Hospital

Mary Breckinridge Arh Hospital

Mary Breckinridge Arh Hospital in Hayden, KY publishes cash prices for 268 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Kentucky median for 199 of 265 procedures and below it for 49. By typical cash price it ranks #63 of 81 Kentucky hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

130 Kate Ireland Dr Hayden KY 41749 Collected Sep 27, 2026 Source price file Check a bill from this hospital (606) 672-2901

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 181316 · CMS hospital register NPI 1649554007

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Mary Breckinridge Arh Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Kentucky	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABD W/WO CONTRAST	$2,256.60	$3,761.00	$542.00–$3,309.68	35% above	40%
Abdominal CT scan without and with contrast CPT 74170 CT ABD W/WO CONTRAST	$2,256.60	$3,761.00	$542.00–$3,309.68	35% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W/WO CONTRAST	$2,256.60	$3,761.00	$542.00–$3,309.68	—	40%
Abdominal X-ray, 2 views CPT 74019 XR ABD 2 VIEWS	$388.80	$648.00	$97.20–$570.24	21% above	40%
Abdominal X-ray, 2 views CPT 74019 XR ABD 2 VIEWS	$388.80	$648.00	$97.20–$570.24	21% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD 2 VIEWS	$388.80	$648.00	$97.20–$570.24	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE MIN 3 VIEWS RT	$317.40	$529.00	$79.35–$465.52	at median	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE MIN 3 VIEWS LT	$317.40	$529.00	$79.35–$465.52	at median	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE MIN 3 VIEWS RT	$317.40	$529.00	$79.35–$465.52	at median	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE MIN 3 VIEWS LT	$317.40	$529.00	$79.35–$465.52	at median	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE MIN 3 VIEWS LT	$317.40	$529.00	$79.35–$465.52	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE MIN 3 VIEWS RT	$317.40	$529.00	$79.35–$465.52	—	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREMITY WO CONTRAST LT	$1,463.40	$2,439.00	$365.85–$2,146.32	40% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREMITY WO CONTRAST LT	$1,463.40	$2,439.00	$365.85–$2,146.32	40% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREMITY WO CONTRAST RT	$1,463.40	$2,439.00	$365.85–$2,146.32	40% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREMITY WO CONTRAST RT	$1,463.40	$2,439.00	$365.85–$2,146.32	40% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXTREMITY WO CONTRAST LT	$1,463.40	$2,439.00	$365.85–$2,146.32	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXTREMITY WO CONTRAST RT	$1,463.40	$2,439.00	$365.85–$2,146.32	—	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COMP RT	$462.60	$771.00	$115.65–$678.48	14% above	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COMP RT	$462.60	$771.00	$115.65–$678.48	14% above	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT COMP RT	$462.60	$771.00	$115.65–$678.48	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED BIL	$924.60	$1,541.00	$231.15–$1,356.08	210% above	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED BIL	$924.60	$1,541.00	$231.15–$1,356.08	210% above	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIM RT	$462.60	$771.00	$115.65–$678.48	55% above	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIM RT	$462.60	$771.00	$115.65–$678.48	55% above	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED BIL	$924.60	$1,541.00	$231.15–$1,356.08	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIM RT	$462.60	$771.00	$115.65–$678.48	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANG ABD+PLVS W OR WO CNTRS	$4,842.60	$8,071.00	$542.00–$7,102.48	107% above	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANG ABD+PLVS W OR WO CNTRS	$4,842.60	$8,071.00	$542.00–$7,102.48	107% above	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANG ABD+PLVS W OR WO CNTRS	$4,842.60	$8,071.00	$542.00–$7,102.48	—	40%
CT angiography (CTA) of the head CPT 70496 CT ANG HEAD W OR WO CONTR	$2,098.20	$3,497.00	$524.55–$3,077.36	43% above	40%
CT angiography (CTA) of the head CPT 70496 CT ANG HEAD W OR WO CONTR	$2,098.20	$3,497.00	$524.55–$3,077.36	43% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANG HEAD W OR WO CONTR	$2,098.20	$3,497.00	$524.55–$3,077.36	—	40%
CT angiography (CTA) of the neck CPT 70498 CT ANG NECK W OR WO CONTR	$2,098.20	$3,497.00	$524.55–$3,077.36	46% above	40%
CT angiography (CTA) of the neck CPT 70498 CT ANG NECK W OR WO CONTR	$2,098.20	$3,497.00	$524.55–$3,077.36	46% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANG NECK W OR WO CONTR	$2,098.20	$3,497.00	$524.55–$3,077.36	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANG CHST W OR WO CONTR	$2,693.40	$4,489.00	$542.00–$3,950.32	81% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANG CHST W OR WO CONTR	$2,693.40	$4,489.00	$542.00–$3,950.32	81% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANG CHST W OR WO CONTR	$2,693.40	$4,489.00	$542.00–$3,950.32	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD+PELVIS WO CONTRAST	$3,292.80	$5,488.00	$542.00–$4,829.44	60% above	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD+PELVIS WO CONTRAST	$3,292.80	$5,488.00	$542.00–$4,829.44	60% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD+PELVIS WO CONTRAST	$3,292.80	$5,488.00	$542.00–$4,829.44	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD+PELVIS W/CONTRAST	$4,247.40	$7,079.00	$542.00–$6,229.52	56% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD+PELVIS W/CONTRAST	$4,247.40	$7,079.00	$542.00–$6,229.52	56% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD+PELVIS W/CONTRAST	$4,247.40	$7,079.00	$542.00–$6,229.52	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD+PELVIS W+WO CONTRAST	$5,270.40	$8,784.00	$542.00–$7,729.92	75% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD+PELVIS W+WO CONTRAST	$5,270.40	$8,784.00	$542.00–$7,729.92	75% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD+PELVIS W+WO CONTRAST	$5,270.40	$8,784.00	$542.00–$7,729.92	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$1,892.40	$3,154.00	$473.10–$2,775.52	20% above	40%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$1,892.40	$3,154.00	$473.10–$2,775.52	20% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONTRAST	$1,892.40	$3,154.00	$473.10–$2,775.52	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABD WO ORAL+IV CONTRAST	$1,533.00	$2,555.00	$383.25–$2,248.40	28% above	40%
CT scan of the abdomen without contrast CPT 74150 CT ABD WO ORAL+IV CONTRAST	$1,533.00	$2,555.00	$383.25–$2,248.40	28% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD WO ORAL+IV CONTRAST	$1,533.00	$2,555.00	$383.25–$2,248.40	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL W/O CONTRAST	$1,595.40	$2,659.00	$398.85–$2,339.92	36% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL W/O CONTRAST	$1,595.40	$2,659.00	$398.85–$2,339.92	36% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL W/O CONTRAST	$1,595.40	$2,659.00	$398.85–$2,339.92	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,806.60	$3,011.00	$451.65–$2,649.68	63% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,806.60	$3,011.00	$451.65–$2,649.68	63% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$1,806.60	$3,011.00	$451.65–$2,649.68	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD W/IV CONTRAST	$1,577.40	$2,629.00	$394.35–$2,313.52	15% above	40%
CT scan of the head with contrast CPT 70460 CT HEAD W/IV CONTRAST	$1,577.40	$2,629.00	$394.35–$2,313.52	15% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/IV CONTRAST	$1,577.40	$2,629.00	$394.35–$2,313.52	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST	$2,240.40	$3,734.00	$542.00–$3,285.92	38% above	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST	$2,240.40	$3,734.00	$542.00–$3,285.92	38% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST	$2,240.40	$3,734.00	$542.00–$3,285.92	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$2,088.60	$3,481.00	$522.15–$3,063.28	51% above	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$2,088.60	$3,481.00	$522.15–$3,063.28	51% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST	$2,088.60	$3,481.00	$522.15–$3,063.28	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO CONTRAST	$2,537.40	$4,229.00	$542.00–$3,721.52	74% above	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO CONTRAST	$2,537.40	$4,229.00	$542.00–$3,721.52	74% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO CONTRAST	$2,537.40	$4,229.00	$542.00–$3,721.52	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$2,357.40	$3,929.00	$542.00–$3,457.52	71% above	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$2,357.40	$3,929.00	$542.00–$3,457.52	71% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$2,357.40	$3,929.00	$542.00–$3,457.52	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID ART DUPLX BIL COMPL	$889.20	$1,482.00	$222.30–$1,304.16	2% above	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID ART DUPLX BIL COMPL	$889.20	$1,482.00	$222.30–$1,304.16	2% above	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID ART DUPLX BIL COMPL	$889.20	$1,482.00	$222.30–$1,304.16	—	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST	$2,899.80	$4,833.00	$542.00–$4,253.04	75% above	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST	$2,899.80	$4,833.00	$542.00–$4,253.04	75% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST	$2,899.80	$4,833.00	$542.00–$4,253.04	—	40%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$251.40	$419.00	$62.85–$368.72	1% below	40%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$251.40	$419.00	$62.85–$368.72	1% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$251.40	$419.00	$62.85–$368.72	—	40%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$213.60	$356.00	$53.40–$313.28	7% above	40%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$213.60	$356.00	$53.40–$313.28	7% above	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$213.60	$356.00	$53.40–$313.28	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X RAY COLLARBONE RT	$294.00	$490.00	$73.50–$431.20	8% above	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X RAY COLLARBONE RT	$294.00	$490.00	$73.50–$431.20	8% above	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X RAY COLLARBONE LT	$294.00	$490.00	$73.50–$431.20	8% above	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X RAY COLLARBONE LT	$294.00	$490.00	$73.50–$431.20	8% above	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X RAY COLLARBONE LT	$294.00	$490.00	$73.50–$431.20	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X RAY COLLARBONE RT	$294.00	$490.00	$73.50–$431.20	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL/RETROPERITONEAL COMP	$581.40	$969.00	$145.35–$852.72	at median	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL/RETROPERITONEAL COMP	$581.40	$969.00	$145.35–$852.72	at median	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL/RETROPERITONEAL COMP	$581.40	$969.00	$145.35–$852.72	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$579.60	$966.00	$144.90–$850.08	80% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$579.60	$966.00	$144.90–$850.08	80% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$579.60	$966.00	$144.90–$850.08	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL	$89.40	$149.00	$22.35–$131.12	56% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL	$89.40	$149.00	$22.35–$131.12	56% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY/PERIPHERAL	$89.40	$149.00	$22.35–$131.12	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$2,011.80	$3,353.00	$502.95–$2,950.64	87% above	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$2,011.80	$3,353.00	$502.95–$2,950.64	87% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$2,011.80	$3,353.00	$502.95–$2,950.64	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$2,422.80	$4,038.00	$542.00–$3,553.44	76% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$2,422.80	$4,038.00	$542.00–$3,553.44	76% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST	$2,422.80	$4,038.00	$542.00–$3,553.44	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$567.60	$946.00	$120.00–$832.48	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$567.60	$946.00	$120.00–$832.48	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$567.60	$946.00	$120.00–$832.48	—	40%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI RT	$479.40	