above | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CB US CAROTID DOP BILAT | $1,134.60 | $1,891.00 | $516.24–$1,796.45 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DOPP BILAT | $1,134.60 | $1,891.00 | $516.24–$1,796.45 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 93880 DUPLEX SCAN EXTCRANIAL ART COMP | $352.20 | $587.00 | $160.25–$557.65 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US BIL W/DOP & FLOW VEL | $1,134.60 | $1,891.00 | $516.24–$1,796.45 | — | 40% |
| Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $243.00 | $405.00 | $29.41–$384.75 | 9% below | 40% |
| Chest X-ray, 2 views CPT 71046 UC XR CHEST 2VWS | $327.60 | $546.00 | $29.41–$518.70 | 23% above | 40% |
| Chest X-ray, 2 views CPT 71046 CB XR CHEST 2 VWS | $342.36 | $570.60 | $29.41–$542.07 | 28% above | 40% |
| Chest X-ray, 2 views CPT 71046 XR CHEST 2VWS | $342.36 | $570.60 | $29.41–$542.07 | 28% above | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $243.00 | $405.00 | $29.41–$384.75 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 UC XR CHEST 2VWS | $327.60 | $546.00 | $29.41–$518.70 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 CB XR CHEST 2 VWS | $342.36 | $570.60 | $29.41–$542.07 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2VWS | $342.36 | $570.60 | $29.41–$542.07 | — | 40% |
| Chest X-ray, single view CPT 71045 UC XR CHEST 1V | $279.60 | $466.00 | $22.62–$442.70 | 16% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $279.60 | $466.00 | $22.62–$442.70 | 16% above | 40% |
| Chest X-ray, single view CPT 71045 CB XR CHEST 1 VW | $292.20 | $487.00 | $22.62–$462.65 | 22% above | 40% |
| Chest X-ray, single view CPT 71045 XR CHEST 1V | $292.20 | $487.00 | $22.62–$462.65 | 22% above | 40% |
| Chest X-ray, single view inpatient CPT 71045 UC XR CHEST 1V | $279.60 | $466.00 | $22.62–$442.70 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW | $279.60 | $466.00 | $22.62–$442.70 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 CB XR CHEST 1 VW | $292.20 | $487.00 | $22.62–$462.65 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST 1V | $292.20 | $487.00 | $22.62–$462.65 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US (KIDNEY) EXAM ABDO BACK WALL CO | $678.00 | $1,130.00 | $87.58–$1,073.50 | 27% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 CB US RETROPERITONEAL | $754.80 | $1,258.00 | $87.58–$1,195.10 | 41% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL | $754.80 | $1,258.00 | $87.58–$1,195.10 | 41% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US (KIDNEY) EXAM ABDO BACK WALL CO | $678.00 | $1,130.00 | $99.23–$1,073.50 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 CB US RETROPERITONEAL | $754.80 | $1,258.00 | $99.23–$1,195.10 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL | $754.80 | $1,258.00 | $99.23–$1,195.10 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA HIP/SPINE | $456.00 | $760.00 | $70.59–$722.00 | 26% above | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA HIP/SPINE | $456.00 | $760.00 | $70.59–$722.00 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA FOREARM | $228.60 | $381.00 | $32.02–$361.95 | 52% above | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA FOREARM | $228.60 | $381.00 | $32.02–$361.95 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O | $1,810.14 | $3,016.90 | $87.58–$2,866.05 | 6% above | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O | $1,810.14 | $3,016.90 | $199.14–$2,866.05 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CON | $2,118.60 | $3,531.00 | $146.62–$3,354.45 | 2% above | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CON | $2,118.60 | $3,531.00 | $242.51–$3,354.45 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAM DIAGNOSTIC BILATERAL CONVENTIONAL | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO-DIAG-BILAT | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAM 2D DIAGNOSTIC BILATERAL | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, both breasts CPT 77066 MM MAMMO IMPLANTS DX CONVENTIONAL | $416.40 | $694.00 | $144.68–$659.30 | 10% above | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAM 2D DIAGNOSTIC BILATERAL | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO-DIAG-BILAT | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAM DIAGNOSTIC BILATERAL CONVENTIONAL | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MM MAMMO IMPLANTS DX CONVENTIONAL | $416.40 | $694.00 | $144.68–$659.30 | — | 40% |
| Diagnostic mammogram, one breast CPT 77065 MM DIAG DIGTL MAMO UNIL | $325.20 | $542.00 | $114.48–$514.90 | 31% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM UNILATERAL LEFT CONVENTIONAL | $325.20 | $542.00 | $114.48–$514.90 | 31% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM 2D UNILATERAL LEFT | $325.20 | $542.00 | $114.48–$514.90 | 31% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM 2D UNILATERAL RIGHT | $325.20 | $542.00 | $114.48–$514.90 | 31% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO-DIAG-UNILAT | $325.20 | $542.00 | $114.48–$514.90 | 31% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM UNILATERAL RIGHT CONVENTIONAL | $325.20 | $542.00 | $114.48–$514.90 | 31% above | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MM DIAG DIGTL MAMO UNIL | $325.20 | $542.00 | $114.48–$514.90 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM 2D UNILATERAL LEFT | $325.20 | $542.00 | $114.48–$514.90 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM 2D UNILATERAL RIGHT | $325.20 | $542.00 | $114.48–$514.90 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO-DIAG-UNILAT | $325.20 | $542.00 | $114.48–$514.90 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM UNILATERAL RIGHT CONVENTIONAL | $325.20 | $542.00 | $114.48–$514.90 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM UNILATERAL LEFT CONVENTIONAL | $325.20 | $542.00 | $114.48–$514.90 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 CB US ART DOPP BIL UE | $1,108.80 | $1,848.00 | $184.27–$1,755.60 | 4% above | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 CB US ART DOPP BIL LE | $1,108.80 | $1,848.00 | $184.27–$1,755.60 | 4% above | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US ART DOPP BIL LE | $1,108.80 | $1,848.00 | $184.27–$1,755.60 | 4% above | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ART DOPP BIL LE | $1,108.80 | $1,848.00 | $504.50–$1,755.60 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 CB US ART DOPP BIL UE | $1,108.80 | $1,848.00 | $504.50–$1,755.60 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 CB US ART DOPP BIL LE | $1,108.80 | $1,848.00 | $504.50–$1,755.60 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEN DOPP BILAT | $1,235.82 | $2,059.70 | $184.27–$1,956.71 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CB US VENOUS INSUFFICIENCY BILAT | $1,249.20 | $2,082.00 | $184.27–$1,977.90 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS INSUFFICIENCY BILAT | $1,249.20 | $2,082.00 | $184.27–$1,977.90 | — | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 CB US VEN DOPP BIL LE | $1,235.82 | $2,059.70 | $184.27–$1,956.71 | 31% above | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 CB US VEN DOPP BIL UE | $1,235.82 | $2,059.70 | $184.27–$1,956.71 | 31% above | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEN DOPP BILAT | $1,235.82 | $2,059.70 | $562.30–$1,956.71 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS INSUFFICIENCY BILAT | $1,249.20 | $2,082.00 | $568.39–$1,977.90 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CB US VENOUS INSUFFICIENCY BILAT | $1,249.20 | $2,082.00 | $568.39–$1,977.90 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 CB US VEN DOPP BIL UE | $1,235.82 | $2,059.70 | $562.30–$1,956.71 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 CB US VEN DOPP BIL LE | $1,235.82 | $2,059.70 | $562.30–$1,956.71 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC& | $363.60 | $606.00 | $165.44–$1,062.58 | 76% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO 2-D/M W DOP &CF | $2,041.20 | $3,402.00 | $451.60–$3,231.90 | 32% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CB US ECHO 2-D/M W DOP &CF | $2,041.20 | $3,402.00 | $451.60–$3,231.90 | 32% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC& | $363.60 | $606.00 | $165.44–$575.70 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO 2-D/M W DOP &CF | $2,041.20 | $3,402.00 | $928.75–$3,231.90 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CB US ECHO 2-D/M W DOP &CF | $2,041.20 | $3,402.00 | $928.75–$3,231.90 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA SCAN W/O PHARMA | $1,627.20 | $2,712.00 | $285.99–$2,576.40 | 19% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA SCAN W/O PHARMA | $1,627.20 | $2,712.00 | $285.99–$2,576.40 | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT | $242.40 | $404.00 | $110.29–$383.80 | 15% below | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT | $242.40 | $404.00 | $110.29–$383.80 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PAR | $1,121.40 | $1,869.00 | $510.24–$1,971.66 | 44% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PAR | $1,121.40 | $1,869.00 | $510.24–$1,775.55 | — | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3VWS | $391.20 | $652.00 | $34.50–$619.40 | 8% above | 40% |
| Knee X-ray, 3 views CPT 73562 CB XR KNEE 3 VWS | $391.20 | $652.00 | $34.50–$619.40 | 8% above | 40% |
| Knee X-ray, 3 views CPT 73562 UC XR KNEE 3V | $400.80 | $668.00 | $34.50–$634.60 | 10% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 UC XR KNEE 3V RT | $400.80 | $668.00 | $34.50–$634.60 | 10% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3VWS RIGHT | $400.80 | $668.00 | $34.50–$634.60 | 10% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3VWS LEFT | $400.80 | $668.00 | $34.50–$634.60 | 10% above | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3VWS | $391.20 | $652.00 | $34.50–$619.40 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 CB XR KNEE 3 VWS | $391.20 | $652.00 | $34.50–$619.40 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 UC XR KNEE 3V | $400.80 | $668.00 | $34.50–$634.60 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3VWS RIGHT | $400.80 | $668.00 | $34.50–$634.60 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3VWS LEFT | $400.80 | $668.00 | $34.50–$634.60 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 UC XR KNEE 3V RT | $400.80 | $668.00 | $34.50–$634.60 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SINGLE ORG QUAD | $711.00 | $1,185.00 | $81.14–$1,125.75 | 54% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 CB US ABD/RUQ/GB | $742.98 | $1,238.30 | $81.14–$1,176.38 | 61% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED GALLBLADDER | $742.98 | $1,238.30 | $81.14–$1,176.38 | 61% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER | $742.98 | $1,238.30 | $81.14–$1,176.38 | 61% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD/RUQ/GB | $742.98 | $1,238.30 | $81.14–$1,176.38 | 61% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SINGLE ORG QUAD | $711.00 | $1,185.00 | $81.14–$1,125.75 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 CB US ABD/RUQ/GB | $742.98 | $1,238.30 | $81.14–$1,176.38 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD/RUQ/GB | $742.98 | $1,238.30 | $81.14–$1,176.38 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER | $742.98 | $1,238.30 | $81.14–$1,176.38 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED GALLBLADDER | $742.98 | $1,238.30 | $81.14–$1,176.38 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LOW DOSE | $715.20 | $1,192.00 | $87.58–$1,132.40 | 117% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LOW DOSE | $715.20 | $1,192.00 | $127.18–$1,132.40 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST W/WO BILATERAL | $2,057.40 | $3,429.00 | $368.06–$3,257.55 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 CB MRI BREAST C-+ W/CAD BILATERAL | $2,057.40 | $3,429.00 | $368.06–$3,257.55 | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 CB MRI BREAST C-+ W/CAD BILATERAL | $2,057.40 | $3,429.00 | $368.06–$3,257.55 | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W/WO BILATERAL | $2,057.40 | $3,429.00 | $368.06–$3,257.55 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 ORTHO MRI JNT LOWER EXT | $1,471.80 | $2,453.00 | $199.09–$2,330.35 | 11% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 CB MRI LE JNT W/O | $2,436.00 | $4,060.00 | $199.09–$3,857.00 | 47% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE JNT W/O | $2,436.00 | $4,060.00 | $199.09–$3,857.00 | 47% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE JNT W/O RT | $2,436.00 | $4,060.00 | $199.09–$3,857.00 | 47% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 ORTHO MRI JNT LOWER EXT | $1,471.80 | $2,453.00 | $399.38–$2,330.35 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JNT W/O | $2,436.00 | $4,060.00 | $399.38–$3,857.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 CB MRI LE JNT W/O | $2,436.00 | $4,060.00 | $399.38–$3,857.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE JNT W/O RT | $2,436.00 | $4,060.00 | $399.38–$3,857.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 CB MRI LE JNT W/WO | $3,219.60 | $5,366.00 | $294.14–$5,097.70 | 17% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JNT W/WO | $3,219.60 | $5,366.00 | $294.14–$5,097.70 | 17% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE JNT W/WO RT | $3,219.60 | $5,366.00 | $294.14–$5,097.70 | 17% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 CB MRI LE JNT W/WO | $3,219.60 | $5,366.00 | $596.14–$5,097.70 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JNT W/WO | $3,219.60 | $5,366.00 | $596.14–$5,097.70 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE JNT W/WO RT | $3,219.60 | $5,366.00 | $596.14–$5,097.70 | — | 40% |
| MRI of the abdomen without contrast CPT 74181 CB MRI ABD W/O | $2,460.00 | $4,100.00 | $199.09–$3,895.00 | 2% above | 40% |
| MRI of the abdomen without contrast CPT 74181 CB MRI MRCP (MRI ABD W/O) | $2,460.00 | $4,100.00 | $199.09–$3,895.00 | 2% above | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP (MRI ABD W/O) | $2,460.00 | $4,100.00 | $199.09–$3,895.00 | 2% above | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABD W/O | $2,460.00 | $4,100.00 | $199.09–$3,895.00 | 2% above | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD W/O | $2,460.00 | $4,100.00 | $393.06–$3,895.00 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 CB MRI MRCP (MRI ABD W/O) | $2,460.00 | $4,100.00 | $393.06–$3,895.00 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 CB MRI ABD W/O | $2,460.00 | $4,100.00 | $393.06–$3,895.00 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP (MRI ABD W/O) | $2,460.00 | $4,100.00 | $393.06–$3,895.00 | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/WO | $3,345.60 | $5,576.00 | $294.14–$5,297.20 | 13% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 CB MRI ABD W/WO | $3,345.60 | $5,576.00 | $294.14–$5,297.20 | 13% above | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/WO | $3,345.60 | $5,576.00 | $620.91–$5,297.20 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 CB MRI ABD W/WO | $3,345.60 | $5,576.00 | $620.91–$5,297.20 | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 CB MRI BRAIN W/O | $2,598.90 | $4,331.50 | $199.09–$4,114.93 | 36% above | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O | $2,598.90 | $4,331.50 | $199.09–$4,114.93 | 36% above | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O | $2,598.90 | $4,331.50 | $411.17–$4,114.93 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 CB MRI BRAIN W/O | $2,598.90 | $4,331.50 | $411.17–$4,114.93 | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO | $3,600.00 | $6,000.00 | $294.14–$5,700.00 | at median | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITARY W/WO | $3,600.00 | $6,000.00 | $294.14–$5,700.00 | at median | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 CB MRI BRAIN W/WO | $3,600.00 | $6,000.00 | $294.14–$5,700.00 | at median | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO | $3,600.00 | $6,000.00 | $582.86–$5,700.00 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITARY W/WO | $3,600.00 | $6,000.00 | $582.86–$5,700.00 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 CB MRI BRAIN W/WO | $3,600.00 | $6,000.00 | $582.86–$5,700.00 | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O | $2,623.38 | $4,372.30 | $199.09–$4,153.69 | 29% above | 40% |
| MRI of the lower back, no contrast dye CPT 72148 CB MRI L-SPINE W/O | $2,623.38 | $4,372.30 | $199.09–$4,153.69 | 29% above | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 CB MRI L-SPINE W/O | $2,623.38 | $4,372.30 | $405.74–$4,153.69 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O | $2,623.38 | $4,372.30 | $405.74–$4,153.69 | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 CB MRI L-SPINE W/WO | $3,544.20 | $5,907.00 | $294.14–$5,611.65 | 24% above | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W/WO | $3,544.20 | $5,907.00 | $294.14–$5,611.65 | 24% above | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W/WO | $3,544.20 | $5,907.00 | $578.83–$5,611.65 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 CB MRI L-SPINE W/WO | $3,544.20 | $5,907.00 | $578.83–$5,611.65 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O | $2,463.00 | $4,105.00 | $199.09–$3,899.75 | 11% above | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 CB MRI T-SPINE W/O | $2,463.00 | $4,105.00 | $199.09–$3,899.75 | 11% above | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE W/O | $2,463.00 | $4,105.00 | $408.74–$3,899.75 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 CB MRI T-SPINE W/O | $2,463.00 | $4,105.00 | $408.74–$3,899.75 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 CB MRI C-SPINE W/WO | $3,501.00 | $5,835.00 | $294.14–$5,543.25 | 25% above | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W/WO | $3,501.00 | $5,835.00 | $294.14–$5,543.25 | 25% above | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W/WO | $3,501.00 | $5,835.00 | $584.23–$5,543.25 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CB MRI C-SPINE W/WO | $3,501.00 | $5,835.00 | $584.23–$5,543.25 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O | $2,627.16 | $4,378.60 | $199.09–$4,159.67 | 26% above | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 CB MRI C-SPINE W/O | $2,627.16 | $4,378.60 | $199.09–$4,159.67 | 26% above | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CB MRI C-SPINE W/O | $2,627.16 | $4,378.60 | $408.93–$4,159.67 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O | $2,627.16 | $4,378.60 | $408.93–$4,159.67 | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI SCROTUM W/WO | $3,268.80 | $5,448.00 | $294.14–$5,175.60 | 5% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 CB MRI SCROTUM W/WO | $3,268.80 | $5,448.00 | $294.14–$5,175.60 | 5% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE W/WO CONTRAST | $3,268.80 | $5,448.00 | $294.14–$5,175.60 | 5% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 CB MRI PELVIS W/WO | $3,268.80 | $5,448.00 | $294.14–$5,175.60 | 5% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO | $3,268.80 | $5,448.00 | $294.14–$5,175.60 | 5% above | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE W/WO CONTRAST | $3,268.80 | $5,448.00 | $620.58–$5,175.60 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI SCROTUM W/WO | $3,268.80 | $5,448.00 | $620.58–$5,175.60 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 CB MRI SCROTUM W/WO | $3,268.80 | $5,448.00 | $620.58–$5,175.60 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO | $3,268.80 | $5,448.00 | $620.58–$5,175.60 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 CB MRI PELVIS W/WO | $3,268.80 | $5,448.00 | $620.58–$5,175.60 | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O | $2,346.00 | $3,910.00 | $199.09–$3,714.50 | 18% above | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 CB MRI PELVIS W/O | $2,346.00 | $3,910.00 | $199.09–$3,714.50 | 18% above | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 CB MRI PELVIS W/O | $2,346.00 | $3,910.00 | $406.97–$3,714.50 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O | $2,346.00 | $3,910.00 | $406.97–$3,714.50 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 ORTHO MRI JNT UPPER EXT | $1,314.00 | $2,190.00 | $199.09–$2,080.50 | 21% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JNT W/O | $2,400.00 | $4,000.00 | $199.09–$3,800.00 | 44% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 CB MRI UE JNT W/O | $2,400.00 | $4,000.00 | $199.09–$3,800.00 | 44% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE JNT W/O RT | $2,400.00 | $4,000.00 | $199.09–$3,800.00 | 44% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 ORTHO MRI JNT UPPER EXT | $1,314.00 | $2,190.00 | $407.01–$2,080.50 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JNT W/O | $2,400.00 | $4,000.00 | $407.01–$3,800.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 CB MRI UE JNT W/O | $2,400.00 | $4,000.00 | $407.01–$3,800.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE JNT W/O RT | $2,400.00 | $4,000.00 | $407.01–$3,800.00 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM STRESS TEST | $3,912.00 | $6,520.00 | $443.80–$6,194.00 | 55% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM STRESS TEST | $3,912.00 | $6,520.00 | $443.80–$6,194.00 | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL TO THIGH | $5,157.60 | $8,596.00 | $1,201.34–$8,166.20 | 69% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL TO THIGH | $5,157.60 | $8,596.00 | $1,562.32–$8,166.20 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED | $477.00 | $795.00 | $66.60–$755.25 | 15% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ED US PELVC NONOBS IMAG DCMTN LIMITD/F/U | $477.00 | $795.00 | $66.60–$755.25 | 15% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 CB US PELVIS LIMITED | $477.00 | $795.00 | $66.60–$755.25 | 15% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED | $504.60 | $841.00 | $66.60–$798.95 | 22% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED | $477.00 | $795.00 | $66.60–$755.25 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 CB US PELVIS LIMITED | $477.00 | $795.00 | $66.60–$755.25 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ED US PELVC NONOBS IMAG DCMTN LIMITD/F/U | $477.00 | $795.00 | $66.60–$755.25 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED | $504.60 | $841.00 | $66.60–$798.95 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 CB US PELVIC COMP | $775.20 | $1,292.00 | $87.58–$1,227.40 | 44% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMP | $775.20 | $1,292.00 | $87.58–$1,227.40 | 44% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMP | $775.20 | $1,292.00 | $93.16–$1,227.40 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 CB US PELVIC COMP | $775.20 | $1,292.00 | $93.16–$1,227.40 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CB US OB>14WK SGL 1ST G | $734.40 | $1,224.00 | $87.58–$1,162.80 | 43% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB>14WK SGL 1ST G | $734.40 | $1,224.00 | $87.58–$1,162.80 | 43% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB>14WK SGL 1ST G | $734.40 | $1,224.00 | $117.98–$1,162.80 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CB US OB>14WK SGL 1ST G | $734.40 | $1,224.00 | $117.98–$1,162.80 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 CB US OB<14WKS SGL 1GES | $652.80 | $1,088.00 | $87.58–$1,033.60 | 26% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB<14WKS SGL 1GES | $652.80 | $1,088.00 | $87.58–$1,033.60 | 26% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 CB US OB<14WKS SGL 1GES | $652.80 | $1,088.00 | $102.30–$1,033.60 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB<14WKS SGL 1GES | $652.80 | $1,088.00 | $102.30–$1,033.60 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ED PREGNANT TRANSABDOMINAL | $487.20 | $812.00 | $70.81–$771.40 | 3% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG FETAL POSIT | $487.20 | $812.00 | $70.81–$771.40 | 3% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB PEL/PREG COMP | $487.20 | $812.00 | $70.81–$771.40 | 3% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ED PREGNANT TRANSABDOMINAL | $487.20 | $812.00 | $70.81–$771.40 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG FETAL POSIT | $487.20 | $812.00 | $70.81–$771.40 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB PEL/PREG COMP | $487.20 | $812.00 | $70.81–$771.40 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MAM SCREEN BILATERAL CONVENTIONAL | $285.00 | $475.00 | $116.58–$451.25 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MAM 2D SCREEN BILATERAL | $285.00 | $475.00 | $116.58–$451.25 | — | 40% |
| Screening mammogram, both breasts CPT 77067 MM MAMMO IMPLANTS SCR CONVENTIONAL | $285.00 | $475.00 | $116.58–$451.25 | 5% above | 40% |
