Boone Memorial Hospital
Boone Memorial Hospital in Madison, WV publishes cash prices for 426 common procedures listed here, from its own machine-readable price file updated Apr 7, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the West Virginia median for 274 of 419 procedures and above it for 128. By typical cash price it ranks #6 of 36 West Virginia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
701 Madison Avenue, Madison, WV, 25130 Collected Sep 27, 2026 Source price file Check a bill from this hospital (304) 369-1230
Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CMS star rating 4 of 5 CCN 511313 · CMS hospital register NPI 1639135221
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Boone Memorial Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W WO CONTRAST,Technical Component | $1,181.50 | $2,363.00 | $166.20–$2,244.85 | 4% below | 50% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W WO CONTRAST,Technical Component | $1,181.50 | $2,363.00 | $166.20–$2,244.85 | — | 50% |
| Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN FLAT & UPRIGHT,Technical Component | $175.00 | $350.00 | $21.80–$332.50 | 20% below | 50% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN FLAT & UPRIGHT,Technical Component | $175.00 | $350.00 | $21.80–$332.50 | — | 50% |
| 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% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN,Technical Component | $659.00 | $1,318.00 | $188.47–$1,252.10 | 24% below | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN,Technical Component | $659.00 | $1,318.00 | $188.47–$1,252.10 | — | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US ADD VIEW BREAST,Technical Component | $217.00 | $434.00 | $44.56–$412.30 | 18% below | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US ADD VIEW BREAST,Technical Component | $217.00 | $434.00 | $44.56–$412.30 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD & PELVIS W CONTRAST,Technical Component | $1,195.00 | $2,390.00 | $237.11–$2,270.50 | 30% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD & PELVIS,Technical Component | $1,344.50 | $2,689.00 | $237.11–$2,554.55 | 22% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD & PELVIS W CONTRAST,Technical Component | $1,195.00 | $2,390.00 | $237.11–$2,270.50 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD & PELVIS,Technical Component | $1,344.50 | $2,689.00 | $237.11–$2,554.55 | — | 50% |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD,Technical Component | $1,062.50 | $2,125.00 | $165.53–$2,018.75 | 12% below | 50% |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD PERFUSION W CONT,Technical Component | $1,098.00 | $2,196.00 | $165.53–$2,086.20 | 9% below | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD,Technical Component | $1,062.50 | $2,125.00 | $165.53–$2,018.75 | — | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD PERFUSION W CONT,Technical Component | $1,098.00 | $2,196.00 | $165.53–$2,086.20 | — | 50% |
| CT angiography (CTA) of the neck CPT 70498 CTA CAROTID,Technical Component | $1,096.00 | $2,192.00 | $165.53–$2,082.40 | 5% below | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA CAROTID,Technical Component | $1,096.00 | $2,192.00 | $165.53–$2,082.40 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST FOR PE,Technical Component | $1,065.50 | $2,131.00 | $168.37–$2,024.45 | 16% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTR,Technical Component | $1,065.50 | $2,131.00 | $168.37–$2,024.45 | 16% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTR,Technical Component | $1,065.50 | $2,131.00 | $168.37–$2,024.45 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHEST FOR PE,Technical Component | $1,065.50 | $2,131.00 | $168.37–$2,024.45 | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA CORONARY,Technical Component | $1,109.00 | $2,218.00 | $183.92–$2,107.10 | at median | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA WITH FFRCT AS MEDICALLY INDICATED,Technical Component | $1,413.00 | $2,826.00 | $183.92–$2,684.70 | 27% above | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA CORONARY,Technical Component | $1,109.00 | $2,218.00 | $183.92–$2,107.10 | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA WITH FFRCT AS MEDICALLY INDICATED,Technical Component | $1,413.00 | $2,826.00 | $183.92–$2,684.70 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CORONARY CALCIUM SCORE,Technical Component | $171.00 | $342.00 | $62.38–$324.90 | 73% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CARDIAC CALCIUM SCORE,Technical Component | $216.50 | $433.00 | $62.38–$411.35 | 119% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CORONARY CALCIUM SCORE,Technical Component | $171.00 | $342.00 | $62.38–$324.90 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CARDIAC CALCIUM SCORE,Technical Component | $216.50 | $433.00 | $62.38–$411.35 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 