$799.00	$119.85–$703.12	108% above	40%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI RT	$479.40	$799.00	$119.85–$703.12	108% above	40%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI LT	$479.40	$799.00	$119.85–$703.12	108% above	40%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI LT	$479.40	$799.00	$119.85–$703.12	108% above	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI LT	$479.40	$799.00	$119.85–$703.12	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI RT	$479.40	$799.00	$119.85–$703.12	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL DOPPLER LEG BILAT	$755.40	$1,259.00	$188.85–$1,107.92	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL DOPPLER LEG BILAT	$755.40	$1,259.00	$188.85–$1,107.92	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL DOPPLER LEG BILAT	$755.40	$1,259.00	$188.85–$1,107.92	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEN DOP EXT BILAT	$859.20	$1,432.00	$214.80–$1,260.16	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEN DOP EXT BILAT	$859.20	$1,432.00	$214.80–$1,260.16	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEN DOP EXT BILAT	$859.20	$1,432.00	$214.80–$1,260.16	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMP W DOPPLER & COLOR	$2,376.60	$3,961.00	$594.15–$3,485.68	39% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMP W DOPPLER & COLOR	$2,376.60	$3,961.00	$594.15–$3,485.68	39% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMP W DOPPLER & COLOR	$2,376.60	$3,961.00	$594.15–$3,485.68	—	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$255.00	$425.00	$63.75–$374.00	6% above	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$255.00	$425.00	$63.75–$374.00	6% above	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$255.00	$425.00	$63.75–$374.00	6% above	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$255.00	$425.00	$63.75–$374.00	6% above	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS LT	$255.00	$425.00	$63.75–$374.00	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS RT	$255.00	$425.00	$63.75–$374.00	—	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMP MIN 3 VIEWS RT	$333.00	$555.00	$83.25–$488.40	at median	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMP MIN 3 VIEWS LT	$333.00	$555.00	$83.25–$488.40	at median	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMP MIN 3 VIEWS LT	$333.00	$555.00	$83.25–$488.40	at median	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMP MIN 3 VIEWS RT	$333.00	$555.00	$83.25–$488.40	at median	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW COMP MIN 3 VIEWS LT	$333.00	$555.00	$83.25–$488.40	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW COMP MIN 3 VIEWS RT	$333.00	$555.00	$83.25–$488.40	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA POS WO CONTRAST	$1,636.20	$2,727.00	$409.05–$2,399.76	54% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA POS WO CONTRAST	$1,636.20	$2,727.00	$409.05–$2,399.76	54% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA POS WO CONTRAST	$1,636.20	$2,727.00	$409.05–$2,399.76	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMP MIN 3 VWS	$432.60	$721.00	$108.15–$634.48	20% above	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMP MIN 3 VWS	$432.60	$721.00	$108.15–$634.48	20% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMP MIN 3 VWS	$432.60	$721.00	$108.15–$634.48	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$285.60	$476.00	$71.40–$418.88	at median	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$285.60	$476.00	$71.40–$418.88	at median	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$285.60	$476.00	$71.40–$418.88	at median	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$285.60	$476.00	$71.40–$418.88	at median	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT	$285.60	$476.00	$71.40–$418.88	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT	$285.60	$476.00	$71.40–$418.88	—	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT	$213.60	$356.00	$53.40–$313.28	5% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT	$213.60	$356.00	$53.40–$313.28	5% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT	$213.60	$356.00	$53.40–$313.28	5% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT	$213.60	$356.00	$53.40–$313.28	5% below	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT	$213.60	$356.00	$53.40–$313.28	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT	$213.60	$356.00	$53.40–$313.28	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEOUS MIN 2 VIEWS LT	$285.60	$476.00	$71.40–$418.88	11% above	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEOUS MIN 2 VIEWS RT	$285.60	$476.00	$71.40–$418.88	11% above	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEOUS MIN 2 VIEWS LT	$285.60	$476.00	$71.40–$418.88	11% above	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEOUS MIN 2 VIEWS RT	$285.60	$476.00	$71.40–$418.88	11% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEOUS MIN 2 VIEWS RT	$285.60	$476.00	$71.40–$418.88	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEOUS MIN 2 VIEWS LT	$285.60	$476.00	$71.40–$418.88	—	40%
Knee X-ray, 3 views one side CPT 73562 XR PATELLA LT 3 VIEWS	$231.60	$386.00	$57.90–$339.68	27% below	40%
Knee X-ray, 3 views one side CPT 73562 XR PATELLA LT 3 VIEWS	$231.60	$386.00	$57.90–$339.68	27% below	40%
Knee X-ray, 3 views one side CPT 73562 XR PATELLA RT 3 VIEWS	$231.60	$386.00	$57.90–$339.68	27% below	40%
Knee X-ray, 3 views one side CPT 73562 XR PATELLA RT 3 VIEWS	$231.60	$386.00	$57.90–$339.68	27% below	40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR PATELLA LT 3 VIEWS	$231.60	$386.00	$57.90–$339.68	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR PATELLA RT 3 VIEWS	$231.60	$386.00	$57.90–$339.68	—	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE COMP 4 OR MORE VIEW LT	$364.80	$608.00	$91.20–$535.04	at median	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 OR MORE VIEW RT	$364.80	$608.00	$91.20–$535.04	at median	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE COMP 4 OR MORE VIEW LT	$364.80	$608.00	$91.20–$535.04	at median	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 OR MORE VIEW RT	$364.80	$608.00	$91.20–$535.04	at median	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE COMP 4 OR MORE VIEW LT	$364.80	$608.00	$91.20–$535.04	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4 OR MORE VIEW RT	$364.80	$608.00	$91.20–$535.04	—	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXTREMITY WO CON RT	$1,463.40	$2,439.00	$365.85–$2,146.32	30% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXTREMITY WO CON RT	$1,463.40	$2,439.00	$365.85–$2,146.32	30% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXTREMITY WO CON LT	$1,463.40	$2,439.00	$365.85–$2,146.32	30% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXTREMITY WO CON LT	$1,463.40	$2,439.00	$365.85–$2,146.32	30% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXTREMITY WO CON LT	$1,463.40	$2,439.00	$365.85–$2,146.32	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXTREMITY WO CON RT	$1,463.40	$2,439.00	$365.85–$2,146.32	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED OR LOWER BACK	$664.20	$1,107.00	$166.05–$974.16	16% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED OR LOWER BACK	$664.20	$1,107.00	$166.05–$974.16	16% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED OR LOWER BACK	$664.20	$1,107.00	$166.05–$974.16	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NON-VASC LIM BIL	$299.40	$499.00	$74.85–$439.12	11% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NON-VASC LIM BIL	$299.40	$499.00	$74.85–$439.12	11% above	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NON-VASC LIM RT	$149.40	$249.00	$37.35–$219.12	44% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NON-VASC LIM RT	$149.40	$249.00	$37.35–$219.12	44% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NON-VASC LIM BIL	$299.40	$499.00	$74.85–$439.12	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NON-VASC LIM RT	$149.40	$249.00	$37.35–$219.12	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LDCT FOR LUNG CA SCREENING	$2,011.80	$3,353.00	$502.95–$2,950.64	313% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LDCT FOR LUNG CA SCREENING	$2,011.80	$3,353.00	$502.95–$2,950.64	313% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LDCT FOR LUNG CA SCREENING	$2,011.80	$3,353.00	$502.95–$2,950.64	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA 2 VIEWS RT	$301.20	$502.00	$75.30–$441.76	1% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA 2 VIEWS LT	$301.20	$502.00	$75.30–$441.76	1% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA 2 VIEWS RT	$301.20	$502.00	$75.30–$441.76	1% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA 2 VIEWS LT	$301.20	$502.00	$75.30–$441.76	1% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA FIBULA 2 VIEWS RT	$301.20	$502.00	$75.30–$441.76	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA FIBULA 2 VIEWS LT	$301.20	$502.00	$75.30–$441.76	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOW EXT JNT WO CON LT	$3,205.20	$5,342.00	$760.00–$4,700.96	112% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOW EXT JNT WO CON LT	$3,205.20	$5,342.00	$760.00–$4,700.96	112% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOW EXT JNT WO CON RT	$3,205.20	$5,342.00	$760.00–$4,700.96	112% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOW EXT JNT WO CON RT	$3,205.20	$5,342.00	$760.00–$4,700.96	112% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LOW EXT JNT WO CON RT	$3,205.20	$5,342.00	$760.00–$4,700.96	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LOW EXT JNT WO CON LT	$3,205.20	$5,342.00	$760.00–$4,700.96	—	40%
MRI of the brain, no contrast dye CPT 70551 MR HEAD W/O CONTRAST	$3,205.20	$5,342.00	$760.00–$4,700.96	83% above	40%
MRI of the brain, no contrast dye CPT 70551 MR HEAD W/O CONTRAST	$3,205.20	$5,342.00	$760.00–$4,700.96	83% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR HEAD W/O CONTRAST	$3,205.20	$5,342.00	$760.00–$4,700.96	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MR HEAD W/WO CONTRAST	$4,602.60	$7,671.00	$760.00–$6,750.48	102% above	40%
MRI of the brain, with and without contrast dye CPT 70553 MR HEAD W/WO CONTRAST	$4,602.60	$7,671.00	$760.00–$6,750.48	102% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR HEAD W/WO CONTRAST	$4,602.60	$7,671.00	$760.00–$6,750.48	—	40%
MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR SPINE W/O CONTRAST	$3,053.40	$5,089.00	$760.00–$4,478.32	77% above	40%
MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR SPINE W/O CONTRAST	$3,053.40	$5,089.00	$760.00–$4,478.32	77% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR LUMBAR SPINE W/O CONTRAST	$3,053.40	$5,089.00	$760.00–$4,478.32	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC W/O CONTRAST	$3,205.20	$5,342.00	$760.00–$4,700.96	74% above	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC W/O CONTRAST	$3,205.20	$5,342.00	$760.00–$4,700.96	74% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC W/O CONTRAST	$3,205.20	$5,342.00	$760.00–$4,700.96	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C-SPINE W/O CONTRAST	$3,052.20	$5,087.00	$760.00–$4,476.56	88% above	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C-SPINE W/O CONTRAST	$3,052.20	$5,087.00	$760.00–$4,476.56	88% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C-SPINE W/O CONTRAST	$3,052.20	$5,087.00	$760.00–$4,476.56	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT JNT WO CON RT	$3,205.20	$5,342.00	$760.00–$4,700.96	83% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT JNT WO CON LT	$3,205.20	$5,342.00	$760.00–$4,700.96	83% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT JNT WO CON LT	$3,205.20	$5,342.00	$760.00–$4,700.96	83% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT JNT WO CON RT	$3,205.20	$5,342.00	$760.00–$4,700.96	83% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UP EXT JNT WO CON RT	$3,205.20	$5,342.00	$760.00–$4,700.96	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UP EXT JNT WO CON LT	$3,205.20	$5,342.00	$760.00–$4,700.96	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C SPINE 4-5 VIEWS	$445.80	$743.00	$111.45–$653.84	1% above	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C SPINE 4-5 VIEWS	$445.80	$743.00	$111.45–$653.84	1% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR C SPINE 4-5 VIEWS	$445.80	$743.00	$111.45–$653.84	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$2,067.60	$3,446.00	$516.90–$3,032.48	54% above	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$2,067.60	$3,446.00	$516.90–$3,032.48	54% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$2,067.60	$3,446.00	$516.90–$3,032.48	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SFT TISSUE NECK WO CNTRST	$1,636.20	$2,727.00	$409.05–$2,399.76	41% above	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SFT TISSUE NECK WO CNTRST	$1,636.20	$2,727.00	$409.05–$2,399.76	41% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SFT TISSUE NECK WO CNTRST	$1,636.20	$2,727.00	$409.05–$2,399.76	—	40%