| Screening mammogram, both breasts CPT 77067 MM SCREEN DIG MAMO ALL | $285.00 | $475.00 | $116.58–$451.25 | 5% above | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAM 2D SCREEN BILATERAL | $285.00 | $475.00 | $116.58–$451.25 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAM SCREEN BILATERAL CONVENTIONAL | $285.00 | $475.00 | $116.58–$451.25 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MM MAMMO IMPLANTS SCR CONVENTIONAL | $285.00 | $475.00 | $116.58–$451.25 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MM SCREEN DIG MAMO ALL | $285.00 | $475.00 | $116.58–$451.25 | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 UC XR SHOULDER COM | $240.60 | $401.00 | $29.41–$380.95 | 18% below | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMP | $373.80 | $623.00 | $29.41–$591.85 | 27% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 CB XR SHOULDER COM | $373.80 | $623.00 | $29.41–$591.85 | 27% above | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COM RIGHT | $240.60 | $401.00 | $29.41–$380.95 | 18% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 UC XR SHOULDER COM RIGHT | $240.60 | $401.00 | $29.41–$380.95 | 18% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COM LEFT | $240.60 | $401.00 | $29.41–$380.95 | 18% below | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 UC XR SHOULDER COM | $240.60 | $401.00 | $29.41–$380.95 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMP | $373.80 | $623.00 | $29.41–$591.85 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 CB XR SHOULDER COM | $373.80 | $623.00 | $29.41–$591.85 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 UC XR SHOULDER COM RIGHT | $240.60 | $401.00 | $29.41–$380.95 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COM RIGHT | $240.60 | $401.00 | $29.41–$380.95 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COM LEFT | $240.60 | $401.00 | $29.41–$380.95 | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTN | $1,069.20 | $1,782.00 | $486.49–$1,971.66 | 42% below | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTN | $1,069.20 | $1,782.00 | $486.49–$1,692.90 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 CB SWALLOWING FUNCJ W/CINERADIOGRAPY/VID | $531.60 | $886.00 | $104.01–$841.70 | 6% above | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 FL MOD BARIUM SWALLOW | $580.20 | $967.00 | $104.01–$918.65 | 15% above | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR DYSPHAGIA SWALLOW | $580.20 | $967.00 | $104.01–$918.65 | 15% above | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 CB SWALLOWING FUNCJ W/CINERADIOGRAPY/VID | $531.60 | $886.00 | $112.12–$841.70 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR DYSPHAGIA SWALLOW | $580.20 | $967.00 | $112.12–$918.65 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL MOD BARIUM SWALLOW | $580.20 | $967.00 | $112.12–$918.65 | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $643.20 | $1,072.00 | $87.58–$1,018.40 | 26% above | 40% |
| Transvaginal pelvic ultrasound CPT 76830 CB US TRANSVAGINAL | $643.20 | $1,072.00 | $87.58–$1,018.40 | 26% above | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 CB US TRANSVAGINAL | $643.20 | $1,072.00 | $104.38–$1,018.40 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $643.20 | $1,072.00 | $104.38–$1,018.40 | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN T | $570.00 | $950.00 | $74.23–$902.50 | 28% above | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 CB US TRANSVAGINAL US OBSTETRIC | $570.00 | $950.00 | $74.23–$902.50 | 28% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN T | $570.00 | $950.00 | $80.85–$902.50 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 CB US TRANSVAGINAL US OBSTETRIC | $570.00 | $950.00 | $80.85–$902.50 | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD SOFT TISSUE | $931.80 | $1,553.00 | $87.58–$1,475.35 | 42% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD SURVEY COMP | $931.80 | $1,553.00 | $87.58–$1,475.35 | 42% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 CB US ABD SURVEY COMP | $931.80 | $1,553.00 | $87.58–$1,475.35 | 42% above | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD SOFT TISSUE | $931.80 | $1,553.00 | $105.15–$1,475.35 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD SURVEY COMP | $931.80 | $1,553.00 | $105.15–$1,475.35 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 CB US ABD SURVEY COMP | $931.80 | $1,553.00 | $105.15–$1,475.35 | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM | $632.40 | $1,054.00 | $87.58–$1,001.30 | 21% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/TESTICULA | $718.20 | $1,197.00 | $87.58–$1,137.15 | 37% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 CB US SCROTUM/TESTICULA | $718.20 | $1,197.00 | $87.58–$1,137.15 | 37% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM | $632.40 | $1,054.00 | $88.31–$1,001.30 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM/TESTICULA | $718.20 | $1,197.00 | $88.31–$1,137.15 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 CB US SCROTUM/TESTICULA | $718.20 | $1,197.00 | $88.31–$1,137.15 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 76536 US SOFT TISSUE HEAD & NECK RE TIME | $204.00 | $340.00 | $87.58–$323.00 | 56% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 CB US SFT TISS/HEAD/NECK/THYROID | $689.10 | $1,148.50 | $87.58–$1,091.08 | 50% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SFT TIS HEAD & NK | $689.10 | $1,148.50 | $87.58–$1,091.08 | 50% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $689.10 | $1,148.50 | $87.58–$1,091.08 | 50% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 76536 US SOFT TISSUE HEAD & NECK RE TIME | $204.00 | $340.00 | $98.06–$323.00 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID | $689.10 | $1,148.50 | $98.06–$1,091.08 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SFT TIS HEAD & NK | $689.10 | $1,148.50 | $98.06–$1,091.08 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 CB US SFT TISS/HEAD/NECK/THYROID | $689.10 | $1,148.50 | $98.06–$1,091.08 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UPPER GI W/SMALL BOWEL FOLLOW THROUGH | $669.00 | $1,115.00 | $104.01–$1,059.25 | at median | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UPPER GI SERIES | $669.00 | $1,115.00 | $104.01–$1,059.25 | at median | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UPPER GI SERIES | $669.00 | $1,115.00 | $105.99–$1,059.25 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UPPER GI W/SMALL BOWEL FOLLOW THROUGH | $669.00 | $1,115.00 | $105.99–$1,059.25 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VEN DOPP UE | $819.60 | $1,366.00 | $87.58–$1,297.70 | 15% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUPLX UNI EXT FU/LIM | $819.60 | $1,366.00 | $87.58–$1,297.70 | 15% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED DVT FOCUSED STUDY | $819.60 | $1,366.00 | $87.58–$1,297.70 | 15% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 CB US VEN DOPP UE | $819.60 | $1,366.00 | $87.58–$1,297.70 | 15% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 CB US VEN DOPP LE | $819.60 | $1,366.00 | $87.58–$1,297.70 | 15% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VEN DOPP LE | $819.60 | $1,366.00 | $87.58–$1,297.70 | 15% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US DUPLX UNI EXT FU/LIM | $819.60 | $1,366.00 | $372.92–$1,297.70 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VEN DOPP LE | $819.60 | $1,366.00 | $372.92–$1,297.70 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VEN DOPP UE | $819.60 | $1,366.00 | $372.92–$1,297.70 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 CB US VEN DOPP LE | $819.60 | $1,366.00 | $372.92–$1,297.70 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 CB US VEN DOPP UE | $819.60 | $1,366.00 | $372.92–$1,297.70 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 ED DVT FOCUSED STUDY | $819.60 | $1,366.00 | $372.92–$1,297.70 | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 UC XR WRIST COMP | $265.20 | $442.00 | $34.78–$419.90 | 10% below | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMP | $373.20 | $622.00 | $34.78–$590.90 | 27% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 CB XR WRIST COMP | $373.20 | $622.00 | $34.78–$590.90 | 27% above | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 UC XR WRIST COMP RIGHT | $265.20 | $442.00 | $34.78–$419.90 | 10% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP RIGHT | $265.20 | $442.00 | $34.78–$419.90 | 10% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP LEFT | $265.20 | $442.00 | $34.78–$419.90 | 10% below | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 UC XR WRIST COMP | $265.20 | $442.00 | $34.78–$419.90 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 CB XR WRIST COMP | $373.20 | $622.00 | $34.78–$590.90 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMP | $373.20 | $622.00 | $34.78–$590.90 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP LEFT | $265.20 | $442.00 | $34.78–$419.90 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 UC XR WRIST COMP RIGHT | $265.20 | $442.00 | $34.78–$419.90 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP RIGHT | $265.20 | $442.00 | $34.78–$419.90 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 UC XR HIP 2/3 VW | $167.40 | $279.00 | $45.31–$265.05 | 32% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 CB XR HIP 2/3 VW | $352.20 | $587.00 | $45.31–$557.65 | 43% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP 2 or 3 VW | $352.20 | $587.00 | $45.31–$557.65 | 43% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY HIP UNILATERAL 2/3 VIEWS | $76.20 | $127.00 | $45.31–$170.64 | 69% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 UC XR HIP UNI 2-3 VW RT | $167.40 | $279.00 | $45.31–$265.05 | 32% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 UC XR HIP 2/3 VW | $167.40 | $279.00 | $45.31–$265.05 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP 2 or 3 VW | $352.20 | $587.00 | $45.31–$557.65 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 CB XR HIP 2/3 VW | $352.20 | $587.00 | $45.31–$557.65 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY HIP UNILATERAL 2/3 VIEWS | $76.20 | $127.00 | $45.31–$120.65 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 UC XR HIP UNI 2-3 VW RT | $167.40 | $279.00 | $45.31–$265.05 | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 CB XR ABD 1 VW | $289.20 | $482.00 | $26.31–$457.90 | 17% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD 1V | $289.20 | $482.00 | $26.31–$457.90 | 17% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 UC XR ABD 1V | $289.20 | $482.00 | $26.31–$457.90 | 17% above | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD 1V | $289.20 | $482.00 | $26.31–$457.90 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 UC XR ABD 1V | $289.20 | $482.00 | $26.31–$457.90 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 CB XR ABD 1 VW | $289.20 | $482.00 | $26.31–$457.90 | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2V | $305.40 | $509.00 | $27.71–$483.55 | 49% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 UC XR ANKLE 2V | $305.40 | $509.00 | $27.71–$483.55 | 49% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 CB XR ANKLE 2V | $305.40 | $509.00 | $27.71–$483.55 | 49% above | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE AP & LAT/2V LEFT | $192.60 | $321.00 | $27.71–$304.95 | 6% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE AP & LAT/2V RIGHT | $192.60 | $321.00 | $27.71–$304.95 | 6% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 UC XR ANKLE 2V RIGHT | $305.40 | $509.00 | $27.71–$483.55 | 49% above | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 CB XR ANKLE 2V | $305.40 | $509.00 | $27.71–$483.55 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 UC XR ANKLE 2V | $305.40 | $509.00 | $27.71–$483.55 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2V | $305.40 | $509.00 | $27.71–$483.55 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE AP & LAT/2V RIGHT | $192.60 | $321.00 | $27.71–$304.95 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE AP & LAT/2V LEFT | $192.60 | $321.00 | $27.71–$304.95 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 UC XR ANKLE 2V RIGHT | $305.40 | $509.00 | $27.71–$483.55 | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 UC XR FINGER | $137.40 | $229.00 | $32.23–$217.55 | 39% below | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 CB XR FINGER | $282.00 | $470.00 | $32.23–$446.50 | 25% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER | $282.00 | $470.00 | $32.23–$446.50 | 25% above | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3 VIEW LEFT | $137.40 | $229.00 | $32.23–$217.55 | 39% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 UC XR FINGER RIGHT | $137.40 | $229.00 | $32.23–$217.55 | 39% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3 VIEW RIGHT | $137.40 | $229.00 | $32.23–$217.55 | 39% below | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 UC XR FINGER | $137.40 | $229.00 | $32.23–$217.55 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 CB XR FINGER | $282.00 | $470.00 | $32.23–$446.50 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER | $282.00 | $470.00 | $32.23–$446.50 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3 VIEW RIGHT | $137.40 | $229.00 | $32.23–$217.55 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 UC XR FINGER RIGHT | $137.40 | $229.00 | $32.23–$217.55 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3 VIEW LEFT | $137.40 | $229.00 | $32.23–$217.55 | — | 40% |
| X-ray of the foot, 2 views CPT 73620 CB XR FOOT 2V | $191.40 | $319.00 | $24.03–$303.05 | 15% below | 40% |
| X-ray of the foot, 2 views CPT 73620 UC XR FOOT 2 VWS | $191.40 | $319.00 | $24.03–$303.05 | 15% below | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2V | $313.20 | $522.00 | $24.03–$495.90 | 39% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT AP & LAT LEFT | $191.40 | $319.00 | $24.03–$303.05 | 15% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT AP & LAT RIGHT | $191.40 | $319.00 | $24.03–$303.05 | 15% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 UC XR FOOT RIGHT 2VWS | $191.40 | $319.00 | $24.03–$303.05 | 15% below | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 CB XR FOOT 2V | $191.40 | $319.00 | $24.03–$303.05 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 UC XR FOOT 2 VWS | $191.40 | $319.00 | $24.03–$303.05 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2V | $313.20 | $522.00 | $24.03–$495.90 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT AP & LAT RIGHT | $191.40 | $319.00 | $24.03–$303.05 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 UC XR FOOT RIGHT 2VWS | $191.40 | $319.00 | $24.03–$303.05 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT AP & LAT LEFT | $191.40 | $319.00 | $24.03–$303.05 | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 CB XR FOOT COMP | $262.80 | $438.00 | $29.12–$416.10 | 10% below | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 UC XR FOOT COMP | $262.80 | $438.00 | $29.12–$416.10 | 10% below | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMP | $363.00 | $605.00 | $29.12–$574.75 | 24% above | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 UC XR FOOT COMP RIGHT | $262.80 | $438.00 | $29.12–$416.10 | 10% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP RIGHT | $262.80 | $438.00 | $29.12–$416.10 | 10% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP LEFT | $262.80 | $438.00 | $29.12–$416.10 | 10% below | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 UC XR FOOT COMP | $262.80 | $438.00 | $29.12–$416.10 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 CB XR FOOT COMP | $262.80 | $438.00 | $29.12–$416.10 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMP | $363.00 | $605.00 | $29.12–$574.75 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP RIGHT | $262.80 | $438.00 | $29.12–$416.10 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP LEFT | $262.80 | $438.00 | $29.12–$416.10 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 UC XR FOOT COMP RIGHT | $262.80 | $438.00 | $29.12–$416.10 | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 UC XR HAND COMP | $254.40 | $424.00 | $31.38–$402.80 | 13% below | 40% |
| X-ray of the hand, 3 or more views CPT 73130 CB XR HAND COMP | $369.60 | $616.00 | $31.38–$585.20 | 26% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMP | $369.60 | $616.00 | $31.38–$585.20 | 26% above | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMP LEFT | $254.40 | $424.00 | $31.38–$402.80 | 13% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 UC XR HAND COMP RIGHT | $254.40 | $424.00 | $31.38–$402.80 | 13% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMP RIGHT | $254.40 | $424.00 | $31.38–$402.80 | 13% below | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 UC XR HAND COMP | $254.40 | $424.00 | $31.38–$402.80 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 CB XR HAND COMP | $369.60 | $616.00 | $31.38–$585.20 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMP | $369.60 | $616.00 | $31.38–$585.20 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 UC XR HAND COMP RIGHT | $254.40 | $424.00 | $31.38–$402.80 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND COMP RIGHT | $254.40 | $424.00 | $31.38–$402.80 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND COMP LEFT | $254.40 | $424.00 | $31.38–$402.80 | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 UC XR KNEE 1-2V | $219.00 | $365.00 | $29.12–$346.75 | 6% below | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 CB XR KNEE 2V | $320.40 | $534.00 | $29.12–$507.30 | 37% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE 2V | $320.40 | $534.00 | $29.12–$507.30 | 37% above | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE AP LAT RIGHT | $219.00 | $365.00 | $29.12–$346.75 | 6% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE AP LAT LEFT | $219.00 | $365.00 | $29.12–$346.75 | 6% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 UC XR KNEE RIGHT 1-2V | $219.00 | $365.00 | $29.12–$346.75 | 6% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 UC XR KNEE 1-2V | $219.00 | $365.00 | $29.12–$346.75 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 CB XR KNEE 2V | $320.40 | $534.00 | $29.12–$507.30 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE 2V | $320.40 | $534.00 | $29.12–$507.30 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE AP LAT LEFT | $219.00 | $365.00 | $29.12–$346.75 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE AP LAT RIGHT | $219.00 | $365.00 | $29.12–$346.75 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 UC XR KNEE RIGHT 1-2V | $219.00 | $365.00 | $29.12–$346.75 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS | $316.20 | $527.00 | $33.93–$500.65 | 2% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 UC XR L-SPINE 2/3 VWS | $316.20 | $527.00 | $33.93–$500.65 | 2% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 CB XR L-SPINE 2/3 VWS | $436.38 | $727.30 | $33.93–$690.93 | 36% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VWS | $436.38 | $727.30 | $33.93–$690.93 | 36% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 UC XR L-SPINE 2/3 VWS | $316.20 | $527.00 | $33.93–$500.65 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS | $316.20 | $527.00 | $33.93–$500.65 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE 2/3 VWS | $436.38 | $727.30 | $33.93–$690.93 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 CB XR L-SPINE 2/3 VWS | $436.38 | $727.30 | $33.93–$690.93 | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $390.00 | $650.00 | $43.55–$617.50 | 16% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 UC XR L-SPINE COMP | $390.00 | $650.00 | $43.55–$617.50 | 16% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE COMP | $584.40 | $974.00 | $43.55–$925.30 | 26% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 CB XR L-SPINE COMP | $584.40 | $974.00 | $43.55–$925.30 | 26% above | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $390.00 | $650.00 | $43.55–$617.50 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 UC XR L-SPINE COMP | $390.00 | $650.00 | $43.55–$617.50 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE COMP | $584.40 | $974.00 | $43.55–$925.30 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CB XR L-SPINE COMP | $584.40 | $974.00 | $43.55–$925.30 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 UC XR T-SPINE 2V | $358.20 | $597.00 | $27.99–$567.15 | 9% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 RADEX SPINE THORACIC 2 VIEWS | $358.20 | $597.00 | $27.99–$567.15 | 9% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 CB XR T-SPINE 2V | $376.80 | $628.00 | $27.99–$596.60 | 15% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2V | $376.80 | $628.00 | $27.99–$596.60 | 15% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RADEX SPINE THORACIC 2 VIEWS | $358.20 | $597.00 | $27.99–$567.15 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 UC XR T-SPINE 2V | $358.20 | $597.00 | $27.99–$567.15 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR T-SPINE 2V | $376.80 | $628.00 | $27.99–$596.60 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 CB XR T-SPINE 2V | $376.80 | $628.00 | $27.99–$596.60 | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 UC XR NASAL BONES COMP | $302.40 | $504.00 | $32.52–$478.80 | 6% above | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP | $357.60 | $596.00 | $32.52–$566.20 | 25% above | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 CB XR NASAL BONES COMP | $357.60 | $596.00 | $32.52–$566.20 | 25% above | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 UC XR NASAL BONES COMP | $302.40 | $504.00 | $32.52–$478.80 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMP | $357.60 | $596.00 | $32.52–$566.20 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 CB XR NASAL BONES COMP | $357.60 | $596.00 | $32.52–$566.20 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS | $327.00 | $545.00 | $33.65–$517.75 | 17% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CB XR C-SPINE 2/3 VWS | $382.20 | $637.00 | $33.65–$605.15 | 36% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2/3 VWS | $382.20 | $637.00 | $33.65–$605.15 | 36% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 UC XR C-SPINE 2/3 VWS | $382.20 | $637.00 | $33.65–$605.15 | 36% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS | $327.00 | $545.00 | $33.65–$517.75 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 UC XR C-SPINE 2/3 VWS | $382.20 | $637.00 | $33.65–$605.15 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE 2/3 VWS | $382.20 | $637.00 | $33.65–$605.15 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CB XR C-SPINE 2/3 VWS | $382.20 | $637.00 | $33.65–$605.15 | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 UC XR PELVIS 1/2 VWS | $187.20 | $312.00 | $27.07–$296.40 | 26% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VWS | $326.40 | $544.00 | $27.07–$516.80 | 29% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 CB XR PELVIS 1/2 VWS | $326.40 | $544.00 | $27.07–$516.80 | 29% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAM RSA | $326.40 | $544.00 | $27.07–$516.80 | 29% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXM RSA LWR EXTR | $326.40 | $544.00 | $27.07–$516.80 | 29% above | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 UC XR PELVIS 1/2 VWS | $187.20 | $312.00 | $27.07–$296.40 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1/2 VWS | $326.40 | $544.00 | $27.07–$516.80 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 CB XR PELVIS 1/2 VWS | $326.40 | $544.00 | $27.07–$516.80 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RADIOLOGIC EXAM RSA | $326.40 | $544.00 | $27.07–$516.80 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXM RSA LWR EXTR | $326.40 | $544.00 | $27.07–$516.80 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 ORTHO XR SACRUM/COCCYX 2+ VIEW | $297.00 | $495.00 | $27.71–$470.25 | 2% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS | $297.00 | $495.00 | $27.71–$470.25 | 2% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 UC XR SACRUM/COCCYX 2 VWS | $297.00 | $495.00 | $27.71–$470.25 | 2% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE | $346.20 | $577.00 | $27.71–$548.15 | 19% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2+ VIEW | $357.00 | $595.00 | $27.71–$565.25 | 23% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 CB XR SACRUM/COCCYX 2 VWS | $357.00 | $595.00 | $27.71–$565.25 | 23% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS | $297.00 | $495.00 | $27.71–$470.25 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 ORTHO XR SACRUM/COCCYX 2+ VIEW | $297.00 | $495.00 | $27.71–$470.25 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 UC XR SACRUM/COCCYX 2 VWS | $297.00 | $495.00 | $27.71–$470.25 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE | $346.20 | $577.00 | $27.71–$548.15 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2+ VIEW | $357.00 | $595.00 | $27.71–$565.25 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 CB XR SACRUM/COCCYX 2 VWS | $357.00 | $595.00 | $27.71–$565.25 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT (Vitros) | $62.40 | $104.00 | $4.50–$98.80 | 25% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT (Vitros) | $62.40 | $104.00 | $6.77–$98.80 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT (Vitros) | $62.40 | $104.00 | $4.40–$98.80 | 41% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT (Vitros) | $62.40 | $104.00 | $6.28–$98.80 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 hepatitis pan ABC w/hcv reflex REF144000 | $392.40 | $654.00 | $40.49–$621.30 | 19% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 hepatitis pan ABC w/hcv reflex REF144000 | $392.40 | $654.00 | $59.07–$621.30 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 soybean IgE REF602457 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 sesame seed IgE REF602485 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 cottonwood IgE REF602518 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 maple box elder IgE REF602489 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 elm, american IgE REF602476 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 alternaria alternata REF602455 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IGE | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 timothy grass IgE REF602506 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 bermuda grass IgE REF602464 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 cladosporium herbarum REF602462 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 dermatophagoides farinae IgE REF602475 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 dermatophagoides pteronyss IgE REF602467 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 penicillium chrysogen IgE REF602502 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 cockroach, american IgE REF602481 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 mulberry white IgE REF602569 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 sheep sorrell IgE REF602542 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 mulberry white IgE REF 602569 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 penicillium glabrum, IgE REF806871 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 eucalyptus, IgE REF602930 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 corn IgE REF602460 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 wheat IgE REF602459 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 codfish, IgE REF602465 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 scallop IgE REF602478 