TRAUMA CT ABD & PELVIS WO CONTRAST,Technical Component | $1,222.00 | $2,444.00 | $88.26–$2,321.80 | 10% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS ORAL ONLY,Technical Component | $1,222.00 | $2,444.00 | $88.26–$2,321.80 | 10% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS WO CONT,Technical Component | $1,222.00 | $2,444.00 | $88.26–$2,321.80 | 10% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ENTEROGRAPHY A&P ORAL ONLY,Technical Component | $1,224.00 | $2,448.00 | $88.26–$2,325.60 | 10% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS WO CONT,Technical Component | $1,222.00 | $2,444.00 | $88.26–$2,321.80 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 TRAUMA CT ABD & PELVIS WO CONTRAST,Technical Component | $1,222.00 | $2,444.00 | $88.26–$2,321.80 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS ORAL ONLY,Technical Component | $1,222.00 | $2,444.00 | $88.26–$2,321.80 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ENTEROGRAPHY A&P ORAL ONLY,Technical Component | $1,224.00 | $2,448.00 | $88.26–$2,325.60 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY A&P W CONTRAST,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | 11% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS IV ONLY,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | 11% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 TRAUMA CT ABD & PELVIS IV CONTRAST,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | 11% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W CONT,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | 11% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY A&P W CONTRAST,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS IV ONLY,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W CONT,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 TRAUMA CT ABD & PELVIS IV CONTRAST,Technical Component | $1,439.50 | $2,879.00 | $184.69–$2,735.05 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W WO CONT,Technical Component | $686.50 | $1,373.00 | $209.34–$1,304.35 | 60% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM,Technical Component | $686.50 | $1,373.00 | $209.34–$1,304.35 | 60% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM,Technical Component | $686.50 | $1,373.00 | $209.34–$1,304.35 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS W WO CONT,Technical Component | $686.50 | $1,373.00 | $209.34–$1,304.35 | — | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST,Technical Component | $941.50 | $1,883.00 | $146.58–$1,788.85 | 11% below | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST,Technical Component | $941.50 | $1,883.00 | $146.58–$1,788.85 | — | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT STONE PROTOCOL ABDOMEN & PELVIS | $639.10 | $913.00 | $69.59–$867.35 | 13% below | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST,Technical Component | $797.50 | $1,595.00 | $69.59–$1,515.25 | 8% above | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT STONE PROTOCOL ABDOMEN & PELVIS | $639.10 | $913.00 | $69.59–$867.35 | — | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST,Technical Component | $797.50 | $1,595.00 | $69.59–$1,515.25 | — | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 TRAUMA CT FACIAL WO CONTRAST,Technical Component | $709.50 | $1,419.00 | $75.56–$1,348.05 | 2% above | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES WO,Technical Component | $709.50 | $1,419.00 | $75.56–$1,348.05 | 2% above | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO CONTRAST,Technical Component | $730.00 | $1,460.00 | $75.56–$1,387.00 | 5% above | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES WO,Technical Component | $709.50 | $1,419.00 | $75.56–$1,348.05 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 TRAUMA CT FACIAL WO CONTRAST,Technical Component | $709.50 | $1,419.00 | $75.56–$1,348.05 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL WO CONTRAST,Technical Component | $730.00 | $1,460.00 | $75.56–$1,387.00 | — | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 TRAUMA CT HEAD WO CONTRAST,Technical Component | $709.50 | $1,419.00 | $57.36–$1,348.05 | at median | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT STROKE HEAD WO CONT,Technical Component | $736.50 | $1,473.00 | $57.36–$1,399.35 | 4% above | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST,Technical Component | $738.00 | $1,476.00 | $57.36–$1,402.20 | 4% above | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 TRAUMA CT HEAD WO CONTRAST,Technical Component | $709.50 | $1,419.00 | $57.36–$1,348.05 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT STROKE HEAD WO CONT,Technical Component | $736.50 | $1,473.00 | $57.36–$1,399.35 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST,Technical Component | $738.00 | $1,476.00 | $57.36–$1,402.20 | — | 50% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W WO CONTRAST,Technical Component | $1,042.00 | $2,084.00 | $97.93–$1,979.80 | 11% below | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W WO CONTRAST,Technical Component | $1,042.00 | $2,084.00 | $97.93–$1,979.80 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 TRAUMA CT LUMBAR SPINE WO CONTRAST,Technical Component | $806.00 | $1,612.00 | $71.30–$1,531.40 | 4% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR WO CONTRAST,Technical Component | $808.50 | $1,617.00 | $71.30–$1,536.15 | 4% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 TRAUMA CT LUMBAR SPINE WO CONTRAST,Technical Component | $806.00 | $1,612.00 | $71.30–$1,531.40 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR WO CONTRAST,Technical Component | $808.50 | $1,617.00 | $71.30–$1,536.15 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 TRAUMA CTC SPINE WO CONTRAST,Technical Component | $810.50 | $1,621.00 | $71.86–$1,539.95 | 1% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO CONTRAST,Technical Component | $811.00 | $1,622.00 | $71.86–$1,540.90 | 1% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 TRAUMA CTC SPINE WO CONTRAST,Technical Component | $810.50 | $1,621.00 | $71.86–$1,539.95 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO CONTRAST,Technical Component | $811.00 | $1,622.00 | $71.86–$1,540.90 | — | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST,Technical Component | $937.00 | $1,874.00 | $147.15–$1,780.30 | 1% below | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST,Technical Component | $937.00 | $1,874.00 | $147.15–$1,780.30 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUPLEX SCAN BILAT,Technical Component | $825.50 | $1,651.00 | $129.69–$1,568.45 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DUPLEX SCAN BILAT,Technical Component | $825.50 | $1,651.00 | $129.69–$1,568.45 | — | 50% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST W WO,Technical Component | $1,069.00 | $2,138.00 | $118.13–$2,031.10 | 15% below | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W WO,Technical Component | $1,069.00 | $2,138.00 | $118.13–$2,031.10 | — | 50% |
| Chest X-ray, 2 views CPT 71046 XR CHEST 2V W/INTERPRETATION,Technical Component | $82.00 | $164.00 | $19.82–$155.80 | 57% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR CHEST PA & LAT WITH FLUOR,Technical Component | $92.00 | $184.00 | $19.82–$174.80 | 51% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR CHEST W BOTH OBLIQUES,Technical Component | $124.50 | $249.00 | $19.82–$236.55 | 34% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR CHEST PA AND LATERAL,Technical Component | $147.00 | $294.00 | $19.82–$279.30 | 22% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR CHEST INSPIRATION/EXPIRATION 2 VIEWS,Technical Component | $148.00 | $296.00 | $19.82–$281.20 | 22% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR CHEST W LORDOTIC VIEW,Technical Component | $148.00 | $296.00 | $19.82–$281.20 | 22% below | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2V W/INTERPRETATION,Technical Component | $82.00 | $164.00 | $19.82–$155.80 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA & LAT WITH FLUOR,Technical Component | $92.00 | $184.00 | $19.82–$174.80 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST W BOTH OBLIQUES,Technical Component | $124.50 | $249.00 | $19.82–$236.55 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA AND LATERAL,Technical Component | $147.00 | $294.00 | $19.82–$279.30 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST INSPIRATION/EXPIRATION 2 VIEWS,Technical Component | $148.00 | $296.00 | $19.82–$281.20 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST W LORDOTIC VIEW,Technical Component | $148.00 | $296.00 | $19.82–$281.20 | — | 50% |
| Chest X-ray, single view CPT 71045 BL B Read Chest XRay IME | $87.50 | $175.00 | $22.76–$166.25 | 50% below | 50% |
| Chest X-ray, single view CPT 71045 SBL B READ CHEST XRAY | $92.50 | $185.00 | $22.76–$175.75 | 47% below | 50% |
| Chest X-ray, single view CPT 71045 BL B Read Chest XRay | $100.00 | $200.00 | $22.76–$190.00 | 43% below | 50% |
| Chest X-ray, single view CPT 71045 **BL B-READ CHEST X-RAY | $140.00 | $200.00 | $22.76–$190.00 | 20% below | 30% |
| Chest X-ray, single view CPT 71045 BL IME B-READ CHEST X-RAY | $174.30 | $249.00 | $22.76–$236.55 | 1% below | 30% |