Neck soft tissue X-ray CPT 70360 XR SOFT TISSUE NECK	$265.80	$443.00	$66.45–$389.84	4% above	40%
Neck soft tissue X-ray CPT 70360 XR SOFT TISSUE NECK	$265.80	$443.00	$66.45–$389.84	4% above	40%
Neck soft tissue X-ray inpatient CPT 70360 XR SOFT TISSUE NECK	$265.80	$443.00	$66.45–$389.84	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO ORAL+IV CONTRAST	$1,700.40	$2,834.00	$425.10–$2,493.92	60% above	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO ORAL+IV CONTRAST	$1,700.40	$2,834.00	$425.10–$2,493.92	60% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO ORAL+IV CONTRAST	$1,700.40	$2,834.00	$425.10–$2,493.92	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON OB LIMITED	$637.20	$1,062.00	$159.30–$934.56	68% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON OB LIMITED	$637.20	$1,062.00	$159.30–$934.56	68% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON OB LIMITED	$637.20	$1,062.00	$159.30–$934.56	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PLVC NON OB REAL TIME COMP	$918.60	$1,531.00	$229.65–$1,347.28	22% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PLVC NON OB REAL TIME COMP	$918.60	$1,531.00	$229.65–$1,347.28	22% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PLVC NON OB REAL TIME COMP	$918.60	$1,531.00	$229.65–$1,347.28	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMEST SINGLE GEST	$809.40	$1,349.00	$202.35–$1,187.12	37% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMEST SINGLE GEST	$809.40	$1,349.00	$202.35–$1,187.12	37% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMEST SINGLE GEST	$809.40	$1,349.00	$202.35–$1,187.12	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED 1 OR MORE FETUS	$643.20	$1,072.00	$160.80–$943.36	23% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED 1 OR MORE FETUS	$643.20	$1,072.00	$160.80–$943.36	23% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED 1 OR MORE FETUS	$643.20	$1,072.00	$160.80–$943.36	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILAT 2 VIEWS	$383.40	$639.00	$95.85–$562.32	22% above	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILAT 2 VIEWS	$383.40	$639.00	$95.85–$562.32	22% above	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNILAT 2 VIEWS	$383.40	$639.00	$95.85–$562.32	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 XR RIBS UNI 3V W/PA CHEST	$468.60	$781.00	$117.15–$687.28	34% above	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 XR RIBS UNI 3V W/PA CHEST	$468.60	$781.00	$117.15–$687.28	34% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 XR RIBS UNI 3V W/PA CHEST	$468.60	$781.00	$117.15–$687.28	—	40%
Screening mammogram, both breasts CPT 77067 MM MAMMGM SPCL SCRN INCL CAD	$30.00	$50.00	$7.50–$120.00	82% below	40%
Screening mammogram, both breasts CPT 77067 MM MAMMGM SPCL SCRN INCL CAD	$30.00	$50.00	$7.50–$120.00	82% below	40%
Screening mammogram, both breasts CPT 77067 MM MAMMOGRAM SCRN BIL INCL CAD	$188.40	$314.00	$47.10–$276.32	14% above	40%
Screening mammogram, both breasts CPT 77067 MM MAMMOGRAM SCRN BIL INCL CAD	$188.40	$314.00	$47.10–$276.32	14% above	40%
Screening mammogram, both breasts inpatient CPT 77067 MM MAMMGM SPCL SCRN INCL CAD	$30.00	$50.00	$7.50–$120.00	—	40%
Screening mammogram, both breasts inpatient CPT 77067 MM MAMMOGRAM SCRN BIL INCL CAD	$188.40	$314.00	$47.10–$276.32	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP MIN 2VIEWS LT	$294.00	$490.00	$73.50–$431.20	3% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP MIN 2 V RT	$294.00	$490.00	$73.50–$431.20	3% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP MIN 2VIEWS LT	$294.00	$490.00	$73.50–$431.20	3% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP MIN 2 V RT	$294.00	$490.00	$73.50–$431.20	3% below	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COMP MIN 2VIEWS LT	$294.00	$490.00	$73.50–$431.20	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COMP MIN 2 V RT	$294.00	$490.00	$73.50–$431.20	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES COMP MIN 3 VIEWS	$477.00	$795.00	$119.25–$699.60	25% above	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES COMP MIN 3 VIEWS	$477.00	$795.00	$119.25–$699.60	25% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES COMP MIN 3 VIEWS	$477.00	$795.00	$119.25–$699.60	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL <4 VIEWS	$259.80	$433.00	$64.95–$381.04	4% below	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL <4 VIEWS	$259.80	$433.00	$64.95–$381.04	4% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL <4 VIEWS	$259.80	$433.00	$64.95–$381.04	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 VIEWS RT	$294.00	$490.00	$73.50–$431.20	at median	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 VIEWS RT	$294.00	$490.00	$73.50–$431.20	at median	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR MIN 2 VIEWS RT	$294.00	$490.00	$73.50–$431.20	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTRAST	$2,247.00	$3,745.00	$542.00–$3,295.60	79% above	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTRAST	$2,247.00	$3,745.00	$542.00–$3,295.60	79% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONTRAST	$2,247.00	$3,745.00	$542.00–$3,295.60	—	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) MIN 2 VIEWS LT	$173.40	$289.00	$43.35–$254.32	8% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) MIN 2 VIEWS LT	$173.40	$289.00	$43.35–$254.32	8% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) MIN 2 VIEWS RT	$173.40	$289.00	$43.35–$254.32	8% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) MIN 2 VIEWS RT	$173.40	$289.00	$43.35–$254.32	8% below	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) MIN 2 VIEWS LT	$173.40	$289.00	$43.35–$254.32	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) MIN 2 VIEWS RT	$173.40	$289.00	$43.35–$254.32	—	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB	$878.40	$1,464.00	$219.60–$1,288.32	32% above	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB	$878.40	$1,464.00	$219.60–$1,288.32	32% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON-OB	$878.40	$1,464.00	$219.60–$1,288.32	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL	$813.00	$1,355.00	$203.25–$1,192.40	62% above	40%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL	$813.00	$1,355.00	$203.25–$1,192.40	62% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL	$813.00	$1,355.00	$203.25–$1,192.40	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$815.40	$1,359.00	$203.85–$1,195.92	9% below	40%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$815.40	$1,359.00	$203.85–$1,195.92	9% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$815.40	$1,359.00	$203.85–$1,195.92	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$907.20	$1,512.00	$226.80–$1,330.56	43% above	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$907.20	$1,512.00	$226.80–$1,330.56	43% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$907.20	$1,512.00	$226.80–$1,330.56	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$723.60	$1,206.00	$180.90–$1,061.28	12% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$723.60	$1,206.00	$180.90–$1,061.28	12% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$723.60	$1,206.00	$180.90–$1,061.28	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS AP/LAT BIL	$589.20	$982.00	$147.30–$864.16	105% above	40%
Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS AP/LAT BIL	$589.20	$982.00	$147.30–$864.16	105% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS AP/LAT RT	$294.00	$490.00	$73.50–$431.20	2% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS AP/LAT RT	$294.00	$490.00	$73.50–$431.20	2% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS AP/LAT LT	$294.00	$490.00	$73.50–$431.20	2% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS AP/LAT LT	$294.00	$490.00	$73.50–$431.20	2% above	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS AP/LAT BIL	$589.20	$982.00	$147.30–$864.16	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS AP/LAT LT	$294.00	$490.00	$73.50–$431.20	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS AP/LAT RT	$294.00	$490.00	$73.50–$431.20	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOP EXT VEIN UNI/LIM RT	$721.20	$1,202.00	$180.30–$1,057.76	16% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOP EXT VEIN UNI/LIM LT	$721.20	$1,202.00	$180.30–$1,057.76	16% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOP EXT VEIN UNI/LIM LT	$721.20	$1,202.00	$180.30–$1,057.76	16% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOP EXT VEIN UNI/LIM RT	$721.20	$1,202.00	$180.30–$1,057.76	16% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOP EXT VEIN UNI/LIM LT	$721.20	$1,202.00	$180.30–$1,057.76	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOP EXT VEIN UNI/LIM RT	$721.20	$1,202.00	$180.30–$1,057.76	—	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST PA/LAT RT	$285.60	$476.00	$71.40–$418.88	36% above	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST PA/LAT LT	$285.60	$476.00	$71.40–$418.88	36% above	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST PA/LAT LT	$285.60	$476.00	$71.40–$418.88	36% above	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST PA/LAT RT	$285.60	$476.00	$71.40–$418.88	36% above	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST PA/LAT RT	$285.60	$476.00	$71.40–$418.88	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST PA/LAT LT	$285.60	$476.00	$71.40–$418.88	—	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP MIN 3 VIEWS RT	$331.20	$552.00	$82.80–$485.76	5% above	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP MIN 3 VIEWS LT	$331.20	$552.00	$82.80–$485.76	5% above	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP MIN 3 VIEWS RT	$331.20	$552.00	$82.80–$485.76	5% above	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP MIN 3 VIEWS LT	$331.20	$552.00	$82.80–$485.76	5% above	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP MIN 3 VIEWS RT	$331.20	$552.00	$82.80–$485.76	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP MIN 3 VIEWS LT	$331.20	$552.00	$82.80–$485.76	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNI 2-3V W PLVS RT	$234.00	$390.00	$58.50–$343.20	2% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNI 2-3V W PLVS RT	$234.00	$390.00	$58.50–$343.20	2% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNI 2-3V W PLVS RT	$234.00	$390.00	$58.50–$343.20	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABD 1 VIEW	$294.00	$490.00	$73.50–$431.20	12% above	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABD 1 VIEW	$294.00	$490.00	$73.50–$431.20	12% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD 1 VIEW	$294.00	$490.00	$73.50–$431.20	—	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$265.80	$443.00	$66.45–$389.84	12% above	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$265.80	$443.00	$66.45–$389.84	12% above	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$265.80	$443.00	$66.45–$389.84	12% above	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$265.80	$443.00	$66.45–$389.84	12% above	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT	$265.80	$443.00	$66.45–$389.84	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT	$265.80	$443.00	$66.45–$389.84	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS MIN 2 VIEWS RT	$238.20	$397.00	$59.55–$349.36	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS MIN 2 VIEWS LT	$238.20	$397.00	$59.55–$349.36	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS MIN 2 VIEWS RT	$238.20	$397.00	$59.55–$349.36	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS MIN 2 VIEWS LT	$238.20	$397.00	$59.55–$349.36	2% above	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS MIN 2 VIEWS RT	$238.20	$397.00	$59.55–$349.36	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS MIN 2 VIEWS LT	