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 cinnamon, IgE REF602781 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 pineapple, IgE REF602770 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 banana, IgE REF602742 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 egg yolk IgE REF602487 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ragweed, western REF602544 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 mesquite IgE REF602932 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 kentucky bluegrass IgE REF602496 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 pork, IgE REF602498 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 allergen profile-nutREF604764 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 latex, IgE REF602669 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 penicillin, IgE REF067108 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 kiwi fruit, IgE REF602781 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 avocado, IgE REF602781 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 melon, IgE REF602737 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ascaris, IgE REF602923 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 horse fly, IgE REF602898 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 insulin, human IgE REF602652 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 russian thistle IgE REF602515 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 common ragweed IgE REF602463 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 mugwort IgE REF602531 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 rough pigweed IgE REF602484 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 dog dander IgE REF602456 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 cat hair/dander IgE REF602454 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 oak, white IgE REF602480 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 milk (cow) IgE REF602453 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 egg white IgE REF602452 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 salmon IgE REF602507 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 olive tree IgE REF602527 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 hazelnut tree, IgE | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 peanut IgE REF602451 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 mouse urine igE REF 602689 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 walnut IgE REF602530 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 clam, IgE REF602529 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 cedar mountain IgE REF602491 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 alder, grey IgE REF602545 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IGE | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 shrimp IgE REF602473 | $33.60 | $56.00 | $4.44–$53.20 | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 sesame seed IgE REF602485 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 dermatophagoides pteronyss IgE REF602467 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 penicillium chrysogen IgE REF602502 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 cockroach, american IgE REF602481 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 mulberry white IgE REF602569 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 sheep sorrell IgE REF602542 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 mulberry white IgE REF 602569 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 penicillium glabrum, IgE REF806871 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 eucalyptus, IgE REF602930 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 insulin, human IgE REF602652 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 horse fly, IgE REF602898 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ascaris, IgE REF602923 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 melon, IgE REF602737 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 avocado, IgE REF602781 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 kiwi fruit, IgE REF602781 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 penicillin, IgE REF067108 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 cladosporium herbarum REF602462 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 alternaria alternata REF602455 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 latex, IgE REF602669 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 allergen profile-nutREF604764 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 pork, IgE REF602498 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 kentucky bluegrass IgE REF602496 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 mesquite IgE REF602932 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ragweed, western REF602544 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 egg yolk IgE REF602487 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 elm, american IgE REF602476 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 oak, white IgE REF602480 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 cat hair/dander IgE REF602454 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 dog dander IgE REF602456 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 rough pigweed IgE REF602484 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 mugwort IgE REF602531 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 common ragweed IgE REF602463 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 russian thistle IgE REF602515 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 bermuda grass IgE REF602464 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 timothy grass IgE REF602506 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 maple box elder IgE REF602489 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 cottonwood IgE REF602518 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 alder, grey IgE REF602545 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 cedar mountain IgE REF602491 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 olive tree IgE REF602527 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 salmon IgE REF602507 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 egg white IgE REF602452 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 milk (cow) IgE REF602453 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 codfish, IgE REF602465 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 wheat IgE REF602459 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 corn IgE REF602460 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 peanut IgE REF602451 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 soybean IgE REF602457 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 shrimp IgE REF602473 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 walnut IgE REF602530 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 clam, IgE REF602529 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 banana, IgE REF602742 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 pineapple, IgE REF602770 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 cinnamon, IgE REF602781 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 scallop IgE REF602478 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 hazelnut tree, IgE | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT IGE | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND IGE | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 mouse urine igE REF 602689 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 dermatophagoides farinae IgE REF602475 | $33.60 | $56.00 | $7.93–$53.20 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ccp abs (IgA, IgG) REF164914 | $142.20 | $237.00 | $11.01–$225.15 | 125% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ccp abs (IgA, IgG) REF164914 | $142.20 | $237.00 | $16.25–$225.15 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ana w/ reflex titer/pattern REF 164947 | $109.20 | $182.00 | $10.28–$172.90 | at median | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ana w/ reflex titer/pattern REF 164947 | $109.20 | $182.00 | $13.86–$172.90 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 probnp n terminal REF143000 | $201.60 | $336.00 | $32.78–$319.20 | 23% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (Vitros) | $201.60 | $336.00 | $32.78–$319.20 | 23% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (Vitros) | $201.60 | $336.00 | $32.78–$319.20 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 probnp n terminal REF143000 | $201.60 | $336.00 | $32.78–$319.20 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE (Vitros) | $187.80 | $313.00 | $7.19–$297.35 | 40% above | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE (Vitros) | $187.80 | $313.00 | $10.46–$297.35 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PAT LEV IV | $220.20 | $367.00 | $44.00–$348.65 | 35% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PAT LEV IV | $220.20 | $367.00 | $73.01–$348.65 | — | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLD set 5 | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLD set 6 | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CCULTURE BLD | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD (SEPSIS) set 2 | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD (SEPSIS) set 1 | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLD set 3 | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLD set 4 | $120.60 | $201.00 | $8.77–$190.95 | 15% below | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CCULTURE BLD | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLD set 5 | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLD set 6 | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD (SEPSIS) set 1 | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD (SEPSIS) set 2 | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLD set 3 | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLD set 4 | $120.60 | $201.00 | $12.01–$190.95 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE | $16.20 | $27.00 | $7.37–$25.65 | 16% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE | $16.20 | $27.00 | $7.37–$25.65 | — | 40% |
| Blood glucose (sugar) test CPT 82947 FASTING GLUCOSE (Vitros) | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE 2 Hour (Vitros) | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test CPT 82947 GTT FASTING GLUCOSE (Vitros) | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test CPT 82947 REPEAT GLUCOSE | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test CPT 82947 ASSAY, GLUCOSE, BLOOD QUA | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE (Vitros) | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test CPT 82947 1 HR GLUCOSE (Vitros) | $18.00 | $30.00 | $3.34–$28.50 | 56% below | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 FASTING GLUCOSE (Vitros) | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE (Vitros) | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 1 HR GLUCOSE (Vitros) | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2 Hour (Vitros) | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GTT FASTING GLUCOSE (Vitros) | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 REPEAT GLUCOSE | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 ASSAY, GLUCOSE, BLOOD QUA | $18.00 | $30.00 | $5.49–$28.50 | — | 40% |
| Blood lead test CPT 83655 lead urine REF007633 | $78.60 | $131.00 | $10.29–$124.45 | 11% above | 40% |
| Blood lead test CPT 83655 lead whole blood (adult) REF007625 | $78.60 | $131.00 | $10.29–$124.45 | 11% above | 40% |
| Blood lead test CPT 83655 lead whole blood pediatric REF717009 | $78.60 | $131.00 | $10.29–$124.45 | 11% above | 40% |
| Blood lead test inpatient CPT 83655 lead whole blood (adult) REF007625 | $78.60 | $131.00 | $15.47–$124.45 | — | 40% |
| Blood lead test inpatient CPT 83655 lead whole blood pediatric REF717009 | $78.60 | $131.00 | $15.47–$124.45 | — | 40% |
| Blood lead test inpatient CPT 83655 lead urine REF007633 | $78.60 | $131.00 | $15.47–$124.45 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL SERUM | $75.60 | $126.00 | $6.39–$119.70 | 16% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL SERUM | $75.60 | $126.00 | $13.62–$119.70 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLD TYPE ABO | $65.40 | $109.00 | $2.54–$103.55 | 37% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 abo REF006056 | $65.40 | $109.00 | $2.54–$103.55 | 37% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 abo REF006056 | $65.40 | $109.00 | $4.44–$103.55 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB BLD TYPE ABO | $65.40 | $109.00 | $4.44–$103.55 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP REF | $68.40 | $114.00 | $4.40–$108.30 | 23% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP (Vitros) AGH | $112.20 | $187.00 | $4.40–$177.65 | 27% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP REF | $68.40 | $114.00 | $7.32–$108.30 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP (Vitros) AGH | $112.20 | $187.00 | $7.32–$177.65 | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 clostridium diff toxin pcr REF183988 | $170.40 | $284.00 | $31.68–$269.80 | 19% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 clostridium diff toxin pcr REF183988 | $170.40 | $284.00 | $44.88–$269.80 | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 ca 19-9 REF002261 | $115.20 | $192.00 | $17.69–$182.40 | 33% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $115.20 | $192.00 | $17.69–$182.40 | 33% below | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 ca 19-9 REF002261 | $115.20 | $192.00 | $27.46–$182.40 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $115.20 | $192.00 | $27.46–$182.40 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 ca 125 REF002303 | $106.80 | $178.00 | $17.69–$169.10 | 14% below | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 ca 125 REF002303 | $106.80 | $178.00 | $27.46–$169.10 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 STAT 15 MIN RESULT ABBOTT AGH | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 covid19 24hr lubbock REF | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CLINIC COVID19 STAT 15 MIN CARLSBAD | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 covid19 emp 24hr roswell REF | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 covid19 result 48hr ip/emp LC REF990011 | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID19 ARIES RT-PCR AGH | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID-19, RT-PCR Cepheid AGH | $103.80 | $173.00 | $42.71–$164.35 | 1% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CLINIC COVID19 STAT 15 MIN CARLSBAD | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 STAT 15 MIN RESULT ABBOTT AGH | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 covid19 result 48hr ip/emp LC REF990011 | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 covid19 emp 24hr roswell REF | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 covid19 24hr lubbock REF | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 COVID19 ARIES RT-PCR AGH | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 COVID-19, RT-PCR Cepheid AGH | $103.80 | $173.00 | $42.71–$164.35 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 pop CHLAMYDIA | $121.80 | $203.00 | $29.83–$192.85 | 24% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 pop CHLAMYDIA | $121.80 | $203.00 | $39.21–$192.85 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 lipid panel (labcorp) REF303756 | $151.20 | $252.00 | $11.38–$239.40 | 5% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL AMA (Vitros) | $151.20 | $252.00 | $11.38–$239.40 | 5% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 pop CARDIO IQ PANEL LIPID | $151.20 | $252.00 | $11.38–$239.40 | 5% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 pop CARDIO IQ PANEL LIPID | $151.20 | $252.00 | $16.58–$239.40 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL AMA (Vitros) | $151.20 | $252.00 | $16.58–$239.40 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 lipid panel (labcorp) REF303756 | $151.20 | $252.00 | $16.58–$239.40 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $45.60 | $76.00 | $5.50–$72.20 | 17% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 CHARGE ONLY HEMOGRAM | $45.60 | $76.00 | $5.50–$72.20 | 17% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $45.60 | $76.00 | $8.89–$72.20 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CHARGE ONLY HEMOGRAM | $45.60 | $76.00 | $8.89–$72.20 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL (Vitros) | $245.40 | $409.00 | $8.98–$388.55 | 10% above | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 LAB test for HIT (Vitros) | $245.40 | $409.00 | $8.98–$388.55 | 10% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL (Vitros) | $245.40 | $409.00 | $13.03–$388.55 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LAB test for HIT (Vitros) | $245.40 | $409.00 | $13.03–$388.55 | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER | $83.40 | $139.00 | $8.65–$132.05 | 20% below | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER | $83.40 | $139.00 | $11.03–$132.05 | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 dhea sulfate (dheas) REF004020 | $128.40 | $214.00 | $18.90–$203.30 | 6% above | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 dhea sulfate (dheas) REF004020 | $128.40 | $214.00 | $24.01–$203.30 | — | 40% |
| Estradiol blood test CPT 82670 estradiol REF004515 | $265.20 | $442.00 | $23.75–$419.90 | 103% above | 40% |
| Estradiol blood test CPT 82670 estradiol free w/ total REF500649 | $265.20 | $442.00 | $23.75–$419.90 | 103% above | 40% |
| Estradiol blood test inpatient CPT 82670 estradiol free w/ total REF500649 | $265.20 | $442.00 | $34.76–$419.90 | — | 40% |
| Estradiol blood test inpatient CPT 82670 estradiol REF004515 | $265.20 | $442.00 | $34.76–$419.90 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 fsh REF004309 | $100.20 | $167.00 | $15.79–$158.65 | 8% above | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 fsh REF004309 | $100.20 | $167.00 | $23.34–$158.65 | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 calprotectin, stool REF123255 | $219.60 | $366.00 | $16.69–$347.70 | at median | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 calprotectin, stool REF123255 | $219.60 | $366.00 | $20.94–$347.70 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 ferritin REF 004598 | $142.20 | $237.00 | $11.59–$225.15 | 27% above | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (Vitros) | $142.20 | $237.00 | $11.59–$225.15 | 27% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 ferritin REF 004598 | $142.20 | $237.00 | $15.90–$225.15 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (Vitros) | $142.20 | $237.00 | $15.90–$225.15 | — | 40% |
| Folate (folic acid) blood test CPT 82746 folate (folic acid) REF002014 | $117.00 | $195.00 | $12.49–$185.25 | 7% above | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $117.00 | $195.00 | $12.49–$185.25 | 7% above | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID (Vitros) | $117.00 | $195.00 | $12.49–$185.25 | 7% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 folate (folic acid) REF002014 | $117.00 | $195.00 | $19.47–$185.25 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID (Vitros) | $117.00 | $195.00 | $19.47–$185.25 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $117.00 | $195.00 | $19.47–$185.25 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 t3 free dialysis lc/ms-ms REF503600 | $150.00 | $250.00 | $14.40–$237.50 | 24% above | 40% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 (Vitros) | $150.00 | $250.00 | $14.40–$237.50 | 24% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 t3 free dialysis lc/ms-ms REF503600 | $150.00 | $250.00 | $22.03–$237.50 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 (Vitros) | $150.00 | $250.00 | $22.03–$237.50 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 (Vitros) | $94.80 | $158.00 | $7.67–$150.10 | 29% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 t4 free, dialysis/ ms REF501902 | $94.80 | $158.00 | $7.67–$150.10 | 29% below | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 t4 free, dialysis/ ms REF501902 | $94.80 | $158.00 | $10.36–$150.10 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 (Vitros) | $94.80 | $158.00 | $10.36–$150.10 | — | 40% |
| Free testosterone test CPT 84402 pop HIGH SENS TESTO FREE REF | $133.80 | $223.00 | $21.65–$211.85 | 27% above | 40% |
| Free testosterone test inpatient CPT 84402 pop HIGH SENS TESTO FREE REF | $133.80 | $223.00 | $33.17–$211.85 | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $426.00 | $710.00 | $36.78–$674.50 | 92% above | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $426.00 | $710.00 | $36.78–$674.50 | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 lactose tolerance test REF046300 | $119.40 | $199.00 | $10.94–$189.05 | 11% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 4 HOUR | $127.80 | $213.00 | $10.94–$202.35 | 4% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 1 HOUR | $127.80 | $213.00 | $10.94–$202.35 | 4% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 OGCT 50G GLUCOSE (Vitros) | $127.80 | $213.00 | $10.94–$202.35 | 4% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3 HOUR | $127.80 | $213.00 | $10.94–$202.35 | 4% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2 HOUR | $127.80 | $213.00 | $10.94–$202.35 | 4% below | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 lactose tolerance test REF046300 | $119.40 | $199.00 | $14.83–$189.05 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 OGCT 50G GLUCOSE (Vitros) | $127.80 | $213.00 | $14.83–$202.35 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 4 HOUR | $127.80 | $213.00 | $14.83–$202.35 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 HOUR | $127.80 | $213.00 | $14.83–$202.35 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 HOUR | $127.80 | $213.00 | $14.83–$202.35 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1 HOUR | $127.80 | $213.00 | $14.83–$202.35 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 pop N GONORRHEA | $157.20 | $262.00 | $29.83–$248.90 | 60% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 pop N GONORRHEA | $157.20 | $262.00 | $39.21–$248.90 | — | 40% |
| H. pylori antibody blood test CPT 86677 h pylori ab IgG, serum REF162289 | $121.80 | $203.00 | $14.32–$192.85 | at median | 40% |
| H. pylori antibody blood test inpatient CPT 86677 h pylori ab IgG, serum REF162289 | $121.80 | $203.00 | $17.37–$192.85 | — | 40% |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL AG AGH | $255.00 | $425.00 | $12.22–$403.75 | 85% above | 40% |
| H. pylori stool antigen test CPT 87338 zzHELICOBACER PYLORI STOOL AG REF | $255.00 | $425.00 | $12.22–$403.75 | 85% above | 40% |
| H. pylori stool antigen test CPT 87338 h pylori ag, stool REF180764 | $255.00 | $425.00 | $12.22–$403.75 | 85% above | 40% |
| H. pylori stool antigen test inpatient CPT 87338 h pylori ag, stool REF180764 | $255.00 | $425.00 | $16.25–$403.75 | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 zzHELICOBACER PYLORI STOOL AG REF | $255.00 | $425.00 | $16.25–$403.75 | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL AG AGH | $255.00 | $425.00 | $16.25–$403.75 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 hiv 1 rna pcr viral load/quant REF550880 | $340.20 | $567.00 | $72.33–$538.65 | 11% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 hiv 1 rna pcr viral load/quant REF550880 | $340.20 | $567.00 | $82.03–$538.65 | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2 AGH | $106.80 | $178.00 | $11.65–$169.10 | 5% below | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 AND 2 AGH | $106.80 | $178.00 | $14.69–$169.10 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 hiv 1&2 labcorp only REF083935 | $82.20 | $137.00 | $20.47–$130.15 | 1% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 hiv 1&2 labcorp only REF083935 | $82.20 | $137.00 | $27.80–$130.15 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 90887 hpv mrna ThinPrep | $187.80 | $313.00 | $29.83–$297.35 | 10% below | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 90887 hpv mrna ThinPrep | $187.80 | $313.00 | $32.52–$297.35 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C (VITROS) | $99.60 | $166.00 | $8.25–$157.70 | 29% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 hemoglobin hba1c REF83036 | $208.80 | $348.00 | $8.25–$330.60 | 170% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C (VITROS) | $99.60 | $166.00 | $10.45–$157.70 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 hemoglobin hba1c REF83036 | $208.80 | $348.00 | $10.45–$330.60 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 hepatitis b surface ab qual REF006395 | $91.20 | $152.00 | $9.13–$144.40 | 11% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 hepatitis b surface ab qual REF006395 | $91.20 | $152.00 | $14.19–$144.40 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 hepatitis b surface ag w/ rflx REF006510 | $61.20 | $102.00 | $8.78–$96.90 | at median | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 hepatitis b surface ag w/ rflx REF006510 | $61.20 | $102.00 | $11.52–$96.90 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 hepatitis c antibody REF140659 | $61.20 | $102.00 | $12.13–$96.90 | 26% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 hcv w/reflex to quant REF144050 | $61.20 | $102.00 | $12.13–$96.90 | 26% below | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 hepatitis c antibody REF140659 | $61.20 | $102.00 | $15.52–$96.90 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 hcv w/reflex to quant REF144050 | $61.20 | $102.00 | $15.52–$96.90 | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 hcv rna qnt pcr reflex ns5b REF550349 | $296.40 | $494.00 | $36.41–$469.30 | 25% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 hepatitis c virus quant rna pcrREF551300 | $577.80 | $963.00 | $36.41–$914.85 | 144% above | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 hcv rna qnt pcr reflex ns5b REF550349 | $296.40 | $494.00 | $47.99–$469.30 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 hepatitis c virus quant rna pcrREF551300 | $577.80 | $963.00 | $47.99–$914.85 | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 herpes simplex virus 1 IgG REF164897 | $68.40 | $114.00 | $11.21–$108.30 | 22% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 pop HERPES SIMPLEX VIRUS 1 IGM REF | $68.40 | $114.00 | $11.21–$108.30 | 22% below | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 pop HERPES SIMPLEX VIRUS 1 IGM REF | $68.40 | $114.00 | $14.80–$108.30 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 herpes simplex virus 1 IgG REF164897 | $68.40 | $114.00 | $14.80–$108.30 | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 herpes simplex virus 2 IgG REF163033 | $78.60 | $131.00 | $16.45–$124.45 | 8% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 pop HERPES SIMPLEX VIRUS 2 IGM REF | $78.60 | $131.00 | $16.45–$124.45 | 8% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 pop HERPES SIMPLEX VIRUS 2 IGG REF | $78.60 | $131.00 | $16.45–$124.45 | 8% below | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 herpes simplex virus 2 IgG REF163033 | $78.60 | $131.00 | $25.12–$124.45 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 pop HERPES SIMPLEX VIRUS 2 IGG REF | $78.60 | $131.00 | $25.12–$124.45 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 pop HERPES SIMPLEX VIRUS 2 IGM REF | $78.60 | $131.00 | $25.12–$124.45 | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 highsensitivity crp REF120766 | $112.20 | $187.00 | $11.01–$177.65 | 65% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 highsensitivity crp REF120766 | $112.20 | $187.00 | $33.99–$177.65 | — | 40% |
