Hospital Charleston, WV

Boone Memorial Hospital

Boone Memorial Hospital in Madison, WV publishes cash prices for 286 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the West Virginia median for 181 of 280 procedures and above it for 88. By typical cash price it ranks #2 of 26 West Virginia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

701 Madison Avenue, Madison, WV, 25130 Collected Sep 27, 2026 Source price file (304) 369-1230

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 511313 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Barium swallow (esophagus X-ray with contrast) both sides CPT 74220 RETROGRADE PYELOGRAM BILATERAL	$246.00	$492.00	$83.48–$467.40	—	50%
Barium swallow (esophagus X-ray with contrast) inpatient both sides CPT 74220 RETROGRADE PYELOGRAM BILATERAL	$246.00	$492.00	$83.48–$467.40	—	50%
Chest X-ray, single view CPT 71045 BL B-Read Professional Fee	$35.00	$70.00	$19.21–$66.50	76% below	50%
Chest X-ray, single view CPT 71045 BL B-Read Professional Fee IME	$35.00	$70.00	$19.21–$66.50	76% below	50%
Chest X-ray, single view CPT 71045 BL B Read Chest XRay IME	$87.50	$175.00	$22.76–$166.25	40% below	50%
Chest X-ray, single view CPT 71045 SBL B READ CHEST XRAY	$92.50	$185.00	$22.76–$175.75	37% below	50%
Chest X-ray, single view CPT 71045 BL B Read Chest XRay	$100.00	$200.00	$22.76–$190.00	32% below	50%
Chest X-ray, single view CPT 71045 **BL B-READ CHEST X-RAY	$140.00	$200.00	$22.76–$190.00	5% below	30%
Chest X-ray, single view CPT 71045 BL IME B-READ CHEST X-RAY	$174.30	$249.00	$22.76–$236.55	19% above	30%
Chest X-ray, single view inpatient CPT 71045 BL B-Read Professional Fee	$35.00	$70.00	$19.21–$66.50	—	50%
Chest X-ray, single view inpatient CPT 71045 BL B-Read Professional Fee IME	$35.00	$70.00	$19.21–$66.50	—	50%
Chest X-ray, single view inpatient CPT 71045 BL B Read Chest XRay IME	$87.50	$175.00	$22.76–$166.25	—	50%
Chest X-ray, single view inpatient CPT 71045 SBL B READ CHEST XRAY	$92.50	$185.00	$22.76–$175.75	—	50%
Chest X-ray, single view inpatient CPT 71045 BL B Read Chest XRay	$100.00	$200.00	$22.76–$190.00	—	50%
Chest X-ray, single view inpatient CPT 71045 **BL B-READ CHEST X-RAY	$140.00	$200.00	$22.76–$190.00	—	30%
Chest X-ray, single view inpatient CPT 71045 BL IME B-READ CHEST X-RAY	$174.30	$249.00	$22.76–$236.55	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILATERAL	$137.20	$196.00	$53.78–$186.20	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAG BILATERAL	$137.20	$196.00	$53.78–$186.20	—	30%
Diagnostic mammogram, one breast CPT 77065 CAD W PHYSICIAN REVIEW SCREENING	$196.70	$281.00	$73.57–$266.95	at median	30%
Diagnostic mammogram, one breast inpatient CPT 77065 CAD W PHYSICIAN REVIEW SCREENING	$196.70	$281.00	$73.57–$266.95	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 DICICCO HOME SLEEP STUDY	$275.50	$551.00	$92.90–$523.45	28% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY	$275.50	$551.00	$92.90–$523.45	28% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 DICICCO HOME SLEEP STUDY	$275.50	$551.00	$92.90–$523.45	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP STUDY	$275.50	$551.00	$92.90–$523.45	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY WITH TITRATION	$1,705.00	$3,410.00	$618.79–$3,239.50	37% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY WITH TITRATION	$1,705.00	$3,410.00	$618.79–$3,239.50	—	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY	$1,550.00	$3,100.00	$588.98–$2,945.00	36% below	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY SPLIT NIGHT STUDY	$1,550.00	$3,100.00	$588.98–$2,945.00	36% below	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY "PROTOCOL"	$1,550.00	$3,100.00	$588.98–$2,945.00	36% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY "PROTOCOL"	$1,550.00	$3,100.00	$588.98–$2,945.00	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY	$1,550.00	$3,100.00	$588.98–$2,945.00	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY SPLIT NIGHT STUDY	$1,550.00	$3,100.00	$588.98–$2,945.00	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT, MAYO RL	$18.75	$37.50	$5.19–$35.62	35% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$20.15	$40.29	$5.19–$38.28	31% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT P5P, MAYO	$25.90	$37.00	$5.19–$35.15	11% below	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HCV FIBROSURE RL	$33.50	$67.00	$5.19–$63.65	16% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT RL	$48.50	$97.00	$5.19–$92.15	67% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 FIBROSURE RL	$281.25	$562.50	$5.19–$534.38	870% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT, MAYO RL	$18.75	$37.50	$5.19–$35.62	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$20.15	$40.29	$5.19–$38.28	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT P5P, MAYO	$25.90	$37.00	$5.19–$35.15	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HCV FIBROSURE RL	$33.50	$67.00	$5.19–$63.65	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT RL	$48.50	$97.00	$5.19–$92.15	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FIBROSURE RL	$281.25	$562.50	$5.19–$534.38	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$20.15	$40.29	$5.08–$38.28	42% below	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST P5P, MAYO	$25.90	$37.00	$5.08–$35.15	26% below	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST RL	$48.50	$97.00	$5.08–$92.15	39% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$20.15	$40.29	$5.08–$38.28	—	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST P5P, MAYO	$25.90	$37.00	$5.08–$35.15	—	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST RL	$48.50	$97.00	$5.08–$92.15	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE A B C RL	$71.50	$143.00	$39.24–$135.85	68% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE A B C RL	$71.50	$143.00	$39.24–$135.85	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST RASPBERRY RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CHUB MACKEREL RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST APRICOT RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST AVOCADO RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BLACKBERRY RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BLUEBERRY RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST LIME RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MANDARIN RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MELONS RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PEAR RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GLUTEN RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOXTAIL MILLET RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST RYE GRAIN RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST SUNFLOWER SEED RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BAKER'S YEAST RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GUM ARABIC RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUSHROOM RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BEAN NAVY WHITE RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ASCARIS IGE RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GREY ALDER IgE MAYO RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE RED MAPLE	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITH IgE MAYO RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST SWEET CHESTNUT RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PINE NUT RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BASIL RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BAY LEAF RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CLOVE RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CORIANDER RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST OREGANO RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST VANILLA RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ASPARAGUS RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BAMBOO SHOOT RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BEETS (BEETROOT) RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BROCCOLI RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BRUSSEL SPROUTS RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CABBAGE RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAULIFLOWER RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CHICK PEA RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST LETTUCE RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOUNTAIN CEDAR RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MULBERRY RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST RUSSIAN THISTLE RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GOAT'S MILK RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST OVALBUMIN RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST OVOMUCOID RL	$7.50	$15.00	$4.12–$14.25	65% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS NIGER	$8.00	$16.00	$4.39–$15.20	62% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FLAVUS	$8.00	$16.00	$4.39–$15.20	62% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITH IgE-MAYO	$10.50	$15.00	$4.12–$14.25	51% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE B LACTOALBUMIN MILK RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ITELMINTHOSPORIUM RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE CASEIN MILK RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE SYCAMORE RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST F MONILIFORME RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PENICILLIN RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE A LACTOALBUMIN MILK RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BOX ELDER MAPLE RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 F MONILIFORME IgE RL	$12.50	$25.00	$5.12–$23.75	41% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST LATEX ALLERGEN RL	$13.00	$26.00	$5.12–$24.70	39% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BLACK WALNUT RL	$14.00	$28.00	$5.12–$26.60	34% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 MANGO IgE RL	$14.00	$28.00	$5.12–$26.60	34% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GRAPE RL	$16.50	$33.00	$5.12–$31.35	22% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST RHODOTORULA GLUTINUS	$17.00	$34.00	$5.12–$32.30	20% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 OVALBUMIN, IgE RL	$17.00	$34.00	$5.12–$32.30	20% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST EGG YOLK RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST COCKROACH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE COMMON SILVER BIRCH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CASEIN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD LACTOGLOBULIN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD ALPHA LACTALB RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BARLEY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD/BLUE CHEESE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHEDDAR CHEESE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD RICE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE RUSSIAN THISTLE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MOUNTAIN CEDAR RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SALMON	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PERCH OCEAN	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TROUT	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD MACKEREL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD HALIBUT	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS COMMON PIGWEED	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS GOLDENROD	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PAPRIKA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GINGER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD VANILLA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SUGAR CANE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD OYSTER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD LOBSTER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD EGG YOLK RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SCALLOP RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GREEN BEANS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CATFISH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD COCONUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PISTACHIO RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHILI PEPPER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PINEAPPLE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHERRY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CUMIN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAYENNE PEPPER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD ORANGE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GARLIC RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST KIWI FRUIT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST SALMON RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUSTARD RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ONION RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CINNAMON RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST BLACK PEPPER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST NUTMEG RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ASPERGILLUS NIGER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TOMATO RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUST MITE D PTERONYSSINUS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUST MITE D MICROCERAS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST DOG DANDER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST COCKSFOOT (ORCHARD GRASS) RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAT DANDER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST AUREOBASIDIUM PULLULANS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ASPERGILLUS FUMIGATUS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST SPECIFIC ALLERGEN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST SHEEP SORREL (RUMEX A CETOSELLA) RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PLANTAIN RIBWORT (PLANTAGO LANCE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST HOUSE DUST (HOLLISTER STIER LABS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GOOSEFOOT LAMB'S QUARTERS (C ALB RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GIANT RAGWEED (AMBROSIA TRIFIDA) RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD LEMON RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD APPLE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD STRAWBERRY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GRAPEFRUIT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD OLIVE OIL RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PECAN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD WALNUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CASHEW NUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BRAZIL NUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CLAM RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST C HERBARUM HORMODEND RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST DANDELION RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CODFISH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CRAB RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD ALMOND RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD HAZELNUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHICKEN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PORK RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BEEF RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD POTATO SWEET RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD POTATO WHITE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CELERY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CARROT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BANANA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PEAS GREEN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PULLARLARIA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST WHITE ASH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST CHICKEN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TURKEY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALTERNARIA TENUIS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUGWORT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST SHEEP SORREL RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST COCKLEBUR RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST LAMBS QUARTER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE SWEET GUM RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE POPLAR RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUSTMITE (P) RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PHOMA BETAE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST RHIZOPUS NIGRICANS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUCOR RACEMOS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS ASPERGILLUS RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS CLADOSPORIUM RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS PENICILLUM RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE PIG WEED RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE ENGLISH PLANTAI RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE SHORT RAGWEED RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE GIANT RAGWEED RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WILLOW RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE PIN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE ASH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WALNUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE PECAN HICKORY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE OLIVE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE OAK RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MESQUITE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MELALENCA CAJEP RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE HAZELNUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE ELM RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE COTTONWOOD RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BIRCH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BEECH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE ALDER RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS WILD RYE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS VELVET RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS TIMOTHY RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS SWEET RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS RED RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS PERENNIAL RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS ORCHARD RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS FOX TAIL RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS MEADOW FESCUE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS JUNE KY BLUE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS WHEAT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS RYE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS CULTIVATED OAT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS COMMON	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS BROME RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS BERMUDA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUST MITE (D FARINAE) RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ANIMAL DOG EPITHELIA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ANIMAL CAT EPITHELIA RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST HOUSE DUST RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHOCOLATE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SHRIMP RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TUNA FISH RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CITRUS ORANGE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SOYBEAN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PEANUT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD OAT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD WHEAT RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CORN RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD MILK RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD EGG WHITE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT PAPER WASP RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT YELLOW HORNET RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT YELLOW JACKET RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT HONEY BEE RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT WH FCD HORNET RL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PANEL	$21.00	$42.00	$5.12–$39.90	1% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HONEY IgE RL	$24.50	$49.00	$5.12–$46.55	15% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 BOTRYTIS CINEREA IgE RL	$24.50	$49.00	$5.12–$46.55	15% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 BOLTYTIS IgE RL	$24.50	$49.00	$5.12–$46.55	15% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 EPICPCCUM PURPURASCENS RL	$24.50	$49.00	$5.12–$46.55	15% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 .RAST/BOX ELDER	$29.40	$42.00	$5.12–$39.90	39% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS MUCOR	$29.40	$42.00	$5.12–$39.90	39% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST EGG YOLK	$29.40	$42.00	$5.12–$39.90	39% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ISOCYANATE HDI IgE RL	$38.50	$77.00	$5.12–$73.15	81% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ISOCYANATE MDI IgE RL	$38.50	$77.00	$5.12–$73.15	81% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ISOCYANATE TDI IgE RL	$38.50	$77.00	$5.12–$73.15	81% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 CURVULARIA SPICIFERA/BIPOLARIS	$42.00	$84.00	$5.12–$79.80	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 FUSANIVM OXYSPORUM VASIFECTUM RL	$46.25	$92.50	$5.12–$87.88	118% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MULBERRY RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE LOCUST RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PEACH RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE HICKORY RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE OAK RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST STEMPHYLIUM RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS ALTERNARIA RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS JOHNSON RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS BAHIA RL	$48.75	$97.50	$5.12–$92.62	130% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST HELMINTHOSPORIUM SAT RL	$52.00	$104.00	$5.12–$98.80	145% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM OXYSPORUM/VASINFECTUM MAYO I RL	$63.00	$126.00	$5.12–$119.70	197% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST RHODOTURULA GLUTINIS RL	$70.50	$141.00	$5.12–$133.95	232% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 TRICHOPHYTON MENTAGROPHYTES IgE RL	$84.00	$168.00	$5.12–$159.60	296% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 OCCUPATIONAL PANEL #2	$89.60	$128.00	$5.12–$121.60	322% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST OVALBUMIN RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST APRICOT RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GOAT'S MILK RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CABBAGE RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST AVOCADO RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST RASPBERRY RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BRUSSEL SPROUTS RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GLUTEN RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BROCCOLI RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOXTAIL MILLET RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BEETS (BEETROOT) RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST RYE GRAIN RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BAMBOO SHOOT RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST SUNFLOWER SEED RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ASPARAGUS RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BAKER'S YEAST RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST VANILLA RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GUM ARABIC RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST OREGANO RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GREY ALDER IgE MAYO RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CORIANDER RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MUSHROOM RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CLOVE RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BAY LEAF RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BEAN NAVY WHITE RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BASIL RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PINE NUT RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST SWEET CHESTNUT RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITH IgE MAYO RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CHUB MACKEREL RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST RUSSIAN THISTLE RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BLACKBERRY RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASCARIS IGE RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MULBERRY RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BLUEBERRY RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOUNTAIN CEDAR RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST LIME RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST LETTUCE RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MANDARIN RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CHICK PEA RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST OVOMUCOID RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MELONS RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE RED MAPLE	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CAULIFLOWER RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PEAR RL	$7.50	$15.00	$4.12–$14.25	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS NIGER	$8.00	$16.00	$4.39–$15.20	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FLAVUS	$8.00	$16.00	$4.39–$15.20	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITH IgE-MAYO	$10.50	$15.00	$4.12–$14.25	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE BOX ELDER MAPLE RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE SYCAMORE RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE A LACTOALBUMIN MILK RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE B LACTOALBUMIN MILK RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ITELMINTHOSPORIUM RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST F MONILIFORME RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PENICILLIN RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F MONILIFORME IgE RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE CASEIN MILK RL	$12.50	$25.00	$5.12–$23.75	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST LATEX ALLERGEN RL	$13.00	$26.00	$5.12–$24.70	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO IgE RL	$14.00	$28.00	$5.12–$26.60	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE BLACK WALNUT RL	$14.00	$28.00	$5.12–$26.60	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD GRAPE RL	$16.50	$33.00	$5.12–$31.35	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST RHODOTORULA GLUTINUS	$17.00	$34.00	$5.12–$32.30	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OVALBUMIN, IgE RL	$17.00	$34.00	$5.12–$32.30	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD MILK RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE COMMON SILVER BIRCH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CASEIN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE OLIVE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD LACTOGLOBULIN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD ALPHA LACTALB RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE OAK RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD BARLEY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD/BLUE CHEESE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE MESQUITE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CHEDDAR CHEESE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD RICE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE MELALENCA CAJEP RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE RUSSIAN THISTLE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE MOUNTAIN CEDAR RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD SALMON	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE PECAN HICKORY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PERCH OCEAN	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE HAZELNUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD TROUT	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PANEL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD MACKEREL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE ELM RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD HALIBUT	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST COCKROACH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS COMMON PIGWEED	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE COTTONWOOD RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS GOLDENROD	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PAPRIKA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE BIRCH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD GINGER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD VANILLA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE BEECH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD SUGAR CANE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD OYSTER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE ALDER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD LOBSTER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD EGG YOLK RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD SCALLOP RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD GREEN BEANS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CATFISH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD COCONUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PISTACHIO RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS WILD RYE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CHILI PEPPER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PINEAPPLE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS VELVET RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CHERRY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CUMIN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS TIMOTHY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CAYENNE PEPPER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD ORANGE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS SWEET RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GARLIC RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST KIWI FRUIT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS RED RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST SALMON RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MUSTARD RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS PERENNIAL RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ONION RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST INSECT WH FCD HORNET RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WHITE PIN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WILLOW RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST INSECT HONEY BEE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE GIANT RAGWEED RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE SHORT RAGWEED RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST INSECT YELLOW JACKET RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE ENGLISH PLANTAI RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE PIG WEED RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CLAM RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ANIMAL DOG EPITHELIA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST EGG YOLK RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST C HERBARUM HORMODEND RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST DANDELION RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ANIMAL CAT EPITHELIA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CODFISH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST INSECT YELLOW HORNET RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CRAB RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST HOUSE DUST RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD ALMOND RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD HAZELNUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CHOCOLATE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CHICKEN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PORK RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD SHRIMP RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD BEEF RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD POTATO SWEET RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD TUNA FISH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD POTATO WHITE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CELERY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CITRUS ORANGE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CARROT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOLDS PENICILLUM RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD BANANA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD SOYBEAN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PEAS GREEN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PULLARLARIA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PEANUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST WHITE ASH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CHICKEN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD OAT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOLDS CLADOSPORIUM RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST INSECT PAPER WASP RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOLDS ASPERGILLUS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MUCOR RACEMOS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD EGG WHITE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST RHIZOPUS NIGRICANS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD TURKEY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PHOMA BETAE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALTERNARIA TENUIS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD WHEAT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MUGWORT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST SHEEP SORREL RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST COCKLEBUR RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST LAMBS QUARTER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE SWEET GUM RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CORN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WHITE POPLAR RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST DUSTMITE (P) RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CINNAMON RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST BLACK PEPPER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS ORCHARD RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST NUTMEG RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ASPERGILLUS NIGER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS FOX TAIL RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD TOMATO RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST DUST MITE D PTERONYSSINUS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS MEADOW FESCUE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST DUST MITE D MICROCERAS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST DOG DANDER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS JUNE KY BLUE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST COCKSFOOT (ORCHARD GRASS) RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST CAT DANDER RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST AUREOBASIDIUM PULLULANS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ASPERGILLUS FUMIGATUS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS WHEAT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST SPECIFIC ALLERGEN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST SHEEP SORREL (RUMEX A CETOSELLA) RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS RYE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PLANTAIN RIBWORT (PLANTAGO LANCE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST HOUSE DUST (HOLLISTER STIER LABS RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS CULTIVATED OAT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GOOSEFOOT LAMB'S QUARTERS (C ALB RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WALNUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GIANT RAGWEED (AMBROSIA TRIFIDA) RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS COMMON	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD LEMON RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WHITE ASH RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD APPLE RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS BROME RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD STRAWBERRY RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD GRAPEFRUIT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS BERMUDA RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD OLIVE OIL RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PECAN RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD WALNUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD CASHEW NUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST DUST MITE (D FARINAE) RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD BRAZIL NUT RL	$21.00	$42.00	$5.12–$39.90	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICPCCUM PURPURASCENS RL	$24.50	$49.00	$5.12–$46.55	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEY IgE RL	$24.50	$49.00	$5.12–$46.55	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOTRYTIS CINEREA IgE RL	$24.50	$49.00	$5.12–$46.55	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOLTYTIS IgE RL	$24.50	$49.00	$5.12–$46.55	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST EGG YOLK	$29.40	$42.00	$5.12–$39.90	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOLDS MUCOR	$29.40	$42.00	$5.12–$39.90	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .RAST/BOX ELDER	$29.40	$42.00	$5.12–$39.90	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ISOCYANATE TDI IgE RL	$38.50	$77.00	$5.12–$73.15	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ISOCYANATE MDI IgE RL	$38.50	$77.00	$5.12–$73.15	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ISOCYANATE HDI IgE RL	$38.50	$77.00	$5.12–$73.15	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CURVULARIA SPICIFERA/BIPOLARIS	$42.00	$84.00	$5.12–$79.80	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSANIVM OXYSPORUM VASIFECTUM RL	$46.25	$92.50	$5.12–$87.88	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST STEMPHYLIUM RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS BAHIA RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE LOCUST RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WHITE HICKORY RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST GRASS JOHNSON RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOOD PEACH RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE MULBERRY RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOLDS ALTERNARIA RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TREE WHITE OAK RL	$48.75	$97.50	$5.12–$92.62	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST HELMINTHOSPORIUM SAT RL	$52.00	$104.00	$5.12–$98.80	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM OXYSPORUM/VASINFECTUM MAYO I RL	$63.00	$126.00	$5.12–$119.70	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST RHODOTURULA GLUTINIS RL	$70.50	$141.00	$5.12–$133.95	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TRICHOPHYTON MENTAGROPHYTES IgE RL	$84.00	$168.00	$5.12–$159.60	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OCCUPATIONAL PANEL #2	$89.60	$128.00	$5.12–$121.60	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP RL	$25.00	$50.00	$12.69–$47.50	39% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP RL	$25.00	$50.00	$12.69–$47.50	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN RL	$59.50	$119.00	$11.85–$113.05	9% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN RL	$59.50	$119.00	$11.85–$113.05	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP	$120.00	$240.00	$38.47–$228.00	at median	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$168.00	$240.00	$38.47–$228.00	40% above	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PRO BNP	$120.00	$240.00	$38.47–$228.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$168.00	$240.00	$38.47–$228.00	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$62.50	$125.00	$8.29–$118.75	60% above	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL RL	$62.50	$125.00	$8.29–$118.75	60% above	50%
Basic metabolic panel (blood test) CPT 80048 BMP REOCCURRING	$98.00	$196.00	$8.29–$186.20	151% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL RL	$62.50	$125.00	$8.29–$118.75	—	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$62.50	$125.00	$8.29–$118.75	—	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP REOCCURRING	$98.00	$196.00	$8.29–$186.20	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK RL	$133.00	$266.00	$63.23–$252.70	50% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK RL	$133.00	$266.00	$63.23–$252.70	—	50%
Blood culture for bacteria CPT 87040 CULTURE BLOOD RL	$71.50	$143.00	$10.11–$135.85	10% below	50%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD RL	$71.50	$143.00	$10.11–$135.85	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION FEE VEIN	$10.50	$21.00	$5.76–$9.15	8% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION FEE-COC-DRUG SCREEN BLOOD RL	$15.50	$31.00	$8.51–$9.30	36% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DOT COLLECTION FEE	$17.50	$35.00	$9.15–$10.50	53% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION FEE VEIN	$10.50	$21.00	$5.76–$9.15	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION FEE-COC-DRUG SCREEN BLOOD RL	$15.50	$31.00	$8.51–$9.30	—	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE, CC RL	$7.50	$15.00	$3.85–$14.25	67% below	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE, MAYO	$26.25	$37.50	$3.85–$35.62	14% above	30%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$27.00	$54.00	$3.85–$51.30	17% above	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM RL	$27.00	$54.00	$3.85–$51.30	17% above	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, CC RL	$7.50	$15.00	$3.85–$14.25	—	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, MAYO	$26.25	$37.50	$3.85–$35.62	—	30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM RL	$27.00	$54.00	$3.85–$51.30	—	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$27.00	$54.00	$3.85–$51.30	—	50%
Blood lead test CPT 83655 LEAD WHOLE BLOOD RL	$16.00	$32.00	$8.78–$30.40	129% above	50%
Blood lead test CPT 83655 LEAD URINE 24 HR RL	$36.50	$73.00	$11.87–$69.35	421% above	50%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD RL	$16.00	$32.00	$8.78–$30.40	—	50%