$238.20	$397.00	$59.55–$349.36	—	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$231.60	$386.00	$57.90–$339.68	3% above	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$231.60	$386.00	$57.90–$339.68	3% above	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$231.60	$386.00	$57.90–$339.68	3% above	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$231.60	$386.00	$57.90–$339.68	3% above	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT	$231.60	$386.00	$57.90–$339.68	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT	$231.60	$386.00	$57.90–$339.68	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP MIN 3 VIEWS LT	$301.20	$502.00	$75.30–$441.76	2% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP MIN 3 VIEWS LT	$301.20	$502.00	$75.30–$441.76	2% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP MIN 3 VIEWS RT	$301.20	$502.00	$75.30–$441.76	2% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP MIN 3 VIEWS RT	$301.20	$502.00	$75.30–$441.76	2% below	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP MIN 3 VIEWS LT	$301.20	$502.00	$75.30–$441.76	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP MIN 3 VIEWS RT	$301.20	$502.00	$75.30–$441.76	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMP MIN 3 VIEWS RT	$300.60	$501.00	$75.15–$440.88	1% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMP MIN 3 VIEWS LT	$300.60	$501.00	$75.15–$440.88	1% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMP MIN 3 VIEWS LT	$300.60	$501.00	$75.15–$440.88	1% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMP MIN 3 VIEWS RT	$300.60	$501.00	$75.15–$440.88	1% below	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND COMP MIN 3 VIEWS LT	$300.60	$501.00	$75.15–$440.88	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND COMP MIN 3 VIEWS RT	$300.60	$501.00	$75.15–$440.88	—	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEWS LT	$205.80	$343.00	$51.45–$301.84	14% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEWS LT	$205.80	$343.00	$51.45–$301.84	14% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEWS RT	$205.80	$343.00	$51.45–$301.84	14% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEWS RT	$205.80	$343.00	$51.45–$301.84	14% below	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEWS RT	$205.80	$343.00	$51.45–$301.84	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEWS LT	$205.80	$343.00	$51.45–$301.84	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2-3 VIEWS	$348.00	$580.00	$87.00–$510.40	3% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2-3 VIEWS	$348.00	$580.00	$87.00–$510.40	3% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2-3 VIEWS	$348.00	$580.00	$87.00–$510.40	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE MIN 4 VIEW	$583.20	$972.00	$145.80–$855.36	17% above	40%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE MIN 4 VIEW	$583.20	$972.00	$145.80–$855.36	17% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE MIN 4 VIEW	$583.20	$972.00	$145.80–$855.36	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS	$315.00	$525.00	$78.75–$462.00	at median	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS	$315.00	$525.00	$78.75–$462.00	at median	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS	$315.00	$525.00	$78.75–$462.00	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3 VIEWS	$294.00	$490.00	$73.50–$431.20	at median	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3 VIEWS	$294.00	$490.00	$73.50–$431.20	at median	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MIN 3 VIEWS	$294.00	$490.00	$73.50–$431.20	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS	$333.00	$555.00	$83.25–$488.40	5% above	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS	$333.00	$555.00	$83.25–$488.40	5% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE 2-3 VIEWS	$333.00	$555.00	$83.25–$488.40	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VIEWS	$294.00	$490.00	$73.50–$431.20	5% above	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VIEWS	$294.00	$490.00	$73.50–$431.20	5% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2 VIEWS	$294.00	$490.00	$73.50–$431.20	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM & COCCYX MIN 2 VIEW	$333.00	$555.00	$83.25–$488.40	13% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM & COCCYX MIN 2 VIEW	$333.00	$555.00	$83.25–$488.40	13% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM & COCCYX MIN 2 VIEW	$333.00	$555.00	$83.25–$488.40	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Kentucky	Off list
ACTH blood test CPT 82024 ACTH	$663.00	$1,105.00	$165.75–$972.40	235% above	40%
ACTH blood test CPT 82024 ACTH	$663.00	$1,105.00	$165.75–$972.40	235% above	40%
ACTH blood test inpatient CPT 82024 ACTH	$663.00	$1,105.00	$165.75–$972.40	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$135.60	$226.00	$5.30–$198.88	115% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$135.60	$226.00	$5.30–$198.88	115% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$135.60	$226.00	$5.30–$198.88	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$130.80	$218.00	$5.18–$191.84	110% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$130.80	$218.00	$5.18–$191.84	110% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$130.80	$218.00	$5.18–$191.84	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL	$388.80	$648.00	$97.20–$570.24	72% above	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL	$388.80	$648.00	$97.20–$570.24	72% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL	$388.80	$648.00	$97.20–$570.24	—	40%
Albumin blood test CPT 82040 ALBUMIN SERUM	$110.40	$184.00	$4.95–$161.92	90% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM	$110.40	$184.00	$4.95–$161.92	90% above	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$110.40	$184.00	$4.95–$161.92	—	40%
Aldosterone blood test CPT 82088 ALDOSTERONE 24H UR	$87.00	$145.00	$21.75–$127.60	30% below	40%
Aldosterone blood test CPT 82088 ALDOSTERONE 24H UR	$87.00	$145.00	$21.75–$127.60	30% below	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24H UR	$87.00	$145.00	$21.75–$127.60	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$95.40	$159.00	$5.18–$139.92	66% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$95.40	$159.00	$5.18–$139.92	66% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$95.40	$159.00	$5.18–$139.92	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE EACH	$10.20	$17.00	$2.25–$14.96	at median	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE EACH	$10.20	$17.00	$2.25–$14.96	at median	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE EACH	$10.20	$17.00	$2.25–$14.96	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SING MARKER SCRN MAT REF	$202.20	$337.00	$50.55–$296.56	128% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SING MARKER SCRN MAT REF	$202.20	$337.00	$50.55–$296.56	128% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SING MARKER SCRN MATERNAL	$202.20	$337.00	$50.55–$296.56	128% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SING MARKER SCRN MATERNAL	$202.20	$337.00	$50.55–$296.56	128% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SING MARKER SCRN MAT REF	$202.20	$337.00	$50.55–$296.56	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SING MARKER SCRN MATERNAL	$202.20	$337.00	$50.55–$296.56	—	40%
Ammonia blood test CPT 82140 AMMONIUM	$239.40	$399.00	$59.85–$351.12	138% above	40%
Ammonia blood test CPT 82140 AMMONIUM	$239.40	$399.00	$59.85–$351.12	138% above	40%
Ammonia blood test inpatient CPT 82140 AMMONIUM	$239.40	$399.00	$59.85–$351.12	—	40%
Amylase blood test CPT 82150 AMYLASE-AMB	$51.00	$85.00	$6.48–$74.80	26% below	40%
Amylase blood test CPT 82150 AMYLASE-AMB	$51.00	$85.00	$6.48–$74.80	26% below	40%
Amylase blood test CPT 82150 AMYLASE	$412.80	$688.00	$6.48–$605.44	499% above	40%
Amylase blood test CPT 82150 AMYLASE	$412.80	$688.00	$6.48–$605.44	499% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE-AMB	$51.00	$85.00	$6.48–$74.80	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$412.80	$688.00	$6.48–$605.44	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS	$137.40	$229.00	$34.35–$201.52	84% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS REF	$137.40	$229.00	$34.35–$201.52	84% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS	$137.40	$229.00	$34.35–$201.52	84% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS REF	$137.40	$229.00	$34.35–$201.52	84% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ABS	$137.40	$229.00	$34.35–$201.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ABS REF	$137.40	$229.00	$34.35–$201.52	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$310.20	$517.00	$77.55–$454.96	349% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$310.20	$517.00	$77.55–$454.96	349% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES REF	$310.20	$517.00	$77.55–$454.96	349% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES REF	$310.20	$517.00	$77.55–$454.96	349% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES REF	$310.20	$517.00	$77.55–$454.96	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$310.20	$517.00	$77.55–$454.96	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$230.40	$384.00	$39.26–$337.92	33% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$230.40	$384.00	$39.26–$337.92	33% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$230.40	$384.00	$39.26–$337.92	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTH SPECIMEN AEROBIC	$186.60	$311.00	$46.65–$273.68	83% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTH SPECIMEN AEROBIC	$186.60	$311.00	$46.65–$273.68	83% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTH SPECIMEN AEROBIC	$186.60	$311.00	$46.65–$273.68	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$148.80	$248.00	$8.46–$218.24	78% above	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$148.80	$248.00	$8.46–$218.24	78% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$148.80	$248.00	$8.46–$218.24	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN BODY FLUID	$135.60	$226.00	$5.02–$198.88	170% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN BODY FLUID	$135.60	$226.00	$5.02–$198.88	170% above	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN BODY FLUID	$135.60	$226.00	$5.02–$198.88	—	40%
Blood culture for bacteria CPT 87040 CULT BLOOD	$208.20	$347.00	$52.05–$305.36	86% above	40%
Blood culture for bacteria CPT 87040 CULT BLOOD	$208.20	$347.00	$52.05–$305.36	86% above	40%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD	$208.20	$347.00	$52.05–$305.36	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ED	$22.80	$38.00	$5.70–$33.44	41% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$22.80	$38.00	$5.70–$33.44	41% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ED	$22.80	$38.00	$5.70–$33.44	41% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$22.80	$38.00	$5.70–$33.44	41% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$22.80	$38.00	$5.70–$33.44	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ED	$22.80	$38.00	$5.70–$33.44	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD	$130.80	$218.00	$3.93–$191.84	290% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD	$130.80	$218.00	$3.93–$191.84	290% above	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD	$130.80	$218.00	$3.93–$191.84	—	40%
Blood lead test CPT 83655 LEAD	$181.20	$302.00	$12.11–$265.76	186% above	40%
Blood lead test CPT 83655 LEAD	$181.20	$302.00	$12.11–$265.76	186% above	40%