| Homocysteine blood test CPT 83090 homocysteine REF501700 | $199.80 | $333.00 | $15.23–$316.35 | 48% above | 40% |
| Homocysteine blood test inpatient CPT 83090 homocysteine REF501700 | $199.80 | $333.00 | $21.13–$316.35 | — | 40% |
| Insulin blood test CPT 83525 insulin REF004333 | $76.20 | $127.00 | $9.72–$120.65 | 1% above | 40% |
| Insulin blood test CPT 83525 insulin 2 hour REF312114 | $76.20 | $127.00 | $9.72–$120.65 | 1% above | 40% |
| Insulin blood test inpatient CPT 83525 insulin REF004333 | $76.20 | $127.00 | $14.99–$120.65 | — | 40% |
| Insulin blood test inpatient CPT 83525 insulin 2 hour REF312114 | $76.20 | $127.00 | $14.99–$120.65 | — | 40% |
| Iron blood test (serum iron) CPT 83540 iron REF 001339 | $53.40 | $89.00 | $5.50–$84.55 | 26% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON (Vitros) | $53.40 | $89.00 | $5.50–$84.55 | 26% below | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 iron REF 001339 | $53.40 | $89.00 | $8.51–$84.55 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON (Vitros) | $53.40 | $89.00 | $8.51–$84.55 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC, direct (Vitros) | $30.00 | $50.00 | $7.43–$47.50 | 58% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 tibc iron REF 100333 | $30.00 | $50.00 | $7.43–$47.50 | 58% below | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC, direct (Vitros) | $30.00 | $50.00 | $10.72–$47.50 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 tibc iron REF 100333 | $30.00 | $50.00 | $10.72–$47.50 | — | 40% |
| Kidney function blood test panel CPT 80069 RENAL PANEL (Vitros) | $184.80 | $308.00 | $7.38–$292.60 | 8% above | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL PANEL (Vitros) | $184.80 | $308.00 | $10.63–$292.60 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 lh (luteinizing hormone) REF004283 | $138.60 | $231.00 | $15.74–$219.45 | 17% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 lh (luteinizing hormone) REF004283 | $138.60 | $231.00 | $22.86–$219.45 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (Vitros) | $91.20 | $152.00 | $5.86–$144.40 | 5% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE (Vitros) | $91.20 | $152.00 | $9.23–$144.40 | — | 40% |
| Liver function blood test panel CPT 80076 REPEAT LIVER PROFILE | $180.00 | $300.00 | $6.94–$285.00 | 19% above | 40% |
| Liver function blood test panel CPT 80076 LIVER PROFILE (Vitros) | $180.00 | $300.00 | $6.94–$285.00 | 19% above | 40% |
| Liver function blood test panel inpatient CPT 80076 REPEAT LIVER PROFILE | $180.00 | $300.00 | $9.93–$285.00 | — | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER PROFILE (Vitros) | $180.00 | $300.00 | $9.93–$285.00 | — | 40% |
| Lyme disease antibody test CPT 86618 CSF REF LYME DISEASE AB IGM REF | $111.60 | $186.00 | $14.48–$176.70 | at median | 40% |
| Lyme disease antibody test CPT 86618 lyme dis, ab w/ reflex REF164226 | $111.60 | $186.00 | $14.48–$176.70 | at median | 40% |
| Lyme disease antibody test CPT 86618 CSF RER LYME DISEASE AB IGG REF | $111.60 | $186.00 | $14.48–$176.70 | at median | 40% |
| Lyme disease antibody test inpatient CPT 86618 lyme dis, ab w/ reflex REF164226 | $111.60 | $186.00 | $18.36–$176.70 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 CSF RER LYME DISEASE AB IGG REF | $111.60 | $186.00 | $18.36–$176.70 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 CSF REF LYME DISEASE AB IGM REF | $111.60 | $186.00 | $18.36–$176.70 | — | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM (Vitros) | $66.60 | $111.00 | $5.70–$105.45 | 17% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM UA POP | $66.60 | $111.00 | $5.70–$105.45 | 17% below | 40% |
| Magnesium blood test CPT 83735 REPEAT MAGNESIUM SERUM | $66.60 | $111.00 | $5.70–$105.45 | 17% below | 40% |
| Magnesium blood test CPT 83735 pop magnesium ua 306266 REF | $66.60 | $111.00 | $5.70–$105.45 | 17% below | 40% |
| Magnesium blood test CPT 83735 magnesium rbc REF080283 | $82.80 | $138.00 | $5.70–$131.10 | 3% above | 40% |
| Magnesium blood test inpatient CPT 83735 pop magnesium ua 306266 REF | $66.60 | $111.00 | $8.53–$105.45 | — | 40% |
| Magnesium blood test inpatient CPT 83735 REPEAT MAGNESIUM SERUM | $66.60 | $111.00 | $8.53–$105.45 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM UA POP | $66.60 | $111.00 | $8.53–$105.45 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM (Vitros) | $66.60 | $111.00 | $8.53–$105.45 | — | 40% |
| Magnesium blood test inpatient CPT 83735 magnesium rbc REF080283 | $82.80 | $138.00 | $8.53–$131.10 | — | 40% |
| Measles (rubeola) antibody test CPT 86765 measles (rubeola) ab IgG titer REF096560 | $157.20 | $262.00 | $10.95–$248.90 | 136% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 measles (rubeola) ab IgG titer REF096560 | $157.20 | $262.00 | $14.75–$248.90 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST AGH | $61.20 | $102.00 | $4.40–$96.90 | 45% below | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST AGH | $61.20 | $102.00 | $5.78–$96.90 | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 pop free psa | $100.80 | $168.00 | $15.63–$159.60 | 26% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE AGH | $100.80 | $168.00 | $15.63–$159.60 | 26% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 TOTAL PSA(RL) | $118.20 | $197.00 | $15.63–$187.15 | 48% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE AGH | $100.80 | $168.00 | $19.77–$159.60 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 pop free psa | $100.80 | $168.00 | $19.77–$159.60 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 TOTAL PSA(RL) | $118.20 | $197.00 | $19.77–$187.15 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 psa ultrasensitive serial monitREF140723 | $129.60 | $216.00 | $15.63–$205.20 | 19% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAG (Vitros) | $129.60 | $216.00 | $15.63–$205.20 | 19% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 psa Diagnostic REF 010322 | $129.60 | $216.00 | $15.63–$205.20 | 19% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 pop total psa | $129.60 | $216.00 | $15.63–$205.20 | 19% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 pop total psa | $129.60 | $216.00 | $19.77–$205.20 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 psa Diagnostic REF 010322 | $129.60 | $216.00 | $19.77–$205.20 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAG (Vitros) | $129.60 | $216.00 | $19.77–$205.20 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 psa ultrasensitive serial monitREF140723 | $129.60 | $216.00 | $19.77–$205.20 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 pth (parathy hormo) intact REF015610 | $261.60 | $436.00 | $35.09–$414.20 | 42% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 pth (parathy hormo) intact REF015610 | $261.60 | $436.00 | $48.24–$414.20 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAGULANT CONFIRMATION | $89.40 | $149.00 | $5.11–$141.55 | 14% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT | $89.40 | $149.00 | $5.11–$141.55 | 14% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAGULANT CONFIRMATION | $89.40 | $149.00 | $6.83–$141.55 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT | $89.40 | $149.00 | $6.83–$141.55 | — | 40% |
| Progesterone blood test CPT 84144 progesterone REF004317 | $147.60 | $246.00 | $17.73–$233.70 | at median | 40% |
| Progesterone blood test inpatient CPT 84144 progesterone REF004317 | $147.60 | $246.00 | $26.07–$233.70 | — | 40% |
| Prolactin blood test CPT 84146 pop monomeric prolactin REF500324 | $149.40 | $249.00 | $16.47–$236.55 | 3% above | 40% |
| Prolactin blood test CPT 84146 prolactin REF004465 | $187.80 | $313.00 | $16.47–$297.35 | 29% above | 40% |
| Prolactin blood test CPT 84146 pop prolactin REF | $187.80 | $313.00 | $16.47–$297.35 | 29% above | 40% |
| Prolactin blood test inpatient CPT 84146 pop monomeric prolactin REF500324 | $149.40 | $249.00 | $25.42–$236.55 | — | 40% |
| Prolactin blood test inpatient CPT 84146 pop prolactin REF | $187.80 | $313.00 | $25.42–$297.35 | — | 40% |
| Prolactin blood test inpatient CPT 84146 prolactin REF004465 | $187.80 | $313.00 | $25.42–$297.35 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $33.00 | $55.00 | $3.65–$52.25 | 10% below | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME | $33.00 | $55.00 | $4.77–$52.25 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 CLINIC URINE DRUG SCREEN | $208.20 | $347.00 | $10.16–$329.65 | 244% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 CLINIC URINE DRUG SCREEN | $208.20 | $347.00 | $10.16–$329.65 | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 CLINIC INFLUENZA B | $46.80 | $78.00 | $14.07–$74.10 | 5% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 CLINIC INFLUENZA A | $46.80 | $78.00 | $14.07–$74.10 | 5% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 pop INFLUENZA A | $46.80 | $78.00 | $14.07–$74.10 | 5% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 pop INFLUENZA B | $46.80 | $78.00 | $14.07–$74.10 | 5% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 CLINIC INFLUENZA A | $46.80 | $78.00 | $22.93–$74.10 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 pop INFLUENZA B | $46.80 | $78.00 | $22.93–$74.10 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 pop INFLUENZA A | $46.80 | $78.00 | $22.93–$74.10 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 CLINIC INFLUENZA B | $46.80 | $78.00 | $22.93–$74.10 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $105.60 | $176.00 | $14.05–$167.20 | 77% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC | $105.60 | $176.00 | $14.71–$167.20 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 rheumatoid factor quant REF 006502 | $149.40 | $249.00 | $4.82–$236.55 | 142% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 rheumatoid factor quant REF 006502 | $149.40 | $249.00 | $8.71–$236.55 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 rubella abs IgM REF096537 | $74.40 | $124.00 | $12.23–$117.80 | 1% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 rubella abs IgG REF006197 | $74.40 | $124.00 | $12.23–$117.80 | 1% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 rubella abs IgM REF096537 | $74.40 | $124.00 | $15.53–$117.80 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 rubella abs IgG REF006197 | $74.40 | $124.00 | $15.53–$117.80 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDRATE AUTOMATED | $45.60 | $76.00 | $2.29–$72.20 | 26% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDRATE AUTOMATED | $45.60 | $76.00 | $4.32–$72.20 | — | 40% |
| Stool ova and parasites exam CPT 87177 ova and parasites examination REF008623 | $84.00 | $140.00 | $7.57–$133.00 | 47% below | 40% |
| Stool ova and parasites exam CPT 87177 pop smear ova and parasite | $84.00 | $140.00 | $7.57–$133.00 | 47% below | 40% |
| Stool ova and parasites exam inpatient CPT 87177 pop smear ova and parasite | $84.00 | $140.00 | $11.26–$133.00 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 ova and parasites examination REF008623 | $84.00 | $140.00 | $11.26–$133.00 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL #3 | $3.00 | $5.00 | $2.00–$8.76 | 90% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL #2 | $3.00 | $5.00 | $2.00–$8.76 | 90% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 2ND SCREEN | $3.00 | $5.00 | $2.00–$8.76 | 90% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 3RD SCREEN | $3.00 | $5.00 | $2.00–$8.76 | 90% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 1 SCREEN | $3.00 | $5.00 | $2.00–$8.76 | 90% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES - SALGADO | $14.40 | $24.00 | $3.72–$22.80 | 53% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES - KAYDAHZINNE | $14.40 | $24.00 | $3.72–$22.80 | 53% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES | $15.00 | $25.00 | $3.72–$23.75 | 51% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL | $36.60 | $61.00 | $3.72–$57.95 | 21% above | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES - MEMORIAL FAMILY | $42.60 | $71.00 | $3.72–$67.45 | 40% above | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $42.60 | $71.00 | $3.72–$67.45 | 40% above | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL #3 | $3.00 | $5.00 | $2.00–$5.51 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD 1 SCREEN | $3.00 | $5.00 | $2.00–$5.51 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD 3RD SCREEN | $3.00 | $5.00 | $2.00–$5.51 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD 2ND SCREEN | $3.00 | $5.00 | $2.00–$5.51 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL #2 | $3.00 | $5.00 | $2.00–$5.51 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECES - KAYDAHZINNE | $14.40 | $24.00 | $3.90–$22.80 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECES - SALGADO | $14.40 | $24.00 | $3.90–$22.80 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES | $15.00 | $25.00 | $3.90–$23.75 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL | $36.60 | $61.00 | $3.90–$57.95 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECES - MEMORIAL FAMILY | $42.60 | $71.00 | $3.90–$67.45 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES | $42.60 | $71.00 | $3.90–$67.45 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECAL DIAGNOSTIC IMMUNO | $50.40 | $84.00 | $13.53–$79.80 | 12% below | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECAL SCREENING IMMUNO | $50.40 | $84.00 | $13.53–$79.80 | 12% below | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FECAL SCREENING IMMUNO | $50.40 | $84.00 | $14.71–$79.80 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FECAL DIAGNOSTIC IMMUNO | $50.40 | $84.00 | $14.71–$79.80 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 rpr REF006460 | $54.60 | $91.00 | $3.63–$86.45 | 14% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (RAPID PLASMA REAGIN) AGH | $61.20 | $102.00 | $3.63–$96.90 | 28% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 vdrl csf REF006445 | $72.00 | $120.00 | $3.63–$114.00 | 51% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 QUEST VDRL CSF | $72.00 | $120.00 | $3.63–$114.00 | 51% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 rpr REF006460 | $54.60 | $91.00 | $5.31–$86.45 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (RAPID PLASMA REAGIN) AGH | $61.20 | $102.00 | $5.31–$96.90 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 vdrl csf REF006445 | $72.00 | $120.00 | $5.31–$114.00 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 QUEST VDRL CSF | $72.00 | $120.00 | $5.31–$114.00 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 quantiferon tb (client incubated) | $208.80 | $348.00 | $52.68–$330.60 | at median | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 quantiferon tb gold plus REF182879 | $208.80 | $348.00 | $52.68–$330.60 | at median | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 quantiferon tb gold plus REF182879 | $208.80 | $348.00 | $77.25–$330.60 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 quantiferon tb (client incubated) | $208.80 | $348.00 | $77.25–$330.60 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 pop testo total hs female REF070001 | $138.00 | $230.00 | $21.94–$218.50 | 29% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 testosterone, total REF004226 | $138.00 | $230.00 | $21.94–$218.50 | 29% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (Vitros) | $145.80 | $243.00 | $21.94–$230.85 | 36% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 pop testo total hs female REF070001 | $138.00 | $230.00 | $32.42–$218.50 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 testosterone, total REF004226 | $138.00 | $230.00 | $32.42–$218.50 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE (Vitros) | $145.80 | $243.00 | $32.42–$230.85 | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 thyroid peroxidase abs tpo REF006676 | $87.00 | $145.00 | $12.37–$137.75 | 13% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 liver kidney microsomal(lkm)absREF163980 | $87.00 | $145.00 | $12.37–$137.75 | 13% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 thyroid peroxidase abs tpo REF006676 | $87.00 | $145.00 | $19.81–$137.75 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 liver kidney microsomal(lkm)absREF163980 | $87.00 | $145.00 | $19.81–$137.75 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Vitros) | $126.00 | $210.00 | $14.28–$199.50 | 21% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Vitros) | $126.00 | $210.00 | $19.80–$199.50 | — | 40% |
| Trichomonas test (NAAT) CPT 87661 pop TRICHOMONAS VAG pcr REF | $49.80 | $83.00 | $29.83–$78.85 | 31% below | 40% |
| Trichomonas test (NAAT) CPT 87661 19550 trichomonas vaginalis Aptima | $121.80 | $203.00 | $29.83–$192.85 | 68% above | 40% |
| Trichomonas test (NAAT) CPT 87661 90521 trichomonas vaginalis ThinPrep | $121.80 | $203.00 | $29.83–$192.85 | 68% above | 40% |
| Trichomonas test (NAAT) CPT 87661 trichomonas vaginalis, naa REF188052 | $121.80 | $203.00 | $29.83–$192.85 | 68% above | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 pop TRICHOMONAS VAG pcr REF | $49.80 | $83.00 | $32.52–$78.85 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 90521 trichomonas vaginalis ThinPrep | $121.80 | $203.00 | $32.52–$192.85 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 trichomonas vaginalis, naa REF188052 | $121.80 | $203.00 | $32.52–$192.85 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 19550 trichomonas vaginalis Aptima | $121.80 | $203.00 | $32.52–$192.85 | — | 40% |
| Uric acid blood test CPT 84550 URIC ACID (Vitros) | $61.20 | $102.00 | $3.84–$96.90 | 8% above | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID (Vitros) | $61.20 | $102.00 | $5.57–$96.90 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 UA COMPLETE | $38.40 | $64.00 | $2.69–$60.80 | 39% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA COMPLETE | $38.40 | $64.00 | $4.42–$60.80 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACRO / DIPSTICK | $22.80 | $38.00 | $1.91–$36.10 | 2% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 pop ua auto REF | $38.40 | $64.00 | $1.91–$60.80 | 66% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA PH AGH | $38.40 | $64.00 | $1.91–$60.80 | 66% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACRO / DIPSTICK | $22.80 | $38.00 | $2.68–$36.10 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA PH AGH | $38.40 | $64.00 | $2.68–$60.80 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pop ua auto REF | $38.40 | $64.00 | $2.68–$60.80 | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK | $12.00 | $20.00 | $2.96–$19.00 | 26% below | 40% |
| Urinalysis without microscope exam, manual CPT 81002 HORIZON CLINIC URINALYSIS BY DIPSTICK | $22.80 | $38.00 | $2.96–$36.10 | 40% above | 40% |
| Urinalysis without microscope exam, manual CPT 81002 CLINIC URINALYSIS BY DIPSTICK | $22.80 | $38.00 | $2.96–$36.10 | 40% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS BY DIPSTICK | $12.00 | $20.00 | $3.12–$19.00 | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HORIZON CLINIC URINALYSIS BY DIPSTICK | $22.80 | $38.00 | $3.12–$36.10 | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CLINIC URINALYSIS BY DIPSTICK | $22.80 | $38.00 | $3.12–$36.10 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE | $121.80 | $203.00 | $6.86–$192.85 | 24% above | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE | $121.80 | $203.00 | $9.29–$192.85 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES | $15.00 | $25.00 | $6.79–$23.75 | 68% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 CBFP URINE PREGNANCY TEST | $76.20 | $127.00 | $6.79–$120.65 | 64% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 HCG QUAL URINE | $76.20 | $127.00 | $6.79–$120.65 | 64% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 CLINIC URINE PREGNANCY TEST | $76.20 | $127.00 | $6.79–$120.65 | 64% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 HORIZON CLINIC URINE PREGNANCY TEST | $76.20 | $127.00 | $6.79–$120.65 | 64% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $102.00 | $170.00 | $6.79–$161.50 | 119% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES | $15.00 | $25.00 | $6.79–$23.75 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HORIZON CLINIC URINE PREGNANCY TEST | $76.20 | $127.00 | $6.79–$120.65 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 CBFP URINE PREGNANCY TEST | $76.20 | $127.00 | $6.79–$120.65 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL URINE | $76.20 | $127.00 | $6.79–$120.65 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 CLINIC URINE PREGNANCY TEST | $76.20 | $127.00 | $6.79–$120.65 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST | $102.00 | $170.00 | $6.79–$161.50 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 (Vitros) | $128.40 | $214.00 | $12.82–$203.30 | 1% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 vitamin B12 REF 001503 | $142.20 | $237.00 | $12.82–$225.15 | 11% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 (Vitros) | $128.40 | $214.00 | $20.48–$203.30 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 vitamin B12 REF 001503 | $142.20 | $237.00 | $20.48–$225.15 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 vit d 25 hydroxy REF081950 | $199.20 | $332.00 | $25.16–$315.40 | 31% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH (Vitros) | $199.20 | $332.00 | $25.16–$315.40 | 31% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 vit d (d2+d3 frac) lc/ms-ms REF504115 | $199.20 | $332.00 | $25.16–$315.40 | 31% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 vitamin D 25 hydroxy REF 081950 | $199.20 | $332.00 | $25.16–$315.40 | 31% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-OH (Vitros) | $199.20 | $332.00 | $38.95–$315.40 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 vit d 25 hydroxy REF081950 | $199.20 | $332.00 | $38.95–$315.40 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 vitamin D 25 hydroxy REF 081950 | $199.20 | $332.00 | $38.95–$315.40 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 vit d (d2+d3 frac) lc/ms-ms REF504115 | $199.20 | $332.00 | $38.95–$315.40 | — | 40% |
| Zinc blood test CPT 84630 zinc serum/plasma REF001800 | $74.40 | $124.00 | $9.68–$117.80 | 5% above | 40% |
| Zinc blood test inpatient CPT 84630 zinc serum/plasma REF001800 | $74.40 | $124.00 | $14.00–$117.80 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 beta hcg subunit quant REF004416 | $149.40 | $249.00 | $12.79–$236.55 | 12% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANT (Vitros) | $189.00 | $315.00 | $12.79–$299.25 | 11% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 beta hcg subunit quant REF004416 | $149.40 | $249.00 | $19.60–$236.55 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG BETA QUANT (Vitros) | $189.00 | $315.00 | $19.60–$299.25 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS | $319.20 | $532.00 | $145.24–$6,284.94 | 96% below | 40% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS | $319.20 | $532.00 | $145.24–$505.40 | — | 40% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY | $1,104.00 | $1,840.00 | $460.00–$1,748.00 | 37% below | 40% |
| Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY | $1,104.00 | $1,840.00 | $502.32–$1,748.00 | — | 40% |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY | $811.20 | $1,352.00 | $369.10–$12,092.38 | — | 40% |
| Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY | $811.20 | $1,352.00 | $369.10–$1,284.40 | — | 40% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY | $1,219.80 | $2,033.00 | $555.01–$13,844.26 | 87% below | 40% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 KNEE ARTHROSCOPY/SURGERY | $1,219.80 | $2,033.00 | $555.01–$1,931.35 | — | 40% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOP ROTATOR CUFF REPR | $1,301.40 | $2,169.00 | $592.14–$13,844.26 | 86% below | 40% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOP ROTATOR CUFF REPR | $1,301.40 | $2,169.00 | $592.14–$2,060.55 | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 NASAL/SINUS NDSC SURG W/DILATION MAXILLA | $3,396.00 | $5,660.00 | $1,545.18–$13,415.46 | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 31295 MAXILLARY ENDO W/DILATION | $3,396.00 | $5,660.00 | $1,545.18–$13,415.46 | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NASAL/SINUS NDSC SURG W/DILATION MAXILLA | $3,396.00 | $5,660.00 | $1,545.18–$5,377.00 | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 31295 MAXILLARY ENDO W/DILATION | $3,396.00 | $5,660.00 | $1,545.18–$5,377.00 | — | 40% |
| Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIG | $278.40 | $464.00 | $126.67–$572.06 | — | 40% |
| Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIG | $278.40 | $464.00 | $126.67–$440.80 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W/DEV 1ST LESION STEREOTACT GD | $3,395.40 | $5,659.00 | $773.82–$5,376.05 | 13% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST W/DEV 1ST LESION STEREOTACT GD | $3,395.40 | $5,659.00 | $1,544.91–$5,376.05 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ | $862.80 | $1,438.00 | $132.77–$1,366.10 | 76% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ | $862.80 | $1,438.00 | $392.57–$1,366.10 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPU | $393.60 | $656.00 | $132.77–$623.20 | 41% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPU | $393.60 | $656.00 | $179.09–$623.20 | — | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION OF BUNION | $637.80 | $1,063.00 | $290.20–$6,287.92 | 89% below | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION OF BUNION | $637.80 | $1,063.00 | $290.20–$1,009.85 | — | 40% |
| Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION OF BUNION | $1,196.32 | $1,993.86 | $544.32–$6,287.92 | 93% below | 40% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION OF BUNION | $1,196.32 | $1,993.86 | $544.32–$1,894.17 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERN | $1,187.40 | $1,979.00 | $440.92–$1,880.05 | 39% above | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERN | $1,187.40 | $1,979.00 | $540.27–$1,880.05 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CRDIOVRSN, ELECTIV, ELECTRI CONV ARRHYTH | $1,610.14 | $2,683.57 | $732.61–$2,549.39 | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY | $519.00 | $865.00 | $236.15–$3,784.40 | 91% below | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY | $519.00 | $865.00 | $236.15–$821.75 | — | 40% |
| Cataract surgery with lens implant CPT 66984 PM CATARACT SURG W/IOL 1 STAGE | $952.80 | $1,588.00 | $433.52–$4,419.96 | — | 40% |
| Cataract surgery with lens implant inpatient CPT 66984 PM CATARACT SURG W/IOL 1 STAGE | $952.80 | $1,588.00 | $433.52–$1,508.60 | — | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVX SINGL/MULT/EXCIS OF LES SPX | $240.00 | $400.00 | $109.20–$1,687.46 | 74% below | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVX SINGL/MULT/EXCIS OF LES SPX | $240.00 | $400.00 | $109.20–$380.00 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION AGE >28 DAYS | $370.80 | $618.00 | $168.71–$3,969.94 | 96% below | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION AGE >28 DAYS | $370.80 | $618.00 | $168.71–$587.10 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK | $282.60 | $471.00 | $128.58–$3,969.94 | 87% below | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK | $282.60 | $471.00 | $128.58–$447.45 | — | 40% |
| Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE | $270.60 | $451.00 | $123.12–$2,354.20 | — | 40% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE | $270.60 | $451.00 | $123.12–$428.45 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA | $460.80 | $768.00 | $132.77–$729.60 | 16% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA | $460.80 | $768.00 | $209.66–$729.60 | — | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $416.40 | $694.00 | $189.46–$2,285.00 | — | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $416.40 | $694.00 | $189.46–$659.30 | — | 40% |
| Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY | $488.40 | $814.00 | $222.22–$2,285.00 | 81% below | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 LESION REMOVAL COLONOSCOPY | $488.40 | $814.00 | $222.22–$773.30 | — | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $384.00 | $640.00 | $174.72–$2,285.00 | 85% below | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY | $384.00 | $640.00 | $174.72–$608.00 | — | 40% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $355.20 | $592.00 | $161.62–$1,766.86 | 81% below | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY | $355.20 | $592.00 | $161.62–$562.40 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERV | $298.80 | $498.00 | $135.95–$6,161.80 | 97% below | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERV | $298.80 | $498.00 | $135.95–$473.10 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CU | $249.00 | $415.00 | $113.30–$589.50 | 97% below | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CU | $249.00 | $415.00 | $113.30–$394.25 | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT | $613.13 | $1,021.89 | $278.98–$6,683.96 | 93% below | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY AND TREATMENT | $613.13 | $1,021.89 | $278.98–$970.80 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $364.80 | $608.00 | $165.98–$1,293.54 | 97% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY | $364.80 | $608.00 | $165.98–$577.60 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE | $501.08 | $835.14 | $227.99–$6,161.80 | 95% below | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE | $501.08 | $835.14 | $227.99–$793.38 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 CRYOTHERAPY - WART 1 SITE | $117.00 | $195.00 | $53.23–$385.08 | 23% below | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST | $117.00 | $195.00 | $53.23–$385.08 | 23% below | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST | $117.00 | $195.00 | $53.23–$185.25 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 17000 CRYOTHERAPY - WART 1 SITE | $117.00 | $195.00 | $53.23–$185.25 | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING | $294.00 | $490.00 | $133.77–$2,870.66 | 84% below | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING | $294.00 | $490.00 | $133.77–$465.50 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA | $357.00 | $595.00 | $162.44–$986.90 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA | $357.00 | $595.00 | $162.44–$565.25 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIG/LVG UNILA | $217.20 | $362.00 | $48.93–$343.90 | at median | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN IRRIG/LVG UNILA | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENT UNIL | $85.80 | $143.00 | $39.04–$135.85 | 59% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 69210 REMOVAL IMPACTED CERUMEN | $85.80 | $143.00 | $39.04–$135.85 | 59% below | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUM UNILAT | $85.80 | $143.00 | $39.04–$135.85 | 59% below | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENT UNIL | $85.80 | $143.00 | $39.04–$135.85 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210 REMOVAL IMPACTED CERUMEN | $85.80 | $143.00 | $39.04–$135.85 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUM UNILAT | $85.80 | $143.00 | $39.04–$135.85 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DI | $168.68 | $281.13 | $76.75–$389.86 | 27% below | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DI | $168.68 | $281.13 | $76.75–$267.07 | — | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 REMOVAL OF ETHMOID SINUS | $498.00 | $830.00 | $226.59–$13,415.46 | 93% below | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 REMOVAL OF ETHMOID SINUS | $498.00 | $830.00 | $226.59–$788.50 | — | 40% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 SINUS ENDOSCOPY SURGICAL | $629.40 | $1,049.00 | $286.38–$13,415.46 | 89% below | 40% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 SINUS ENDOSCOPY SURGICAL | $629.40 | $1,049.00 | $286.38–$996.55 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS | $307.20 | $512.00 | $139.78–$7,145.16 | 94% below | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 EXPLORATION MAXILLARY SINUS | $307.20 | $512.00 | $139.78–$486.40 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS | $493.80 | $823.00 | $224.68–$13,415.46 | 95% below | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 ENDOSCOPY MAXILLARY SINUS | $493.80 | $823.00 | $224.68–$781.85 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THE SBST INTRLM CRV/THR W/IMG GDN | $194.40 | $324.00 | $88.45–$1,342.08 | 77% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG | $441.60 | $736.00 | $200.93–$1,342.08 | 47% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR NJX SBST INTRLMNR CRV/THRC W/IMG GDN | $2,070.60 | $3,451.00 | $570.38–$3,278.45 | 149% above | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR ESI CERV/THOR INJECTION | $2,070.60 | $3,451.00 | $570.38–$3,278.45 | 149% above | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX/THE SBST INTRLM CRV/THR W/IMG GDN | $194.40 | $324.00 | $88.45–$307.80 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG | $441.60 | $736.00 | $200.93–$699.20 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR ESI CERV/THOR INJECTION | $2,070.60 | $3,451.00 | $942.12–$3,278.45 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR NJX SBST INTRLMNR CRV/THRC W/IMG GDN | $2,070.60 | $3,451.00 | $942.12–$3,278.45 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 NJX DX/THER AGT PVRT FAC JT L/S 1 LVL BI | $616.20 | $1,027.00 | $280.37–$1,725.34 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THER AGT PVRT FACET JT L/S 1 LVL | $308.40 | $514.00 | $140.32–$1,725.34 | 58% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 NJX DX/THER AGT PVRT FAC JT L/S 1 LVL BI | $616.20 | $1,027.00 | $280.37–$975.65 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THER AGT PVRT FACET JT L/S 1 LVL | $308.40 | $514.00 | $140.32–$488.30 | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM RDUCIBLE | $1,015.88 | $1,693.14 | $462.23–$12,092.38 | 86% below | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HERNIA 1ST 3-10 CM RDUCIBLE | $1,015.88 | $1,693.14 | $462.23–$1,608.48 | — | 40% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE | $1,367.17 | $2,278.62 | $622.06–$12,092.38 | 88% below | 40% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE | $1,367.17 | $2,278.62 | $622.06–$2,164.69 | — | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE | $605.30 | $1,008.84 | $275.41–$6,839.18 | 93% below | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE | $605.30 | $1,008.84 | $275.41–$958.40 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA | $302.40 | $504.00 | $137.59–$1,766.86 | 80% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA | $302.40 | $504.00 | $137.59–$478.80 | — | 40% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $1,263.60 | $2,106.00 | $574.94–$11,306.76 | 87% below | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $1,263.60 | $2,106.00 | $574.94–$2,000.70 | — | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH | $899.40 | $1,499.00 | $409.23–$11,306.76 | 92% below | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH | $899.40 | $1,499.00 | $409.23–$1,424.05 | — | 40% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER | $1,345.80 | $2,243.00 | $560.75–$2,130.85 | 83% below | 40% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 REMOVAL OF GALLBLADDER | $1,345.80 | $2,243.00 | $612.34–$2,130.85 | — | 40% |
| Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE | $576.00 | $960.00 | $262.08–$6,287.92 | 94% below | 40% |
| Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE | $576.00 | $960.00 | $262.08–$912.00 | — | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LI | $1,712.40 | $2,854.00 | $429.72–$2,711.30 | at median | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LI | $1,712.40 | $2,854.00 | $779.14–$2,711.30 | — | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY NTRNL&XTRNL 1 COLMN/GRP | $939.00 | $1,565.00 | $427.25–$5,314.64 | 84% below | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY NTRNL&XTRNL 1 COLMN/GRP | $939.00 | $1,565.00 | $427.25–$1,486.75 | — | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY | $2,080.80 | $3,468.00 | $867.00–$3,294.60 | — | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 TOTAL HIP ARTHROPLASTY | $2,080.80 | $3,468.00 | $946.76–$3,294.60 | — | 40% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL HYSTERECTOMY | $1,807.33 | $3,012.21 | $753.05–$2,861.60 | 14% below | 40% |
| Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL HYSTERECTOMY | $1,807.33 | $3,012.21 | $822.33–$2,861.60 | — | 40% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ENDOMETRIAL ABLATION | $3,445.52 | $5,742.54 | $1,567.71–$9,566.64 | 67% below | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ENDOMETRIAL ABLATION | $3,445.52 | $5,742.54 | $1,567.71–$5,455.41 | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO | $2,389.80 | $3,983.00 | $1,087.36–$6,161.80 | 79% below | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO | $2,389.80 | $3,983.00 | $1,087.36–$3,783.85 | — | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD | $58.81 | $98.01 | $25.48–$389.26 | 99% below | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE DEVICE IUD | $58.81 | $98.01 | $26.76–$93.11 | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGL | $213.60 | $356.00 | $97.19–$385.08 | 72% below | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGL | $213.60 | $356.00 | $97.19–$338.20 | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR | $652.20 | $1,087.00 | $296.75–$6,839.18 | 90% below | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP I/HERN INIT REDUC >5 YR | $652.20 | $1,087.00 | $296.75–$1,032.65 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $97.20 | $162.00 | $44.23–$572.06 | 91% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 IR INJECTION 1 TENDON SHEATH/LIGAMENT | $951.60 | $1,586.00 | $204.72–$1,506.70 | 11% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $97.20 | $162.00 | $44.23–$153.90 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 IR INJECTION 1 TENDON SHEATH/LIGAMENT | $951.60 | $1,586.00 | $432.98–$1,506.70 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ARTHROCENT MAJOR JOINT | $112.80 | $188.00 | $51.32–$572.06 | 68% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US | $804.00 | $1,340.00 | $204.72–$1,273.00 | 129% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT JOINT LARGE | $951.60 | $1,586.00 | $204.72–$1,506.70 | 171% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 IR INJECTION MAJOR JOINT W/OUT US GUI | $951.60 | $1,586.00 | $204.72–$1,506.70 | 171% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 ARTHROCENT MAJOR JOINT | $112.80 | $188.00 | $51.32–$178.60 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US | $804.00 | $1,340.00 | $365.82–$1,273.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECT JOINT LARGE | $951.60 | $1,586.00 | $432.98–$1,506.70 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 IR INJECTION MAJOR JOINT W/OUT US GUI | $951.60 | $1,586.00 | $432.98–$1,506.70 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG DELIVERY IMPLANT | $169.52 | $282.54 | $77.13–$397.05 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT | $169.52 | $282.54 | $77.13–$397.05 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMP | $258.60 | $431.00 | $106.17–$409.45 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT | $169.52 | $282.54 | $77.13–$268.41 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG DELIVERY IMPLANT | $169.52 | $282.54 | $77.13–$268.41 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMP | $258.60 | $431.00 | $117.66–$409.45 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O | $92.40 | $154.00 | $42.04–$572.06 | 74% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IR ARTHROCENT, INTRM JOINT; W/OUT US GUI | $609.00 | $1,015.00 | $204.72–$964.25 | 72% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O | $92.40 | $154.00 | $42.04–$146.30 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 IR ARTHROCENT, INTRM JOINT; W/OUT US GUI | $609.00 | $1,015.00 | $277.10–$964.25 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ARTHROCENT SM JOINT; W/O US GUIDE | $88.80 | $148.00 | $40.40–$572.06 | 82% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT ASPIR&/INJ SM JT/BURSA W/O US | $88.80 | $148.00 | $40.40–$572.06 | 82% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 IR ARTHROCENT, SM JOINT; W/OUT US GUIDE | $860.40 | $1,434.00 | $204.72–$1,362.30 | 79% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 ARTHROCENT SM JOINT; W/O US GUIDE | $88.80 | $148.00 | $40.40–$140.60 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT ASPIR&/INJ SM JT/BURSA W/O US | $88.80 | $148.00 | $40.40–$140.60 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 IR ARTHROCENT, SM JOINT; W/OUT US GUIDE | $860.40 | $1,434.00 | $391.48–$1,362.30 | — | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY | $863.40 | $1,439.00 | $392.85–$6,287.92 | 94% below | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 KNEE ARTHROSCOPY/SURGERY | $863.40 | $1,439.00 | $392.85–$1,367.05 | — | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY | $664.20 | $1,107.00 | $302.21–$6,287.92 | 94% below | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY/SURGERY | $664.20 | $1,107.00 | $302.21–$1,051.65 | — | 40% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY | $690.00 | $1,150.00 | $313.95–$6,287.92 | 93% below | 40% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY/SURGERY | $690.00 | $1,150.00 | $313.95–$1,092.50 | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY | $765.00 | $1,275.00 | $348.07–$6,287.92 | 93% below | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 KNEE ARTHROSCOPY/SURGERY | $765.00 | $1,275.00 | $348.07–$1,211.25 | — | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 LAP GASTRIC BYPASS/ROUX-EN-Y | $2,193.00 | $3,655.00 | $913.75–$3,472.25 | 34% below | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 LAP GASTRIC BYPASS/ROUX-EN-Y | $2,193.00 | $3,655.00 | $997.82–$3,472.25 | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY | $756.00 | $1,260.00 | $343.98–$11,306.76 | 94% below | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY | $756.00 | $1,260.00 | $343.98–$1,197.00 | — | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY | $1,368.00 | $2,280.00 | $622.44–$20,176.52 | 38% below | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY FUNDOPLASTY | $1,368.00 | $2,280.00 | $622.44–$2,166.00 | — | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS | $1,467.60 | $2,446.00 | $667.76–$20,176.52 | 12% below | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS | $1,467.60 | $2,446.00 | $667.76–$2,323.70 | — | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUB | $1,699.80 | $2,833.00 | $773.41–$20,176.52 | 86% below | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUB | $1,699.80 | $2,833.00 | $773.41–$2,691.35 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT | $535.20 | $892.00 | $243.52–$11,306.76 | 94% below | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP ING HERNIA REPAIR INIT | $535.20 | $892.00 | $243.52–$847.40 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR | $696.00 | $1,160.00 | $316.68–$11,306.76 | 92% below | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP ING HERNIA REPAIR RECUR | $696.00 | $1,160.00 | $316.68–$1,102.00 | — | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY, REMOVE ADNEXA | $1,161.99 | $1,936.65 | $528.71–$11,306.76 | 87% below | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY, REMOVE ADNEXA | $1,161.99 | $1,936.65 | $528.71–$1,839.82 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< | $279.60 | $466.00 | $108.47–$774.28 | 42% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< | $279.60 | $466.00 | $127.22–$442.70 | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THE SBST INTRLM CRV/THR W/IMG GDN | $179.40 | $299.00 | $81.63–$1,342.08 | 87% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG | $511.80 | $853.00 | $341.20–$1,342.08 | 64% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR ESI LUMBAR INJECTION | $2,035.20 | $3,392.00 | $570.38–$3,222.40 | 43% above | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR NJX SBST INTRLMNR LMBR/SAC W/IMG GDN | $2,035.20 | $3,392.00 | $570.38–$3,222.40 | 43% above | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THE SBST INTRLM CRV/THR W/IMG GDN | $179.40 | $299.00 | $81.63–$284.05 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG | $511.80 | $853.00 | $232.87–$810.35 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR ESI LUMBAR INJECTION | $2,035.20 | $3,392.00 | $926.02–$3,222.40 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR NJX SBST INTRLMNR LMBR/SAC W/IMG GDN | $2,035.20 | $3,392.00 | $926.02–$3,222.40 | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O I | $511.20 | $852.00 | $340.80–$1,725.34 | 21% below | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 IR NJX SBST INTRLMNR LMBR/SAC W/O IMG GD | $2,143.20 | $3,572.00 | $602.44–$3,393.40 | 230% above | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O I | $511.20 | $852.00 | $232.60–$809.40 | — | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 IR NJX SBST INTRLMNR LMBR/SAC W/O IMG GD | $2,143.20 | $3,572.00 | $975.16–$3,393.40 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX ANES&/STRD W/IMG TFRML EDRL L/S 1LVL | $403.80 | $673.00 | $183.73–$1,725.34 | 65% below | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX ANES&/STRD W/IMG TFRML EDRL L/S 1LVL | $403.80 | $673.00 | $183.73–$639.35 | — | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 PARTICAL MASTECTOMY | $815.40 | $1,359.00 | $371.01–$7,421.00 | 88% below | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTICAL MASTECTOMY | $815.40 | $1,359.00 | $371.01–$1,291.05 | — | 40% |
| Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE | $1,263.60 | $2,106.00 | $574.94–$12,638.32 | 90% below | 40% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 MAST SIMPLE COMPLETE | $1,263.60 | $2,106.00 | $574.94–$2,000.70 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/< | $221.40 | $369.00 | $100.74–$1,363.52 | 88% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/< | $221.40 | $369.00 | $100.74–$350.55 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B9 LS MRGN XCP SK TG F/E/E/N/L/M.5/< | $233.21 | $388.68 | $106.11–$1,363.52 | 73% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B9 LS MRGN XCP SK TG F/E/E/N/L/M.5/< | $233.21 | $388.68 | $106.11–$369.25 | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART/COMPL SIMPLE 1 | $194.40 | $324.00 | $70.39–$385.08 | 60% below | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART/COMPL SIMPLE 1 | $194.40 | $324.00 | $88.45–$307.80 | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NER | $153.00 | $255.00 | $69.61–$572.06 | 63% below | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NER | $153.00 | $255.00 | $69.61–$242.25 | — | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAG GDNCE | $203.40 | $339.00 | $92.55–$1,816.96 | 78% below | 40% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,086.00 | $1,810.00 | $440.79–$1,816.96 | 16% above | 40% |
| Paracentesis with imaging guidance CPT 49083 US PARACENTESIS (RADIOLOGIST) | $1,651.20 | $2,752.00 | $440.79–$2,614.40 | 76% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING | $1,086.00 | $1,810.00 | $494.13–$1,719.50 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAG GDNCE | $1,546.20 | $2,577.00 | $703.52–$2,448.15 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS (RADIOLOGIST) | $1,651.20 | $2,752.00 | $751.30–$2,614.40 | — | 40% |
| Partial knee replacement (one compartment) CPT 27446 REVISION OF KNEE JOINT | $1,437.60 | $2,396.00 | $654.11–$24,935.38 | 96% below | 40% |
| Partial knee replacement (one compartment) inpatient CPT 27446 REVISION OF KNEE JOINT | $1,437.60 | $2,396.00 | $654.11–$2,276.20 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL | $278.40 | $464.00 | $126.67–$774.28 | 64% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL | $278.40 | $464.00 | $126.67–$440.80 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIA | $1,626.60 | $2,711.00 | $740.10–$2,575.45 | — | 40% |
| Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH | $450.60 | $751.00 | $205.02–$3,969.94 | 97% below | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH | $450.60 | $751.00 | $205.02–$713.45 | — | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPARO RADICAL PROSTATECTOMY | $1,716.00 | $2,860.00 | $780.78–$20,176.52 | — | 40% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPARO RADICAL PROSTATECTOMY | $1,716.00 | $2,860.00 | $780.78–$2,717.00 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL L/S | $410.40 | $684.00 | $186.73–$3,784.40 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL L/S | $410.40 | $684.00 | $186.73–$649.80 | — | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABRRNT BREAST TISS OPEN 1/> LES | $927.60 | $1,546.00 | $422.06–$7,421.00 | 85% below | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABRRNT BREAST TISS OPEN 1/> LES | $927.60 | $1,546.00 | $422.06–$1,468.70 | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMVAL FOREIGN BODY SQ SIMPLE | $271.80 | $453.00 | $123.67–$774.28 | 64% below | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMVAL FOREIGN BODY SQ SIMPLE | $271.80 | $453.00 | $123.67–$430.35 | — | 40% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID | $882.00 | $1,470.00 | $401.31–$11,306.76 | 91% below | 40% |
| Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PARTIAL REMOVAL OF THYROID | $882.00 | $1,470.00 | $401.31–$1,396.50 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND | $355.20 | $592.00 | $161.62–$1,766.86 | 84% below | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLOREC CNCR SCR;COLNSCPY NO HI RSK | $583.20 | $972.00 | $265.36–$1,766.86 | 73% below | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING/NOT HI RISK | $583.20 | $972.00 | $265.36–$1,766.86 | 73% below | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CA SCRN NOT HI RSK IND | $355.20 | $592.00 | $161.62–$562.40 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLOREC CNCR SCR;COLNSCPY NO HI RSK | $583.20 | $972.00 | $265.36–$923.40 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLORECTAL CANCER SCREENING/NOT HI RISK | $583.20 | $972.00 | $265.36–$923.40 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND | $582.60 | $971.00 | $265.08–$1,766.86 | 76% below | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLOREC CANCR SCR; COLNSCPY HI RISK | $582.60 | $971.00 | $265.08–$1,766.86 | 76% below | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCRN; HI RISK IND | $582.60 | $971.00 | $265.08–$922.45 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLOREC CANCR SCR; COLNSCPY HI RISK | $582.60 | $971.00 | $265.08–$922.45 | — | 40% |
| Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM | $751.20 | $1,252.00 | $341.80–$6,284.94 | 87% below | 40% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR OF NASAL SEPTUM | $751.20 | $1,252.00 | $341.80–$1,189.40 | — | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE | $700.20 | $1,167.00 | $318.59–$6,683.96 | 94% below | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE | $700.20 | $1,167.00 | $318.59–$1,108.65 | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CA | $156.00 | $260.00 | $70.98–$514.68 | 4% below | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CA | $156.00 | $260.00 | $70.98–$247.00 | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICAT SHRT ARM SPLINT FOREARM-HAND ST | $154.20 | $257.00 | $70.16–$249.80 | 53% below | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICAT SHRT ARM SPLINT FOREARM-HAND ST | $154.20 | $257.00 | $70.16–$244.15 | — | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHRT LEG CAST BELOW KNEE-TOE | $146.40 | $244.00 | $66.61–$514.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHRT LEG CAST BELOW KNEE-TOE | $146.40 | $244.00 | $66.61–$231.80 | — | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $441.60 | $736.00 | $84.40–$699.20 | at median | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $441.60 | $736.00 | $200.93–$699.20 | — | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHOULDER ARTHROSCOPY/SURGERY | $816.60 | $1,361.00 | $371.55–$6,287.92 | 91% below | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SHOULDER ARTHROSCOPY/SURGERY | $816.60 | $1,361.00 | $371.55–$1,292.95 | — | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHOULDER ARTHROSCOPY/SURGERY | $331.20 | $552.00 | $143.52–$4,935.90 | 99% below | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHOULDER ARTHROSCOPY/SURGERY | $331.20 | $552.00 | $150.70–$524.40 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK | $160.20 | $267.00 | $72.89–$385.08 | 56% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR S/N/A/G/T 2.5CM/< | $295.20 | $492.00 | $117.00–$467.40 | 18% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK | $160.20 | $267.00 | $72.89–$253.65 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR S/N/A/G/T 2.5CM/< | $295.20 | $492.00 | $134.32–$467.40 | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $219.60 | $366.00 | $99.92–$774.28 | 85% below | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $219.60 | $366.00 | $99.92–$347.70 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MLG+MARG 0.5 < CM | $217.20 | $362.00 | $98.83–$1,363.52 | 96% below | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM | $217.20 | $362.00 | $98.83–$1,363.52 | 96% below | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC TR-EXT MLG+MARG 0.5 < CM | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 REMOVAL SKIN TAGS 1-15 | $158.40 | $264.00 | $72.07–$385.08 | 47% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REM SKN TAGS MLT FIBRQ TAGS UPW/15 | $158.40 | $264.00 | $72.07–$385.08 | 47% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS, MULT FIBROCU ANY AREA | $1,105.76 | $1,842.93 | $117.00–$1,750.78 | 272% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKN TAGS MLT FIBRQ TAGS UPW/15 | $158.40 | $264.00 | $72.07–$250.80 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 REMOVAL SKIN TAGS 1-15 | $158.40 | $264.00 | $72.07–$250.80 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS, MULT FIBROCU ANY AREA | $1,105.76 | $1,842.93 | $503.12–$1,750.78 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC | $249.84 | $416.40 | $113.68–$1,342.08 | 71% below | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC | $249.84 | $416.40 | $113.68–$395.58 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC | $1,246.67 | $2,077.79 | $567.24–$1,973.90 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR S/N/A/G/T 2.6-7.5CM | $337.20 | $562.00 | $117.00–$533.90 | 16% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR S/N/A/G/T 2.6-7.5CM | $337.20 | $562.00 | $153.43–$533.90 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5 CM/< | $103.80 | $173.00 | $47.23–$385.08 | 71% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $331.80 | $553.00 | $117.00–$525.35 | 7% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5 CM/< | $103.80 | $173.00 | $47.23–$164.35 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $331.80 | $553.00 | $150.97–$525.35 | — | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP) | $1,046.40 | $1,744.00 | $476.11–$9,851.86 | 87% below | 40% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 PROSTATECTOMY (TURP) | $1,046.40 | $1,744.00 | $476.11–$1,656.80 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $175.20 | $292.00 | $79.72–$385.08 | 41% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $175.20 | $292.00 | $79.72–$277.40 | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI | $378.60 | $631.00 | $172.26–$1,198.16 | 67% below | 40% |
| Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS (RADIOLOGIST) | $1,653.60 | $2,756.00 | $463.20–$2,618.20 | 45% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI | $378.60 | $631.00 | $172.26–$599.45 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS (RADIOLOGIST) | $1,653.60 | $2,756.00 | $752.39–$2,618.20 | — | 40% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS | $467.40 | $779.00 | $212.67–$6,284.94 | 95% below | 40% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS AND ADENOIDS | $467.40 | $779.00 | $212.67–$740.05 | — | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS | $450.00 | $750.00 | $204.75–$11,464.32 | 95% below | 40% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS AND ADENOIDS | $450.00 | $750.00 | $204.75–$712.50 | — | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS | $388.80 | $648.00 | $176.90–$6,284.94 | 97% below | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 REMOVAL OF TONSILS | $388.80 | $648.00 | $176.90–$615.60 | — | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS | $405.00 | $675.00 | $184.28–$11,464.32 | 96% below | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 REMOVAL OF TONSILS | $405.00 | $675.00 | $184.28–$641.25 | — | 40% |
| Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY | $1,684.20 | $2,807.00 | $766.31–$24,935.38 | 92% below | 40% |
| Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY | $1,684.20 | $2,807.00 | $766.31–$2,666.65 | — | 40% |
| Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY | $1,683.60 | $2,806.00 | $766.04–$24,935.38 | 93% below | 40% |
| Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY | $1,683.60 | $2,806.00 | $766.04–$2,665.70 | — | 40% |
| Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT | $1,807.20 | $3,012.00 | $822.28–$35,639.18 | 94% below | 40% |
| Total shoulder replacement inpatient CPT 23472 RECONSTRUCT SHOULDER JOINT | $1,807.20 | $3,012.00 | $822.28–$2,861.40 | — | 40% |
| Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID | $1,150.80 | $1,918.00 | $523.61–$11,306.76 | 90% below | 40% |
| Total thyroid removal (thyroidectomy) inpatient CPT 60240 REMOVAL OF THYROID | $1,150.80 | $1,918.00 | $523.61–$1,822.10 | — | 40% |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $465.00 | $775.00 | $211.57–$3,101.54 | 92% below | 40% |
| Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH | $465.00 | $775.00 | $211.57–$736.25 | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $99.60 | $166.00 | $45.32–$572.06 | 86% below | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 TRIGGER POINTS 1-2 MUSCLES | $99.60 | $166.00 | $45.32–$572.06 | 86% below | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 TRIGGER POINTS 1-2 MUSCLES | $99.60 | $166.00 | $45.32–$157.70 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $99.60 | $166.00 | $45.32–$157.70 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 IR BREAST 1ST LESION US IMAG | $1,167.60 | $1,946.00 | $531.26–$3,139.96 | 56% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 IR BX BREAST US GUIDE w/CLIP | $2,694.60 | $4,491.00 | $773.82–$4,266.45 | 1% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 IR GUIDED BREAST BIOPSY/W CLIP PLACEMENT | $2,748.60 | $4,581.00 | $773.82–$4,351.95 | 3% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 IR BREAST 1ST LESION US IMAG | $1,167.60 | $1,946.00 | $531.26–$1,848.70 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 IR BX BREAST US GUIDE w/CLIP | $2,694.60 | $4,491.00 | $1,226.04–$4,266.45 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 IR GUIDED BREAST BIOPSY/W CLIP PLACEMENT | $2,748.60 | $4,581.00 | $1,250.61–$4,351.95 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH ENDOSCOPY DILATION | $294.00 | $490.00 | $133.77–$3,676.30 | 93% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH ENDOSCOPY DILATION | $294.00 | $490.00 | $133.77–$465.50 | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY BIOPSY | $265.20 | $442.00 | $120.67–$1,816.96 | 88% below | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY BIOPSY | $265.20 | $442.00 | $120.67–$419.90 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ | $273.00 | $455.00 | $124.22–$1,816.96 | 90% below | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPR GI SCOPE W/SUBMUC INJ | $273.00 | $455.00 | $124.22–$432.25 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OPERATIVE UPPER GI ENDOSCOPY | $2,403.60 | $4,006.00 | $700.56–$3,805.70 | 17% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 OPERATIVE UPPER GI ENDOSCOPY | $2,403.60 | $4,006.00 | $1,093.64–$3,805.70 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPR GI ENDOSCOPY/GUIDE WIRE | $325.20 | $542.00 | $147.97–$1,816.96 | 89% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UPPR GI ENDOSCOPY/GUIDE WIRE | $325.20 | $542.00 | $147.97–$514.90 | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY DIAGNOSIS | $234.00 | $390.00 | $106.47–$1,816.96 | 88% below | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPR GI ENDOSCOPY DIAGNOSIS | $234.00 | $390.00 | $106.47–$370.50 | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 ESOPH ENDOSCOPE W/DRAIN CYST | $504.00 | $840.00 | $229.32–$11,536.30 | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 ESOPH ENDOSCOPE W/DRAIN CYST | $504.00 | $840.00 | $229.32–$798.00 | — | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY | $610.80 | $1,018.00 | $277.91–$9,851.86 | 90% below | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETERO W/LITHOTRIPSY | $610.80 | $1,018.00 | $277.91–$967.10 | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY | $518.40 | $864.00 | $235.87–$9,851.86 | 96% below | 40% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY | $518.40 | $864.00 | $235.87–$820.80 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM | $3,769.80 | $6,283.00 | $1,687.22–$5,968.85 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM | $3,769.80 | $6,283.00 | $1,715.26–$5,968.85 | — | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 | $195.60 | $326.00 | $89.00–$385.08 | 9% below | 40% |
| Wart removal, up to 14 warts CPT 17110 17110 WART FLAT 1-14 | $195.60 | $326.00 | $89.00–$385.08 | 9% below | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 17110 WART FLAT 1-14 | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBCUTANEOUS TISSUE 20 SQ CM/< | $1,207.80 | $2,013.00 | $224.14–$1,912.35 | 4% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SUBCUTANEOUS TISSUE 20 SQ CM/< | $1,207.80 | $2,013.00 | $549.55–$1,912.35 | — | 40% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL | $898.20 | $1,497.00 | $408.68–$13,844.26 | 89% below | 40% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 TREAT FX RAD EXTRA-ARTICUL | $898.20 | $1,497.00 | $408.68–$1,422.15 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BBB BLOOD TRANSFUSION SERVICE SET | $680.40 | $1,134.00 | $270.80–$1,077.30 | 11% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS SET 1-2 UNIT | $680.40 | $1,134.00 | $270.80–$1,077.30 | 11% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS SET 2-4 UNT | $767.40 | $1,279.00 | $270.80–$1,215.05 | 25% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS EACH ADDL HOUR | $785.40 | $1,309.00 | $270.80–$1,243.55 | 28% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS FIRST HOUR | $785.40 | $1,309.00 | $270.80–$1,243.55 | 28% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS SET >4UNITS | $914.40 | $1,524.00 | $270.80–$1,447.80 | 49% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE SET | $1,063.80 | $1,773.00 | $270.80–$1,684.35 | 73% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BBB BLOOD TRANSFUSION SERVICE SET | $680.40 | $1,134.00 | $309.58–$1,077.30 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS SET 1-2 UNIT | $680.40 | $1,134.00 | $309.58–$1,077.30 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS SET 2-4 UNT | $767.40 | $1,279.00 | $349.17–$1,215.05 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS FIRST HOUR | $785.40 | $1,309.00 | $357.36–$1,243.55 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS EACH ADDL HOUR | $785.40 | $1,309.00 | $357.36–$1,243.55 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS SET >4UNITS | $914.40 | $1,524.00 | $416.05–$1,447.80 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE SET | $1,063.80 | $1,773.00 | $484.03–$1,684.35 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SECOND MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI THIRD MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN TX SUB | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPTUM INDUCTION | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUBSEQUENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL TX | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TX | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN SECOND MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN THIRD MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN FOURTH MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$394.16 | 17% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN INIT | $284.05 | $473.42 | $129.24–$449.75 | 154% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN FOURTH MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TX | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPTUM INDUCTION | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN TX SUB | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL TX | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUBSEQUENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SECOND MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI THIRD MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN SECOND MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN THIRD MED SUBSEQUENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT | $130.80 | $218.00 | $59.51–$207.10 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN INIT | $284.05 | $473.42 | $129.24–$449.75 | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBS | $244.20 | $407.00 | $111.11–$642.80 | 54% below | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBS | $244.20 | $407.00 | $111.11–$386.65 | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 PROFEE ED SERVICE CRITICAL 30-74 MIN | $412.80 | $688.00 | $187.82–$1,632.94 | 80% below | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 3 | $505.80 | $843.00 | $230.14–$1,632.94 | 75% below | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 ER VISIT CRITICAL CARE FACILITY W/MOD 25 | $2,242.20 | $3,737.00 | $588.66–$3,550.15 | 10% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 ER VISIT CRITICAL CARE FACILITY | $2,242.20 | $3,737.00 | $588.66–$3,550.15 | 10% above | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 PROFEE ED SERVICE CRITICAL 30-74 MIN | $412.80 | $688.00 | $187.82–$653.60 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, INITIAL 30-74 MIN | $505.80 | $843.00 | $230.14–$800.85 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 3 | $505.80 | $843.00 | $230.14–$800.85 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ER VISIT CRITICAL CARE FACILITY W/MOD 25 | $2,242.20 | $3,737.00 | $1,020.20–$3,550.15 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ER VISIT CRITICAL CARE FACILITY | $2,242.20 | $3,737.00 | $1,020.20–$3,550.15 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 95816 EEG AWAKE AND DROWSY | $622.80 | $1,038.00 | $192.58–$986.10 | 31% below | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 95816 EEG AWAKE AND DROWSY | $622.80 | $1,038.00 | $283.37–$986.10 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG/ECG | $278.40 | $464.00 | $116.00–$440.80 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG/ECG CLINIC | $278.40 | $464.00 | $116.00–$440.80 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG/ECG | $278.40 | $464.00 | $126.67–$440.80 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG/ECG CLINIC | $278.40 | $464.00 | $126.67–$440.80 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG/ECG SAME DAY DIFF PROVIDER W/MOD 77 | $136.80 | $228.00 | $48.93–$216.60 | 19% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG/ECG SAME DAY/PROVIDER W/MOD 76 | $136.80 | $228.00 | $48.93–$216.60 | 19% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG/ECG SAME DAY DIFF PROVIDER W/MOD 77 | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG/ECG SAME DAY/PROVIDER W/MOD 76 | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY | $316.20 | $527.00 | $80.00–$1,028.28 | — | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY | $316.20 | $527.00 | $143.87–$500.65 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VST THAT MAY NOT REQ PRSNCE OF PROVID | $39.60 | $66.00 | $18.02–$170.64 | 81% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL I FACILITY | $201.00 | $335.00 | $63.17–$318.25 | 2% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL I FACILITY W/MOD 25 | $201.00 | $335.00 | $63.17–$318.25 | 2% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VST THAT MAY NOT REQ PRSNCE OF PROVID | $39.60 | $66.00 | $18.02–$62.70 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL I FACILITY | $201.00 | $335.00 | $91.45–$318.25 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL I FACILITY W/MOD 25 | $201.00 | $335.00 | $91.45–$318.25 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT STRAIGHTFORWARD MDM | $77.40 | $129.00 | $35.22–$306.90 | 73% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL II FACILITY | $380.40 | $634.00 | $104.39–$602.30 | 34% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL II FACILITY W/MOD 25 | $380.40 | $634.00 | $104.39–$602.30 | 34% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT STRAIGHTFORWARD MDM | $77.40 | $129.00 | $35.22–$122.55 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEVEL II FACILITY W/MOD 25 | $380.40 | $634.00 | $173.08–$602.30 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEVEL II FACILITY | $380.40 | $634.00 | $173.08–$602.30 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LOW MDM | $344.40 | $574.00 | $156.70–$545.30 | 42% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL III FACILITY | $382.80 | $638.00 | $166.58–$606.10 | 36% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL III FACILITY W/MOD 25 | $382.80 | $638.00 | $166.58–$606.10 | 36% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LOW MDM | $344.40 | $574.00 | $156.70–$545.30 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEVEL III FACILITY | $382.80 | $638.00 | $174.17–$606.10 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEVEL III FACILITY W/MOD 25 | $382.80 | $638.00 | $174.17–$606.10 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT MODERATE MDM | $219.60 | $366.00 | $99.92–$825.22 | 78% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL IV FACILITY | $615.00 | $1,025.00 | $265.19–$973.75 | 38% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL IV FACILITY W/MOD 25 | $615.00 | $1,025.00 | $265.19–$973.75 | 38% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT MODERATE MDM | $219.60 | $366.00 | $99.92–$347.70 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEVEL IV FACILITY W/MOD 25 | $615.00 | $1,025.00 | $279.82–$973.75 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEVEL IV FACILITY | $615.00 | $1,025.00 | $279.82–$973.75 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT HIGH MDM | $324.00 | $540.00 | $147.42–$1,188.16 | 77% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL V FACILITY | $1,428.00 | $2,380.00 | $391.82–$2,261.00 | 2% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL V FACILITY W/MOD 25 | $1,428.00 | $2,380.00 | $391.82–$2,261.00 | 2% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT HIGH MDM | $324.00 | $540.00 | $147.42–$513.00 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEVEL V FACILITY W/MOD 25 | $1,428.00 | $2,380.00 | $649.74–$2,261.00 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEVEL V FACILITY | $1,428.00 | $2,380.00 | $649.74–$2,261.00 | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TRACING ONLY | $364.80 | $608.00 | $165.98–$603.48 | 50% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 93017 TRACING ONLY (TECH) | $364.80 | $608.00 | $165.98–$603.48 | 50% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST | $1,270.80 | $2,118.00 | $256.48–$2,012.10 | 74% above | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 93017 TRACING ONLY (TECH) | $364.80 | $608.00 | $165.98–$577.60 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST TRACING ONLY | $364.80 | $608.00 | $165.98–$577.60 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST | $1,270.80 | $2,118.00 | $578.21–$2,012.10 | — | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 FAMILY PSYTX W/PATIENT | $184.20 | $307.00 | $83.81–$311.38 | 14% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 5 | $207.60 | $346.00 | $80.00–$328.70 | 3% below | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 FAMILY PSYTX W/PATIENT | $184.20 | $307.00 | $83.81–$291.65 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 5 | $207.60 | $346.00 | $94.46–$328.70 | — | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYTX W/O PATIENT | $177.00 | $295.00 | $80.53–$311.38 | 7% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT | $199.80 | $333.00 | $80.00–$316.35 | 4% above | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 FAMILY PSYTX W/O PATIENT | $177.00 | $295.00 | $80.53–$280.25 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT | $199.80 | $333.00 | $90.91–$316.35 | — | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $49.20 | $82.00 | $22.39–$179.26 | 50% below | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY | $49.20 | $82.00 | $22.39–$77.90 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 H | $66.60 | $111.00 | $30.30–$408.30 | 79% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRA, 31 MINS TO 1 HR | $379.20 | $632.00 | $89.94–$600.40 | 19% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 M/S INITIAL HYDRATION 31-60 MIN | $379.20 | $632.00 | $89.94–$600.40 | 19% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV TX HYD 1ST HR | $379.20 | $632.00 | $89.94–$600.40 | 19% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 TRT INITIAL HYDRATION 31 MIN-1 HR | $379.20 | $632.00 | $89.94–$600.40 | 19% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 TRT INITIAL HYDRATION 31 MIN-1 HOUR | $441.00 | $735.00 | $89.94–$698.25 | 38% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 H | $66.60 | $111.00 | $30.30–$105.45 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRA, 31 MINS TO 1 HR | $379.20 | $632.00 | $172.54–$600.40 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 TRT INITIAL HYDRATION 31 MIN-1 HR | $379.20 | $632.00 | $172.54–$600.40 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV TX HYD 1ST HR | $379.20 | $632.00 | $172.54–$600.40 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 M/S INITIAL HYDRATION 31-60 MIN | $379.20 | $632.00 | $172.54–$600.40 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 TRT INITIAL HYDRATION 31 MIN-1 HOUR | $441.00 | $735.00 | $200.66–$698.25 | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST | $124.20 | $207.00 | $56.51–$408.30 | 69% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV THERAPY 1ST HOUR | $409.80 | $683.00 | $150.65–$648.85 | 1% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF, INIT UP TO 1 HR | $409.80 | $683.00 | $150.65–$648.85 | 1% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 TRT INFUSION INITIAL HOUR | $487.20 | $812.00 | $150.65–$771.40 | 21% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST | $124.20 | $207.00 | $56.51–$196.65 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF, INIT UP TO 1 HR | $409.80 | $683.00 | $186.46–$648.85 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY 1ST HOUR | $409.80 | $683.00 | $186.46–$648.85 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 M/S INFUSION INITIAL (16 MIN TO 1 HOUR) | $409.80 | $683.00 | $186.46–$648.85 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 TRT INFUSION INITIAL HOUR | $487.20 | $812.00 | $221.68–$771.40 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ, SC/IM | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJ SUBQ/IM | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ, SC/I | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THRAPUTIC PRPHYLCTIC/DX INJECTION SQ/IM | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM THER/PROPH/DIAG INJ SC/IM | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THERAP PROPHYLACTIC/DX INJ SQ | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPH/DX INJECTION SUBQ/IM | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SQ | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SU | $116.40 | $194.00 | $30.50–$184.30 | 4% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ, SQ/IM (NOT VACC) | $118.20 | $197.00 | $30.50–$187.15 | 6% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION | $138.60 | $231.00 | $30.50–$219.45 | 24% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 TRT INTRAMUSCULAR/SQ INJECTION | $156.00 | $260.00 | $30.50–$247.00 | 40% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SQ | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THRAPUTIC PRPHYLCTIC/DX INJECTION SQ/IM | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SU | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM THER/PROPH/DIAG INJ SC/IM | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THERAP PROPHYLACTIC/DX