Blood lead test inpatient CPT 83655 LEAD URINE 24 HR RL	$36.50	$73.00	$11.87–$69.35	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HCG	$48.50	$97.00	$7.37–$92.15	23% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HCG	$48.50	$97.00	$7.37–$92.15	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO/RH TYPE	$51.00	$102.00	$2.93–$96.90	15% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO/Rh RL	$145.00	$290.00	$2.93–$275.50	226% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO/RH TYPE	$51.00	$102.00	$2.93–$96.90	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO/Rh RL	$145.00	$290.00	$2.93–$275.50	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP SCREEN RL	$37.50	$75.00	$5.08–$71.25	34% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP SCREEN	$37.50	$75.00	$5.08–$71.25	34% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP TITER	$52.50	$75.00	$5.08–$71.25	88% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 .CRP, QUANTITATIVE	$54.60	$78.00	$5.08–$74.10	95% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP SCREEN	$37.50	$75.00	$5.08–$71.25	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP SCREEN RL	$37.50	$75.00	$5.08–$71.25	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP TITER	$52.50	$75.00	$5.08–$71.25	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 .CRP, QUANTITATIVE	$54.60	$78.00	$5.08–$74.10	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$22.50	$45.00	$12.35–$42.75	75% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$22.50	$45.00	$12.35–$42.75	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 RL	$70.00	$140.00	$20.39–$133.00	39% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 RL	$70.00	$140.00	$20.39–$133.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 QUEST	$112.50	$225.00	$50.28–$213.75	14% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 QLABS	$125.00	$250.00	$50.28–$237.50	27% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 CAMC	$125.00	$250.00	$50.28–$237.50	27% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MEDICAL CLEARANCE FOR PROCEDURE	$157.50	$225.00	$50.28–$213.75	60% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 BIOFIRE RESPIRATORY PANEL	$600.00	$1,200.00	$50.28–$1,140.00	508% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 QUEST	$112.50	$225.00	$50.28–$213.75	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 QLABS	$125.00	$250.00	$50.28–$237.50	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 CAMC	$125.00	$250.00	$50.28–$237.50	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MEDICAL CLEARANCE FOR PROCEDURE	$157.50	$225.00	$50.28–$213.75	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 BIOFIRE RESPIRATORY PANEL	$600.00	$1,200.00	$50.28–$1,140.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .CHLAMYDIA, URINE	$42.70	$61.00	$16.74–$57.95	at median	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, PCR RL	$44.00	$88.00	$24.15–$83.60	3% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CYTOLOGY CHLAMYDIA (CT) RL	$49.50	$99.00	$27.17–$94.05	16% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE RL	$51.50	$103.00	$28.26–$97.85	21% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .CHLAMYDIA, URINE	$42.70	$61.00	$16.74–$57.95	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS, PCR RL	$44.00	$88.00	$24.15–$83.60	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CYTOLOGY CHLAMYDIA (CT) RL	$49.50	$99.00	$27.17–$94.05	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE RL	$51.50	$103.00	$28.26–$97.85	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID CHOL TRIG HDL	$50.00	$100.00	$13.12–$95.00	20% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID CHOL TRIG HDL RL	$75.00	$150.00	$13.12–$142.50	20% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID CHOL TRIG HDL	$50.00	$100.00	$13.12–$95.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID CHOL TRIG HDL RL	$75.00	$150.00	$13.12–$142.50	—	50%
Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED DIFF	$44.00	$88.00	$7.61–$83.60	3% above	50%
Complete blood count (CBC) with differential CPT 85025 CBC w/DIFF, RL	$44.00	$88.00	$7.61–$83.60	3% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/DIFF, RL	$44.00	$88.00	$7.61–$83.60	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTOMATED DIFF	$44.00	$88.00	$7.61–$83.60	—	50%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$22.50	$45.00	$6.34–$42.75	45% below	50%
Complete blood count (CBC), no differential CPT 85027 CBC MANUAL DIFF	$44.00	$88.00	$6.34–$83.60	7% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$22.50	$45.00	$6.34–$42.75	—	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC MANUAL DIFF	$44.00	$88.00	$6.34–$83.60	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE PANEL RL	$62.50	$125.00	$10.35–$118.75	28% above	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE PANEL	$62.50	$125.00	$10.35–$118.75	28% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE PANEL RL	$62.50	$125.00	$10.35–$118.75	—	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE PANEL	$62.50	$125.00	$10.35–$118.75	—	50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE, PLASMA, RL	$64.00	$128.00	$9.98–$121.60	at median	50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE	$64.00	$128.00	$9.98–$121.60	at median	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE	$64.00	$128.00	$9.98–$121.60	—	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE, PLASMA, RL	$64.00	$128.00	$9.98–$121.60	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S RL	$93.00	$186.00	$21.79–$176.70	2% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S RL	$93.00	$186.00	$21.79–$176.70	—	50%
Estradiol blood test CPT 82670 ESTRADIOL FREE RL	$54.50	$109.00	$27.38–$103.55	38% below	50%
Estradiol blood test CPT 82670 ESTRADIOL SERUM RL	$113.25	$226.50	$27.38–$215.18	29% above	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL FREE RL	$54.50	$109.00	$27.38–$103.55	—	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL SERUM RL	$113.25	$226.50	$27.38–$215.18	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH SERUM RL	$92.00	$184.00	$18.21–$174.80	6% above	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH SERUM RL	$92.00	$184.00	$18.21–$174.80	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN RL	$233.00	$466.00	$19.24–$442.70	195% above	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN RL	$233.00	$466.00	$19.24–$442.70	—	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN RL	$75.00	$150.00	$13.36–$142.50	2% above	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$75.00	$150.00	$13.36–$142.50	2% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$75.00	$150.00	$13.36–$142.50	—	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN RL	$75.00	$150.00	$13.36–$142.50	—	50%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM RL	$44.00	$88.00	$14.41–$83.60	41% below	50%
Folate (folic acid) blood test CPT 82746 FOLATE, SERUM	$44.00	$88.00	$14.41–$83.60	41% below	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$61.60	$88.00	$14.41–$83.60	18% below	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM	$44.00	$88.00	$14.41–$83.60	—	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM RL	$44.00	$88.00	$14.41–$83.60	—	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$61.60	$88.00	$14.41–$83.60	—	30%
Free T3 thyroid hormone test CPT 84481 FREE T3 RL	$166.00	$332.00	$16.60–$315.40	92% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 RL	$166.00	$332.00	$16.60–$315.40	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$52.50	$105.00	$8.84–$99.75	11% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 RL	$52.50	$105.00	$8.84–$99.75	11% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY DIALYSIS	$129.50	$185.00	$8.84–$175.75	120% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 RL	$52.50	$105.00	$8.84–$99.75	—	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$52.50	$105.00	$8.84–$99.75	—	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 BY DIALYSIS	$129.50	$185.00	$8.84–$175.75	—	30%
Free testosterone test CPT 84402 TESTOSTERONE, FREE, RL	$22.50	$45.00	$12.35–$42.75	61% below	50%
Free testosterone test CPT 84402 TESTOSTERONE FREE AND TOTAL, RL	$131.50	$263.00	$24.96–$249.85	127% above	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE, RL	$22.50	$45.00	$12.35–$42.75	—	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE AND TOTAL, RL	$131.50	$263.00	$24.96–$249.85	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$293.50	$587.00	$161.07–$557.65	25% above	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$293.50	$587.00	$161.07–$557.65	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HOUR POST	$54.50	$109.00	$4.66–$103.55	70% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HOUR POST	$54.50	$109.00	$4.66–$103.55	70% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 HOUR POST	$54.50	$109.00	$4.66–$103.55	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HOUR POST	$54.50	$109.00	$4.66–$103.55	—	50%
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$64.00	$128.00	$12.61–$121.60	12% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1ST 3 SPECIMENS	$64.00	$128.00	$12.61–$121.60	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, PCR RL	$44.00	$88.00	$24.15–$83.60	27% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CYTOLOGY GC RL	$49.50	$99.00	$27.17–$94.05	18% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA PROBE RL	$51.50	$103.00	$28.26–$97.85	14% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, PCR RL	$44.00	$88.00	$24.15–$83.60	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CYTOLOGY GC RL	$49.50	$99.00	$27.17–$94.05	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA PROBE RL	$51.50	$103.00	$28.26–$97.85	—	50%
H. pylori antibody blood test CPT 86677 H. PYLORI Ab, IgM, S RL	$25.50	$51.00	$13.99–$48.45	53% below	50%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODIES	$40.60	$58.00	$15.92–$55.10	25% below	30%
H. pylori antibody blood test CPT 86677 H-PYLORI GAST BIOPSY	$41.50	$83.00	$16.51–$78.85	23% below	50%
H. pylori antibody blood test inpatient CPT 86677 H. PYLORI Ab, IgM, S RL	$25.50	$51.00	$13.99–$48.45	—	50%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODIES	$40.60	$58.00	$15.92–$55.10	—	30%
H. pylori antibody blood test inpatient CPT 86677 H-PYLORI GAST BIOPSY	$41.50	$83.00	$16.51–$78.85	—	50%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN, FECES RL	$75.00	$150.00	$14.09–$142.50	53% above	50%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN, FECES RL	$75.00	$150.00	$14.09–$142.50	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 VIRAL LOAD RL	$194.50	$389.00	$83.40–$369.55	25% below	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA RL	$285.50	$571.00	$83.40–$542.45	10% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 VIRAL LOAD RL	$194.50	$389.00	$83.40–$369.55	—	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA RL	$285.50	$571.00	$83.40–$542.45	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODY SEROLOGY RL	$34.00	$68.00	$18.66–$64.60	31% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ANTIBODY SEROLOGY RL	$34.00	$68.00	$18.66–$64.60	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C	$38.00	$76.00	$9.52–$72.20	27% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C	$38.00	$76.00	$9.52–$72.20	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB RL	$34.00	$68.00	$10.53–$64.60	39% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB RL	$34.00	$68.00	$10.53–$64.60	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SCREENING RL	$33.00	$66.00	$10.12–$62.70	44% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIG RL	$33.00	$66.00	$10.12–$62.70	44% below	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SCREENING RL	$33.00	$66.00	$10.12–$62.70	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIG RL	$33.00	$66.00	$10.12–$62.70	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY, SCREENING RL	$59.50	$119.00	$13.98–$113.05	at median	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY RL	$59.50	$119.00	$13.98–$113.05	at median	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY, SCREENING RL	$59.50	$119.00	$13.98–$113.05	—	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY RL	$59.50	$119.00	$13.98–$113.05	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL LOAD RL	$45.50	$91.00	$24.97–$86.45	78% below	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA (PCR) RL	$315.00	$630.00	$41.98–$598.50	52% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL LOAD RL	$45.50	$91.00	$24.97–$86.45	—	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA (PCR) RL	$315.00	$630.00	$41.98–$598.50	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 IGG RL	$62.50	$125.00	$12.93–$118.75	43% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 .HERPES SIMPLEX 1 IGM	$65.10	$93.00	$12.93–$88.35	49% above	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX 1 IGG RL	$62.50	$125.00	$12.93–$118.75	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 .HERPES SIMPLEX 1 IGM	$65.10	$93.00	$12.93–$88.35	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 IGG RL	$46.50	$93.00	$18.96–$88.35	7% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 .HERPES SIMPLEX 2 IGM	$65.10	$93.00	$18.96–$88.35	50% above	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 IGG RL	$46.50	$93.00	$18.96–$88.35	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HERPES SIMPLEX 2 IGM	$65.10	$93.00	$18.96–$88.35	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP (hsCRP) RL	$39.00	$78.00	$12.69–$74.10	37% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP (hsCRP) RL	$39.00	$78.00	$12.69–$74.10	—	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL RL	$245.00	$490.00	$17.56–$465.50	178% above	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE LEVEL RL	$245.00	$490.00	$17.56–$465.50	—	50%
Insulin blood test CPT 83525 INSULIN LEVEL RL	$36.50	$73.00	$11.20–$69.35	36% below	50%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL RL	$36.50	$73.00	$11.20–$69.35	—	50%
Iron blood test (serum iron) CPT 83540 IRON	$18.00	$36.00	$6.34–$34.20	58% below	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$18.00	$36.00	$6.34–$34.20	—	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$44.50	$89.00	$8.57–$84.55	8% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$44.50	$89.00	$8.57–$84.55	—	50%
Kidney function blood test panel CPT 80069 RENAL PANEL	$122.50	$245.00	$8.51–$232.75	206% above	50%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$122.50	$245.00	$8.51–$232.75	—	50%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE(LH) RL	$104.00	$208.00	$18.15–$197.60	5% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE(LH) RL	$104.00	$208.00	$18.15–$197.60	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$44.00	$88.00	$6.75–$83.60	2% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE RL	$44.00	$88.00	$6.75–$83.60	2% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE RL	$44.00	$88.00	$6.75–$83.60	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$44.00	$88.00	$6.75–$83.60	—	50%
Liver function blood test panel CPT 80076 HEPATIC (LIVER) PANEL RL	$141.00	$282.00	$8.01–$267.90	271% above	50%
Liver function blood test panel CPT 80076 HEPATIC (LIVER) PANEL	$141.00	$282.00	$8.01–$267.90	271% above	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC (LIVER) PANEL RL	$141.00	$282.00	$8.01–$267.90	—	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC (LIVER) PANEL	$141.00	$282.00	$8.01–$267.90	—	50%
Lyme disease antibody test CPT 86618 LYMES SEROLOGY AB, EIA RL	$96.50	$193.00	$16.69–$183.35	239% above	50%
Lyme disease antibody test inpatient CPT 86618 LYMES SEROLOGY AB, EIA RL	$96.50	$193.00	$16.69–$183.35	—	50%
Magnesium blood test CPT 83735 MAGNESIUM, 24 HR, URINE SUPERSATURATION	$10.00	$20.00	$5.49–$19.00	34% below	50%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$10.00	$20.00	$5.49–$19.00	34% below	50%
Magnesium blood test CPT 83735 MAGNESIUM	$36.50	$73.00	$6.57–$69.35	139% above	50%
Magnesium blood test CPT 83735 MAGNESIUM URINE 24 HOUR RL	$55.50	$111.00	$6.57–$105.45	264% above	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, 24 HR, URINE SUPERSATURATION	$10.00	$20.00	$5.49–$19.00	—	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$10.00	$20.00	$5.49–$19.00	—	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$36.50	$73.00	$6.57–$69.35	—	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE 24 HOUR RL	$55.50	$111.00	$6.57–$105.45	—	50%
Measles (rubeola) antibody test CPT 86765 MEASLES SCREEN IgG RL	$18.00	$36.00	$9.88–$34.20	56% below	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY RL	$67.50	$135.00	$12.62–$128.25	66% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES SCREEN IgG RL	$18.00	$36.00	$9.88–$34.20	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY RL	$67.50	$135.00	$12.62–$128.25	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$35.00	$70.00	$5.08–$66.50	1% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$35.00	$70.00	$5.08–$66.50	—	50%
Obstetric blood test panel CPT 80055 OB PANEL	$212.00	$424.00	$46.85–$402.80	4% below	50%
Obstetric blood test panel inpatient CPT 80055 OB PANEL	$212.00	$424.00	$46.85–$402.80	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA (PHI) - MAYO RL	$41.00	$82.00	$18.02–$77.90	34% below	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE RL	$68.00	$136.00	$18.02–$129.20	9% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA RL	$95.20	$136.00	$18.02–$129.20	53% above	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA (PHI) - MAYO RL	$41.00	$82.00	$18.02–$77.90	—	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE RL	$68.00	$136.00	$18.02–$129.20	—	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA RL	$95.20	$136.00	$18.02–$129.20	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX - MAYO RL	$20.00	$40.00	$10.98–$38.00	70% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL DIAGNOSTIC	$68.00	$136.00	$18.02–$129.20	1% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL RL DIAGNOSTIC RL	$68.00	$136.00	$18.02–$129.20	1% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE HEALTH INDEX - MAYO RL	$20.00	$40.00	$10.98–$38.00	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL DIAGNOSTIC	$68.00	$136.00	$18.02–$129.20	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL RL DIAGNOSTIC RL	$68.00	$136.00	$18.02–$129.20	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY PAP SMEAR LIQUID BASED PRO F RL	$25.50	$51.00	$13.99–$48.45	49% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY PAP SMEAR LIQUID BASED PRO F RL	$25.50	$51.00	$13.99–$48.45	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$141.50	$283.00	$40.45–$268.85	7% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT RL	$141.50	$283.00	$40.45–$268.85	7% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT RL	$141.50	$283.00	$40.45–$268.85	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$141.50	$283.00	$40.45–$268.85	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$23.50	$47.00	$5.89–$44.65	50% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT REOCCURRING	$167.50	$335.00	$5.89–$318.25	254% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$23.50	$47.00	$5.89–$44.65	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT REOCCURRING	$167.50	$335.00	$5.89–$318.25	—	50%
Progesterone blood test CPT 84144 PROGESTERONE RL	$59.00	$118.00	$20.44–$112.10	48% below	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE RL	$59.00	$118.00	$20.44–$112.10	—	50%
Prolactin blood test CPT 84146 PROLACTIN (RIA) RL	$149.50	$299.00	$18.99–$284.05	122% above	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN (RIA) RL	$149.50	$299.00	$18.99–$284.05	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT 1:1 MIX RL	$7.00	$14.00	$3.84–$13.30	76% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME RL	$23.50	$47.00	$4.20–$44.65	18% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME (PT)	$23.50	$47.00	$4.20–$44.65	18% below	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT 1:1 MIX RL	$7.00	$14.00	$3.84–$13.30	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME (PT)	$23.50	$47.00	$4.20–$44.65	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME RL	$23.50	$47.00	$4.20–$44.65	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN, SINGLE DRUG CLASS EA DRU RL	$12.00	$24.00	$6.59–$22.80	66% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 10 PANEL MSHA DRUG SCREEN RL	$60.00	$120.00	$12.35–$114.00	71% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN MSHA ONLY	$60.00	$120.00	$12.35–$114.00	71% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN, URINE MEDTOX	$71.00	$142.00	$12.35–$134.90	103% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN (MAYO) RL	$126.00	$252.00	$12.35–$239.40	260% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 INSTANT CUP DRUG SCREEN	$202.30	$289.00	$12.35–$274.55	478% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE PS DIP INSTANT TEST	$202.30	$289.00	$12.35–$274.55	478% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN, SINGLE DRUG CLASS EA DRU RL	$12.00	$24.00	$6.59–$22.80	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 10 PANEL MSHA DRUG SCREEN RL	$60.00	$120.00	$12.35–$114.00	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN, URINE MEDTOX	$71.00	$142.00	$12.35–$134.90	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN (MAYO) RL	$126.00	$252.00	$12.35–$239.40	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 INSTANT CUP DRUG SCREEN	$202.30	$289.00	$12.35–$274.55	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE PS DIP INSTANT TEST	$202.30	$289.00	$12.35–$274.55	—	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A/B	$27.50	$55.00	$15.09–$52.25	47% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN	$44.00	$88.00	$16.20–$83.60	8% above	50%
Rheumatoid factor (RF) test CPT 86431 QUANT RHEUMATOID FACTOR MEASUREMENT	$12.60	$18.00	$4.94–$17.10	66% below	30%
Rheumatoid factor (RF) test CPT 86431 RA TITER	$34.00	$68.00	$5.56–$64.60	8% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANT RHEUMATOID FACTOR MEASUREMENT	$12.60	$18.00	$4.94–$17.10	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER	$34.00	$68.00	$5.56–$64.60	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG RL	$14.00	$28.00	$7.68–$26.60	78% below	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM (TITER) RL	$56.50	$113.00	$14.10–$107.35	13% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG RL	$14.00	$28.00	$7.68–$26.60	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM (TITER) RL	$56.50	$113.00	$14.10–$107.35	—	50%
Stool ova and parasites exam CPT 87177 TAPE/HOOKWORM	$13.00	$26.00	$7.13–$24.70	74% below	50%
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$73.50	$105.00	$8.72–$99.75	47% above	30%