Blood lead test inpatient CPT 83655 LEAD	$181.20	$302.00	$12.11–$265.76	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM QUAL	$132.60	$221.00	$7.52–$194.48	55% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM QUAL	$132.60	$221.00	$7.52–$194.48	55% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM QUAL	$132.60	$221.00	$7.52–$194.48	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE	$70.20	$117.00	$17.55–$102.96	21% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE	$70.20	$117.00	$17.55–$102.96	21% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPE	$70.20	$117.00	$17.55–$102.96	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN SERUM	$82.20	$137.00	$3.95–$120.56	81% above	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN SERUM	$82.20	$137.00	$3.95–$120.56	81% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN SERUM	$82.20	$137.00	$3.95–$120.56	—	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$218.40	$364.00	$54.60–$320.32	59% above	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$218.40	$364.00	$54.60–$320.32	59% above	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$218.40	$364.00	$54.60–$320.32	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$116.40	$194.00	$29.10–$170.72	114% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$116.40	$194.00	$29.10–$170.72	114% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$116.40	$194.00	$29.10–$170.72	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 EPI STRAIN	$54.60	$91.00	$13.65–$80.08	45% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 EPI STRAIN	$54.60	$91.00	$13.65–$80.08	45% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF AMPLIFIED PROBE	$85.20	$142.00	$21.30–$124.96	15% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF AMPLIFIED PROBE	$85.20	$142.00	$21.30–$124.96	15% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 EPI STRAIN	$54.60	$91.00	$13.65–$80.08	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDIFF AMPLIFIED PROBE	$85.20	$142.00	$21.30–$124.96	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 (FLUID)	$699.60	$1,166.00	$174.90–$1,026.08	466% above	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 (FLUID)	$699.60	$1,166.00	$174.90–$1,026.08	466% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 (FLUID)	$699.60	$1,166.00	$174.90–$1,026.08	—	40%
Calcium blood test, total CPT 82310 CALCIUM	$95.40	$159.00	$5.16–$139.92	109% above	40%
Calcium blood test, total CPT 82310 CALCIUM	$95.40	$159.00	$5.16–$139.92	109% above	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$95.40	$159.00	$5.16–$139.92	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA SERUM	$512.40	$854.00	$128.10–$751.52	318% above	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA SERUM	$512.40	$854.00	$128.10–$751.52	318% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA SERUM	$512.40	$854.00	$128.10–$751.52	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB QNT IGM	$297.00	$495.00	$74.25–$435.60	200% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB QNT IGM	$297.00	$495.00	$74.25–$435.60	200% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB QNT IGM	$297.00	$495.00	$74.25–$435.60	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$272.40	$454.00	$13.39–$399.52	139% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$272.40	$454.00	$13.39–$399.52	139% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$272.40	$454.00	$13.39–$399.52	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED W/DIFF	$82.20	$137.00	$7.77–$120.56	43% above	40%
Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED W/DIFF	$82.20	$137.00	$7.77–$120.56	43% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTOMATED W/DIFF	$82.20	$137.00	$7.77–$120.56	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$64.20	$107.00	$16.05–$94.16	11% above	40%
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$64.20	$107.00	$16.05–$94.16	11% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTOMATED	$64.20	$107.00	$16.05–$94.16	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$172.80	$288.00	$10.56–$253.44	40% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$172.80	$288.00	$10.56–$253.44	40% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$172.80	$288.00	$10.56–$253.44	—	40%
Cortisol blood test, total CPT 82533 CORTISOL SALIVARY	$49.80	$83.00	$12.45–$73.04	37% below	40%
Cortisol blood test, total CPT 82533 CORTISOL SALIVARY	$49.80	$83.00	$12.45–$73.04	37% below	40%
Cortisol blood test, total CPT 82533 CORTISOL SERUM	$216.60	$361.00	$54.15–$317.68	174% above	40%
Cortisol blood test, total CPT 82533 CORTISOL SERUM	$216.60	$361.00	$54.15–$317.68	174% above	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SALIVARY	$49.80	$83.00	$12.45–$73.04	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM	$216.60	$361.00	$54.15–$317.68	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$93.60	$156.00	$6.51–$137.28	37% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$93.60	$156.00	$6.51–$137.28	37% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$93.60	$156.00	$6.51–$137.28	—	40%
Creatinine blood test CPT 82565 CREATININE	$100.20	$167.00	$5.12–$146.96	135% above	40%
Creatinine blood test CPT 82565 CREATININE	$100.20	$167.00	$5.12–$146.96	135% above	40%
Creatinine blood test inpatient CPT 82565 CREATININE	$100.20	$167.00	$5.12–$146.96	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS (CMV)	$91.20	$152.00	$22.80–$133.76	39% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS (CMV)	$91.20	$152.00	$22.80–$133.76	39% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS (CMV)	$91.20	$152.00	$22.80–$133.76	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$322.80	$538.00	$80.70–$473.44	155% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$322.80	$538.00	$80.70–$473.44	155% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$322.80	$538.00	$80.70–$473.44	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL URINE	$47.40	$79.00	$11.85–$69.52	2% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL URINE	$47.40	$79.00	$11.85–$69.52	2% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 10 W/CONF SERUM	$101.40	$169.00	$25.35–$148.72	118% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 10 W/CONF SERUM	$101.40	$169.00	$25.35–$148.72	118% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANALYZR	$124.20	$207.00	$31.05–$182.16	166% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLY REF	$124.20	$207.00	$31.05–$182.16	166% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANALYZR	$124.20	$207.00	$31.05–$182.16	166% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLY REF	$124.20	$207.00	$31.05–$182.16	166% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$220.80	$368.00	$55.20–$323.84	374% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$220.80	$368.00	$55.20–$323.84	374% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL URINE	$47.40	$79.00	$11.85–$69.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 10 W/CONF SERUM	$101.40	$169.00	$25.35–$148.72	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANALYZR	$124.20	$207.00	$31.05–$182.16	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLY REF	$124.20	$207.00	$31.05–$182.16	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$220.80	$368.00	$55.20–$323.84	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EB VIRUS AB IGM	$67.80	$113.00	$16.95–$99.44	18% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EB VIRUS AB IGM	$67.80	$113.00	$16.95–$99.44	18% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VIRUS AB IGM	$67.80	$113.00	$16.95–$99.44	—	40%
Estradiol blood test CPT 82670 ESTRADIOL	$223.20	$372.00	$55.80–$327.36	65% above	40%
Estradiol blood test CPT 82670 ESTRADIOL	$223.20	$372.00	$55.80–$327.36	65% above	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$223.20	$372.00	$55.80–$327.36	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$316.20	$527.00	$18.58–$463.76	91% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$316.20	$527.00	$18.58–$463.76	91% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$316.20	$527.00	$18.58–$463.76	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$542.40	$904.00	$135.60–$795.52	163% above	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$542.40	$904.00	$135.60–$795.52	163% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$542.40	$904.00	$135.60–$795.52	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$271.80	$453.00	$67.95–$398.64	157% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$271.80	$453.00	$67.95–$398.64	157% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$271.80	$453.00	$67.95–$398.64	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN PLASMA	$155.40	$259.00	$38.85–$227.92	81% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN PLASMA	$155.40	$259.00	$38.85–$227.92	81% above	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN PLASMA	$155.40	$259.00	$38.85–$227.92	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$301.20	$502.00	$0.90–$441.76	206% above	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$301.20	$502.00	$0.90–$441.76	206% above	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$301.20	$502.00	$0.90–$441.76	—	40%
Free T3 thyroid hormone test CPT 84481 T3 FREE WO TOTAL T3	$388.80	$648.00	$97.20–$570.24	213% above	40%
Free T3 thyroid hormone test CPT 84481 T3 FREE WO TOTAL T3	$388.80	$648.00	$97.20–$570.24	213% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE WO TOTAL T3	$388.80	$648.00	$97.20–$570.24	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE WO TOTAL T4	$208.20	$347.00	$52.05–$305.36	179% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE WO TOTAL T4	$208.20	$347.00	$52.05–$305.36	179% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE WO TOTAL T4	$208.20	$347.00	$52.05–$305.36	—	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$58.20	$97.00	$14.55–$85.36	23% below	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$58.20	$97.00	$14.55–$85.36	23% below	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$58.20	$97.00	$14.55–$85.36	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$135.60	$226.00	$7.20–$198.88	151% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$135.60	$226.00	$7.20–$198.88	151% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$135.60	$226.00	$7.20–$198.88	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR PP	$141.00	$235.00	$4.75–$206.80	179% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR PP	$141.00	$235.00	$4.75–$206.80	179% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR PP	$141.00	$235.00	$4.75–$206.80	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPEC	$208.20	$347.00	$12.87–$305.36	54% above	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPEC	$208.20	$347.00	$12.87–$305.36	54% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPEC	$208.20	$347.00	$12.87–$305.36	—	40%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTIGEN ST	$208.80	$348.00	$14.38–$306.24	43% above	40%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTIGEN ST	$208.80	$348.00	$14.38–$306.24	43% above	40%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI ANTIGEN ST	$208.80	$348.00	$14.38–$306.24	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GENERAT SERUM W/REFLX	$286.20	$477.00	$24.08–$419.76	298% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GENERAT SERUM W/REFLX	$286.20	$477.00	$24.08–$419.76	298% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GENERAT SERUM W/REFLX	$286.20	$477.00	$24.08–$419.76	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV APTIMA HIGH 16/18 45	$44.40	$74.00	$11.10–$65.12	43% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV APTIMA HIGH 16/18 45	$44.40	$74.00	$11.10–$65.12	43% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV APTIMA HIGH 16/18 45	$44.40	$74.00	$11.10–$65.12	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C/GLYCOHEMOGLOBIN	$80.40	$134.00	$9.71–$117.92	14% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C/GLYCOHEMOGLOBIN	$80.40	$134.00	$9.71–$117.92	14% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C/GLYCOHEMOGLOBIN	$80.40	$134.00	$9.71–$117.92	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$67.20	$112.00	$2.37–$98.56	150% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$67.20	$112.00	$2.37–$98.56	150% above	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$67.20	$112.00	$2.37–$98.56	—	40%
Hepatitis B core antibody test (total) CPT 86704 ANTI HBC TOTAL	$172.20	$287.00	$43.05–$252.56	145% above	40%