INJ SQ | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPH/DX INJECTION SUBQ/IM | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ, SC/I | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJ SUBQ/IM | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ, SC/IM | $116.40 | $194.00 | $52.96–$184.30 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ, SQ/IM (NOT VACC) | $118.20 | $197.00 | $53.78–$187.15 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 M/S SQ OR INTRAMUSCULAR INJECTION | $118.20 | $197.00 | $53.78–$187.15 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM INJECTION | $138.60 | $231.00 | $63.06–$219.45 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TRT INTRAMUSCULAR/SQ INJECTION | $156.00 | $260.00 | $70.98–$247.00 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $130.20 | $217.00 | $59.24–$311.38 | 49% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DX INTERVIEW | $225.60 | $376.00 | $102.65–$357.20 | 11% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 PSYCH DIAGNOSTIC EVALUATI | $225.60 | $376.00 | $102.65–$357.20 | 11% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $253.80 | $423.00 | $80.00–$401.85 | at median | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $130.20 | $217.00 | $59.24–$206.15 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DX INTERVIEW | $225.60 | $376.00 | $102.65–$357.20 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 PSYCH DIAGNOSTIC EVALUATI | $225.60 | $376.00 | $102.65–$357.20 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $253.80 | $423.00 | $115.48–$401.85 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 95910 NRV CNDJ TEST 7-8 STUDIES | $349.80 | $583.00 | $48.42–$603.48 | at median | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 95910 NRV CNDJ TEST 7-8 STUDIES | $349.80 | $583.00 | $159.16–$553.85 | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC REED EA 15 | $119.40 | $199.00 | $45.29–$189.05 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUS RE ED EA 15 MIN | $261.60 | $436.00 | $45.29–$414.20 | 119% above | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC REED EA 15 | $119.40 | $199.00 | $54.33–$189.05 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUS RE ED EA 15 MIN | $261.60 | $436.00 | $119.03–$414.20 | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 OFF VIS LOW MDDM AT LEAST 30 MINS | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 OFFICE VISIT LEVEL 3 HIGH COMP | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 TELEMED OFFICE VISIT LEVEL 3 HIGH COMP | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 E/M NEW PT LOW MDM AT LEAST 30 MINS - PR | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE OUTPATIENT NEW 30 MINUTES | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFF OP NEW PT LOW MDM AT LEAST 30 MINS | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 E/M NEW PATIENT AT LEAST 30 MINS - FACIL | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE CONS NEW PT LOW MDM AT LEAST 30 M | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 TELEMED OFC VIS LOW MDM AT LEAST 30 MINS | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 OFF VIS LOW MDM AT LEAST 30 MINS | $195.60 | $326.00 | $81.50–$309.70 | 10% above | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE VISIT LEVEL 3 HIGH COMP | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E/M NEW PATIENT AT LEAST 30 MINS - FACIL | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFF VIS LOW MDM AT LEAST 30 MINS | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE CONS NEW PT LOW MDM AT LEAST 30 M | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFF OP NEW PT LOW MDM AT LEAST 30 MINS | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE OUTPATIENT NEW 30 MINUTES | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFF VIS LOW MDDM AT LEAST 30 MINS | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 TELEMED OFC VIS LOW MDM AT LEAST 30 MINS | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 TELEMED OFFICE VISIT LEVEL 3 HIGH COMP | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT NEW 30 MINUTES | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E/M NEW PT LOW MDM AT LEAST 30 MINS - PR | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 E/M NEW PT MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $121.25–$460.75 | 3% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 TELEMED OFC VIS MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $121.25–$460.75 | 3% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFC VIS NEW PT MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $121.25–$460.75 | 3% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFC CON NEW PT MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $121.25–$460.75 | 3% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 OFC VIS NEW PT MOD MDM AT LEAST 45 | $291.00 | $485.00 | $121.25–$460.75 | 3% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 TELEMED OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $124.00–$471.20 | 6% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE OUTPATIENT NEW 45 MINUTES | $297.60 | $496.00 | $124.00–$471.20 | 6% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $124.00–$471.20 | 6% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $124.00–$471.20 | 6% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 TELEMED OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $124.00–$471.20 | 6% above | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E/M NEW PT MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $132.41–$460.75 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFC CON NEW PT MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $132.41–$460.75 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFC VIS NEW PT MOD MDM AT LEAST 45 | $291.00 | $485.00 | $132.41–$460.75 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFC VIS NEW PT MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $132.41–$460.75 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 TELEMED OFC VIS MOD MDM AT LEAST 45 MINS | $291.00 | $485.00 | $132.41–$460.75 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $135.41–$471.20 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE OUTPATIENT NEW 45 MINUTES | $297.60 | $496.00 | $135.41–$471.20 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT NEW 45 MINUTES | $297.60 | $496.00 | $135.41–$471.20 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 TELEMED OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $135.41–$471.20 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 TELEMED OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $135.41–$471.20 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE VISIT LEVEL 4 EXTD COMP | $297.60 | $496.00 | $135.41–$471.20 | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 TELEMED OFFICE VISIT LEVEL 5 COMPL COMP | $375.00 | $625.00 | $156.25–$593.75 | 3% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 OFFICE VISIT LEVEL 5 COMPL COMP | $375.00 | $625.00 | $156.25–$593.75 | 3% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE OUTPATIENT NEW 60 MINUTES | $375.00 | $625.00 | $156.25–$593.75 | 3% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT CONS HIGH MDM AT LEAST 60 MINS | $384.60 | $641.00 | $160.25–$608.95 | 5% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 E/M NEW PT HIGH MDM AT LEAST 60 MINS | $384.60 | $641.00 | $160.25–$608.95 | 5% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 E/M NEW PT HIGH MDM AT LEAST 60 MINS - F | $384.60 | $641.00 | $160.25–$608.95 | 5% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 NEW PT HIGH MDM AT LEAST 60 MINS | $384.60 | $641.00 | $160.25–$608.95 | 5% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 TELEMED OFC VIS HIGH MDM AT LEAST 60 MIN | $384.60 | $641.00 | $160.25–$608.95 | 5% above | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 OFFICE VISIT LEVEL 5 COMPL COMP | $375.00 | $625.00 | $170.62–$593.75 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 TELEMED OFFICE VISIT LEVEL 5 COMPL COMP | $375.00 | $625.00 | $170.62–$593.75 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPATIENT NEW 60 MINUTES | $375.00 | $625.00 | $170.62–$593.75 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OUTPATIENT NEW 60 MINUTES | $375.00 | $625.00 | $170.62–$593.75 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT CONS HIGH MDM AT LEAST 60 MINS | $384.60 | $641.00 | $174.99–$608.95 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E/M NEW PT HIGH MDM AT LEAST 60 MINS | $384.60 | $641.00 | $174.99–$608.95 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 NEW PT HIGH MDM AT LEAST 60 MINS | $384.60 | $641.00 | $174.99–$608.95 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E/M NEW PT HIGH MDM AT LEAST 60 MINS - F | $384.60 | $641.00 | $174.99–$608.95 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 TELEMED OFC VIS HIGH MDM AT LEAST 60 MIN | $384.60 | $641.00 | $174.99–$608.95 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFF VIS NEW PT STRFWD MDM AT LEAST 15 MI | $125.40 | $209.00 | $52.25–$198.55 | 8% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFC VIS STRFWD MDM AT LEAST 15 MIN | $125.40 | $209.00 | $52.25–$198.55 | 8% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E/M NP STRFWD MDM AT LEAST 15 MINS - PRO | $125.40 | $209.00 | $52.25–$198.55 | 8% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E/M NP STRFWD MDM AT LEAST 15 MINS - FAC | $125.40 | $209.00 | $52.25–$198.55 | 8% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 TELEMED OFC VIS STRFWD MDM AT LEAST 15 M | $125.40 | $209.00 | $52.25–$198.55 | 8% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFF CONS NEW PT STRFWD MDM AT LEAST 15 M | $125.40 | $209.00 | $52.25–$198.55 | 8% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $136.80 | $228.00 | $57.00–$216.60 | 18% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 TELEMED OFFICE VISIT LEVEL 2 MODE COMP | $136.80 | $228.00 | $57.00–$216.60 | 18% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $136.80 | $228.00 | $57.00–$216.60 | 18% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 TELEMED OFFICE VISIT LEVEL 2 MODE COM | $136.80 | $228.00 | $57.00–$216.60 | 18% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE VISIT LEVEL 2 MODE COMP | $136.80 | $228.00 | $57.00–$216.60 | 18% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TELEMED OFC VIS STRFWD MDM AT LEAST 15 M | $125.40 | $209.00 | $57.06–$198.55 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E/M NP STRFWD MDM AT LEAST 15 MINS - PRO | $125.40 | $209.00 | $57.06–$198.55 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E/M NP STRFWD MDM AT LEAST 15 MINS - FAC | $125.40 | $209.00 | $57.06–$198.55 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFC VIS STRFWD MDM AT LEAST 15 MIN | $125.40 | $209.00 | $57.06–$198.55 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFF VIS NEW PT STRFWD MDM AT LEAST 15 MI | $125.40 | $209.00 | $57.06–$198.55 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFF CONS NEW PT STRFWD MDM AT LEAST 15 M | $125.40 | $209.00 | $57.06–$198.55 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPATIENT NEW 20 MINUTES | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE VISIT LEVEL 2 MODE COMP | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TELEMED OFFICE VISIT LEVEL 2 MODE COMP | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TELEMED OFFICE VISIT LEVEL 2 MODE COM | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV I | $61.15 | $101.91 | $26.50–$96.81 | 8% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&INVTJ INDIV 15MI | $64.20 | $107.00 | $27.82–$101.65 | 4% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT-INITIAL 15 MINS | $64.20 | $107.00 | $27.82–$101.65 | 4% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV 15MI | $64.20 | $107.00 | $27.82–$101.65 | 4% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TELEMED MNT-INITIAL 15 MINS | $64.20 | $107.00 | $27.82–$101.65 | 4% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION INDIV I | $61.15 | $101.91 | $27.82–$96.81 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&INVTJ INDIV 15MI | $64.20 | $107.00 | $29.21–$101.65 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TELEMED MNT-INITIAL 15 MINS | $64.20 | $107.00 | $29.21–$101.65 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV 15MI | $64.20 | $107.00 | $29.21–$101.65 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT-INITIAL 15 MINS | $64.20 | $107.00 | $29.21–$101.65 | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY/WC EVAL | $264.60 | $441.00 | $114.66–$418.95 | 17% above | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY/WC EVAL | $264.60 | $441.00 | $120.39–$418.95 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX | $332.40 | $554.00 | $134.93–$526.30 | at median | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX | $332.40 | $554.00 | $151.24–$526.30 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX | $249.60 | $416.00 | $108.16–$395.20 | at median | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX | $249.60 | $416.00 | $113.57–$395.20 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVALUATION MOD COMPLEX | $153.00 | $255.00 | $66.30–$242.25 | 37% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX | $292.80 | $488.00 | $126.88–$463.60 | 21% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVALUATION MOD COMPLEX | $153.00 | $255.00 | $69.61–$242.25 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX | $292.80 | $488.00 | $133.22–$463.60 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY | $122.40 | $204.00 | $36.42–$193.80 | at median | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY | $261.60 | $436.00 | $36.42–$414.20 | 114% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY | $122.40 | $204.00 | $55.69–$193.80 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY | $261.60 | $436.00 | $119.03–$414.20 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EX E15 | $106.20 | $177.00 | $39.22–$168.15 | 3% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER EXER E15 | $120.60 | $201.00 | $39.22–$190.95 | 10% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THER EX E15 | $106.20 | $177.00 | $48.32–$168.15 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THER EXER E15 | $120.60 | $201.00 | $54.87–$190.95 | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 18-39 YRS | $199.20 | $332.00 | $86.32–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385 PREVENTIVE MED NEW PT 18-39YRS | $199.20 | $332.00 | $86.32–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385 INITIAL PREVENT MED NEW PT 18-39YR | $199.20 | $332.00 | $86.32–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MED NEW PT 18-39YR | $199.20 | $332.00 | $86.32–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 18 - 39 YRS | $199.20 | $332.00 | $86.32–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 18-39 YRS | $199.20 | $332.00 | $90.64–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 PREVENTIVE MED NEW PT 18-39YRS | $199.20 | $332.00 | $90.64–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 INITIAL PREVENT MED NEW PT 18-39YR | $199.20 | $332.00 | $90.64–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITIAL PREVENTIVE MED NEW PT 18-39YR | $199.20 | $332.00 | $90.64–$315.40 | — | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 18 - 39 YRS | $199.20 | $332.00 | $90.64–$315.40 | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 PREVENTIVE MED NEW PT 40-64YRS | $217.20 | $362.00 | $90.50–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 40 - 64 YRS | $217.20 | $362.00 | $90.50–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 40-64 YRS | $217.20 | $362.00 | $90.50–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MED NEW PAT 40-64YR | $217.20 | $362.00 | $90.50–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 INITIAL PREVENT MED NEW PT 40-64YR | $217.20 | $362.00 | $90.50–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 40 - 64 YRS | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 40-64 YRS | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITIAL PREVENTIVE MED NEW PAT 40-64YR | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 INITIAL PREVENT MED NEW PT 40-64YR | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 PREVENTIVE MED NEW PT 40-64YRS | $217.20 | $362.00 | $98.83–$343.90 | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 65 YRS AND OVER | $97.80 | $163.00 | $40.75–$154.85 | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 PREVENTIVE MED NEW PT 65YRS + | $244.80 | $408.00 | $102.00–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 PREVENTIVE MED NEW PT 65YRS+ | $244.80 | $408.00 | $102.00–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREVENTIV MED NEW PATIENT 65+YR | $244.80 | $408.00 | $102.00–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 INITIAL PREVENT MED NEW PT 65+YR | $244.80 | $408.00 | $102.00–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 INITIAL PREVENT MED NEW PT 65+YR | $244.80 | $408.00 | $102.00–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 65 YRS AND OVER | $97.80 | $163.00 | $44.50–$154.85 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INITIAL PREVENTIV MED NEW PATIENT 65+YR | $244.80 | $408.00 | $111.38–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 INITIAL PREVENT MED NEW PT 65+YR | $244.80 | $408.00 | $111.38–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 INITIAL PREVENT MED NEW PT 65+YR | $244.80 | $408.00 | $111.38–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 PREVENTIVE MED NEW PT 65YRS + | $244.80 | $408.00 | $111.38–$387.60 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 PREVENTIVE MED NEW PT 65YRS+ | $244.80 | $408.00 | $111.38–$387.60 | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 18-39 YRS | $165.60 | $276.00 | $71.76–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-3 | $165.60 | $276.00 | $71.76–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PAT 18-39YR | $165.60 | $276.00 | $71.76–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 99395 EST PAT REEVAL (18-39 YR) | $165.60 | $276.00 | $71.76–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 99395 PERIODIC PREVENT MED EST PT 18-39Y | $165.60 | $276.00 | $71.76–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 18-39 YRS | $165.60 | $276.00 | $75.35–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-3 | $165.60 | $276.00 | $75.35–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PERIODIC PREVENTIVE MED EST PAT 18-39YR | $165.60 | $276.00 | $75.35–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 PERIODIC PREVENT MED EST PT 18-39Y | $165.60 | $276.00 | $75.35–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 EST PAT REEVAL (18-39 YR) | $165.60 | $276.00 | $75.35–$262.20 | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PERIODIC PREVENTIVE MED EST PAT 40-64YR | $180.60 | $301.00 | $75.25–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 EST PAT REEVAL (40-64 YR) | $180.60 | $301.00 | $75.25–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 PERIODIC PREVENT MED EST PT 40-64Y | $180.60 | $301.00 | $75.25–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 ESTABLISHED PREV MED 40-64 YRS | $180.60 | $301.00 | $75.25–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 PERIODIC PREVENT MED EST PT 40-64Y | $180.60 | $301.00 | $82.17–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PERIODIC PREVENTIVE MED EST PAT 40-64YR | $180.60 | $301.00 | $82.17–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 EST PAT REEVAL (40-64 YR) | $180.60 | $301.00 | $82.17–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 ESTABLISHED PREV MED 40-64 YRS | $180.60 | $301.00 | $82.17–$285.95 | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 EST PAT REEVAL (65 YR AND OLDER) | $205.20 | $342.00 | $85.50–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 PERIODIC PREVENT MED EST PT 65+YR | $205.20 | $342.00 | $85.50–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PREVENTIVE MED EST PAT 65+YR | $205.20 | $342.00 | $85.50–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PRVNTVE MED EST PT 65YR & OLDER | $205.20 | $342.00 | $85.50–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 65 YRS AND OVER | $205.20 | $342.00 | $85.50–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PERIODIC PREVENTIVE MED EST PAT 65+YR | $205.20 | $342.00 | $93.37–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 PERIODIC PREVENT MED EST PT 65+YR | $205.20 | $342.00 | $93.37–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 EST PAT REEVAL (65 YR AND OLDER) | $205.20 | $342.00 | $93.37–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 65 YRS AND OVER | $205.20 | $342.00 | $93.37–$324.90 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PERIODIC PRVNTVE MED EST PT 65YR & OLDER | $205.20 | $342.00 | $93.37–$324.90 | — | 40% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRV | $267.00 | $445.00 | $121.48–$422.75 | — | 40% |
| Psychiatric evaluation with medical services CPT 90792 90792 PSYCH DIAG EVAL W/MED SRV | $267.00 | $445.00 | $121.48–$422.75 | — | 40% |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SE | $285.60 | $476.00 | $80.00–$452.20 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRV | $267.00 | $445.00 | $121.48–$422.75 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 90792 PSYCH DIAG EVAL W/MED SRV | $267.00 | $445.00 | $121.48–$422.75 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SE | $285.60 | $476.00 | $129.95–$452.20 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCL TST EVAL PHYS/QHP 1ST | $203.40 | $339.00 | $92.55–$603.48 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCL TST EVAL PHYS/QHP 1ST | $203.40 | $339.00 | $92.55–$322.05 | — | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 90839 PSYTX CRISIS INITIAL 60 MIN | $96.60 | $161.00 | $43.95–$311.38 | 64% below | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 PSYTX CRISIS INITIAL 60 MIN | $96.60 | $161.00 | $43.95–$152.95 | — | 40% |
| Psychotherapy session, 30 minutes CPT 90832 90832 PSYTX PT&/FAMILY 30 MINU | $110.40 | $184.00 | $50.23–$311.38 | 24% below | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUT | $112.80 | $188.00 | $51.32–$311.38 | 22% below | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $124.20 | $207.00 | $56.51–$311.38 | 14% below | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 PSYTX PT&/FAMILY 30 MINU | $110.40 | $184.00 | $50.23–$174.80 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT&/FAMILY 30 MINUT | $112.80 | $188.00 | $51.32–$178.60 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $124.20 | $207.00 | $56.51–$196.65 | — | 40% |
| Psychotherapy session, 45 minutes CPT 90834 90834 PSYTX PT&/FAMILY 45 MINUT | $146.40 | $244.00 | $66.61–$311.38 | 14% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTE | $146.40 | $244.00 | $66.61–$311.38 | 14% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $165.00 | $275.00 | $75.08–$311.38 | 3% below | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 PSYTX PT&/FAMILY 45 MINUT | $146.40 | $244.00 | $66.61–$231.80 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT&/FAMILY 45 MINUTE | $146.40 | $244.00 | $66.61–$231.80 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $165.00 | $275.00 | $75.08–$261.25 | — | 40% |