Stool ova and parasites exam inpatient CPT 87177 TAPE/HOOKWORM	$13.00	$26.00	$7.13–$24.70	—	50%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$73.50	$105.00	$8.72–$99.75	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCCULT	$20.50	$41.00	$4.29–$38.95	32% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES, SCREEN	$28.70	$41.00	$4.29–$38.95	85% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES, 3 SPECIMEN SCREEN	$30.50	$61.00	$4.29–$57.95	97% above	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECES, SCREEN	$28.70	$41.00	$4.29–$38.95	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECES, 3 SPECIMEN SCREEN	$30.50	$61.00	$4.29–$57.95	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL IMMUNOCHEM	$11.25	$22.50	$6.17–$21.38	69% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL IMMUNOCHEM	$11.25	$22.50	$6.17–$21.38	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$6.50	$13.00	$3.57–$12.35	76% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR RL	$21.00	$30.00	$4.18–$28.50	22% below	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF	$21.70	$31.00	$4.18–$29.45	20% below	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS SEROLOGY RL	$37.50	$75.00	$4.18–$71.25	39% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$6.50	$13.00	$3.57–$12.35	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR RL	$21.00	$30.00	$4.18–$28.50	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF	$21.70	$31.00	$4.18–$29.45	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS SEROLOGY RL	$37.50	$75.00	$4.18–$71.25	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL RL	$101.00	$202.00	$25.29–$191.90	26% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$101.00	$202.00	$25.29–$191.90	26% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL RL	$101.00	$202.00	$25.29–$191.90	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$101.00	$202.00	$25.29–$191.90	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 LKM1 ANTIBODIES RL	$80.50	$161.00	$14.26–$152.95	5% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE ANTIBODY RL	$91.50	$183.00	$14.26–$173.85	19% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LKM1 ANTIBODIES RL	$80.50	$161.00	$14.26–$152.95	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE ANTIBODY RL	$91.50	$183.00	$14.26–$173.85	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$50.00	$100.00	$16.46–$95.00	23% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH RL	$50.00	$100.00	$16.46–$95.00	23% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$50.00	$100.00	$16.46–$95.00	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH RL	$50.00	$100.00	$16.46–$95.00	—	50%
Uric acid blood test CPT 84550 URIC ACID SERUM	$33.00	$66.00	$4.43–$62.70	at median	50%
Uric acid blood test CPT 84550 URIC ACID RL	$33.00	$66.00	$4.43–$62.70	at median	50%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM	$33.00	$66.00	$4.43–$62.70	—	50%
Uric acid blood test inpatient CPT 84550 URIC ACID RL	$33.00	$66.00	$4.43–$62.70	—	50%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS with REFLEX	$25.00	$50.00	$3.94–$47.50	56% above	50%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS with REFLEX	$25.00	$50.00	$3.94–$47.50	—	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS PLAIN	$25.00	$50.00	$2.20–$47.50	32% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS PLAIN	$25.00	$50.00	$2.20–$47.50	—	50%
Urinalysis without microscope exam, manual CPT 81002 URINE TEST DIP STICK	$12.50	$25.00	$3.41–$23.75	at median	50%
Urinalysis without microscope exam, manual CPT 81002 ACETONE URINE	$15.00	$30.00	$3.41–$28.50	20% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS WITHOUT MICRO	$15.50	$31.00	$3.41–$29.45	24% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 ACETONE URINE	$15.00	$30.00	$3.41–$28.50	—	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS WITHOUT MICRO	$15.50	$31.00	$3.41–$29.45	—	50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$67.50	$135.00	$7.91–$128.25	10% above	50%
Urine culture for bacteria, with colony count CPT 87086 TEST CULTURE URINE	$94.50	$135.00	$7.91–$128.25	54% above	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$67.50	$135.00	$7.91–$128.25	—	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 TEST CULTURE URINE	$94.50	$135.00	$7.91–$128.25	—	30%
Urine pregnancy test, read by color change CPT 81025 BRIGHTER FUTURES URINE PREGNANCY TEST	$7.75	$15.50	$4.25–$14.72	63% below	50%
Urine pregnancy test, read by color change CPT 81025 CL URINE PREGNANCY TEST	$40.50	$81.00	$8.44–$76.95	95% above	50%
Urine pregnancy test, read by color change CPT 81025 HCG URINE	$48.50	$97.00	$8.44–$92.15	134% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 BRIGHTER FUTURES URINE PREGNANCY TEST	$7.75	$15.50	$4.25–$14.72	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG URINE	$48.50	$97.00	$8.44–$92.15	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$87.00	$174.00	$14.78–$165.30	5% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$87.00	$174.00	$14.78–$165.30	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 RL	$53.50	$107.00	$29.01–$101.65	25% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D ASSAY RL	$106.50	$213.00	$29.01–$202.35	49% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D	$106.50	$213.00	$29.01–$202.35	49% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 RL	$53.50	$107.00	$29.01–$101.65	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D ASSAY RL	$106.50	$213.00	$29.01–$202.35	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D	$106.50	$213.00	$29.01–$202.35	—	50%
Zinc blood test CPT 84630 ZINC, SERUM RL	$20.00	$40.00	$10.98–$38.00	29% below	50%
Zinc blood test CPT 84630 ZINC URINE RL	$73.00	$146.00	$11.16–$138.70	161% above	50%
Zinc blood test inpatient CPT 84630 ZINC, SERUM RL	$20.00	$40.00	$10.98–$38.00	—	50%
Zinc blood test inpatient CPT 84630 ZINC URINE RL	$73.00	$146.00	$11.16–$138.70	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT RL	$48.50	$97.00	$14.75–$92.15	44% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT	$48.50	$97.00	$14.75–$92.15	44% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANT RL	$48.50	$97.00	$14.75–$92.15	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANT	$48.50	$97.00	$14.75–$92.15	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY	$8,658.00	$17,316.00	$830.92–$16,450.20	—	50%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY	$8,658.00	$17,316.00	$830.92–$16,450.20	—	50%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$9,654.50	$19,309.00	$608.06–$18,343.55	1% below	50%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$9,654.50	$19,309.00	$608.06–$18,343.55	—	50%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR	$9,566.00	$19,132.00	$952.73–$18,175.40	at median	50%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR	$9,566.00	$19,132.00	$952.73–$18,175.40	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREAT OF ANKLE FRACTURE	$363.00	$726.00	$217.80–$689.70	9% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TX OF DISTAL FIBULA FRACTURE	$560.50	$1,121.00	$307.60–$1,064.95	69% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREAT OF ANKLE FRACTURE	$583.10	$833.00	$249.90–$791.35	76% above	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TX OF DISTAL FIBULA FRACTURE	$560.50	$1,121.00	$307.60–$1,064.95	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREAT OF ANKLE FRACTURE	$583.10	$833.00	$249.90–$791.35	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TX OF METATARSAL FRACTURE	$478.00	$956.00	$215.79–$908.20	86% above	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TX OF METATARSAL FRACTURE	$478.00	$956.00	$215.79–$908.20	—	50%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 COR HLX VLGS DSTL MTAR OSTEO	$4,542.50	$9,085.00	$801.92–$8,630.75	—	50%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 COR HLX VLGS DSTL MTAR OSTEO	$4,542.50	$9,085.00	$801.92–$8,630.75	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION,ELECTIVE,ELECTRICAL.CONVER	$173.00	$346.00	$103.80–$328.70	83% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION,ELECTIVE,ELECTRICAL CONVER	$840.00	$1,680.00	$142.83–$1,596.00	20% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOLOGY PRO FEE CARDIOVERSION	$860.50	$1,721.00	$105.69–$1,634.95	18% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$878.00	$1,756.00	$142.83–$1,668.20	16% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOLOGY CARDIOVERSION ELECTIVE	$1,122.00	$2,244.00	$142.83–$2,131.80	8% above	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION,ELECTIVE,ELECTRICAL CONVER	$840.00	$1,680.00	$142.83–$1,596.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOLOGY PRO FEE CARDIOVERSION	$860.50	$1,721.00	$105.69–$1,634.95	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$878.00	$1,756.00	$142.83–$1,668.20	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOLOGY CARDIOVERSION ELECTIVE	$1,122.00	$2,244.00	$142.83–$2,131.80	—	50%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL	$2,722.00	$5,444.00	$450.04–$5,171.80	3% below	50%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL	$2,722.00	$5,444.00	$450.04–$5,171.80	—	50%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$134.50	$269.00	$73.81–$255.55	87% below	50%
Cervical biopsy CPT 57500 BIOPSY/EXCISE LSN-CERV	$193.90	$277.00	$76.01–$263.15	82% below	30%
Cervical biopsy inpatient CPT 57500 BIOPSY/EXCISE LSN-CERV	$193.90	$277.00	$76.01–$263.15	—	30%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION	$2,617.00	$5,234.00	$175.79–$4,972.30	3% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION	$2,617.00	$5,234.00	$175.79–$4,972.30	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION, CLAMP, NEWBORN	$147.00	$210.00	$57.62–$199.50	94% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION, CLAMP, NEWBORN	$147.00	$210.00	$57.62–$199.50	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREAT DISTAL RAD FX ULNAR STYLOID	$118.00	$236.00	$70.80–$367.31	68% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREAT DISTAL RAD FX ULNAR STYLOID	$135.50	$271.00	$81.30–$367.31	64% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREAT DISTAL RAD FX ULNAR STYLOID	$135.50	$271.00	$81.30–$367.31	—	50%
Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY W/SNARE	$1,650.00	$3,300.00	$454.33–$3,135.00	8% above	50%
Colonoscopy with polyp removal CPT 45385 BIOPSY SING/MULT STOMACH	$2,429.00	$3,470.00	$454.33–$3,296.50	59% above	30%
Colonoscopy with polyp removal inpatient CPT 45385 LESION REMOVAL COLONOSCOPY W/SNARE	$1,650.00	$3,300.00	$454.33–$3,135.00	—	50%
Colonoscopy with polyp removal inpatient CPT 45385 BIOPSY SING/MULT STOMACH	$2,429.00	$3,470.00	$454.33–$3,296.50	—	30%
Colonoscopy with tissue sample CPT 45380 COLSC FIX PROX SPLENIC	$617.40	$882.00	$242.02–$837.90	55% below	30%
Colonoscopy with tissue sample CPT 45380 COLSC FLX PROX SPLENIC FLXR BX1/MLT	$1,598.50	$3,197.00	$431.36–$3,037.15	17% above	50%
Colonoscopy with tissue sample inpatient CPT 45380 COLSC FIX PROX SPLENIC	$617.40	$882.00	$242.02–$837.90	—	30%
Colonoscopy with tissue sample inpatient CPT 45380 COLSC FLX PROX SPLENIC FLXR BX1/MLT	$1,598.50	$3,197.00	$431.36–$3,037.15	—	50%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY W/ DIAG BRUSH/WASH	$1,266.50	$2,533.00	$343.18–$2,406.35	8% above	50%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY W/ DIAG BRUSH/WASH	$1,266.50	$2,533.00	$343.18–$2,406.35	—	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLP W/BX & ECC	$365.00	$730.00	$158.47–$693.50	10% above	50%
Cystoscopy with ureteral stent placement CPT 52332 URETERAL STENT/REMOVAL/PLACEMENT	$4,302.50	$8,605.00	$335.86–$8,174.75	at median	50%
Cystoscopy with ureteral stent placement inpatient CPT 52332 URETERAL STENT/REMOVAL/PLACEMENT	$4,302.50	$8,605.00	$335.86–$8,174.75	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$892.00	$1,784.00	$193.82–$1,694.80	8% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$892.00	$1,784.00	$193.82–$1,694.80	—	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURRETTAGE	$4,196.00	$8,392.00	$280.98–$7,972.40	17% above	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURRETTAGE	$4,196.00	$8,392.00	$280.98–$7,972.40	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PREMALIGNANT 1ST LESION	$62.50	$125.00	$34.30–$118.75	72% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 REMOVAL OF 1ST LESION	$88.20	$126.00	$34.57–$119.70	60% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION ALL BENIGN LESIONS, 1ST ONE	$105.00	$150.00	$45.00–$142.50	53% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PREMALIGNANT 1ST LESION	$108.50	$155.00	$46.50–$147.25	51% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 LESION / WART REMOVAL X 1	$136.50	$195.00	$53.51–$185.25	38% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 REMOVAL OF 1ST LESION	$88.20	$126.00	$34.57–$119.70	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION ALL BENIGN LESIONS, 1ST ONE	$105.00	$150.00	$45.00–$142.50	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION OF PREMALIGNANT 1ST LESION	$108.50	$155.00	$46.50–$147.25	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 LESION / WART REMOVAL X 1	$136.50	$195.00	$53.51–$185.25	—	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMANOSTOMY GEN ANESTH	$1,969.00	$3,938.00	$136.72–$3,741.10	8% above	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMANOSTOMY GEN ANESTH	$1,969.00	$3,938.00	$136.72–$3,741.10	—	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY LOCAL ANES W/INS OF TUBE	$737.50	$1,475.00	$182.80–$1,401.25	19% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY LOCAL ANES W/INS OF TUBE	$737.50	$1,475.00	$182.80–$1,401.25	19% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$781.50	$1,563.00	$182.80–$1,484.85	26% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY LOCAL ANES W/INS OF TUBE	$737.50	$1,475.00	$182.80–$1,401.25	—	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING	$781.50	$1,563.00	$182.80–$1,484.85	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGAT/LAVAGE	$41.00	$82.00	$14.69–$77.90	50% below	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGAT/LAVAGE	$41.00	$82.00	$14.69–$77.90	50% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGAT/LAVAGE	$41.00	$82.00	$14.69–$77.90	—	50%
Earwax removal with instruments, one ear CPT 69210 LAVAGE EXT EAR CANAL	$57.40	$82.00	$22.50–$77.90	16% below	30%
Earwax removal with instruments, one ear CPT 69210 EAR CLEANING	$57.40	$82.00	$22.50–$77.90	16% below	30%
Earwax removal with instruments, one ear CPT 69210 EAR CLEANING	$97.50	$195.00	$44.49–$185.25	43% above	50%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN UNI W/INSTRUM	$122.50	$175.00	$44.49–$166.25	80% above	30%
Earwax removal with instruments, one ear inpatient CPT 69210 LAVAGE EXT EAR CANAL	$57.40	$82.00	$22.50–$77.90	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR CLEANING	$57.40	$82.00	$22.50–$77.90	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN UNI W/INSTRUM	$122.50	$175.00	$44.49–$166.25	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETIAL BIOPSY	$97.50	$195.00	$53.51–$185.25	52% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$175.00	$250.00	$64.24–$237.50	13% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$175.00	$250.00	$64.24–$237.50	—	30%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY	$8,467.00	$16,934.00	$271.82–$16,087.30	52% above	50%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY	$8,467.00	$16,934.00	$271.82–$16,087.30	—	50%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASAL/SINUS NDSC W/RMVL TISS FRONT SINUS	$8,521.50	$17,043.00	$316.67–$16,190.85	36% above	50%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL/SINUS NDSC W/RMVL TISS FRONT SINUS	$8,521.50	$17,043.00	$316.67–$16,190.85	—	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDO W/MAXILLARY ANTROSTOMY	$4,635.50	$9,271.00	$150.90–$8,807.45	21% above	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDO W/MAXILLARY ANTROSTOMY	$4,635.50	$9,271.00	$150.90–$8,807.45	—	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NSL/SINUS NDSC MAX ANTROST W/RMVL TISS M	$8,411.00	$16,822.00	$222.56–$15,980.90	137% above	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NSL/SINUS NDSC MAX ANTROST W/RMVL TISS M	$8,411.00	$16,822.00	$222.56–$15,980.90	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG	$927.50	$1,855.00	$246.98–$1,762.25	7% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG	$927.50	$1,855.00	$246.98–$1,762.25	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1	$1,172.50	$2,345.00	$171.06–$2,227.75	15% above	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1	$1,172.50	$2,345.00	$171.06–$2,227.75	—	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC	$8,365.50	$16,731.00	$538.05–$15,894.45	at median	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HRN 1ST 3-10 RDC	$8,365.50	$16,731.00	$538.05–$15,894.45	—	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$4,465.50	$8,931.00	$321.13–$8,484.45	14% below	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$4,465.50	$8,931.00	$321.13–$8,484.45	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SGMDSC FLX DIAG BRUSH/WASH	$170.10	$243.00	$59.25–$230.85	80% below	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$187.60	$268.00	$73.54–$254.60	78% below	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA	$1,142.50	$2,285.00	$188.90–$2,170.75	33% above	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SGMDSC FLX DIAG BRUSH/WASH	$170.10	$243.00	$59.25–$230.85	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$187.60	$268.00	$73.54–$254.60	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA	$1,142.50	$2,285.00	$188.90–$2,170.75	—	50%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$7,533.00	$15,066.00	$631.07–$14,312.70	31% below	50%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$7,533.00	$15,066.00	$631.07–$14,312.70	—	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRA	$7,591.00	$15,182.00	$684.86–$14,422.90	10% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRA	$7,591.00	$15,182.00	$684.86–$14,422.90	—	50%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$4,226.50	$8,453.00	$501.97–$8,030.35	5% below	50%
Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE	$4,226.50	$8,453.00	$501.97–$8,030.35	—	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 BAND LIGATION	$1,271.50	$2,543.00	$293.82–$2,415.85	at median	50%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 BAND LIGATION	$1,271.50	$2,543.00	$293.82–$2,415.85	—	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$3,900.50	$7,801.00	$532.15–$7,410.95	25% below	50%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$3,900.50	$7,801.00	$532.15–$7,410.95	—	50%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$6,407.00	$12,814.00	$1,744.01–$12,173.30	41% above	50%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ABLATION	$6,407.00	$12,814.00	$1,744.01–$12,173.30	—	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$4,197.50	$8,395.00	$1,112.17–$7,975.25	7% above	50%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY	$4,197.50	$8,395.00	$1,112.17–$7,975.25	—	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$374.50	$749.00	$205.53–$711.55	128% above	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$374.50	$749.00	$205.53–$711.55	128% above	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$374.50	$749.00	$205.53–$711.55	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINING OF ABCESS SINGLE	$70.00	$100.00	$30.00–$109.26	70% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS-SIMPLE-SING	$99.40	$142.00	$42.60–$134.90	57% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$117.00	$234.00	$64.21–$222.30	50% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D PILONIDAL CYST, SIMPLE	$142.80	$204.00	$61.20–$193.80	39% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE	$150.50	$215.00	$59.00–$204.25	35% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$189.70	$271.00	$74.36–$257.45	19% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$322.50	$645.00	$117.00–$612.75	38% above	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINING OF ABCESS SINGLE	$70.00	$100.00	$30.00–$109.26	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS-SIMPLE-SING	$99.40	$142.00	$42.60–$134.90	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D PILONIDAL CYST, SIMPLE	$142.80	$204.00	$61.20–$193.80	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE	$150.50	$215.00	$59.00–$204.25	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$189.70	$271.00	$74.36–$257.45	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$322.50	$645.00	$117.00–$612.75	—	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$4,642.50	$9,285.00	$503.63–$8,820.75	46% below	50%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$4,642.50	$9,285.00	$503.63–$8,820.75	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION(S); TENDON SHEATH, LIGAMENT	$38.50	$77.00	$23.10–$73.15	89% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TREATMENT	$67.90	$97.00	$29.10–$92.15	81% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION(S); TENDON SHEATH, LIGAMENT	$353.00	$706.00	$56.27–$670.70	at median	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONE	$391.00	$782.00	$56.27–$742.90	11% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION(S); TENDON SHEATH, LIGAMENT	$38.50	$77.00	$23.10–$73.15	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TREATMENT	$67.90	$97.00	$29.10–$92.15	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONE	$391.00	$782.00	$56.27–$742.90	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JNT INJECT MAJ JNT	$61.50	$123.00	$33.75–$116.85	83% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT-DRAIN JOINT/BURSA	$67.90	$97.00	$26.62–$92.15	81% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT INJECTION	$112.70	$161.00	$44.18–$152.95	68% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JNT INJECT MAJ JNT	$154.00	$220.00	$60.37–$209.00	56% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCNT ASPIR&/INJ MAJOR JT/BURSA W/O	$397.50	$795.00	$64.29–$755.25	13% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECT-DRAIN JOINT/BURSA	$67.90	$97.00	$26.62–$92.15	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT INJECTION	$112.70	$161.00	$44.18–$152.95	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JNT INJECT MAJ JNT	$154.00	$220.00	$60.37–$209.00	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCNT ASPIR&/INJ MAJOR JT/BURSA W/O	$397.50	$795.00	$64.29–$755.25	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$222.00	$444.00	$100.21–$421.80	32% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$222.00	$444.00	$100.21–$421.80	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JNT INJECT INTERMEDIAT	$52.50	$105.00	$28.81–$99.75	85% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS-INT JOINT	$87.50	$125.00	$36.35–$118.75	75% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTERMEDIATE JOINT INJECTION	$92.40	$132.00	$36.22–$125.40	74% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JNT INJECT INTERMEDIAT	$136.50	$195.00	$52.94–$185.25	61% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHOCENTESIS INT JOINT	$375.50	$751.00	$52.94–$713.45	7% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O	$389.00	$778.00	$52.94–$739.10	11% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS-INT JOINT	$87.50	$125.00	$36.35–$118.75	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INTERMEDIATE JOINT INJECTION	$92.40	$132.00	$36.22–$125.40	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JNT INJECT INTERMEDIAT	$136.50	$195.00	$52.94–$185.25	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHOCENTESIS INT JOINT	$375.50	$751.00	$52.94–$713.45	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O	$389.00	$778.00	$52.94–$739.10	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHOCENTESIS SM JOINT	$81.20	$116.00	$34.80–$110.20	77% below	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SMALL JOINT INJECTION	$84.00	$120.00	$32.93–$114.00	76% below	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHOCENTESIS SM JOINT	$97.50	$195.00	$52.00–$185.25	72% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SIMPLE 2.6CM TO 7.5CM	$374.00	$748.00	$52.00–$710.60	7% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCNT ASPIR&/INJ SMALL JT/BURSA W/O	$388.00	$776.00	$52.00–$737.20	11% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA	$403.00	$806.00	$52.00–$765.70	15% above	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHOCENTESIS SM JOINT	$81.20	$116.00	$34.80–$110.20	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SMALL JOINT INJECTION	$84.00	$120.00	$32.93–$114.00	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SIMPLE 2.6CM TO 7.5CM	$374.00	$748.00	$52.00–$710.60	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCNT ASPIR&/INJ SMALL JT/BURSA W/O	$388.00	$776.00	$52.00–$737.20	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA	$403.00	$806.00	$52.00–$765.70	—	50%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/L	$4,528.00	$9,056.00	$621.07–$8,603.20	56% below	50%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/L	$4,528.00	$9,056.00	$621.07–$8,603.20	—	50%
Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W	$4,382.50	$8,765.00	$494.31–$8,326.75	54% below	50%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W	$4,382.50	$8,765.00	$494.31–$8,326.75	—	50%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHA	$4,403.50	$8,807.00	$511.94–$8,366.65	—	50%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHA	$4,403.50	$8,807.00	$511.94–$8,366.65	—	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR C	$4,461.00	$8,922.00	$565.00–$8,475.90	6% below	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR C	$4,461.00	$8,922.00	$565.00–$8,475.90	—	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY	$7,473.50	$14,947.00	$575.65–$14,199.65	1% above	50%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPIC APPENDECTOMY	$7,473.50	$14,947.00	$575.65–$14,199.65	—	50%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY	$14,069.50	$28,139.00	$1,022.18–$26,732.05	37% below	50%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY FUNDOPLASTY	$14,069.50	$28,139.00	$1,022.18–$26,732.05	—	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY SURG RPR INITIAL INGUINAL HE	$7,303.00	$14,606.00	$417.82–$13,875.70	24% below	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY SURG RPR INITIAL INGUINAL HE	$7,303.00	$14,606.00	$417.82–$13,875.70	—	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$7,843.50	$15,687.00	$543.07–$14,902.65	64% below	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP ING HERNIA REPAIR RECUR	$7,843.50	$15,687.00	$543.07–$14,902.65	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE-SCALP/TRUNK	$133.00	$266.00	$79.80–$252.70	67% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUNDS SATE 2.5CM OR <	$226.50	$453.00	$135.90–$430.35	44% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUNDS SATE 2.5CM OR <	$243.50	$487.00	$133.63–$462.65	40% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE-SCALP/TRUNK	$607.00	$1,214.00	$233.90–$1,153.30	51% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUNDS SATE 2.5CM OR <	$226.50	$453.00	$135.90–$430.35	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE-SCALP/TRUNK	$607.00	$1,214.00	$233.90–$1,153.30	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG	$919.50	$1,839.00	$243.35–$1,747.05	15% below	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG	$919.50	$1,839.00	$243.35–$1,747.05	—	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRML EPI LMBR/SACRL 1 LVL	$1,192.50	$2,385.00	$236.63–$2,265.75	12% below	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRML EPI LMBR/SACRL 1 LVL	$1,192.50	$2,385.00	$236.63–$2,265.75	—	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRS	$9,436.00	$18,872.00	$885.69–$17,928.40	65% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRS	$9,436.00	$18,872.00	$885.69–$17,928.40	—	50%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTERIOR/POSTEROLATERAL LUM	$23,780.50	$47,561.00	$1,470.02–$45,182.95	67% above	50%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS POSTERIOR/POSTEROLATERAL LUM	$23,780.50	$47,561.00	$1,470.02–$45,182.95	—	50%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5	$1,088.50	$2,177.00	$597.37–$2,068.15	17% above	50%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5	$1,088.50	$2,177.00	$597.37–$2,068.15	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVE BENIGN LESION PRO FEE	$88.20	$126.00	$37.80–$119.70	87% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION-SKIN LESION	$94.50	$135.00	$40.50–$128.25	86% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION B9 TAL 0.5CM OR LESS	$118.00	$236.00	$70.80–$224.20	82% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION TAL 0.5CM OR LESS	$118.00	$236.00	$64.76–$224.20	82% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION TAL 0.5CM OR LESS	$165.20	$236.00	$64.76–$224.20	75% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION TRUNKARMSLEGS	$193.90	$277.00	$81.58–$263.15	71% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION TRUNK,ARMS,LEGS	$222.60	$318.00	$81.58–$302.10	66% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 C	$917.00	$1,834.00	$114.74–$1,742.30	39% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REMOVE BENIGN LESION PRO FEE	$88.20	$126.00	$37.80–$119.70	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION-SKIN LESION	$94.50	$135.00	$40.50–$128.25	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION B9 TAL 0.5CM OR LESS	$118.00	$236.00	$70.80–$224.20	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION TAL 0.5CM OR LESS	$165.20	$236.00	$64.76–$224.20	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION TRUNKARMSLEGS	$193.90	$277.00	$81.58–$263.15	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION TRUNK,ARMS,LEGS	$222.60	$318.00	$81.58–$302.10	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 C	$917.00	$1,834.00	$114.74–$1,742.30	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING	$82.60	$118.00	$35.40–$115.64	88% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION, OTHER BENIGN LESION .1 - 2 C	$82.60	$118.00	$35.40–$115.64	88% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION FEENLM 0.5CM OR LESS	$132.00	$264.00	$72.44–$250.80	80% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISE BENIGN LESION EAR 0.5 < CM	$136.50	$195.00	$53.51–$185.25	80% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION B9 FEENLM 0.5CM OR LESS	$150.00	$300.00	$90.00–$285.00	78% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION FEENLM 0.5CM OR LESS	$207.90	$297.00	$81.50–$282.15	69% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING	$82.60	$118.00	$35.40–$115.64	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION, OTHER BENIGN LESION .1 - 2 C	$82.60	$118.00	$35.40–$115.64	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISE BENIGN LESION EAR 0.5 < CM	$136.50	$195.00	$53.51–$185.25	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION B9 FEENLM 0.5CM OR LESS	$150.00	$300.00	$90.00–$285.00	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION FEENLM 0.5CM OR LESS	$207.90	$297.00	$81.50–$282.15	—	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART OR COMP SIMPLE	$49.50	$99.00	$29.70–$97.02	80% below	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART OR COMP SIMPLE	$107.00	$214.00	$58.72–$203.30	57% below	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL-SUB HEMATOM	$107.10	$153.00	$45.90–$145.35	57% below	30%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL SIMPLE SGL	$277.00	$554.00	$100.85–$526.30	10% above	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIM	$290.50	$581.00	$100.85–$551.95	16% above	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART OR COMP SIMPLE	$49.50	$99.00	$29.70–$97.02	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL-SUB HEMATOM	$107.10	$153.00	$45.90–$145.35	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL SIMPLE SGL	$277.00	$554.00	$100.85–$526.30	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIM	$290.50	$581.00	$100.85–$551.95	—	50%
Occipital nerve block (injection for headaches) CPT 64405 INJ AA &/STRD GREATER OCCIPITAL NERVE	$406.00	$812.00	$74.94–$771.40	7% above	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ AA &/STRD GREATER OCCIPITAL NERVE	$406.00	$812.00	$74.94–$771.40	—	50%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING	$1,181.50	$2,363.00	$254.29–$2,244.85	16% below	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING	$1,181.50	$2,363.00	$254.29–$2,244.85	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX	$206.00	$412.00	$113.05–$391.40	52% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX	$288.40	$412.00	$102.80–$391.40	33% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 INGROWN TOENAIL REMOVAL	$562.50	$1,125.00	$143.44–$1,068.75	30% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$572.00	$1,144.00	$143.44–$1,086.80	32% above	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX	$288.40	$412.00	$102.80–$391.40	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 INGROWN TOENAIL REMOVAL	$562.50	$1,125.00	$143.44–$1,068.75	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$572.00	$1,144.00	$143.44–$1,086.80	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LUM	$2,485.00	$4,970.00	$415.18–$4,721.50	11% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LUM	$2,485.00	$4,970.00	$415.18–$4,721.50	—	50%
Removal of a breast lump, open surgery CPT 19120 EXC CYST,FIB/OTH BRN/MGL BRST	$4,953.50	$9,907.00	$539.53–$9,411.65	5% above	50%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST,FIB/OTH BRN/MGL BRST	$4,953.50	$9,907.00	$539.53–$9,411.65	—	50%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY	$76.30	$109.00	$32.70–$111.15	81% below	30%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY	$97.50	$195.00	$53.51–$185.25	75% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INC & RMVL FB SUBQ TISS SMPL	$99.50	$199.00	$59.70–$189.05	75% below	50%
Removal of a foreign object under the skin, simple CPT 10120 SIMPLE-SUBCUTANEOUS	$104.30	$149.00	$44.70–$141.65	73% below	30%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB	$123.20	$176.00	$48.29–$167.20	69% below	30%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FB, SUBCUT; SIMPLE	$566.00	$1,132.00	$141.65–$1,075.40	44% above	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY	$76.30	$109.00	$32.70–$111.15	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & RMVL FB SUBQ TISS SMPL	$99.50	$199.00	$59.70–$189.05	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 SIMPLE-SUBCUTANEOUS	$104.30	$149.00	$44.70–$141.65	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FB	$123.20	$176.00	$48.29–$167.20	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL FB, SUBCUT; SIMPLE	$566.00	$1,132.00	$141.65–$1,075.40	—	50%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUS	$7,568.50	$15,137.00	$631.26–$14,380.15	15% below	50%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUS	$7,568.50	$15,137.00	$631.26–$14,380.15	—	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONSCPY,NOT MEET CRIT HI RSK	$1,267.00	$2,534.00	$343.65–$2,407.30	15% below	50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONSCPY,NOT MEET CRIT HI RSK	$1,267.00	$2,534.00	$343.65–$2,407.30	—	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 MEDICARE ONLY COLORECTAL HIGH RISK	$601.30	$859.00	$185.63–$816.05	57% below	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCREENING HIGH RISK	$1,266.50	$2,533.00	$343.18–$2,406.35	8% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 MEDICARE ONLY COLORECTAL HIGH RISK	$601.30	$859.00	$185.63–$816.05	—	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCREENING HIGH RISK	$1,266.50	$2,533.00	$343.18–$2,406.35	—	50%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CART G	$4,469.00	$8,938.00	$570.12–$8,491.10	47% above	50%
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CART G	$4,469.00	$8,938.00	$570.12–$8,491.10	—	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 ESWL	$4,708.00	$9,416.00	$710.90–$8,945.20	55% below	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 ESWL	$4,708.00	$9,416.00	$710.90–$8,945.20	—	50%
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM APPLIED	$74.00	$148.00	$44.40–$140.60	74% below	50%
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM	$99.40	$142.00	$38.96–$134.90	65% below	30%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM	$99.40	$142.00	$38.96–$134.90	—	30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT	$30.50	$61.00	$18.30–$59.78	82% below	50%
Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM-STATIC	$42.00	$84.00	$25.20–$79.80	76% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT	$45.50	$65.00	$19.50–$63.70	74% below	30%
Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM-STATIC	$58.80	$84.00	$23.05–$79.80	66% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC	$110.00	$220.00	$60.37–$209.00	37% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT	$30.50	$61.00	$18.30–$59.78	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT	$45.50	$65.00	$19.50–$63.70	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT SHORT ARM-STATIC	$58.80	$84.00	$23.05–$79.80	—	30%
Short leg cast (below the knee) CPT 29405 SHORT LEG CAST	$56.50	$113.00	$33.90–$107.35	82% below	50%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG APPLIED	$68.50	$137.00	$41.10–$130.15	78% below	50%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG	$99.40	$142.00	$38.96–$134.90	69% below	30%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG APPLIED	$157.50	$225.00	$61.23–$213.75	50% below	30%
Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG CAST	$56.50	$113.00	$33.90–$107.35	—	50%
Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG	$99.40	$142.00	$38.96–$134.90	—	30%
Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG APPLIED	$157.50	$225.00	$61.23–$213.75	—	30%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT	$39.00	$78.00	$23.40–$75.51	84% below	50%
Short leg splint (calf to foot) CPT 29515 JONES SPLINT	$48.00	$96.00	$28.80–$91.20	80% below	50%
Short leg splint (calf to foot) CPT 29515 SPLINT-SHORT LEG	$54.50	$109.00	$32.70–$103.55	77% below	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT	$97.50	$195.00	$54.78–$185.25	59% below	50%
Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG	$229.00	$458.00	$75.51–$435.10	3% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT	$39.00	$78.00	$23.40–$75.51	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 JONES SPLINT	$48.00	$96.00	$28.80–$91.20	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SHORT LEG	$229.00	$458.00	$75.51–$435.10	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SNAGTE 2.5CM OR <	$68.00	$136.00	$40.80–$129.20	75% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SNAGTE 2.5CM OR <	$89.00	$178.00	$48.84–$169.10	67% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR LESS T	$123.20	$176.00	$51.03–$167.20	55% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR S,N,T EXT <2.5	$137.20	$196.00	$53.78–$186.20	50% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE-LESS THAN 2.5CM	$137.20	$196.00	$51.03–$186.20	50% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$292.00	$584.00	$103.82–$554.80	7% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR OF SNAGTE 2.5CM OR <	$68.00	$136.00	$40.80–$129.20	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR LESS T	$123.20	$176.00	$51.03–$167.20	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR S,N,T EXT <2.5	$137.20	$196.00	$53.78–$186.20	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE-LESS THAN 2.5CM	$137.20	$196.00	$51.03–$186.20	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$292.00	$584.00	$103.82–$554.80	—	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$70.25	$100.36	$27.54–$98.35	82% below	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY	$105.70	$151.00	$43.19–$143.45	73% below	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY	$115.50	$231.00	$63.39–$219.45	70% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$70.25	$100.36	$27.54–$98.35	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY	$105.70	$151.00	$43.19–$143.45	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCIS MALIG ARM DIAM .5 <	$82.60	$118.00	$35.40–$121.01	90% below	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION TAL 0.5CM OR LESS	$178.00	$356.00	$106.80–$338.20	78% below	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION TAL 0.5CM OR LESS	$184.00	$368.00	$100.98–$349.60	77% below	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCIS MALIG ARM DIAM .5 <	$82.60	$118.00	$35.40–$121.01	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION TAL 0.5CM OR LESS	$178.00	$356.00	$106.80–$338.20	—	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG	$88.20	$126.00	$34.57–$119.70	54% below	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG PRO FEE	$88.20	$126.00	$37.80–$119.70	54% below	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO & INCL 15 LES	$91.50	$183.00	$50.22–$173.85	52% below	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS	$94.50	$135.00	$40.50–$128.25	51% below	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF UP TO 15 SKIN TAGS	$136.50	$195.00	$53.51–$185.25	29% below	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO & INCL 15 LES	$157.50	$225.00	$67.50–$213.75	18% below	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAG PRO FEE	$88.20	$126.00	$37.80–$119.70	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAG	$88.20	$126.00	$34.57–$119.70	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS	$94.50	$135.00	$40.50–$128.25	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF UP TO 15 SKIN TAGS	$136.50	$195.00	$53.51–$185.25	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UP TO & INCL 15 LES	$157.50	$225.00	$67.50–$213.75	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$163.50	$327.00	$69.58–$310.65	83% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR, DIAGNOSTIC	$187.50	$375.00	$69.58–$356.25	80% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR, DIAGNOSTIC	$868.50	$1,737.00	$150.96–$1,650.15	10% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$888.00	$1,776.00	$150.96–$1,687.20	8% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR, DIAGNOSTIC	$868.50	$1,737.00	$150.96–$1,650.15	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$888.00	$1,776.00	$150.96–$1,687.20	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SNAGTE 2.6-7.5	$90.00	$180.00	$54.00–$171.00	65% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SNAGTE 2.6CM TO 7.5CM	$108.00	$216.00	$59.27–$205.20	58% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR WOUND 2.6 CM TO 7.5 CM	$112.70	$161.00	$48.30–$152.95	56% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR S,N,T EXT 2.6-7.5	$115.50	$231.00	$63.39–$219.45	55% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE 2.6CM TO 7.5CM	$161.70	$231.00	$66.82–$219.45	37% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR OF SNAGTE 2.6-7.5	$90.00	$180.00	$54.00–$171.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR WOUND 2.6 CM TO 7.5 CM	$112.70	$161.00	$48.30–$152.95	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR S,N,T EXT 2.6-7.5	$115.50	$231.00	$63.39–$219.45	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE 2.6CM TO 7.5CM	$161.70	$231.00	$66.82–$219.45	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF FEENLMM 2.5CM OR LESS	$84.50	$169.00	$50.70–$160.55	69% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF FEENLMM 2.5CM OR LESS	$106.50	$213.00	$58.45–$202.35	61% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE 2.5CM OR LESS	$151.20	$216.00	$63.32–$205.20	45% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR OF FEENLMM 2.5CM OR LESS	$84.50	$169.00	$50.70–$160.55	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE 2.5CM OR LESS	$151.20	$216.00	$63.32–$205.20	—	30%
TURP (transurethral resection of the prostate) CPT 52601 TURP (TRANSURETHRAL RESECTION OF PROSTAT	$6,872.00	$13,744.00	$512.99–$13,056.80	39% above	50%
TURP (transurethral resection of the prostate) inpatient CPT 52601 TURP (TRANSURETHRAL RESECTION OF PROSTAT	$6,872.00	$13,744.00	$512.99–$13,056.80	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY	$84.00	$120.00	$33.87–$114.00	74% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$84.06	$120.09	$32.96–$114.09	74% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY	$93.00	$186.00	$51.04–$176.70	71% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SUBCUTANEOUS SKIN LESION	$136.50	$195.00	$53.51–$185.25	57% below	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY	$84.00	$120.00	$33.87–$114.00	—	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$84.06	$120.09	$32.96–$114.09	—	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY SUBCUTANEOUS SKIN LESION	$136.50	$195.00	$53.51–$185.25	—	30%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI	$854.00	$1,708.00	$278.35–$1,622.60	38% below	50%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI	$854.00	$1,708.00	$278.35–$1,622.60	—	50%
Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY ADENOIDECTOMY 12 OR OVER	$4,129.50	$8,259.00	$261.27–$7,846.05	at median	50%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY ADENOIDECTOMY 12 OR OVER	$4,129.50	$8,259.00	$261.27–$7,846.05	—	50%
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY ADENOIDECTOMY < AGE 12	$7,257.50	$14,515.00	$250.64–$13,789.25	38% above	50%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY ADENOIDECTOMY < AGE 12	$7,257.50	$14,515.00	$250.64–$13,789.25	—	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY PRIM OR SECOND 12 OR OVER	$4,081.50	$8,163.00	$220.36–$7,754.85	2% above	50%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY PRIM OR SECOND 12 OR OVER	$4,081.50	$8,163.00	$220.36–$7,754.85	—	50%
Total knee replacement CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMP	$16,934.50	$33,869.00	$1,143.22–$32,175.55	47% above	50%
Total knee replacement inpatient CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMP	$16,934.50	$33,869.00	$1,143.22–$32,175.55	—	50%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$8,562.50	$17,125.00	$825.17–$16,268.75	20% below	50%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 REMOVAL OF THYROID	$8,562.50	$17,125.00	$825.17–$16,268.75	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TREATMENT TRIGGER POINTS ONE O	$68.00	$136.00	$37.32–$129.20	77% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TREATMENT TRIGGER POINTS ONE O	$68.00	$136.00	$39.64–$129.20	77% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE OR MULT; ONE OR TWO MUSCLES	$340.00	$680.00	$48.12–$646.00	16% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 M	$388.50	$777.00	$48.12–$738.15	32% above	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION TREATMENT TRIGGER POINTS ONE O	$68.00	$136.00	$39.64–$129.20	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 M	$388.50	$777.00	$48.12–$738.15	—	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALO DIL	$2,414.00	$4,828.00	$1,021.90–$4,586.60	54% above	50%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALO DIL	$2,414.00	$4,828.00	$1,021.90–$4,586.60	—	50%
Upper endoscopy (EGD) with biopsy CPT 43239 UPR GI NDSC BX1/MLT	$1,301.50	$2,603.00	$371.66–$2,472.85	26% above	50%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPR GI NDSC BX1/MLT	$1,301.50	$2,603.00	$371.66–$2,472.85	—	50%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPER GI ENDO	$1,213.00	$2,426.00	$394.98–$2,304.70	32% below	50%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPER GI ENDO	$1,213.00	$2,426.00	$394.98–$2,304.70	—	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPR GI NDSC WITH SNARE	$2,454.50	$4,909.00	$486.45–$4,663.55	127% above	50%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPR GI NDSC WITH SNARE	$2,454.50	$4,909.00	$486.45–$4,663.55	—	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPR GI ENDOSCOPY/GUIDE WIRE	$1,239.50	$2,479.00	$408.42–$2,355.05	6% below	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UPPR GI ENDOSCOPY/GUIDE WIRE	$1,239.50	$2,479.00	$408.42–$2,355.05	—	50%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAG BRUSH/WASH	$1,197.50	$2,395.00	$287.94–$2,275.25	25% above	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAG BRUSH/WASH	$1,197.50	$2,395.00	$287.94–$2,275.25	—	50%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 URETEROSCOPY W/LASER LITHO W/O STENT	$6,542.50	$13,085.00	$341.15–$12,430.75	2% above	50%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 URETEROSCOPY W/LASER LITHO W/O STENT	$6,542.50	$13,085.00	$341.15–$12,430.75	—	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 URETEROSCOPY W/LASER LITHO STENT PLACMNT	$6,566.00	$13,132.00	$363.11–$12,475.40	at median	50%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 URETEROSCOPY W/LASER LITHO STENT PLACMNT	$6,566.00	$13,132.00	$363.11–$12,475.40	—	50%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM	$2,646.50	$5,293.00	$317.09–$5,028.35	—	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM	$2,646.50	$5,293.00	$317.09–$5,028.35	—	50%
Wart removal, up to 14 warts CPT 17110 BENIGN LESION REMOVAL <5	$25.00	$50.00	$13.72–$49.00	88% below	50%
Wart removal, up to 14 warts CPT 17110 BENIGN LESION REMOVAL 5-15	$50.00	$100.00	$27.44–$98.00	76% below	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT OF BENIGN OTHER UP TO 14	$103.50	$207.00	$56.80–$196.65	50% below	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT OF BENIGN OTHER UP TO 14	$136.50	$195.00	$58.50–$185.25	34% below	30%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF LESIONS UP TO 14	$136.50	$195.00	$58.50–$185.25	34% below	30%
Wart removal, up to 14 warts CPT 17110 DESTRUCT LESION, 1-14	$136.50	$195.00	$53.51–$185.25	34% below	30%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS OTH THAN SKIN	$302.00	$604.00	$98.92–$573.80	46% above	50%
Wart removal, up to 14 warts inpatient CPT 17110 BENIGN LESION REMOVAL <5	$25.00	$50.00	$13.72–$49.00	—	50%
Wart removal, up to 14 warts inpatient CPT 17110 BENIGN LESION REMOVAL 5-15	$50.00	$100.00	$27.44–$98.00	—	50%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT LESION, 1-14	$136.50	$195.00	$53.51–$185.25	—	30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT OF BENIGN OTHER UP TO 14	$136.50	$195.00	$58.50–$185.25	—	30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF LESIONS UP TO 14	$136.50	$195.00	$58.50–$185.25	—	30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS OTH THAN SKIN	$302.00	$604.00	$98.92–$573.80	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUBCUTANEOUS TISSUE	$58.50	$117.00	$32.10–$114.66	84% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUBCUTANEOUS TISSUE	$135.80	$194.00	$58.20–$184.30	64% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$533.50	$1,067.00	$119.52–$1,013.65	43% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN & SUBCUTANEOUS TISSUE	$135.80	$194.00	$58.20–$184.30	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$533.50	$1,067.00	$119.52–$1,013.65	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS	$554.00	$1,108.00	$40.94–$1,052.60	13% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$611.50	$1,223.00	$40.94–$1,161.85	4% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$611.50	$1,223.00	$40.94–$1,161.85	4% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS	$554.00	$1,108.00	$40.94–$1,052.60	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$611.50	$1,223.00	$40.94–$1,161.85	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT	$24.50	$35.00	$7.58–$33.25	89% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB CHANGE	$37.80	$54.00	$7.58–$51.30	82% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INDUCED SPUTUM COLLECTION	$239.50	$479.00	$7.58–$455.05	11% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL CHARGE INITIAL	$239.50	$479.00	$7.58–$455.05	11% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUBSEQUENT	$239.50	$479.00	$7.58–$455.05	11% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL	$239.50	$479.00	$7.58–$455.05	11% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV 1	$335.30	$479.00	$7.58–$455.05	55% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT	$24.50	$35.00	$7.58–$33.25	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB CHANGE	$37.80	$54.00	$7.58–$51.30	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INDUCED SPUTUM COLLECTION	$239.50	$479.00	$7.58–$455.05	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL CHARGE INITIAL	$239.50	$479.00	$7.58–$455.05	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUBSEQUENT	$239.50	$479.00	$7.58–$455.05	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL	$239.50	$479.00	$7.58–$455.05	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPV 1	$335.30	$479.00	$7.58–$455.05	—	30%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN, INTRAVEN INFUSION, 1ST HOUR	$113.00	$226.00	$62.01–$214.70	82% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN, INTRAVEN INFUSION, 1ST HOUR	$113.00	$226.00	$62.01–$214.70	—	50%
Critical care, first 30 to 74 minutes CPT 99291 ED VISIT CRITICAL CARE	$218.00	$436.00	$130.80–$414.20	84% below	50%
Critical care, first 30 to 74 minutes CPT 99291 PROFESSIONAL FEE-CRITICAL	$293.30	$419.00	$125.70–$398.05	78% below	30%
Critical care, first 30 to 74 minutes CPT 99291 ER FACILITY FEE-CRITICAL	$844.00	$1,688.00	$290.87–$1,603.60	37% below	50%
Critical care, first 30 to 74 minutes CPT 99291 RHC FACILITY FEE-CRITICAL	$977.20	$1,396.00	$290.87–$1,326.20	27% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED VISIT CRITICAL CARE	$218.00	$436.00	$130.80–$414.20	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PROFESSIONAL FEE-CRITICAL	$293.30	$419.00	$125.70–$398.05	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER FACILITY FEE-CRITICAL	$844.00	$1,688.00	$290.87–$1,603.60	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 RHC FACILITY FEE-CRITICAL	$977.20	$1,396.00	$290.87–$1,326.20	—	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM ROUTINE	$29.00	$58.00	$14.18–$55.10	80% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 BL EKG	$75.00	$150.00	$14.18–$142.50	48% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 BL EKG IME	$88.50	$177.00	$14.18–$168.15	39% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 **BL EKG	$105.00	$150.00	$14.18–$142.50	27% below	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 **BL EKG IME	$123.90	$177.00	$14.18–$168.15	14% below	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 BL EKG	$75.00	$150.00	$14.18–$142.50	—	50%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 BL EKG IME	$88.50	$177.00	$14.18–$168.15	—	50%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 **BL EKG	$105.00	$150.00	$14.18–$142.50	—	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 **BL EKG IME	$123.90	$177.00	$14.18–$168.15	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE	$99.50	$199.00	$6.15–$189.05	20% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE	$99.50	$199.00	$6.15–$189.05	20% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG STAT & EMERGENCY ROOM	$99.50	$199.00	$6.15–$189.05	20% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE	$99.50	$199.00	$6.15–$189.05	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG STAT & EMERGENCY ROOM	$99.50	$199.00	$6.15–$189.05	—	50%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$604.50	$1,209.00	$167.40–$1,148.55	25% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL I	$34.00	$68.00	$11.02–$64.60	78% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PROFESSIONAL FEE-BRIEF	$45.50	$65.00	$11.02–$61.75	70% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER FACILITY FEE-BRIEF	$59.50	$119.00	$11.02–$113.05	61% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 RHC FACILITY FEE-BRIEF	$69.30	$99.00	$11.02–$94.05	55% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT LEVEL I	$34.00	$68.00	$11.02–$64.60	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PROFESSIONAL FEE-BRIEF	$45.50	$65.00	$11.02–$61.75	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER FACILITY FEE-BRIEF	$59.50	$119.00	$11.02–$113.05	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 RHC FACILITY FEE-BRIEF	$69.30	$99.00	$11.02–$94.05	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PROFESSIONAL FEE-LIMITED	$55.30	$79.00	$23.70–$75.05	80% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL II	$92.50	$185.00	$40.42–$175.75	66% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 RHC FACILITY FEE-LIMITED	$95.20	$136.00	$37.32–$129.20	65% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER FACILITY FEE-LIMITED	$137.50	$275.00	$40.42–$261.25	49% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PROFESSIONAL FEE-LIMITED	$55.30	$79.00	$23.70–$75.05	—	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT LEVEL II	$92.50	$185.00	$40.42–$175.75	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 RHC FACILITY FEE-LIMITED	$95.20	$136.00	$37.32–$129.20	—	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER FACILITY FEE-LIMITED	$137.50	$275.00	$40.42–$261.25	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PROFESSIONAL FEE-INTERMED	$84.70	$121.00	$36.30–$114.95	82% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL III	$112.50	$225.00	$67.50–$213.75	77% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 RHC FACILITY FEE-INTERMED	$117.60	$168.00	$46.10–$159.60	75% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER FACILITY FEE-INTERMEDI	$212.50	$425.00	$69.71–$403.75	56% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PROFESSIONAL FEE-INTERMED	$84.70	$121.00	$36.30–$114.95	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LEVEL III	$112.50	$225.00	$67.50–$213.75	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 RHC FACILITY FEE-INTERMED	$117.60	$168.00	$46.10–$159.60	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER FACILITY FEE-INTERMEDI	$212.50	$425.00	$69.71–$403.75	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PROFESSIONAL FEE-EXTENDED	$123.90	$177.00	$53.10–$168.15	83% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 RHC FACILITY FEE-EXTENDED	$128.80	$184.00	$50.49–$174.80	82% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL IV	$162.50	$325.00	$97.50–$308.75	77% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER FACILITY FEE-EXTENDED	$350.00	$700.00	$118.88–$665.00	51% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PROFESSIONAL FEE-EXTENDED	$123.90	$177.00	$53.10–$168.15	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 RHC FACILITY FEE-EXTENDED	$128.80	$184.00	$50.49–$174.80	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT LEVEL IV	$162.50	$325.00	$97.50–$308.75	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER FACILITY FEE-EXTENDED	$350.00	$700.00	$118.88–$665.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PROFESSIONAL FEE-HIGH COM	$235.20	$336.00	$100.80–$319.20	77% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL V	$245.00	$490.00	$147.00–$465.50	77% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 RHC FACILITY FEE-HIGH COM	$317.10	$453.00	$124.30–$430.35	70% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER FACILITY FEE HIGH COMP	$487.50	$975.00	$171.90–$926.25	53% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PROFESSIONAL FEE-HIGH COM	$235.20	$336.00	$100.80–$319.20	—	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT LEVEL V	$245.00	$490.00	$147.00–$465.50	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 RHC FACILITY FEE-HIGH COM	$317.10	$453.00	$124.30–$430.35	—	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER FACILITY FEE HIGH COMP	$487.50	$975.00	$171.90–$926.25	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL ONLY STRESS TEST; NO NUCLEAR	$518.50	$1,037.00	$33.65–$985.15	15% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL ONLY STRESS TEST; NO NUCLEAR	$518.50	$1,037.00	$33.65–$985.15	—	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY WITH PATIENT 50MIN	$147.50	$295.00	$80.95–$280.25	25% below	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY WITH PATIENT 50 MINUTES	$150.66	$301.32	$82.68–$286.25	23% below	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PATIENT 1 HR	$169.40	$242.00	$66.40–$229.90	14% below	30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY WITH PATIENT 50MIN	$147.50	$295.00	$80.95–$280.25	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PATIENT 1 HR	$169.40	$242.00	$66.40–$229.90	—	30%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50MIN	$141.50	$283.00	$77.66–$268.85	28% below	50%
Family therapy without the patient, 50 minutes CPT 90846 LICSW FAMILY THERAPY W/O PATIENT 50 MIN	$145.00	$290.00	$79.58–$275.50	26% below	50%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PATIENT 50 MINUTES	$145.10	$290.19	$79.62–$275.68	26% below	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50MIN	$141.50	$283.00	$77.66–$268.85	—	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 LICSW FAMILY THERAPY W/O PATIENT 50 MIN	$145.00	$290.00	$79.58–$275.50	—	50%
Group psychotherapy session CPT 90853 LICSW GROUP PSYCHOTHERAPY	$100.00	$200.00	$28.94–$190.00	at median	50%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$105.00	$210.00	$28.94–$199.50	5% above	50%
Group psychotherapy session inpatient CPT 90853 LICSW GROUP PSYCHOTHERAPY	$100.00	$200.00	$28.94–$190.00	—	50%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY	$105.00	$210.00	$28.94–$199.50	—	50%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 HOLTER MONITOR W/INTERP AND REPORT	$105.00	$150.00	$45.00–$142.50	86% below	30%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 HOLTER MONITOR W/INTERP AND REPORT	$105.00	$150.00	$45.00–$142.50	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAVENOUS INFUSION HYDRATION UP TO1HR	$35.00	$70.00	$19.21–$66.50	86% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAVENOUS INFUSION,HYDRATION; UP TO1HR	$143.50	$287.00	$29.36–$272.65	42% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAVENOUS INFUSION HYDRATION UP TO1HR	$35.00	$70.00	$19.21–$66.50	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAVENOUS INFUSION,HYDRATION; UP TO1HR	$143.50	$287.00	$29.36–$272.65	—	50%
IV infusion of a medicine, first hour CPT 96365 INTRAVENOUS INFUSION,SPECIFY DRUG UP 1HR	$210.00	$300.00	$58.81–$285.00	23% below	30%
IV infusion of a medicine, first hour inpatient CPT 96365 INTRAVENOUS INFUSION,SPECIFY DRUG UP 1HR	$210.00	$300.00	$58.81–$285.00	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION ADMINISTRATION	$13.00	$26.00	$7.13–$24.70	81% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ ADMINISTRATION	$13.00	$26.00	$7.13–$24.70	81% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION	$13.30	$19.00	$5.21–$18.05	81% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ ADMINISTRATION	$13.90	$19.85	$5.45–$18.86	80% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION SC/IM	$15.62	$22.32	$6.12–$21.20	78% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TREATMENT ROOM - INJECTION	$30.80	$44.00	$12.07–$41.80	56% below	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECTION ADMINISTRATION	$13.00	$26.00	$7.13–$24.70	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECTION	$13.30	$19.00	$5.21–$18.05	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ ADMINISTRATION	$13.90	$19.85	$5.45–$18.86	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECTION SC/IM	$15.62	$22.32	$6.12–$21.20	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TREATMENT ROOM - INJECTION	$30.80	$44.00	$12.07–$41.80	—	30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$163.50	$327.00	$89.73–$310.65	26% below	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVAL BY NON PHYSICIAN	$201.60	$288.00	$79.03–$273.60	8% below	30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$163.50	$327.00	$89.73–$310.65	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVAL BY NON PHYSICIAN	$201.60	$288.00	$79.03–$273.60	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$38.00	$76.00	$20.85–$72.20	52% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$38.00	$76.00	$20.85–$72.20	—	50%
New patient office visit, about 30 minutes CPT 99203 SPEC NEW OFFICE LEVEL 3 FACILITY FEE	$25.00	$50.00	$15.00–$82.94	65% below	50%
New patient office visit, about 30 minutes CPT 99203 OFFICE NEW LEVEL 3 FACILITY FEE	$25.00	$50.00	$15.00–$82.94	65% below	50%
New patient office visit, about 30 minutes CPT 99203 NEW OFFICE VISIT LEVEL 3	$82.00	$164.00	$45.00–$155.80	16% above	50%
New patient office visit, about 30 minutes CPT 99203 NEW PT OFFICE VISIT LVL 3 30-44 MINUTES	$106.40	$152.00	$41.71–$144.40	51% above	30%
New patient office visit, about 30 minutes CPT 99203 DANVILLE SPECIALTY NEW OFFICE VISIT LVL3	$107.00	$214.00	$58.72–$203.30	52% above	50%
New patient office visit, about 30 minutes CPT 99203 NEW OFFICE VISIT LEVEL 3 30-44 MINUTES	$112.50	$225.00	$61.74–$213.75	60% above	50%
New patient office visit, about 30 minutes CPT 99203 EVAL AND MANAGEMENT NEW LVL 3 30-44 MIN	$114.00	$228.00	$62.56–$216.60	62% above	50%
New patient office visit, about 30 minutes CPT 99203 SPECIALTY NEW OFFICE VISIT LEVEL 3	$139.00	$278.00	$76.28–$264.10	97% above	50%
New patient office visit, about 30 minutes CPT 99203 ORTHO NEW OFFICE VISIT LEVEL 3	$139.00	$278.00	$76.28–$264.10	97% above	50%
New patient office visit, about 30 minutes CPT 99203 CARDIOLOGY NEW OFFICE VISIT LVL 3 30-44M	$157.50	$225.00	$61.74–$213.75	123% above	30%
New patient office visit, about 30 minutes CPT 99203 EVALUATION AND MANAGEMENT NEW LEVEL 3	$159.60	$228.00	$62.56–$216.60	126% above	30%
New patient office visit, about 30 minutes CPT 99203 DERM NEW OFFICE VISIT LEVEL 3	$194.60	$278.00	$76.28–$264.10	176% above	30%
New patient office visit, about 30 minutes inpatient CPT 99203 SPEC NEW OFFICE LEVEL 3 FACILITY FEE	$25.00	$50.00	$15.00–$82.94	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE NEW LEVEL 3 FACILITY FEE	$25.00	$50.00	$15.00–$82.94	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW OFFICE VISIT LEVEL 3	$82.00	$164.00	$45.00–$155.80	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT OFFICE VISIT LVL 3 30-44 MINUTES	$106.40	$152.00	$41.71–$144.40	—	30%
New patient office visit, about 30 minutes inpatient CPT 99203 EVAL AND MANAGEMENT NEW LVL 3 30-44 MIN	$114.00	$228.00	$62.56–$216.60	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 SPECIALTY NEW OFFICE VISIT LEVEL 3	$139.00	$278.00	$76.28–$264.10	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 ORTHO NEW OFFICE VISIT LEVEL 3	$139.00	$278.00	$76.28–$264.10	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 CARDIOLOGY NEW OFFICE VISIT LVL 3 30-44M	$157.50	$225.00	$61.74–$213.75	—	30%
New patient office visit, about 30 minutes inpatient CPT 99203 EVALUATION AND MANAGEMENT NEW LEVEL 3	$159.60	$228.00	$62.56–$216.60	—	30%
New patient office visit, about 30 minutes inpatient CPT 99203 DERM NEW OFFICE VISIT LEVEL 3	$194.60	$278.00	$76.28–$264.10	—	30%
New patient office visit, about 45 minutes CPT 99204 SPEC NEW OFFICE LEVEL 4 FACILITY FEE	$25.00	$50.00	$15.00–$135.09	65% below	50%
New patient office visit, about 45 minutes CPT 99204 OFFICE NEW LEVEL 4 FACILITY FEE	$25.00	$50.00	$15.00–$135.09	65% below	50%
New patient office visit, about 45 minutes CPT 99204 NEW SPECIALTY FACILITY PROCEDURE CHARGE	$50.00	$100.00	$30.00–$135.09	29% below	50%
New patient office visit, about 45 minutes CPT 99204 NEW PT OFFICE VISIT LVL 4 45-59 MINUTES	$106.00	$212.00	$58.17–$201.40	50% above	50%