Hepatitis B core antibody test (total) CPT 86704 ANTI HBC TOTAL	$172.20	$287.00	$43.05–$252.56	145% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 ANTI HBC TOTAL	$172.20	$287.00	$43.05–$252.56	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFAC AB QUAL/QUANT	$238.20	$397.00	$59.55–$349.36	161% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFAC AB QUAL/QUANT	$238.20	$397.00	$59.55–$349.36	161% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFAC AB QUAL/QUANT	$238.20	$397.00	$59.55–$349.36	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPAT B SURFACE ANTIGEN	$272.40	$454.00	$68.10–$399.52	291% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPAT B SURFACE ANTIGEN	$272.40	$454.00	$68.10–$399.52	291% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPAT B SURFACE ANTIGEN	$272.40	$454.00	$68.10–$399.52	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$164.40	$274.00	$14.27–$241.12	93% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$164.40	$274.00	$14.27–$241.12	93% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$164.40	$274.00	$14.27–$241.12	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DIAGNOSIS NAA	$174.00	$290.00	$43.50–$255.20	30% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DIAGNOSIS NAA	$174.00	$290.00	$43.50–$255.20	30% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DETECT/QUANT S(PCR)	$210.60	$351.00	$52.65–$308.88	16% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DETECT/QUANT S(PCR)	$210.60	$351.00	$52.65–$308.88	16% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA DIAGNOSIS NAA	$174.00	$290.00	$43.50–$255.20	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA DETECT/QUANT S(PCR)	$210.60	$351.00	$52.65–$308.88	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$149.40	$249.00	$37.35–$219.12	149% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$149.40	$249.00	$37.35–$219.12	149% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1	$149.40	$249.00	$37.35–$219.12	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$109.80	$183.00	$27.45–$161.04	81% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$109.80	$183.00	$27.45–$161.04	81% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$109.80	$183.00	$27.45–$161.04	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-CARDIAC	$114.00	$190.00	$28.50–$167.20	68% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-CARDIAC	$114.00	$190.00	$28.50–$167.20	68% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN-CARDIAC	$114.00	$190.00	$28.50–$167.20	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL PLASMA	$258.60	$431.00	$64.65–$379.28	104% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL PLASMA	$258.60	$431.00	$64.65–$379.28	104% above	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL PLASMA	$258.60	$431.00	$64.65–$379.28	—	40%
Insulin blood test CPT 83525 INSULIN FASTING CONTRACT	$171.60	$286.00	$42.90–$251.68	103% above	40%
Insulin blood test CPT 83525 INSULIN FASTING CONTRACT	$171.60	$286.00	$42.90–$251.68	103% above	40%
Insulin blood test inpatient CPT 83525 INSULIN FASTING CONTRACT	$171.60	$286.00	$42.90–$251.68	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$153.60	$256.00	$38.40–$225.28	113% above	40%
Iron blood test (serum iron) CPT 83540 IRON	$153.60	$256.00	$38.40–$225.28	113% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$153.60	$256.00	$38.40–$225.28	—	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC DIRECT	$135.60	$226.00	$33.90–$198.88	74% above	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC DIRECT	$135.60	$226.00	$33.90–$198.88	74% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC DIRECT	$135.60	$226.00	$33.90–$198.88	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$235.20	$392.00	$8.68–$344.96	164% above	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$235.20	$392.00	$8.68–$344.96	164% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$235.20	$392.00	$8.68–$344.96	—	40%
LH (luteinizing hormone) test CPT 83002 LH	$316.20	$527.00	$18.52–$463.76	128% above	40%
LH (luteinizing hormone) test CPT 83002 LH	$316.20	$527.00	$18.52–$463.76	128% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$316.20	$527.00	$18.52–$463.76	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$208.20	$347.00	$11.57–$305.36	205% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$208.20	$347.00	$11.57–$305.36	205% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$208.20	$347.00	$11.57–$305.36	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$100.20	$167.00	$25.05–$146.96	113% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$100.20	$167.00	$25.05–$146.96	113% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$100.20	$167.00	$25.05–$146.96	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$189.60	$316.00	$47.40–$278.08	156% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$189.60	$316.00	$47.40–$278.08	156% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$189.60	$316.00	$47.40–$278.08	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$209.40	$349.00	$52.35–$307.12	117% above	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$209.40	$349.00	$52.35–$307.12	117% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$209.40	$349.00	$52.35–$307.12	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB W RFLX	$24.60	$41.00	$6.21–$36.08	52% below	40%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB W RFLX	$24.60	$41.00	$6.21–$36.08	52% below	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB W RFLX	$24.60	$41.00	$6.21–$36.08	—	40%
Magnesium blood test CPT 83735 MAGNESIUM RANDOM URINE REF	$9.60	$16.00	$2.40–$14.08	80% below	40%
Magnesium blood test CPT 83735 MAGNESIUM RANDOM URINE REF	$9.60	$16.00	$2.40–$14.08	80% below	40%
Magnesium blood test CPT 83735 MAGNESIUM	$208.80	$348.00	$52.20–$306.24	325% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$208.80	$348.00	$52.20–$306.24	325% above	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RANDOM URINE REF	$9.60	$16.00	$2.40–$14.08	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$208.80	$348.00	$52.20–$306.24	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM LABCORP	$15.60	$26.00	$3.90–$22.88	71% below	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM LABCORP	$15.60	$26.00	$3.90–$22.88	71% below	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$121.80	$203.00	$30.45–$178.64	123% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$121.80	$203.00	$30.45–$178.64	123% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGM LABCORP	$15.60	$26.00	$3.90–$22.88	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$121.80	$203.00	$30.45–$178.64	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES	$45.00	$75.00	$5.18–$66.00	17% below	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES	$45.00	$75.00	$5.18–$66.00	17% below	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO	$111.60	$186.00	$5.18–$163.68	106% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO	$111.60	$186.00	$5.18–$163.68	106% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES	$45.00	$75.00	$5.18–$66.00	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO	$111.60	$186.00	$5.18–$163.68	—	40%
Mumps immunity blood test CPT 86735 MUMPS AB IGM LABCORP	$15.60	$26.00	$3.90–$22.88	78% below	40%
Mumps immunity blood test CPT 86735 MUMPS AB IGM LABCORP	$15.60	$26.00	$3.90–$22.88	78% below	40%
Mumps immunity blood test CPT 86735 MUMPS	$383.40	$639.00	$95.85–$562.32	446% above	40%
Mumps immunity blood test CPT 86735 MUMPS	$383.40	$639.00	$95.85–$562.32	446% above	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGM LABCORP	$15.60	$26.00	$3.90–$22.88	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS	$383.40	$639.00	$95.85–$562.32	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$188.40	$314.00	$47.10–$276.32	156% above	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$188.40	$314.00	$47.10–$276.32	156% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$188.40	$314.00	$47.10–$276.32	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$184.20	$307.00	$46.05–$270.16	60% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING	$184.20	$307.00	$46.05–$270.16	60% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$184.20	$307.00	$46.05–$270.16	60% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING	$184.20	$307.00	$46.05–$270.16	60% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$184.20	$307.00	$46.05–$270.16	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING	$184.20	$307.00	$46.05–$270.16	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUIDED HPV REFLEX	$39.00	$65.00	$9.75–$57.20	19% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUIDED HPV REFLEX	$39.00	$65.00	$9.75–$57.20	19% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IMAGE GUIDED HPV REFLEX	$39.00	$65.00	$9.75–$57.20	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR THIN LAYER	$132.60	$221.00	$33.15–$194.48	119% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR THIN LAYER	$132.60	$221.00	$33.15–$194.48	119% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR THIN LAYER	$132.60	$221.00	$33.15–$194.48	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH SERUM	$517.80	$863.00	$129.45–$759.44	172% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH SERUM	$517.80	$863.00	$129.45–$759.44	172% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH SERUM	$517.80	$863.00	$129.45–$759.44	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$301.20	$502.00	$75.30–$441.76	288% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$301.20	$502.00	$75.30–$441.76	288% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$301.20	$502.00	$75.30–$441.76	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$82.20	$137.00	$20.55–$120.56	53% above	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$82.20	$137.00	$20.55–$120.56	53% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$82.20	$137.00	$20.55–$120.56	—	40%
Potassium blood test CPT 84132 POTASSIUM SERUM PLASMA WB	$89.40	$149.00	$4.76–$131.12	96% above	40%
Potassium blood test CPT 84132 POTASSIUM SERUM PLASMA WB	$89.40	$149.00	$4.76–$131.12	96% above	40%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM PLASMA WB	$89.40	$149.00	$4.76–$131.12	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$234.60	$391.00	$58.65–$344.08	88% above	40%
Progesterone blood test CPT 84144 PROGESTERONE	$234.60	$391.00	$58.65–$344.08	88% above	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$234.60	$391.00	$58.65–$344.08	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$247.20	$412.00	$61.80–$362.56	80% above	40%
Prolactin blood test CPT 84146 PROLACTIN	$247.20	$412.00	$61.80–$362.56	80% above	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$247.20	$412.00	$61.80–$362.56	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$133.20	$222.00	$4.29–$195.36	220% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$133.20	$222.00	$4.29–$195.36	220% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$133.20	$222.00	$4.29–$195.36	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$25.20	$42.00	$6.36–$36.96	39% below	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$25.20	$42.00	$6.36–$36.96	39% below	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$25.20	$42.00	$6.36–$36.96	—	40%
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST-AMB	$34.20	$57.00	$8.64–$50.16	30% below	40%
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST-AMB	$34.20	$57.00	$8.64–$50.16	30% below	40%
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST	$57.60	$96.00	$14.54–$84.48	17% above	40%
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST	$57.60	$96.00	$14.54–$84.48	17% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA TEST-AMB	$34.20	$57.00	$8.64–$50.16	—	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA TEST	$57.60	$96.00	$14.54–$84.48	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W OPTIC	$19.20	$32.00	$4.85–$28.16	68% below	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W OPTIC	$19.20	$32.00	$4.85–$28.16	68% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W OPTIC	$19.20	$32.00	$4.85–$28.16	—	40%
Renin blood test CPT 84244 RENIN	$443.40	$739.00	$110.85–$650.32	221% above	40%
Renin blood test CPT 84244 RENIN	$443.40	$739.00	$110.85–$650.32	221% above	40%
Renin blood test inpatient CPT 84244 RENIN	$443.40	$739.00	$110.85–$650.32	—	40%
Rh blood typing CPT 86901 RH	$70.20	$117.00	$17.55–$102.96	52% above	40%
Rh blood typing CPT 86901 RH	$70.20	$117.00	$17.55–$102.96	52% above	40%
Rh blood typing inpatient CPT 86901 RH	$70.20	$117.00	$17.55–$102.96	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN	$199.20	$332.00	$49.80–$292.16	322% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN	$199.20	$332.00	$49.80–$292.16	322% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUAN	$199.20	$332.00	$49.80–$292.16	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$135.00	$225.00	$33.75–$198.00	48% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$135.00	$225.00	$33.75–$198.00	48% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA	$135.00	$225.00	$33.75–$198.00	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE IN HOUSE	$77.40	$129.00	$19.35–$113.52	102% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE IN HOUSE	$77.40	$129.00	$19.35–$113.52	102% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE IN HOUSE	$77.40	$129.00	$19.35–$113.52	—	40%