| Psychotherapy session, 60 minutes CPT 90837 90837 PSYTX PT&/FAMILY 60 MINUT | $219.60 | $366.00 | $99.92–$347.70 | 7% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTE | $222.00 | $370.00 | $101.01–$351.50 | 6% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $248.40 | $414.00 | $80.00–$393.30 | 5% above | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 PSYTX PT&/FAMILY 60 MINUT | $219.60 | $366.00 | $99.92–$347.70 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX PT&/FAMILY 60 MINUTE | $222.00 | $370.00 | $101.01–$351.50 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $248.40 | $414.00 | $113.02–$393.30 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 | $27.60 | $46.00 | $12.56–$57.74 | 16% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING&TOB CNSL; INTRMED 3-10 MINS | $27.60 | $46.00 | $12.56–$57.74 | 16% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 M | $27.60 | $46.00 | $12.56–$57.74 | 16% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $55.80 | $93.00 | $24.54–$88.35 | 69% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 | $27.60 | $46.00 | $12.56–$43.70 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING&TOB CNSL; INTRMED 3-10 MINS | $27.60 | $46.00 | $12.56–$43.70 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 M | $27.60 | $46.00 | $12.56–$43.70 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $55.80 | $93.00 | $25.39–$88.35 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 TELEMED HIGH COMPLEXITY | $262.80 | $438.00 | $109.50–$416.10 | 5% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OUTPATIENT VISIT 40 MINUTES | $262.80 | $438.00 | $109.50–$416.10 | 5% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 HIGH COMPLEXITY | $262.80 | $438.00 | $109.50–$416.10 | 5% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 *TELEMED OFFICE OUTPATIENT VISIT 40 MIN | $262.80 | $438.00 | $109.50–$416.10 | 5% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFC CONS ESTB PT HIGH MDM AT LEAST 40 MI | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M EST PT HI MDM AT LST 40 MINS - PRO | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 TELEMED ESTB PT HIGH MDM AT LEAST 40 MIN | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 TELEMED HIGH MDM AT LEAST 40 MINS | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 ESTB PT HIGH MDM AT LEAST 40 MINS | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M EST PT HI MDM AT LST 40 MINS - FAC | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFC VIS ESTB PT HIGH MDM AT LEAST 40 MIN | $312.00 | $520.00 | $130.00–$494.00 | 25% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TELEMED HIGH COMPLEXITY | $262.80 | $438.00 | $119.57–$416.10 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPATIENT ESTABLISHD VISIT 40 M | $262.80 | $438.00 | $119.57–$416.10 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 *TELEMED OFFICE OUTPATIENT VISIT 40 MIN | $262.80 | $438.00 | $119.57–$416.10 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 HIGH COMPLEXITY | $262.80 | $438.00 | $119.57–$416.10 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OUTPATIENT VISIT 40 MINUTES | $262.80 | $438.00 | $119.57–$416.10 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TELEMED ESTB PT HIGH MDM AT LEAST 40 MIN | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TELEMED HIGH MDM AT LEAST 40 MINS | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFC CONS ESTB PT HIGH MDM AT LEAST 40 MI | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M EST PT HI MDM AT LST 40 MINS - FAC | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 ESTB PT HIGH MDM AT LEAST 40 MINS | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFC VIS ESTB PT HIGH MDM AT LEAST 40 MIN | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M EST PT HI MDM AT LST 40 MINS - PRO | $312.00 | $520.00 | $141.96–$494.00 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CITY OF ARTESIA OFFICE VISIT | $76.20 | $127.00 | $31.75–$120.65 | 48% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEMED CITY OF ARTESIA OFFICE VISIT | $76.20 | $127.00 | $31.75–$120.65 | 48% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT VISIT | $133.20 | $222.00 | $55.50–$210.90 | 9% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEMED OFFICE/OUTPATIENT VISIT | $133.20 | $222.00 | $55.50–$210.90 | 9% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT VISIT, | $133.20 | $222.00 | $55.50–$210.90 | 9% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEMED OFFICE/OUTPATIENT VISIT, | $133.20 | $222.00 | $55.50–$210.90 | 9% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OUTPATIENT VISIT 15 MINUTES | $133.20 | $222.00 | $55.50–$210.90 | 9% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE OP ESTAB PATIENT 15 MINUTES | $133.20 | $222.00 | $55.50–$210.90 | 9% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E/M ESTB PT LOW MDM AT LEAST 20 MINS - P | $156.60 | $261.00 | $65.25–$247.95 | 6% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E/M ESTB PT LOW MDM AT LEAST 20 MINS - F | $156.60 | $261.00 | $65.25–$247.95 | 6% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEMED OFC VIS LOW MDM AT LEAST 20 MINS | $156.60 | $261.00 | $65.25–$247.95 | 6% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFC CONS ESTB PT LOW MDM AT LEAST 20 MIN | $156.60 | $261.00 | $65.25–$247.95 | 6% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 ESTB PT LOW MDM AT LEAST 20 MINS | $156.60 | $261.00 | $65.25–$247.95 | 6% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFC VIS ESTB PT LOW MDM AT LEAST 20 MINS | $156.60 | $261.00 | $65.25–$247.95 | 6% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TELEMED CITY OF ARTESIA OFFICE VISIT | $76.20 | $127.00 | $34.67–$120.65 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CITY OF ARTESIA OFFICE VISIT | $76.20 | $127.00 | $34.67–$120.65 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OUTPATIENT VISIT 15 MINUTES | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT ESTABLISHD VISIT 15 M | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE OP ESTAB PATIENT 15 MINUTES | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TELEMED OFFICE/OUTPATIENT VISIT, | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT VISIT, | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT VISIT | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TELEMED OFFICE/OUTPATIENT VISIT | $133.20 | $222.00 | $60.61–$210.90 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E/M ESTB PT LOW MDM AT LEAST 20 MINS - P | $156.60 | $261.00 | $71.25–$247.95 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFC VIS ESTB PT LOW MDM AT LEAST 20 MINS | $156.60 | $261.00 | $71.25–$247.95 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFC CONS ESTB PT LOW MDM AT LEAST 20 MIN | $156.60 | $261.00 | $71.25–$247.95 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 ESTB PT LOW MDM AT LEAST 20 MINS | $156.60 | $261.00 | $71.25–$247.95 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TELEMED OFC VIS LOW MDM AT LEAST 20 MINS | $156.60 | $261.00 | $71.25–$247.95 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E/M ESTB PT LOW MDM AT LEAST 20 MINS - F | $156.60 | $261.00 | $71.25–$247.95 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEMED OFFICE OP ESTAB PATIENT 25 MIN | $195.60 | $326.00 | $81.50–$309.70 | 2% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 ESTB PT MOD MDM AT LEAST 30 MINS | $195.60 | $326.00 | $81.50–$309.70 | 2% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OUTPATIENT VISIT 25 MINUTES | $195.60 | $326.00 | $81.50–$309.70 | 2% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 MODERATE COMPLEXITY | $195.60 | $326.00 | $81.50–$309.70 | 2% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEMED MODERATE COMPLEXITY | $195.60 | $326.00 | $81.50–$309.70 | 2% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E/M ESTB PT MOD MDM AT LEAST 30 MINS - P | $222.00 | $370.00 | $92.50–$351.50 | 16% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E/M ESTB PT MOD MDM AT LEAST 30 MINS - F | $222.00 | $370.00 | $92.50–$351.50 | 16% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFC CONS MOD MDM AT LEAST 30 MINS | $222.00 | $370.00 | $92.50–$351.50 | 16% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFC VIS MOD MDM AT LEAST 30 MINS | $222.00 | $370.00 | $92.50–$351.50 | 16% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEMED MOD MDM AT LEAST 30 MINS | $222.00 | $370.00 | $92.50–$351.50 | 16% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 ESTB PT MOD MDM AT LEAST 30 MINS | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 MODERATE COMPLEXITY | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OUTPATIENT VISIT 25 MINUTES | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT ESTABLISHD VISIT 25 M | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TELEMED MODERATE COMPLEXITY | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TELEMED OFFICE OP ESTAB PATIENT 25 MIN | $195.60 | $326.00 | $89.00–$309.70 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E/M ESTB PT MOD MDM AT LEAST 30 MINS - P | $222.00 | $370.00 | $101.01–$351.50 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TELEMED MOD MDM AT LEAST 30 MINS | $222.00 | $370.00 | $101.01–$351.50 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFC VIS MOD MDM AT LEAST 30 MINS | $222.00 | $370.00 | $101.01–$351.50 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFC CONS MOD MDM AT LEAST 30 MINS | $222.00 | $370.00 | $101.01–$351.50 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E/M ESTB PT MOD MDM AT LEAST 30 MINS - F | $222.00 | $370.00 | $101.01–$351.50 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OUTPATIENT VISIT 10 MINUTES | $80.40 | $134.00 | $33.50–$127.30 | 25% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TELEMED STRAIGHT FORWARD | $80.40 | $134.00 | $33.50–$127.30 | 25% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 STRAIGHT FORWARD | $80.40 | $134.00 | $33.50–$127.30 | 25% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE/OP ESTAB SF MDM 10-19 MIN | $80.40 | $134.00 | $33.50–$127.30 | 25% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 ESTB PT STR FWD MDM AT LEAST 10 MI | $97.80 | $163.00 | $40.75–$154.85 | 9% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP ESTAB PATIENT 10 MINUTES | $97.80 | $163.00 | $40.75–$154.85 | 9% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TELEMED OFC VIS STR FWD MDM AT LEAST 10 | $97.80 | $163.00 | $40.75–$154.85 | 9% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E/M ESTB PT STR FWD MDM AT LEAST 10 MINS | $97.80 | $163.00 | $40.75–$154.85 | 9% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OFFICE/OP ESTAB SF MDM 10-19 MIN | $80.40 | $134.00 | $36.58–$127.30 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHD VISIT 10 M | $80.40 | $134.00 | $36.58–$127.30 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TELEMED STRAIGHT FORWARD | $80.40 | $134.00 | $36.58–$127.30 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 STRAIGHT FORWARD | $80.40 | $134.00 | $36.58–$127.30 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OUTPATIENT VISIT 10 MINUTES | $80.40 | $134.00 | $36.58–$127.30 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TELEMED OFC VIS STR FWD MDM AT LEAST 10 | $97.80 | $163.00 | $44.50–$154.85 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E/M ESTB PT STR FWD MDM AT LEAST 10 MINS | $97.80 | $163.00 | $44.50–$154.85 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 ESTB PT STR FWD MDM AT LEAST 10 MI | $97.80 | $163.00 | $44.50–$154.85 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP ESTAB PATIENT 10 MINUTES | $97.80 | $163.00 | $44.50–$154.85 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 TELEMED OFF/OTHR OP CONS NEW/ESTAB; 30 M | $187.20 | $312.00 | $78.00–$296.40 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OTHR OP CONS NEW/ESTAB; 30 MINS OR M | $187.20 | $312.00 | $78.00–$296.40 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OTHR OP CONS NEW/ESTAB; 30 MIN OR MO | $187.20 | $312.00 | $78.00–$296.40 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFF/OTHR OP CONS NEW/ESTAB; 30 MINS OR M | $187.20 | $312.00 | $85.18–$296.40 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFF/OTHR OP CONS NEW/ESTAB; 30 MIN OR MO | $187.20 | $312.00 | $85.18–$296.40 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 TELEMED OFF/OTHR OP CONS NEW/ESTAB; 30 M | $187.20 | $312.00 | $85.18–$296.40 | — | 40% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OTHR OP CONS NEW/ESTAB; 40 MINS OR M | $244.80 | $408.00 | $102.00–$387.60 | — | 40% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFF/OTHR OP CONS NEW/ESTAB; 40 MINS OR M | $244.80 | $408.00 | $111.38–$387.60 | — | 40% |
| Speech and language evaluation CPT 92523 ST EVAL WITH LANG COMP | $304.80 | $508.00 | $132.08–$482.60 | 14% below | 40% |
| Speech and language evaluation inpatient CPT 92523 ST EVAL WITH LANG COMP | $304.80 | $508.00 | $138.68–$482.60 | — | 40% |
| Speech therapy session, individual CPT 92507 ST INDIVIDUAL ST TX | $213.00 | $355.00 | $69.84–$337.25 | at median | 40% |
| Speech therapy session, individual inpatient CPT 92507 ST INDIVIDUAL ST TX | $213.00 | $355.00 | $96.92–$337.25 | — | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY W/O BD LA | $261.00 | $435.00 | $118.75–$413.25 | 3% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY W/O BD | $409.72 | $682.86 | $128.87–$648.72 | 62% above | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/O BD LA | $261.00 | $435.00 | $118.75–$413.25 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/O BD | $409.72 | $682.86 | $186.42–$648.72 | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY W/BD | $372.60 | $621.00 | $113.28–$603.48 | 10% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY W/BD | $372.60 | $621.00 | $169.53–$589.95 | — | 40% |
| TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 REPET TMS TX INITIAL W/MAP/MOTR THRESHLD | $355.80 | $593.00 | $161.89–$603.48 | — | 40% |
| TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 REPET TMS TX INITIAL W/MAP/MOTR THRESHLD | $355.80 | $593.00 | $161.89–$563.35 | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITES | $91.20 | $152.00 | $33.62–$144.40 | 24% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACTIVITY 15 MIN | $118.80 | $198.00 | $33.62–$188.10 | 1% below | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITES | $91.20 | $152.00 | $41.50–$144.40 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THER ACTIVITY 15 MIN | $118.80 | $198.00 | $54.05–$188.10 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDUR | $230.40 | $384.00 | $93.63–$364.80 | 31% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPUTI | $258.00 | $430.00 | $93.63–$408.50 | 47% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDUR | $230.40 | $384.00 | $104.83–$364.80 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPUTI | $258.00 | $430.00 | $117.39–$408.50 | — | 40% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIO STRESS TEST (GLOBA | $136.80 | $228.00 | $57.00–$216.60 | — | 40% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIO STRESS TEST (GLOBA | $136.80 | $228.00 | $62.24–$216.60 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 VACC MRNA MODERNA 0.5ML 12YRS+ | $383.40 | $639.00 | $166.14–$607.05 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CL- COVID-19 VACC MRNA SY 0.5ML MEDICARE | $383.40 | $639.00 | $166.14–$607.05 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CL- COVID-19VACC MRNA 0.5ML NON MEDICARE | $383.40 | $639.00 | $166.14–$607.05 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 VACC MRNA MODERNA 0.5ML 12YRS+ | $383.40 | $639.00 | $174.45–$607.05 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CL- COVID-19 VACC MRNA SY 0.5ML MEDICARE | $383.40 | $639.00 | $174.45–$607.05 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CL- COVID-19VACC MRNA 0.5ML NON MEDICARE | $383.40 | $639.00 | $174.45–$607.05 | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CHICKEN POX VACCINE, SC | $102.00 | $170.00 | $44.20–$161.50 | 68% below | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 CHICKEN POX VACCINE, SC | $102.00 | $170.00 | $46.41–$161.50 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL- Flu Vaccine Quad- Non Medicare | $30.60 | $51.00 | $13.26–$48.45 | 34% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL- Flu Vaccine Quad- Non Medicare - RHC | $30.60 | $51.00 | $13.26–$48.45 | 34% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL- Flu Vaccine Quad- Medicare | $30.60 | $51.00 | $13.26–$48.45 | 34% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE | $71.58 | $119.30 | $25.54–$113.33 | 55% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE | $143.70 | $239.50 | $25.54–$227.53 | 212% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CL- Flu Vaccine Quad- Non Medicare | $30.60 | $51.00 | $13.92–$48.45 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CL- Flu Vaccine Quad- Medicare | $30.60 | $51.00 | $13.92–$48.45 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CL- Flu Vaccine Quad- Non Medicare - RHC | $30.60 | $51.00 | $13.92–$48.45 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE | $71.58 | $119.30 | $32.57–$113.33 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE | $143.70 | $239.50 | $65.38–$227.53 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 CL- GARDASIL 9 **HOSPITAL | $612.00 | $1,020.00 | $257.71–$969.00 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 CL- GARDASIL 9 **HOSPITAL | $612.00 | $1,020.00 | $278.46–$969.00 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A-HEP B VACCINE | $247.80 | $413.00 | $16.76–$392.35 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A-HEP B VACCINE | $247.80 | $413.00 | $112.75–$392.35 | — | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE, ADULT IM | $102.00 | $170.00 | $42.50–$161.50 | 20% below | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE, ADULT IM | $102.00 | $170.00 | $46.41–$161.50 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CL- HEPATITIS B VACCINE- HOSPITAL | $187.20 | $312.00 | $73.04–$296.40 | 33% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) | $187.20 | $312.00 | $73.04–$296.40 | 33% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CL- HEPATITIS B VACCINE- HOSPITAL | $187.20 | $312.00 | $85.18–$296.40 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) | $187.20 | $312.00 | $85.18–$296.40 | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL- Flu Vaccine HD - Non Medicare | $33.00 | $55.00 | $14.30–$107.98 | 64% below | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL- Flu Vaccine HD - Non Medicare - RHC | $43.20 | $72.00 | $18.72–$107.98 | 53% below | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL- Flu Vaccine HD - Medicare | $43.20 | $72.00 | $18.72–$107.98 | 53% below | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CL- Flu Vaccine HD - Non Medicare | $33.00 | $55.00 | $15.02–$52.25 | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CL- Flu Vaccine HD - Non Medicare - RHC | $43.20 | $72.00 | $19.66–$68.40 | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CL- Flu Vaccine HD - Medicare | $43.20 | $72.00 | $19.66–$68.40 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE, SC | $39.00 | $65.00 | $16.25–$61.75 | 77% below | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE, SC | $39.00 | $65.00 | $17.75–$61.75 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL- MENACTRA | $463.20 | $772.00 | $111.49–$733.40 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 CL- MENACTRA | $463.20 | $772.00 | $210.76–$733.40 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20- VALENT CONJUGATE | $677.40 | $1,129.00 | $282.25–$1,072.55 | 8% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL- PNEUMOCOCCAL 20 CONJ-MEDICARE | $677.40 | $1,129.00 | $282.25–$1,072.55 | 8% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL- PNEUMOCOCCAL 20CONJ-NON MEDICARE-RHC | $677.40 | $1,129.00 | $282.25–$1,072.55 | 8% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL- PNEUMOCOCCAL 20 CONJ-NON MEDICARE | $701.64 | $1,169.40 | $292.35–$1,110.93 | 12% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 CL- PNEUMOCOCCAL 20CONJ-NON MEDICARE-RHC | $677.40 | $1,129.00 | $308.22–$1,072.55 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20- VALENT CONJUGATE | $677.40 | $1,129.00 | $308.22–$1,072.55 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 CL- PNEUMOCOCCAL 20 CONJ-MEDICARE | $677.40 | $1,129.00 | $308.22–$1,072.55 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 CL- PNEUMOCOCCAL 20 CONJ-NON MEDICARE | $701.64 | $1,169.40 | $319.25–$1,110.93 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 0.5 ML | $65.40 | $109.00 | $28.34–$148.28 | 63% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- PNEUMOCOCCAL - HOSPITAL | $65.40 | $109.00 | $28.34–$148.28 | 63% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- Pneumovax 23 - Medicare | $70.20 | $117.00 | $30.42–$148.28 | 60% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE | $333.79 | $556.31 | $117.46–$528.49 | 88% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 0.5 ML | $65.40 | $109.00 | $29.76–$103.55 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CL- PNEUMOCOCCAL - HOSPITAL | $65.40 | $109.00 | $29.76–$103.55 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CL- Pneumovax 23 - Medicare | $70.20 | $117.00 | $31.94–$111.15 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE | $333.79 | $556.31 | $151.87–$528.49 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC, PREF A AND PREF B/PF | $772.20 | $1,287.00 | $321.75–$1,222.65 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACC, PREF A AND PREF B/PF | $772.20 | $1,287.00 | $351.35–$1,222.65 | — | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM | $282.60 | $471.00 | $128.58–$627.36 | 62% below | 40% |
| Rabies vaccine, one dose CPT 90675 CL- IMOVAX RABIES VAC IM | $1,263.00 | $2,105.00 | $266.63–$1,999.75 | 71% above | 40% |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VAC IM | $1,264.80 | $2,108.00 | $266.63–$2,002.60 | 71% above | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, IM | $282.60 | $471.00 | $128.58–$447.45 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 CL- IMOVAX RABIES VAC IM | $1,263.00 | $2,105.00 | $574.66–$1,999.75 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VAC IM | $1,264.80 | $2,108.00 | $575.48–$2,002.60 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL- SHINGRIX 50 MCG / 0.5 ML | $508.20 | $847.00 | $211.75–$804.65 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 CL- SHINGRIX 50 MCG / 0.5 ML | $508.20 | $847.00 | $231.23–$804.65 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- TETANUS and DIPHTHERIA- floorstock | $105.60 | $176.00 | $41.11–$167.20 | 6% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- Tetanus/Diphtheria toxoid (Td) | $119.40 | $199.00 | $41.11–$189.05 | 19% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS | $119.40 | $199.00 | $41.11–$189.05 | 19% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 CL- TETANUS and DIPHTHERIA- floorstock | $105.60 | $176.00 | $48.05–$167.20 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 CL- Tetanus/Diphtheria toxoid (Td) | $119.40 | $199.00 | $54.33–$189.05 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS | $119.40 | $199.00 | $54.33–$189.05 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET TOX-DIPH-ACELL PERTUSS 0.5ML IM | $134.40 | $224.00 | $43.79–$212.80 | 12% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL- Tdap 0.5ML - Floorstock | $134.40 | $224.00 | $43.79–$212.80 | 12% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET TOX-DIPH-ACELL PERTUSS 0.5ML IM | $134.40 | $224.00 | $61.15–$212.80 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CL- Tdap 0.5ML - Floorstock | $134.40 | $224.00 | $61.15–$212.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN (STATE) | $12.48 | $20.80 | $5.68–$137.92 | 74% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VP IMMUNIZATION ADMIN | $12.48 | $20.80 | $5.68–$137.92 | 74% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION PNEUMOCOCCAL VACC | $30.00 | $50.00 | $13.65–$137.92 | 37% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 FLU VACCINE ADMINISTRATION | $30.00 | $50.00 | $13.65–$137.92 | 37% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ADMINISTRATION PNEUMOCOCCAL VACC | $30.00 | $50.00 | $13.65–$137.92 | 37% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUNIZATION 1 VACCINE | $30.00 | $50.00 | $13.65–$137.92 | 37% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE | $30.00 | $50.00 | $13.65–$137.92 | 37% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION INFLUENZA VIRUS VACC | $30.00 | $50.00 | $13.65–$137.92 | 37% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, BY INJ; 1 VACC (SNGL | $78.60 | $131.00 | $30.50–$137.92 | 65% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUNIZATION | $91.80 | $153.00 | $30.50–$145.35 | 92% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INITIAL ADMINISTRATION | $95.40 | $159.00 | $30.50–$151.05 | 100% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INITIAL VACCINE ADMINISTRATION | $98.40 | $164.00 | $30.50–$155.80 | 106% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION FLU VIRUS VACC NON MC | $98.40 | $164.00 | $30.50–$155.80 | 106% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION PNEUMO VACC NON MC | $98.40 | $164.00 | $30.50–$155.80 | 106% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VP IMMUNIZATION ADMIN | $12.48 | $20.80 | $5.68–$19.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN (STATE) | $12.48 | $20.80 | $5.68–$19.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION INFLUENZA VIRUS VACC | $30.00 | $50.00 | $13.65–$47.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE | $30.00 | $50.00 | $13.65–$47.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN IMMUNIZATION 1 VACCINE | $30.00 | $50.00 | $13.65–$47.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 ADMINISTRATION PNEUMOCOCCAL VACC | $30.00 | $50.00 | $13.65–$47.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 FLU VACCINE ADMINISTRATION | $30.00 | $50.00 | $13.65–$47.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION PNEUMOCOCCAL VACC | $30.00 | $50.00 | $13.65–$47.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 M/S ADMIN INFLUENZA VACCINE | $78.60 | $131.00 | $35.76–$124.45 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 M/S VACCINE ADMINISTRATION | $78.60 | $131.00 | $35.76–$124.45 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, BY INJ; 1 VACC (SNGL | $78.60 | $131.00 | $35.76–$124.45 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 M/S ADMIN PNEUMONIA VACCINE | $78.60 | $131.00 | $35.76–$124.45 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUNIZATION | $91.80 | $153.00 | $41.77–$145.35 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INITIAL ADMINISTRATION | $95.40 | $159.00 | $43.41–$151.05 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION FLU VIRUS VACC NON MC | $98.40 | $164.00 | $44.77–$155.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION PNEUMO VACC NON MC | $98.40 | $164.00 | $44.77–$155.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INITIAL VACCINE ADMINISTRATION | $98.40 | $164.00 | $44.77–$155.80 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN, ADD-ON; EA ADD'L VAC | $12.00 | $20.00 | $5.20–$38.51 | 62% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 M/S ADDL VACCINE ADMINISTRATION | $12.00 | $20.00 | $5.20–$38.51 | 62% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VP IMMUNIZATION ADMIN, EACH | $12.48 | $20.80 | $5.41–$38.51 | 61% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN, EACH (STATE) | $12.48 | $20.80 | $5.41–$38.51 | 61% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADDITIONAL ADMINISTRATION | $22.80 | $38.00 | $9.88–$38.51 | 28% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE | $22.80 | $38.00 | $9.88–$38.51 | 28% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUNIZATION EACH ADDL VACCINE | $22.80 | $38.00 | $9.88–$38.51 | 28% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN, EACH ADDL | $57.00 | $95.00 | $24.70–$90.25 | 79% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $57.00 | $95.00 | $24.70–$90.25 | 79% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN, ADD-ON; EA ADD'L VAC | $12.00 | $20.00 | $5.46–$19.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 M/S ADDL VACCINE ADMINISTRATION | $12.00 | $20.00 | $5.46–$19.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN, EACH (STATE) | $12.48 | $20.80 | $5.68–$19.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VP IMMUNIZATION ADMIN, EACH | $12.48 | $20.80 | $5.68–$19.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN IMMUNIZATION EACH ADDL VACCINE | $22.80 | $38.00 | $10.37–$36.10 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE | $22.80 | $38.00 | $10.37–$36.10 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EACH ADDITIONAL ADMINISTRATION | $22.80 | $38.00 | $10.37–$36.10 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD | $57.00 | $95.00 | $25.93–$90.25 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN, EACH ADDL | $57.00 | $95.00 | $25.93–$90.25 | — | 40% |
Source file: https://pricetransparency.healthcare/artesia-general-hospital/charges/export