New patient office visit, about 45 minutes CPT 99204 NEW OFFICE VISIT LEVEL 4 45-59 MINUTES	$125.00	$250.00	$68.60–$237.50	77% above	50%
New patient office visit, about 45 minutes CPT 99204 NEW PT OFFICE VISIT LVL 4 45-59 MINUTES	$148.40	$212.00	$58.17–$201.40	111% above	30%
New patient office visit, about 45 minutes CPT 99204 NEW OFFICE VISIT LEVEL 4	$151.20	$216.00	$59.27–$205.20	115% above	30%
New patient office visit, about 45 minutes CPT 99204 DANVILLE SPECIALTY NEW OFFICE VISIT LVL4	$159.50	$319.00	$87.53–$303.05	126% above	50%
New patient office visit, about 45 minutes CPT 99204 CARDIOLOGY NEW OFFICE VISIT LVL 4 45-59M	$175.00	$250.00	$68.60–$237.50	148% above	30%
New patient office visit, about 45 minutes CPT 99204 DERMATOLOGY NEW OFFICE VISIT LEVEL 4	$175.00	$250.00	$68.60–$237.50	148% above	30%
New patient office visit, about 45 minutes CPT 99204 EVAL AND MANAGEMENT NEW LVL 4 45-59 MIN	$192.50	$385.00	$105.64–$365.75	173% above	50%
New patient office visit, about 45 minutes CPT 99204 ORTHO NEW OFFICE VISIT LEVEL 4	$217.50	$435.00	$119.36–$413.25	209% above	50%
New patient office visit, about 45 minutes CPT 99204 SPECIALTY NEW OFFICE VISIT LEVEL 4	$217.50	$435.00	$119.36–$413.25	209% above	50%
New patient office visit, about 45 minutes CPT 99204 EVALUATION AND MANAGEMENT NEW LEVEL 4	$269.50	$385.00	$105.64–$365.75	282% above	30%
New patient office visit, about 45 minutes CPT 99204 DERM NEW OFFICE VISIT LEVEL 4	$304.50	$435.00	$119.36–$413.25	332% above	30%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE NEW LEVEL 4 FACILITY FEE	$25.00	$50.00	$15.00–$135.09	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 SPEC NEW OFFICE LEVEL 4 FACILITY FEE	$25.00	$50.00	$15.00–$135.09	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW SPECIALTY FACILITY PROCEDURE CHARGE	$50.00	$100.00	$30.00–$135.09	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT OFFICE VISIT LVL 4 45-59 MINUTES	$148.40	$212.00	$58.17–$201.40	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW OFFICE VISIT LEVEL 4	$151.20	$216.00	$59.27–$205.20	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 DERMATOLOGY NEW OFFICE VISIT LEVEL 4	$175.00	$250.00	$68.60–$237.50	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 CARDIOLOGY NEW OFFICE VISIT LVL 4 45-59M	$175.00	$250.00	$68.60–$237.50	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 EVAL AND MANAGEMENT NEW LVL 4 45-59 MIN	$192.50	$385.00	$105.64–$365.75	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 SPECIALTY NEW OFFICE VISIT LEVEL 4	$217.50	$435.00	$119.36–$413.25	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 ORTHO NEW OFFICE VISIT LEVEL 4	$217.50	$435.00	$119.36–$413.25	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 EVALUATION AND MANAGEMENT NEW LEVEL 4	$269.50	$385.00	$105.64–$365.75	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 DERM NEW OFFICE VISIT LEVEL 4	$304.50	$435.00	$119.36–$413.25	—	30%
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE VISIT LEVEL 5 60-74 MINS	$150.00	$300.00	$82.32–$285.00	23% above	50%
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE VISIT LEVEL 5 60-74 MINUTES	$150.00	$300.00	$82.32–$285.00	23% above	50%
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE VISIT LEVEL 5	$151.20	$216.00	$59.27–$211.68	23% above	30%
New patient office visit, about 60 minutes CPT 99205 EVAL AND MANAGEMENT NEW LVL 5 60-74 MIN	$238.50	$477.00	$130.89–$453.15	95% above	50%
New patient office visit, about 60 minutes CPT 99205 SUBOXONE NEW PT OFFICE VISIT 60-74 MINS	$245.00	$350.00	$96.04–$332.50	100% above	30%
New patient office visit, about 60 minutes CPT 99205 SUBOXONE NEW PT OFFICE VISIT 60-74 MINS	$245.00	$350.00	$96.04–$332.50	100% above	30%
New patient office visit, about 60 minutes CPT 99205 SPECIALTY NEW OFFICE VISIT LEVEL 5	$280.00	$560.00	$153.66–$532.00	129% above	50%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW OFFICE VISIT LEVEL 5	$151.20	$216.00	$59.27–$211.68	—	30%
New patient office visit, about 60 minutes inpatient CPT 99205 EVAL AND MANAGEMENT NEW LVL 5 60-74 MIN	$238.50	$477.00	$130.89–$453.15	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 SUBOXONE NEW PT OFFICE VISIT 60-74 MINS	$245.00	$350.00	$96.04–$332.50	—	30%
New patient office visit, about 60 minutes inpatient CPT 99205 SPECIALTY NEW OFFICE VISIT LEVEL 5	$280.00	$560.00	$153.66–$532.00	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE NEW LVL 2 FACILITY FEE	$35.00	$50.00	$15.00–$49.00	46% below	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SPEC NEW OFFICE LEVEL 2 FACILITY FEE	$35.00	$50.00	$15.00–$49.00	46% below	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EVAL AND MANAGEMENT NEW LVL 2 15-29 MIN	$54.50	$109.00	$29.91–$103.55	16% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 DANVILLE SPECIALTY NEW OFFICE VISIT LVL2	$68.00	$136.00	$37.32–$129.20	5% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT OFFICE VISIT 15-29M	$76.30	$109.00	$29.91–$103.55	17% above	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE VISIT LEVEL 2	$84.00	$120.00	$32.93–$114.00	29% above	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE VISIT LEVEL 2 15-29 MINUTES	$100.00	$200.00	$54.88–$190.00	54% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SPECIALTY NEW OFFICE VISIT LEVEL 2	$136.50	$273.00	$69.28–$259.35	110% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ORTHO NEW OFFICE VISIT LEVEL 2	$136.50	$273.00	$69.28–$259.35	110% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE VISIT LEVEL 2 15-29 MINUTES	$140.00	$200.00	$54.88–$190.00	115% above	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 DERM NEW OFFICE VISIT LEVEL 2	$191.10	$273.00	$69.28–$259.35	194% above	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE NEW LVL 2 FACILITY FEE	$35.00	$50.00	$15.00–$49.00	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SPEC NEW OFFICE LEVEL 2 FACILITY FEE	$35.00	$50.00	$15.00–$49.00	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 EVAL AND MANAGEMENT NEW LVL 2 15-29 MIN	$54.50	$109.00	$29.91–$103.55	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT OFFICE VISIT 15-29M	$76.30	$109.00	$29.91–$103.55	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW OFFICE VISIT LEVEL 2	$84.00	$120.00	$32.93–$114.00	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SPECIALTY NEW OFFICE VISIT LEVEL 2	$136.50	$273.00	$69.28–$259.35	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ORTHO NEW OFFICE VISIT LEVEL 2	$136.50	$273.00	$69.28–$259.35	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW OFFICE VISIT LEVEL 2 15-29 MINUTES	$140.00	$200.00	$54.88–$190.00	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 DERM NEW OFFICE VISIT LEVEL 2	$191.10	$273.00	$69.28–$259.35	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Initial Nutritional Therapy 15 Min	$26.50	$53.00	$14.54–$50.35	37% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Initial Nutritional Therapy 15 Min	$26.50	$53.00	$14.54–$50.35	—	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY	$112.50	$225.00	$61.74–$213.75	39% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW COMPLEXITY	$112.50	$225.00	$61.74–$213.75	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$113.74	$227.47	$62.42–$216.10	43% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$113.74	$227.47	$62.42–$216.10	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$86.00	$172.00	$47.20–$163.40	55% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$86.00	$172.00	$47.20–$163.40	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THER TECHNIQUE	$43.00	$86.00	$23.60–$81.70	33% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THER TECHNIQUE	$43.00	$86.00	$23.60–$81.70	33% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Postural Drainage	$66.50	$95.00	$25.64–$90.25	4% above	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THER TECHNIQUE	$43.00	$86.00	$23.60–$81.70	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THER TECHNIQUE	$43.00	$86.00	$23.60–$81.70	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Postural Drainage	$66.50	$95.00	$25.64–$90.25	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC PROC/EXER	$24.00	$48.00	$13.17–$45.60	66% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC PROC/EXER	$24.00	$48.00	$13.17–$45.60	—	50%
Preventive checkup, new patient aged 18–39 CPT 99385 WELL CARE VISIT, NEW PT, AGE 18-39	$72.50	$145.00	$39.79–$137.75	12% below	50%
Preventive checkup, new patient aged 18–39 CPT 99385 NEW PREVENTIVE VISITS 18-39YRS	$110.60	$158.00	$43.36–$150.10	34% above	30%
Preventive checkup, new patient aged 18–39 CPT 99385 NEW PREVENTIVE VISITS 18-39YRS	$110.60	$158.00	$43.36–$150.10	34% above	30%
Preventive checkup, new patient aged 18–39 CPT 99385 WELL CARE VISIT, NEW PT, AGE 18-39	$136.50	$195.00	$53.51–$185.25	65% above	30%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 NEW PREVENTIVE VISITS 18-39YRS	$110.60	$158.00	$43.36–$150.10	—	30%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 WELL CARE VISIT, NEW PT, AGE 18-39	$136.50	$195.00	$53.51–$185.25	—	30%
Preventive checkup, new patient aged 40–64 CPT 99386 WELL CARE VISIT, NEW PT, AGE 40-64	$72.50	$145.00	$39.79–$137.75	19% below	50%
Preventive checkup, new patient aged 40–64 CPT 99386 EST PREVENTIVE VISITS 40-64YRS	$93.10	$133.00	$36.50–$126.35	3% above	30%
Preventive checkup, new patient aged 40–64 CPT 99386 EST PREVENTIVE VISITS 40-64YRS	$93.10	$133.00	$36.50–$126.35	3% above	30%
Preventive checkup, new patient aged 40–64 CPT 99386 NEW PREVENTIVE VISITS 40-64YRS	$110.60	$158.00	$43.36–$150.10	23% above	30%
Preventive checkup, new patient aged 40–64 CPT 99386 NEW PREVENTIVE VISITS 40-64YRS	$110.60	$158.00	$43.36–$150.10	23% above	30%
Preventive checkup, new patient aged 40–64 CPT 99386 WELL CARE VISIT, NEW PT, AGE 40-64	$136.50	$195.00	$53.51–$185.25	52% above	30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 EST PREVENTIVE VISITS 40-64YRS	$93.10	$133.00	$36.50–$126.35	—	30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 NEW PREVENTIVE VISITS 40-64YRS	$110.60	$158.00	$43.36–$150.10	—	30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 WELL CARE VISIT, NEW PT, AGE 40-64	$136.50	$195.00	$53.51–$185.25	—	30%
Preventive checkup, new patient aged 65 or older CPT 99387 WELL CARE VISIT, NEW PT, AGE 65 & UP	$72.50	$145.00	$39.79–$137.75	33% below	50%
Preventive checkup, new patient aged 65 or older CPT 99387 EST PREVENTIVE VISITS 65+ YRS	$93.10	$133.00	$36.50–$126.35	14% below	30%
Preventive checkup, new patient aged 65 or older CPT 99387 EST PREVENTIVE VISITS 65+ YRS	$93.10	$133.00	$36.50–$126.35	14% below	30%
Preventive checkup, new patient aged 65 or older CPT 99387 NEW PREVENTIVE VISITS 65+ YRS	$110.60	$158.00	$43.36–$150.10	2% above	30%
Preventive checkup, new patient aged 65 or older CPT 99387 NEW PREVENTIVE VISITS 65+ YRS	$110.60	$158.00	$43.36–$150.10	2% above	30%
Preventive checkup, new patient aged 65 or older CPT 99387 WELL CARE VISIT, NEW PT, AGE 65&UP	$136.50	$195.00	$53.51–$185.25	26% above	30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 EST PREVENTIVE VISITS 65+ YRS	$93.10	$133.00	$36.50–$126.35	—	30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 NEW PREVENTIVE VISITS 65+ YRS	$110.60	$158.00	$43.36–$150.10	—	30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 WELL CARE VISIT, NEW PT, AGE 65&UP	$136.50	$195.00	$53.51–$185.25	—	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 WELL CARE, PREV VISIT, EST, AGE 18-39	$58.00	$116.00	$31.83–$110.20	12% below	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 EST PREVENTIVE VISITS 18-39YRS	$93.10	$133.00	$36.50–$126.35	42% above	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 EST PREVENTIVE VISITS 18-39YRS	$93.10	$133.00	$36.50–$126.35	42% above	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 WELL CARE, PREV VISIT, EST, AGE 18-39	$115.50	$165.00	$45.28–$156.75	76% above	30%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 EST PREVENTIVE VISITS 18-39YRS	$93.10	$133.00	$36.50–$126.35	—	30%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 WELL CARE, PREV VISIT, EST, AGE 18-39	$115.50	$165.00	$45.28–$156.75	—	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 WELL CARE PREV VISIT EST, AGE 40-64	$58.00	$116.00	$31.83–$110.20	22% below	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 WELL CARE PREV VISIT EST, AGE 40-64	$115.50	$165.00	$45.28–$156.75	55% above	30%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WELL CARE PREV VISIT EST, AGE 40-64	$115.50	$165.00	$45.28–$156.75	—	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 WELL CARE VISIT, EST PT, AGE 65 & UP	$58.00	$116.00	$31.83–$110.20	13% below	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 WELL CARE, PREV VISIT, EST, 65 & OVER	$115.50	$165.00	$45.28–$156.75	72% above	30%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 WELL CARE, PREV VISIT, EST, 65 & OVER	$115.50	$165.00	$45.28–$156.75	—	30%
Psychiatric evaluation with medical services CPT 90792 PROFESSIONAL FEE-PSYCHIATRIC ASSESSMENT	$167.50	$335.00	$91.92–$318.25	16% below	50%
Psychiatric evaluation with medical services CPT 90792 PROFESSIONAL FEE-PSYCH ASSESSMENT	$167.50	$335.00	$91.92–$318.25	16% below	50%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MED SERV	$192.50	$385.00	$105.64–$365.75	4% below	50%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAGNOSTIC EVAL WITH MED SERVICES	$204.00	$408.00	$111.96–$387.60	2% above	50%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAGNOSTIC EVAL WITH MED SERVICES	$210.00	$300.00	$82.32–$285.00	5% above	30%
Psychiatric evaluation with medical services inpatient CPT 90792 PROFESSIONAL FEE-PSYCH ASSESSMENT	$167.50	$335.00	$91.92–$318.25	—	50%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MED SERV	$192.50	$385.00	$105.64–$365.75	—	50%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAGNOSTIC EVAL WITH MED SERVICES	$210.00	$300.00	$82.32–$285.00	—	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS; 1ST 60 MINUTES	$185.50	$371.00	$101.80–$352.45	18% below	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS; 1ST 60 MINUTES	$185.50	$371.00	$101.80–$352.45	—	50%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30MIN W/PATIENT AND/OR FAM	$98.50	$197.00	$54.06–$187.15	32% below	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30MIN W/PATIENT AND/OR FAM	$98.50	$197.00	$54.06–$187.15	—	50%
Psychotherapy session, 45 minutes CPT 90834 LICSW PSYCHOTHERAPY W/PT 45 MINUTES	$120.00	$240.00	$65.86–$228.00	29% below	50%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45MIN W/PATIENT AND/OR FAM	$131.00	$262.00	$71.89–$248.90	23% below	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 LICSW PSYCHOTHERAPY W/PT 45 MINUTES	$120.00	$240.00	$65.86–$228.00	—	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45MIN W/PATIENT AND/OR FAM	$131.00	$262.00	$71.89–$248.90	—	50%
Psychotherapy session, 60 minutes CPT 90837 LICSW PSYCHOTHERAPY W/PT 60 MINUTES	$100.00	$200.00	$54.88–$190.00	59% below	50%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINUTES WITH PATIENT	$192.00	$384.00	$105.37–$364.80	21% below	50%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY ONLY 60 MINUTES	$197.00	$394.00	$108.11–$374.30	19% below	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 LICSW PSYCHOTHERAPY W/PT 60 MINUTES	$100.00	$200.00	$54.88–$190.00	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINUTES WITH PATIENT	$192.00	$384.00	$105.37–$364.80	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNS 3-10 MIN	$14.00	$28.00	$7.68–$26.60	60% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION COUNSELING 3-10 MIN	$14.00	$28.00	$8.40–$26.60	60% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Cessation Education 3-10 MINS	$40.00	$80.00	$12.07–$76.00	13% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 **TOBACCO USE COUNSEL 3-10 MIN	$56.00	$80.00	$14.48–$76.00	59% above	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNS 3-10 MIN	$70.00	$100.00	$12.07–$95.00	99% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION COUNSELING 3-10 MIN	$14.00	$28.00	$8.40–$26.60	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Cessation Education 3-10 MINS	$40.00	$80.00	$12.07–$76.00	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 **TOBACCO USE COUNSEL 3-10 MIN	$56.00	$80.00	$14.48–$76.00	—	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE/TOBACCO COUNS 3-10 MIN	$70.00	$100.00	$12.07–$95.00	—	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPEC EST OFFICE LEVEL 5 FACILITY FEE	$25.00	$50.00	$15.00–$144.13	66% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE EST LEVEL 5 FACILITY FEE	$25.00	$50.00	$15.00–$144.13	66% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SUBOXONE EST PT OFFICE VISIT 40-54 MINS	$87.50	$125.00	$34.30–$122.50	21% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SUBOXONE EST PT OFFICE VISIT 40-54 MINS	$87.50	$125.00	$34.30–$122.50	21% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST OFFICE VISIT LEVEL 5 40-54 MINUTES	$125.00	$250.00	$68.60–$237.50	72% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST OFFICE VISIT LEVEL 5	$151.20	$216.00	$59.27–$205.20	109% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EVAL AND MANAGEMENT EST LVL 5 40-49 MIN	$169.00	$338.00	$92.75–$321.10	133% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPECIALTY EST OFFICE VISIT LEVEL 5	$188.50	$377.00	$103.45–$358.15	160% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CARDIOLOGY EST OFFICE VISIT LVL 5 40-54M	$245.00	$350.00	$96.04–$332.50	238% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 RHC FACILITY FEE-HIGH COM	$317.10	$453.00	$124.30–$430.35	337% above	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPEC EST OFFICE LEVEL 5 FACILITY FEE	$25.00	$50.00	$15.00–$144.13	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE EST LEVEL 5 FACILITY FEE	$25.00	$50.00	$15.00–$144.13	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SUBOXONE EST PT OFFICE VISIT 40-54 MINS	$87.50	$125.00	$34.30–$122.50	—	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST OFFICE VISIT LEVEL 5	$151.20	$216.00	$59.27–$205.20	—	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EVAL AND MANAGEMENT EST LVL 5 40-49 MIN	$169.00	$338.00	$92.75–$321.10	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPECIALTY EST OFFICE VISIT LEVEL 5	$188.50	$377.00	$103.45–$358.15	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CARDIOLOGY EST OFFICE VISIT LVL 5 40-54M	$245.00	$350.00	$96.04–$332.50	—	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RHC FACILITY FEE-HIGH COM	$317.10	$453.00	$124.30–$430.35	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE EST LEVEL 3 FAC FEE 20-29 MINS	$25.00	$50.00	$15.00–$65.90	64% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPEC EST OFFICE LEVEL 3 FACILITY FEE	$25.00	$50.00	$15.00–$65.90	64% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OFFICE VISIT LEVEL 3 20-29 MINS	$48.50	$97.00	$26.62–$92.15	31% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EVAL AND MANAGEMENT EST LVL 3 20-29 MIN	$50.50	$101.00	$27.71–$95.95	28% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OFFICE VISIT LEVEL 3 20-29 MINS	$67.90	$97.00	$29.10–$92.15	3% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EVAL AND MANAGEMENT EST VISIT LEVEL 3	$70.49	$100.70	$27.64–$95.66	1% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DANVILLE SPECIALTY EST OFFICE VISIT LVL3	$85.50	$171.00	$46.92–$162.45	22% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OFFICE VISIT LEVEL 3	$88.20	$126.00	$34.57–$119.70	26% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OFFICE VISIT LEVEL 3 20-29 MINUTES	$100.00	$200.00	$54.88–$190.00	43% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OFFICE VISIT LEVEL 3 20-29 MINS	$100.00	$200.00	$54.88–$190.00	43% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ORTHO EST OFFICE VISIT LEVEL 3	$101.00	$202.00	$55.43–$191.90	44% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPECIALTY EST OFFICE VISIT LEVEL 3	$101.00	$202.00	$55.43–$191.90	44% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 RHC FACILITY FEE-INTERMED	$117.60	$168.00	$46.10–$159.60	68% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CARDIOLOGY EST OFFICE VISIT LVL 3 20-29M	$140.00	$200.00	$54.88–$190.00	100% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DERM EST OFFICE VISIT LEVEL 3	$141.40	$202.00	$55.43–$191.90	102% above	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE EST LEVEL 3 FAC FEE 20-29 MINS	$25.00	$50.00	$15.00–$65.90	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SPEC EST OFFICE LEVEL 3 FACILITY FEE	$25.00	$50.00	$15.00–$65.90	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EVAL AND MANAGEMENT EST LVL 3 20-29 MIN	$50.50	$101.00	$27.71–$95.95	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PT OFFICE VISIT LEVEL 3 20-29 MINS	$67.90	$97.00	$29.10–$92.15	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EVAL AND MANAGEMENT EST VISIT LEVEL 3	$70.49	$100.70	$27.64–$95.66	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST OFFICE VISIT LEVEL 3	$88.20	$126.00	$34.57–$119.70	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ORTHO EST OFFICE VISIT LEVEL 3	$101.00	$202.00	$55.43–$191.90	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SPECIALTY EST OFFICE VISIT LEVEL 3	$101.00	$202.00	$55.43–$191.90	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RHC FACILITY FEE-INTERMED	$117.60	$168.00	$46.10–$159.60	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CARDIOLOGY EST OFFICE VISIT LVL 3 20-29M	$140.00	$200.00	$54.88–$190.00	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 DERM EST OFFICE VISIT LEVEL 3	$141.40	$202.00	$55.43–$191.90	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE EST LEVEL 4 FAC FEE 30-34 MINS	$25.00	$50.00	$15.00–$97.13	70% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SPEC EST OFFICE LEVEL 4 FACILITY FEE	$25.00	$50.00	$15.00–$97.13	70% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST SPECIALTY FACILITY PROCEDURE CHARGE	$50.00	$100.00	$30.00–$98.00	40% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT OFFICE VISIT LEVEL 4 30-34 MINS	$93.10	$133.00	$36.50–$126.35	12% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CONSULT VISIT LEVEL 4	$94.00	$188.00	$56.40–$178.60	13% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OFFICE VISIT LEVEL 4 30-34 MINUTES	$112.50	$225.00	$61.74–$213.75	35% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OFFICE VISIT LEVEL 4 30-34 MINS	$112.50	$225.00	$61.74–$213.75	35% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EVAL AND MANAGEMENT EST LVL 4 30-39 MIN	$117.00	$234.00	$64.21–$222.30	40% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 DANVILLE SPECIALTY EST OFFICE VISIT LVL4	$121.50	$243.00	$66.68–$230.85	46% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RHC FACILITY FEE-EXTENDED	$128.80	$184.00	$50.49–$174.80	54% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ORTHO EST OFFICE VISIT LEVEL 4	$142.00	$284.00	$77.93–$269.80	70% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SPECIALTY EST OFFICE VISIT LEVEL 4	$142.00	$284.00	$77.93–$269.80	70% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CARDIOLOGY EST OFFICE VISIT LVL 4 30-34M	$157.50	$225.00	$61.74–$213.75	89% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EVAL AND MANAGEMENT EST VISIT LEVEL 4	$163.80	$234.00	$64.21–$222.30	96% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OFFICE VISIT LEVEL 4	$192.50	$275.00	$75.46–$261.25	131% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 DERM EST OFFICE VISIT LEVEL 4	$198.80	$284.00	$77.93–$269.80	138% above	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SPEC EST OFFICE LEVEL 4 FACILITY FEE	$25.00	$50.00	$15.00–$97.13	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE EST LEVEL 4 FAC FEE 30-34 MINS	$25.00	$50.00	$15.00–$97.13	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST SPECIALTY FACILITY PROCEDURE CHARGE	$50.00	$100.00	$30.00–$98.