Sodium blood test CPT 84295 SODIUM SERUM PLASMA OR WB	$100.20	$167.00	$4.81–$146.96	101% above	40%
Sodium blood test CPT 84295 SODIUM SERUM PLASMA OR WB	$100.20	$167.00	$4.81–$146.96	101% above	40%
Sodium blood test inpatient CPT 84295 SODIUM SERUM PLASMA OR WB	$100.20	$167.00	$4.81–$146.96	—	40%
Stool ova and parasites exam CPT 87177 PARASITE IDENTIFICATION	$183.00	$305.00	$45.75–$268.40	187% above	40%
Stool ova and parasites exam CPT 87177 PARASITE IDENTIFICATION	$183.00	$305.00	$45.75–$268.40	187% above	40%
Stool ova and parasites exam inpatient CPT 87177 PARASITE IDENTIFICATION	$183.00	$305.00	$45.75–$268.40	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IFOBT/FIT	$285.60	$476.00	$15.92–$418.88	656% above	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IFOBT/FIT	$285.60	$476.00	$15.92–$418.88	656% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IFOBT/FIT	$285.60	$476.00	$15.92–$418.88	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB REF	$7.20	$12.00	$1.82–$13.24	84% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB REF	$7.20	$12.00	$1.82–$13.24	84% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB	$192.60	$321.00	$13.24–$282.48	327% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB	$192.60	$321.00	$13.24–$282.48	327% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB REF	$7.20	$12.00	$1.82–$13.24	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB	$192.60	$321.00	$13.24–$282.48	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAl REF	$77.40	$129.00	$19.35–$113.52	88% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAl REF	$77.40	$129.00	$19.35–$113.52	88% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST QUAl REF	$77.40	$129.00	$19.35–$113.52	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 M.TUBERCULOSIS QUANTIFERON B	$132.60	$221.00	$33.15–$194.48	at median	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 M.TUBERCULOSIS QUANTIFERON B	$132.60	$221.00	$33.15–$194.48	at median	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 M.TUBERCULOSIS QUANTIFERON B	$132.60	$221.00	$33.15–$194.48	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$47.40	$79.00	$11.85–$69.52	59% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$47.40	$79.00	$11.85–$69.52	59% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$47.40	$79.00	$11.85–$69.52	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 IMMUNASSY INF AGNT AB QUAN	$184.80	$308.00	$46.20–$271.04	100% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 IMMUNASSY INF AGNT AB QUAN	$184.80	$308.00	$46.20–$271.04	100% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB SERUM	$309.00	$515.00	$77.25–$453.20	234% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB SERUM	$309.00	$515.00	$77.25–$453.20	234% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 IMMUNASSY INF AGNT AB QUAN	$184.80	$308.00	$46.20–$271.04	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB SERUM	$309.00	$515.00	$77.25–$453.20	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$184.20	$307.00	$16.80–$270.16	115% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$184.20	$307.00	$16.80–$270.16	115% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$184.20	$307.00	$16.80–$270.16	—	40%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE	$198.60	$331.00	$49.65–$291.28	100% above	40%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE	$198.60	$331.00	$49.65–$291.28	100% above	40%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN IGE	$198.60	$331.00	$49.65–$291.28	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM	$130.80	$218.00	$4.35–$191.84	181% above	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM	$130.80	$218.00	$4.35–$191.84	181% above	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM	$130.80	$218.00	$4.35–$191.84	—	40%
Total thyroxine (T4) blood test CPT 84436 T4	$189.00	$315.00	$47.25–$277.20	159% above	40%
Total thyroxine (T4) blood test CPT 84436 T4	$189.00	$315.00	$47.25–$277.20	159% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4	$189.00	$315.00	$47.25–$277.20	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$223.20	$372.00	$55.80–$327.36	132% above	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$223.20	$372.00	$55.80–$327.36	132% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$223.20	$372.00	$55.80–$327.36	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$133.20	$222.00	$33.30–$195.36	42% above	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$133.20	$222.00	$33.30–$195.36	42% above	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$133.20	$222.00	$33.30–$195.36	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$105.00	$175.00	$5.74–$154.00	106% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$105.00	$175.00	$5.74–$154.00	106% above	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$105.00	$175.00	$5.74–$154.00	—	40%
Troponin test, quantitative CPT 84484 TROPONIN T	$155.40	$259.00	$38.85–$227.92	27% above	40%
Troponin test, quantitative CPT 84484 TROPONIN T	$155.40	$259.00	$38.85–$227.92	27% above	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUAN (IN HOUSE)	$171.60	$286.00	$42.90–$251.68	40% above	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUAN (IN HOUSE)	$171.60	$286.00	$42.90–$251.68	40% above	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$155.40	$259.00	$38.85–$227.92	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUAN (IN HOUSE)	$171.60	$286.00	$42.90–$251.68	—	40%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$77.40	$129.00	$4.52–$113.52	38% above	40%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$77.40	$129.00	$4.52–$113.52	38% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$77.40	$129.00	$4.52–$113.52	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO	$64.20	$107.00	$16.05–$94.16	27% above	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO	$64.20	$107.00	$16.05–$94.16	27% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO	$64.20	$107.00	$16.05–$94.16	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO	$37.80	$63.00	$2.25–$55.44	47% above	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO	$37.80	$63.00	$2.25–$55.44	47% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO MICRO	$37.80	$63.00	$2.25–$55.44	—	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK/TAB-AMB	$13.80	$23.00	$3.45–$20.24	23% below	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK/TAB-AMB	$13.80	$23.00	$3.45–$20.24	23% below	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS BY DIPSTICK/TAB-AMB	$13.80	$23.00	$3.45–$20.24	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE	$141.00	$235.00	$35.25–$206.80	70% above	40%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE	$141.00	$235.00	$35.25–$206.80	70% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE	$141.00	$235.00	$35.25–$206.80	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RANDOM URINE	$93.00	$155.00	$5.78–$136.40	66% above	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RANDOM URINE	$93.00	$155.00	$5.78–$136.40	66% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RANDOM URINE	$93.00	$155.00	$5.78–$136.40	—	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE	$156.00	$260.00	$39.00–$228.80	202% above	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE	$156.00	$260.00	$39.00–$228.80	202% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE	$156.00	$260.00	$39.00–$228.80	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$247.20	$412.00	$61.80–$362.56	191% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$247.20	$412.00	$61.80–$362.56	191% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$247.20	$412.00	$61.80–$362.56	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY) REF	$255.00	$425.00	$63.75–$374.00	130% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY)	$255.00	$425.00	$63.75–$374.00	130% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY)	$255.00	$425.00	$63.75–$374.00	130% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY) REF	$255.00	$425.00	$63.75–$374.00	130% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D(25-HYDROXY) REF	$255.00	$425.00	$63.75–$374.00	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D(25-HYDROXY)	$255.00	$425.00	$63.75–$374.00	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$159.00	$265.00	$39.75–$233.20	at median	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$159.00	$265.00	$39.75–$233.20	at median	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY	$159.00	$265.00	$39.75–$233.20	—	40%
Zinc blood test CPT 84630 ZINC	$175.20	$292.00	$43.80–$256.96	54% above	40%
Zinc blood test CPT 84630 ZINC	$175.20	$292.00	$43.80–$256.96	54% above	40%
Zinc blood test inpatient CPT 84630 ZINC	$175.20	$292.00	$43.80–$256.96	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG FREE/TOTAL	$208.20	$347.00	$52.05–$305.36	34% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG FREE/TOTAL	$208.20	$347.00	$52.05–$305.36	34% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG FREE/TOTAL	$208.20	$347.00	$52.05–$305.36	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Kentucky	Off list
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMV IMPACTED CERUMEN LAV RT	$105.00	$175.00	$26.25–$154.00	at median	40%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMV IMPACTED CERUMEN LAV LT	$105.00	$175.00	$26.25–$154.00	at median	40%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMV IMPACTED CERUMEN LAV LT	$105.00	$175.00	$26.25–$154.00	at median	40%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMV IMPACTED CERUMEN LAV RT	$105.00	$175.00	$26.25–$154.00	at median	40%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMV IMPACTED CERUMEN LAV LT	$105.00	$175.00	$26.25–$154.00	—	40%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMV IMPACTED CERUMEN LAV RT	$105.00	$175.00	$26.25–$154.00	—	40%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN RT	$110.40	$184.00	$27.60–$161.92	at median	40%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN LT	$110.40	$184.00	$27.60–$161.92	at median	40%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN LT	$110.40	$184.00	$27.60–$161.92	at median	40%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN RT	$110.40	$184.00	$27.60–$161.92	at median	40%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN RT	$110.40	$184.00	$27.60–$161.92	—	40%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN LT	$110.40	$184.00	$27.60–$161.92	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE OR SINGLE	$330.60	$551.00	$82.65–$484.88	13% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE OR SINGLE	$330.60	$551.00	$82.65–$484.88	13% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE OR SINGLE	$330.60	$551.00	$82.65–$484.88	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JNT	$470.40	$784.00	$117.60–$689.92	20% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JNT	$470.40	$784.00	$117.60–$689.92	20% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JNT	$470.40	$784.00	$117.60–$689.92	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMED JNT/BURSA	$394.80	$658.00	$98.70–$579.04	89% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMED JNT/BURSA	$394.80	$658.00	$98.70–$579.04	89% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMED JNT/BURSA	$394.80	$658.00	$98.70–$579.04	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER WND SCLP ARM LEG<2.5CM	$263.40	$439.00	$65.85–$386.32	13% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER WND SCLP ARM LEG<2.5CM	$263.40	$439.00	$65.85–$386.32	13% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER WND SCLP ARM LEG<2.5CM	$263.40	$439.00	$65.85–$386.32	—	40%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$260.40	$434.00	$65.10–$381.92	1% above	40%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$260.40	$434.00	$65.10–$381.92	1% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$260.40	$434.00	$65.10–$381.92	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 RMVL NAIL PART/COMP PERM	$480.60	$801.00	$120.15–$704.88	4% above	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 RMVL NAIL PART/COMP PERM	$480.60	$801.00	$120.15–$704.88	4% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 RMVL NAIL PART/COMP PERM	$480.60	$801.00	$120.15–$704.88	—	40%
Removal of a foreign object under the skin, simple CPT 10120 INCISION REMOVAL FB SQ SIMPLE	$479.40	$799.00	$119.85–$703.12	21% above	40%
Removal of a foreign object under the skin, simple CPT 10120 INCISION REMOVAL FB SQ SIMPLE	$479.40	$799.00	$119.85–$703.12	21% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION REMOVAL FB SQ SIMPLE	$479.40	$799.00	$119.85–$703.12	—	40%
Short arm cast (elbow to hand) one side CPT 29075 CAST APP SHRT ARM ELBW FNG LT	$415.80	$693.00	$103.95–$609.84	150% above	40%
Short arm cast (elbow to hand) one side CPT 29075 CAST APP SHRT ARM ELBW FNG LT	$415.80	$693.00	$103.95–$609.84	150% above	40%
Short arm cast (elbow to hand) inpatient one side CPT 29075 CAST APP SHRT ARM ELBW FNG LT	$415.80	$693.00	$103.95–$609.84	—	40%
Short arm splint (forearm and hand) one side CPT 29125 SHORT ARM SPLINT APP LT	$184.20	$307.00	$46.05–$270.16	at median	40%
Short arm splint (forearm and hand) one side CPT 29125 SHORT ARM SPLINT APP RT	$184.20	$307.00	$46.05–$270.16	at median	40%
Short arm splint (forearm and hand) one side CPT 29125 SHORT ARM SPLINT APP RT	$184.20	$307.00	$46.05–$270.16	at median	40%
Short arm splint (forearm and hand) one side CPT 29125 SHORT ARM SPLINT APP LT	$184.20	$307.00	$46.05–$270.16	at median	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHORT ARM SPLINT APP RT	$184.20	$307.00	$46.05–$270.16	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHORT ARM SPLINT APP LT	$184.20	$307.00	$46.05–$270.16	—	40%
Short leg splint (calf to foot) one side CPT 29515 SHORT LEG SPLINT APP LT	$184.20	$307.00	$46.05–$270.16	1% below	40%
Short leg splint (calf to foot) one side CPT 29515 SHORT LEG SPLINT APP LT	$184.20	$307.00	$46.05–$270.16	1% below	40%
Short leg splint (calf to foot) one side CPT 29515 SHORT LEG SPLINT APP RT	$184.20	$307.00	$46.05–$270.16	1% below	40%
Short leg splint (calf to foot) one side CPT 29515 SHORT LEG SPLINT APP RT	$184.20	$307.00	$46.05–$270.16	1% below	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHORT LEG SPLINT APP RT	$184.20	$307.00	$46.05–$270.16	—	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHORT LEG SPLINT APP LT	$184.20	$307.00	$46.05–$270.16	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP SUPER WOUND <2.5CM	$263.40	$439.00	$65.85–$386.32	2% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP SUPER WOUND <2.5CM	$263.40	$439.00	$65.85–$386.32	2% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMP SUPER WOUND <2.5CM	$263.40	$439.00	$65.85–$386.32	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP SUPER WOUND 2.6-7.5CM	$263.40	$439.00	$65.85–$386.32	10% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP SUPER WOUND 2.6-7.5CM	$263.40	$439.00	$65.85–$386.32	10% 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 SIMP SUPER WOUND 2.6-7.5CM	$263.40	$439.00	$65.85–$386.32	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP LAC FACE <2.5CM	$263.40	$439.00	$65.85–$386.32	4% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP LAC FACE <2.5CM	$263.40	$439.00	$65.85–$386.32	4% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP LAC FACE <2.5CM	$263.40	$439.00	$65.85–$386.32	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISSUE 1ST 20 SQ CM	$542.40	$904.00	$135.60–$795.52	6% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISSUE 1ST 20 SQ CM	$542.40	$904.00	$135.60–$795.52	6% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISSUE 1ST 20 SQ CM	$542.40	$904.00	$135.60–$795.52	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Kentucky	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$603.00	$1,005.00	$150.75–$884.40	at median	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$603.00	$1,005.00	$150.75–$884.40	at median	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$603.00	$1,005.00	$150.75–$884.40	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX SUBS	$266.40	$444.00	$66.60–$390.72	102% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX INIT	$266.40	$444.00	$66.60–$390.72	102% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX SUBS	$266.40	$444.00	$66.60–$390.72	102% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX INIT	$266.40	$444.00	$66.60–$390.72	102% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB TX SUBS	$266.40	$444.00	$66.60–$390.72	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB TX INIT	$266.40	$444.00	$66.60–$390.72	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$238.20	$397.00	$59.55–$349.36	32% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$238.20	$397.00	$59.55–$349.36	32% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$238.20	$397.00	$59.55–$349.36	32% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$238.20	$397.00	$59.55–$349.36	32% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY	$238.20	$397.00	$59.55–$349.36	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$238.20	$397.00	$59.55–$349.36	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1	$141.60	$236.00	$35.40–$207.68	29% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1	$141.60	$236.00	$35.40–$207.68	29% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL 1	$141.60	$236.00	$35.40–$207.68	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL 2	$279.00	$465.00	$69.75–$409.20	5% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL 2	$279.00	$465.00	$69.75–$409.20	5% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEVEL 2	$279.00	$465.00	$69.75–$409.20	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL 3	$378.00	$630.00	$94.50–$554.40	21% below	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL 3	$378.00	$630.00	$94.50–$554.40	21% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEVEL 3	$378.00	$630.00	$94.50–$554.40	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL 4	$1,745.40	$2,909.00	$436.35–$2,559.92	90% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL 4	$1,745.40	$2,909.00	$436.35–$2,559.92	90% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEVEL 4	$1,745.40	$2,909.00	$436.35–$2,559.92	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE EA ADD 30M	$1,109.40	$1,849.00	$277.35–$1,627.12	6% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE EA ADD 30M	$1,109.40	$1,849.00	$277.35–$1,627.12	6% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL 5	$2,258.40	$3,764.00	$564.60–$3,312.32	92% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL 5	$2,258.40	$3,764.00	$564.60–$3,312.32	92% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M	$2,976.00	$4,960.00	$744.00–$4,364.80	153% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M W/P	$2,976.00	$4,960.00	$744.00–$4,364.80	153% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M	$2,976.00	$4,960.00	$744.00–$4,364.80	153% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M W/P	$2,976.00	$4,960.00	$744.00–$4,364.80	153% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CRITICAL CARE EA ADD 30M	$1,109.40	$1,849.00	$277.35–$1,627.12	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEVEL 5	$2,258.40	$3,764.00	$564.60–$3,312.32	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CRITICAL CARE 1ST 30-74M W/P	$2,976.00	$4,960.00	$744.00–$4,364.80	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CRITICAL CARE 1ST 30-74M	$2,976.00	$4,960.00	$744.00–$4,364.80	—	40%
Group psychotherapy session CPT 90853 GROUP THERAPY SC	$144.00	$240.00	$36.00–$211.20	at median	40%
Group psychotherapy session CPT 90853 GROUP THERAPY SC	$144.00	$240.00	$36.00–$211.20	at median	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY SC	$144.00	$240.00	$36.00–$211.20	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION IV HYDRAT UP TO 1 HR	$289.20	$482.00	$72.30–$424.16	2% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION IV HYDRAT UP TO 1 HR	$289.20	$482.00	$72.30–$424.16	2% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION IV HYDRAT UP TO 1 HR	$289.20	$482.00	$72.30–$424.16	—	40%
IV infusion of a medicine, first hour CPT 96365 INFUSION IV THERAP UP TO 1 HR	$366.00	$610.00	$91.50–$536.80	13% above	40%
IV infusion of a medicine, first hour CPT 96365 INFUSION IV THERAP UP TO 1 HR	$366.00	$610.00	$91.50–$536.80	13% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION IV THERAP UP TO 1 HR	$366.00	$610.00	$91.50–$536.80	—	40%
IV push of a medicine, first drug CPT 96374 IVP THER SINGLE/INIT SUBS/DRUG	$218.40	$364.00	$54.60–$320.32	15% above	40%
IV push of a medicine, first drug CPT 96374 IVP THER SINGLE/INIT SUBS/DRUG	$218.40	$364.00	$54.60–$320.32	15% above	40%
IV push of a medicine, first drug inpatient CPT 96374 IVP THER SINGLE/INIT SUBS/DRUG	$218.40	$364.00	$54.60–$320.32	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION (SC) (IM)	$84.60	$141.00	$21.15–$124.08	5% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION (SC) (IM)	$84.60	$141.00	$21.15–$124.08	5% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION (SC) (IM)	$84.60	$141.00	$21.15–$124.08	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL SC	$156.00	$260.00	$39.00–$228.80	3% below	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL SC	$156.00	$260.00	$39.00–$228.80	3% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL SC	$156.00	$260.00	$39.00–$228.80	—	40%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DX EVAL W/MED SC	$162.00	$270.00	$40.50–$237.60	38% below	40%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DX EVAL W/MED SC	$162.00	$270.00	$40.50–$237.60	38% below	40%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DX EVAL W/MED SC	$162.00	$270.00	$40.50–$237.60	—	40%
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL THERAPY 45 MIN SC	$138.00	$230.00	$34.50–$202.40	23% below	40%
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL THERAPY 45 MIN SC	$138.00	$230.00	$34.50–$202.40	23% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL THERAPY 45 MIN SC	$138.00	$230.00	$34.50–$202.40	—	40%
Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL THERAPY 60 MIN SC	$186.00	$310.00	$46.50–$272.80	at median	40%
Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL THERAPY 60 MIN SC	$186.00	$310.00	$46.50–$272.80	at median	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL THERAPY 60 MIN SC	$186.00	$310.00	$46.50–$272.80	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCL GRAPHIC RECORD	$340.80	$568.00	$85.20–$499.84	49% above	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCL GRAPHIC RECORD	$340.80	$568.00	$85.20–$499.84	49% above	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY INCL GRAPHIC RECORD	$340.80	$568.00	$85.20–$499.84	—	40%
Spirometry before and after a bronchodilator CPT 94060 PUL FUNCT TST PRE/POST	$845.40	$1,409.00	$211.35–$1,239.92	83% above	40%
Spirometry before and after a bronchodilator CPT 94060 PUL FUNCT TST PRE/POST	$845.40	$1,409.00	$211.35–$1,239.92	83% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PUL FUNCT TST PRE/POST	$845.40	$1,409.00	$211.35–$1,239.92	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$156.00	$260.00	$39.00–$228.80	at median	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$156.00	$260.00	$39.00–$228.80	at median	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$156.00	$260.00	$39.00–$228.80	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Kentucky	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 30 MCG/0.3 ML PFIZER	$589.50	$982.50	$147.32–$864.60	76% above	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 30 MCG/0.3 ML PFIZER	$589.50	$982.50	$147.32–$864.60	76% above	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 30 MCG/0.3 ML PFIZER	$589.50	$982.50	$147.32–$864.60	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VACCINE	$70.80	$118.00	$17.70–$103.84	at median	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VACCINE	$70.80	$118.00	$17.70–$103.84	at median	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$70.80	$118.00	$17.70–$103.84	at median	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$70.80	$118.00	$17.70–$103.84	at median	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VACCINE	$70.80	$118.00	$17.70–$103.84	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$70.80	$118.00	$17.70–$103.84	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADM EA ADDL VACCINE	$35.40	$59.00	$8.85–$51.92	12% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADM EA ADDL VACCINE	$35.40	$59.00	$8.85–$51.92	12% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADM EA ADDL VACCINE	$35.40	$59.00	$8.85–$51.92	—	40%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.arh.org/wp-content/uploads/2026/05/452696517_ARH-Mary-Breckinridge-Health_standardcharges.csv