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PT OFFICE VISIT LEVEL 4 30-34 MINS	$93.10	$133.00	$36.50–$126.35	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CONSULT VISIT LEVEL 4	$94.00	$188.00	$56.40–$178.60	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EVAL AND MANAGEMENT EST LVL 4 30-39 MIN	$117.00	$234.00	$64.21–$222.30	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RHC FACILITY FEE-EXTENDED	$128.80	$184.00	$50.49–$174.80	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ORTHO EST OFFICE VISIT LEVEL 4	$142.00	$284.00	$77.93–$269.80	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SPECIALTY EST OFFICE VISIT LEVEL 4	$142.00	$284.00	$77.93–$269.80	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CARDIOLOGY EST OFFICE VISIT LVL 4 30-34M	$157.50	$225.00	$61.74–$213.75	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EVAL AND MANAGEMENT EST VISIT LEVEL 4	$163.80	$234.00	$64.21–$222.30	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST OFFICE VISIT LEVEL 4	$192.50	$275.00	$75.46–$261.25	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 DERM EST OFFICE VISIT LEVEL 4	$198.80	$284.00	$77.93–$269.80	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE EST LEVEL 2 FACILITY FEE 10-19 M	$25.00	$50.00	$15.00–$49.00	60% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SPEC EST OFFICE LEVEL 2 FACILITY FEE	$25.00	$50.00	$15.00–$49.00	60% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EVAL AND MANAGEMENT EST LVL 2 10-19 MIN	$36.00	$72.00	$19.76–$68.40	43% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OFFICE VISIT 10-19 MINUTES	$46.90	$67.00	$18.38–$63.65	26% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OFFICE VISIT LEVEL 2 10-19 MINS	$46.90	$67.00	$18.38–$63.65	26% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EVAL AND MANAGEMENT EST VISIT LEVEL 2	$50.55	$72.21	$19.82–$68.60	20% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DANVILLE SPECIALTY EST OFFICE VISIT LVL2	$53.00	$106.00	$29.09–$100.70	16% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OFFICE VISIT LEVEL 2	$60.20	$86.00	$23.60–$81.70	4% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ORTHO EST OFFICE VISIT LEVEL 2	$63.00	$126.00	$34.57–$119.70	at median	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SPECIALTY EST OFFICE VISIT LEVEL 2	$63.00	$126.00	$34.57–$119.70	at median	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OFFICE VISIT LEVEL 2 10-19 MINUTES	$87.50	$175.00	$48.02–$166.25	39% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DERM EST OFFICE VISIT LEVEL 2	$88.20	$126.00	$34.57–$119.70	40% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RHC FACILITY FEE-LIMITED	$95.20	$136.00	$37.32–$129.20	51% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CARDIOLOGY EST OFFICE VISIT LVL 2 10-19M	$136.50	$195.00	$53.51–$185.25	117% above	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE EST LEVEL 2 FACILITY FEE 10-19 M	$25.00	$50.00	$15.00–$49.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SPEC EST OFFICE LEVEL 2 FACILITY FEE	$25.00	$50.00	$15.00–$49.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EVAL AND MANAGEMENT EST LVL 2 10-19 MIN	$36.00	$72.00	$19.76–$68.40	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PT OFFICE VISIT LEVEL 2 10-19 MINS	$46.90	$67.00	$18.38–$63.65	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PT OFFICE VISIT 10-19 MINUTES	$46.90	$67.00	$18.38–$63.65	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EVAL AND MANAGEMENT EST VISIT LEVEL 2	$50.55	$72.21	$19.82–$68.60	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST OFFICE VISIT LEVEL 2	$60.20	$86.00	$23.60–$81.70	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SPECIALTY EST OFFICE VISIT LEVEL 2	$63.00	$126.00	$34.57–$119.70	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ORTHO EST OFFICE VISIT LEVEL 2	$63.00	$126.00	$34.57–$119.70	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 DERM EST OFFICE VISIT LEVEL 2	$88.20	$126.00	$34.57–$119.70	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RHC FACILITY FEE-LIMITED	$95.20	$136.00	$37.32–$129.20	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CARDIOLOGY EST OFFICE VISIT LVL 2 10-19M	$136.50	$195.00	$53.51–$185.25	—	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT EXTENDED	$37.50	$75.00	$22.50–$71.25	64% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION (40 MIN)	$119.00	$238.00	$65.31–$226.10	13% above	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT LEVEL 3	$139.30	$199.00	$59.70–$189.05	32% above	30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT EXTENDED	$37.50	$75.00	$22.50–$71.25	—	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT LEVEL 3	$139.30	$199.00	$59.70–$189.05	—	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 SBL OFFICE VISIT CONSULT	$50.00	$100.00	$27.44–$95.00	50% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT	$50.00	$100.00	$30.00–$95.00	50% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION (60 MIN)	$90.50	$181.00	$49.67–$171.95	9% below	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 SBL OFFICE VISIT CONSULT	$50.00	$100.00	$27.44–$95.00	—	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT	$50.00	$100.00	$30.00–$95.00	—	50%
Speech therapy session, individual CPT 92507 ST TREATMENT SPEECH LANGUAGE VOICE	$95.00	$190.00	$52.14–$180.50	38% below	50%
Speech therapy session, individual inpatient CPT 92507 ST TREATMENT SPEECH LANGUAGE VOICE	$95.00	$190.00	$52.14–$180.50	—	50%
Spirometry (breathing test) CPT 94010 PFT	$37.10	$53.00	$14.54–$50.35	81% below	30%
Spirometry (breathing test) CPT 94010 BL Spirometry Pre IME	$40.00	$80.00	$21.95–$76.00	80% below	50%
Spirometry (breathing test) CPT 94010 SBL SPIROMETRY PRE	$45.00	$90.00	$24.70–$85.50	77% below	50%
Spirometry (breathing test) CPT 94010 BL IME SPIROMETRY PRE	$56.00	$80.00	$21.95–$76.00	72% below	30%
Spirometry (breathing test) CPT 94010 **PFT - PRE-SPIROMETRY -BREATHING CAPACI	$56.00	$80.00	$21.95–$76.00	72% below	30%
Spirometry (breathing test) CPT 94010 PFT SIMPLE	$182.00	$364.00	$26.41–$345.80	9% below	50%
Spirometry (breathing test) CPT 94010 BL Spirometry Pre	$200.00	$400.00	$26.41–$380.00	1% above	50%
Spirometry (breathing test) CPT 94010 BL SPIROMETRY PRE	$280.00	$400.00	$26.41–$380.00	41% above	30%
Spirometry (breathing test) inpatient CPT 94010 PFT	$37.10	$53.00	$14.54–$50.35	—	30%
Spirometry (breathing test) inpatient CPT 94010 BL Spirometry Pre IME	$40.00	$80.00	$21.95–$76.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 SBL SPIROMETRY PRE	$45.00	$90.00	$24.70–$85.50	—	50%
Spirometry (breathing test) inpatient CPT 94010 **PFT - PRE-SPIROMETRY -BREATHING CAPACI	$56.00	$80.00	$21.95–$76.00	—	30%
Spirometry (breathing test) inpatient CPT 94010 BL IME SPIROMETRY PRE	$56.00	$80.00	$21.95–$76.00	—	30%
Spirometry (breathing test) inpatient CPT 94010 PFT SIMPLE	$182.00	$364.00	$26.41–$345.80	—	50%
Spirometry (breathing test) inpatient CPT 94010 BL Spirometry Pre	$200.00	$400.00	$26.41–$380.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 BL SPIROMETRY PRE	$280.00	$400.00	$26.41–$380.00	—	30%
Spirometry before and after a bronchodilator CPT 94060 BL IME SPIROMETRY PRE VS POST	$92.40	$132.00	$36.22–$125.40	75% below	30%
Spirometry before and after a bronchodilator CPT 94060 BL Spirometry Pre VS Post IME	$106.00	$212.00	$38.25–$201.40	71% below	50%
Spirometry before and after a bronchodilator CPT 94060 BL Spirometry Pre VS Post	$325.00	$650.00	$38.25–$617.50	11% below	50%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE AND POST	$350.00	$700.00	$38.25–$665.00	5% below	50%
Spirometry before and after a bronchodilator CPT 94060 BL SPIROMETRY PRE VS POST	$385.00	$550.00	$38.25–$522.50	5% above	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 BL IME SPIROMETRY PRE VS POST	$92.40	$132.00	$36.22–$125.40	—	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 BL Spirometry Pre VS Post IME	$106.00	$212.00	$38.25–$201.40	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 BL Spirometry Pre VS Post	$325.00	$650.00	$38.25–$617.50	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE AND POST	$350.00	$700.00	$38.25–$665.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 BL SPIROMETRY PRE VS POST	$385.00	$550.00	$38.25–$522.50	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY E	$37.00	$74.00	$20.31–$70.30	51% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY EXER	$38.00	$76.00	$20.85–$72.20	50% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY E	$37.00	$74.00	$20.31–$70.30	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY EXER	$38.00	$76.00	$20.85–$72.20	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$145.00	$290.00	$79.58–$275.50	4% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$145.00	$290.00	$79.58–$275.50	—	50%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS	$118.50	$237.00	$65.03–$225.15	85% below	50%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 STRESS TEST W/INTER & RPT	$1,716.50	$3,433.00	$66.44–$3,261.35	111% above	50%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIOVASCULAR STRESS	$118.50	$237.00	$65.03–$225.15	—	50%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 STRESS TEST W/INTER & RPT	$1,716.50	$3,433.00	$66.44–$3,261.35	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CL COVID VACC (SPIKEVAX): 0.5ML 12Y+	$255.24	$510.47	$140.07–$484.95	65% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 CL PFIZER COVID VAC (12Y+): 0.3ML	$201.03	$402.06	$110.33–$381.96	34% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFIZER COVID VAC (12Y+): 0.3ML	$201.03	$402.06	$110.33–$381.96	34% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PFIZER COVID VAC (12Y+): 0.3ML	$201.03	$402.06	$110.33–$381.96	—	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL VARICELLA LIVE (VARIVAX) VACCINE	$244.08	$488.16	$133.95–$463.75	at median	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA (VARIVAX) VAC (1Y+): 0.5ML	$244.08	$488.16	$133.95–$463.75	at median	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA (VARIVAX) VAC (1Y+): 0.5ML	$244.08	$488.16	$133.95–$463.75	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA (FLULAVAL) VAC: 0.5ML	$24.87	$49.74	$13.65–$47.25	28% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL INFLUENZA(FLULAVAL)VACC:0.5ML 6M+	$24.87	$49.74	$13.65–$47.25	28% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL INFLUENZA (FLUARIX) VAC: 0.5ML	$28.20	$56.40	$15.47–$53.58	45% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA (FLUARIX) VAC: 0.5ML	$28.20	$56.40	$15.47–$53.58	45% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA (FLULAVAL) VAC: 0.5ML	$24.87	$49.74	$13.65–$47.25	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA (FLUARIX) VAC: 0.5ML	$28.20	$56.40	$15.47–$53.58	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 CL HPV (GARDISIL) VACCINE 0.5ML VIAL	$274.50	$549.00	$150.65–$521.55	6% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV (GARDISIL) VACCINE 0.5ML VIAL	$384.30	$549.00	$150.65–$521.55	32% above	30%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV (GARDISIL) VACCINE 0.5ML VIAL	$384.30	$549.00	$150.65–$521.55	—	30%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/B (TWINRIX) ADULT 18Y+ VAC: 1ML	$218.07	$436.14	$119.68–$414.33	83% above	50%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A/B (TWINRIX) ADULT 18Y+ VAC: 1ML	$218.07	$436.14	$119.68–$414.33	—	50%
Hepatitis A vaccine, adult dose CPT 90632 CL HEPATITIS A ADULT (HAVRIX) 1ML VIAL	$122.25	$244.50	$67.09–$232.28	25% above	50%
Hepatitis A vaccine, adult dose CPT 90632 HEP A (HAVRIX) ADULT 19Y+ VAC: 1ML	$206.46	$412.92	$72.07–$392.27	112% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A (HAVRIX) ADULT 19Y+ VAC: 1ML	$206.46	$412.92	$72.07–$392.27	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CL HEPATITIS B (ENGERIX-B) 20MCG/ML SDV	$120.11	$240.21	$65.91–$228.20	81% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B(ENGERIX-B)ADULT 20Y+ VAC: 20MCG/ML	$129.81	$259.62	$71.24–$246.64	95% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B(ENGERIX-B)ADULT 20Y+ VAC: 20MCG/ML	$129.81	$259.62	$71.24–$246.64	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL INFLUENZA HIGH DOSE (FLUZONE): 0.5ML	$101.01	$202.02	$55.44–$191.92	20% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA HIGH-DOSE (FLUZONE) VAC: 0.5ML	$101.01	$202.02	$55.44–$191.92	20% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA HIGH-DOSE (FLUZONE) VAC: 0.5ML	$101.01	$202.02	$55.44–$191.92	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CL MEAS/MUMP/RUBELLA (MMR II) 0.5ML VAC	$102.00	$204.00	$55.98–$193.80	12% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLE/MUMP/RUBELLA (MMR II) VAC: 0.5ML	$132.05	$264.09	$72.47–$250.89	13% above	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CL MMR (PRIORIX) VACCINE PWDR VIAL	$161.09	$322.17	$88.41–$306.06	38% above	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLE/MUMP/RUBELLA (MMR II) VAC: 0.5ML	$132.05	$264.09	$72.47–$250.89	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL MENING ACY W-135(MENVEO) VACCINE KIT	$259.31	$518.61	$142.31–$492.68	66% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING ACWY 2 VIAL VAC (2MO-55Y): 0.5ML	$259.31	$518.61	$142.31–$492.68	66% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL MENING VAC W135(MENVEO) 0.5ML SD VIAL	$267.05	$534.09	$146.56–$507.39	71% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING ACWY 1 VIAL VAC (10Y-55Y): 0.5ML	$299.93	$599.85	$164.60–$569.86	92% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOC (MENACTRA) 4MCG/0.5ML VACCINE	$323.21	$461.73	$126.69–$438.64	107% above	30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL MENINGOCOC (MENACTRA) 4MCG/0.5ML VAC	$323.21	$461.73	$126.69–$438.64	107% above	30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VACC W135(MENVEO)SINGLE DOSE VIAL	$373.86	$534.09	$146.56–$507.39	139% above	30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING ACWY 2 VIAL VAC (2MO-55Y): 0.5ML	$259.31	$518.61	$142.31–$492.68	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING ACWY 1 VIAL VAC (10Y-55Y): 0.5ML	$299.93	$599.85	$164.60–$569.86	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 CL MENINGOCOC (MENACTRA) 4MCG/0.5ML VAC	$323.21	$461.73	$126.69–$438.64	—	30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOC (MENACTRA) 4MCG/0.5ML VACCINE	$323.21	$461.73	$126.69–$438.64	—	30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING VACC W135(MENVEO)SINGLE DOSE VIAL	$373.86	$534.09	$146.56–$507.39	—	30%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MININGOCOCCAL (BEXSERO) VACCINE	$272.77	$389.67	$106.93–$370.19	43% above	30%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 CL MENINGOCOCCAL B (BEXSERO) VAC: 0.5ML	$322.43	$644.85	$176.95–$612.61	69% above	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B (BEXSERO) VAC: 0.5ML	$426.60	$853.20	$234.12–$810.54	123% above	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MININGOCOCCAL (BEXSERO) VACCINE	$272.77	$389.67	$106.93–$370.19	—	30%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B (BEXSERO) VAC: 0.5ML	$426.60	$853.20	$234.12–$810.54	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL PNEUMCOCC(PREVNAR 20)INJ: 0.5ML SYR	$447.98	$895.95	$245.85–$851.15	30% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 (PREVNAR 20) VAC: 0.5ML	$494.06	$988.11	$271.14–$938.70	43% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 (PREVNAR 20) VAC: 0.5ML	$494.06	$988.11	$271.14–$938.70	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 (PNEUMOCOCCAL 23)VAC: 0.5ML	$265.08	$378.69	$103.91–$359.76	151% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL PNEUMOVAX-23 VACCINE VIAL	$322.84	$461.20	$126.56–$438.14	206% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 (PNEUMOCOCCAL 23)VAC: 0.5ML	$265.08	$378.69	$103.91–$359.76	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CL PNEUMOVAX-23 VACCINE VIAL	$322.84	$461.20	$126.56–$438.14	—	30%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 CL NIRSEV(BEYFORTUS)INJ:50MG/0.5ML 0.5ML	$1,001.04	$2,002.08	$549.37–$1,901.98	27% above	50%
Rabies vaccine, one dose CPT 90675 RABIES (IMOVAX) VAC VIAL: 2.5U/ML	$649.79	$1,299.57	$313.36–$1,234.59	33% above	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES (IMOVAX) VAC VIAL: 2.5U/ML	$649.79	$1,299.57	$313.36–$1,234.59	—	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL VARICELLA (SHINGRIX) 50MCG/0.5ML VACC	$272.54	$545.07	$149.57–$517.82	56% above	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER (SHINGRIX) VAC (50Y+): 0.5ML	$272.54	$545.07	$149.57–$517.82	56% above	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER (SHINGRIX) VAC (50Y+): 0.5ML	$272.54	$545.07	$149.57–$517.82	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOXOIDS(Td)7 & UP	$9.50	$19.00	$5.21–$18.62	81% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 ADM TETANUS TOXOID, IM .5 ML/DOSE	$9.50	$19.00	$5.21–$18.62	81% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 ADM TETANUS AND DIPHTHERIA TOXOIDS	$9.50	$19.00	$5.21–$18.62	81% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL TETANUS DIPTH (ADULT) 0.5ML/DOSE	$23.50	$47.00	$12.90–$44.65	54% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET DIP (TENIVAC) VAC (7Y+): 0.5ML	$23.50	$47.00	$12.90–$44.65	54% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 ADM TETANUS TOXOID, IM .5 ML/DOSE	$9.50	$19.00	$5.21–$18.62	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 ADM TETANUS AND DIPHTHERIA TOXOIDS	$9.50	$19.00	$5.21–$18.62	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOXOIDS(Td)7 & UP	$9.50	$19.00	$5.21–$18.62	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET DIP (TENIVAC) VAC (7Y+): 0.5ML	$23.50	$47.00	$12.90–$44.65	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL TDAP (BOOSTRIX) VAC: 0.5ML	$80.00	$160.00	$38.90–$152.00	56% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET DIP PERT (Tdap) VAC (10Y+): 0.5ML	$87.08	$174.15	$38.90–$165.44	70% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL TETANUS/DIPHTH/PERTUSS TDAP 0.5ML VAC	$112.00	$160.00	$38.90–$152.00	118% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET DIP PERT (Tdap) VAC (10Y+): 0.5ML	$87.08	$174.15	$38.90–$165.44	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CL TETANUS/DIPHTH/PERTUSS TDAP 0.5ML VAC	$112.00	$160.00	$38.90–$152.00	—	30%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 CL TYPHOID (TYPHIM VI) 25MCG/0.5ML VAC	$238.96	$341.37	$93.67–$324.30	69% above	30%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACC(TYPHIM VI)SYR: 25MCG/0.5ML	$238.96	$341.37	$93.67–$324.30	69% above	30%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 CL TYPHOID (TYPHIM VI) 25MCG/0.5ML VAC	$238.96	$341.37	$93.67–$324.30	—	30%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACC(TYPHIM VI)SYR: 25MCG/0.5ML	$238.96	$341.37	$93.67–$324.30	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 1ST VACCINE	$13.30	$19.00	$5.21–$18.62	75% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF INFLUENZA VACCINE	$16.00	$32.00	$8.78–$30.40	70% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF PNEUMOCOCCAL VACCINE	$16.00	$32.00	$8.78–$30.40	70% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$16.00	$32.00	$8.78–$30.40	70% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION HEPATITIS A AND B VACCINE	$16.00	$32.00	$8.78–$30.40	70% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CL ADMINISTRATION OF VACCINE	$16.00	$32.00	$8.78–$30.40	70% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 1ST VACCINE	$13.30	$19.00	$5.21–$18.62	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION OF VACCINE	$16.00	$32.00	$8.78–$30.40	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION OF INFLUENZA VACCINE	$16.00	$32.00	$8.78–$30.40	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION HEPATITIS A AND B VACCINE	$16.00	$32.00	$8.78–$30.40	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION OF PNEUMOCOCCAL VACCINE	$16.00	$32.00	$8.78–$30.40	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 MULTIPLE VACCINE	$13.30	$19.00	$5.21–$18.05	49% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJECTION ADMIN EACH ADDITIONAL	$13.90	$19.85	$5.45–$18.86	47% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE EACH ADDITIONA	$16.00	$32.00	$8.78–$30.40	39% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CL ADMINISTRATION OF VACCINE EACH ADD	$16.00	$32.00	$8.78–$30.40	39% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 MULTIPLE VACCINE	$13.30	$19.00	$5.21–$18.05	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJECTION ADMIN EACH ADDITIONAL	$13.90	$19.85	$5.45–$18.86	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMINISTRATION OF VACCINE EACH ADDITIONA	$16.00	$32.00	$8.78–$30.40	—	50%

Source file: https://www.bmh.org/wp-content/uploads/2026/04/550477361_boone-memorial-hospital-inc._standardcharges-1.csv