| 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% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US KIDNEYS/BLADDER EVALUATION,Technical Component | $210.00 | $420.00 | $61.62–$399.00 | 52% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ILIAC ARTERY,Technical Component | $320.50 | $641.00 | $61.62–$608.95 | 27% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABD AORTA COMPLETE,Technical Component | $320.50 | $641.00 | $61.62–$608.95 | 27% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US KIDNEYS/BLADDER EVALUATION,Technical Component | $210.00 | $420.00 | $61.62–$399.00 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ABD AORTA COMPLETE,Technical Component | $320.50 | $641.00 | $61.62–$608.95 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ILIAC ARTERY,Technical Component | $320.50 | $641.00 | $61.62–$608.95 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA SCREENING,Technical Component | $214.00 | $428.00 | $25.78–$406.60 | 32% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA SCREENING,Technical Component | $214.00 | $428.00 | $25.78–$406.60 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO | $639.10 | $913.00 | $71.01–$867.35 | 19% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST AETNA,Technical Component | $744.00 | $1,488.00 | $71.01–$1,413.60 | 5% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 TRAUMA CT CHEST WO CONTRAST,Technical Component | $772.00 | $1,544.00 | $71.01–$1,466.80 | 2% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST HIGH RESOLUTION,Technical Component | $773.00 | $1,546.00 | $71.01–$1,468.70 | 2% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST,Technical Component | $773.00 | $1,546.00 | $71.01–$1,468.70 | 2% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO | $639.10 | $913.00 | $71.01–$867.35 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST AETNA,Technical Component | $744.00 | $1,488.00 | $71.01–$1,413.60 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 TRAUMA CT CHEST WO CONTRAST,Technical Component | $772.00 | $1,544.00 | $71.01–$1,466.80 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST,Technical Component | $773.00 | $1,546.00 | $71.01–$1,468.70 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST HIGH RESOLUTION,Technical Component | $773.00 | $1,546.00 | $71.01–$1,468.70 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 TRAUMA CT CHEST IV CONTRAST,Technical Component | $902.00 | $1,804.00 | $96.51–$1,713.80 | 18% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT ROUTINE,Technical Component | $904.00 | $1,808.00 | $96.51–$1,717.60 | 18% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 TRAUMA CT CHEST IV CONTRAST,Technical Component | $902.00 | $1,804.00 | $96.51–$1,713.80 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONT ROUTINE,Technical Component | $904.00 | $1,808.00 | $96.51–$1,717.60 | — | 50% |
| 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 | 10% below | 30% |
| Diagnostic mammogram, one breast inpatient CPT 77065 CAD W PHYSICIAN REVIEW SCREENING | $196.70 | $281.00 | $73.57–$266.95 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LOWER BILAT EXT,Technical Component | $440.50 | $881.00 | $171.69–$836.95 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL LOWER BILAT EXT,Technical Component | $440.50 | $881.00 | $171.69–$836.95 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS LOWER BILAT EXT,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS UPPER BILAT EXT,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | — | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS INSUFFICIENCY STUDY,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | 17% below | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS EXT BIL,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | 17% below | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS LOWER BILAT EXT,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS UPPER BILAT EXT,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS EXT BIL,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS INSUFFICIENCY STUDY,Technical Component | $491.50 | $983.00 | $129.98–$933.85 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE BUBBLE STDY,Technical Component | $1,067.50 | $2,135.00 | $110.63–$2,028.25 | 8% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE COLOR & SPEC,Technical Component | $1,067.50 | $2,135.00 | $110.63–$2,028.25 | 8% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ..ECHO COMPLETE | $1,538.60 | $2,198.00 | $110.63–$2,088.10 | 33% above | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE BUBBLE STDY,Technical Component | $1,067.50 | $2,135.00 | $110.63–$2,028.25 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE COLOR & SPEC,Technical Component | $1,067.50 | $2,135.00 | $110.63–$2,028.25 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ..ECHO COMPLETE | $1,538.60 | $2,198.00 | $110.63–$2,088.10 | — | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONE WO CONTRAST,Technical Component | $764.00 | $1,528.00 | $84.85–$1,451.60 | 10% above | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS W/O CONTRAST,Technical Component | $764.00 | $1,528.00 | $84.85–$1,451.60 | 10% above | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONE WO CONTRAST,Technical Component | $764.00 | $1,528.00 | $84.85–$1,451.60 | — | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O CONTRAST,Technical Component | $764.00 | $1,528.00 | $84.85–$1,451.60 | — | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPLETE,Technical Component | $177.50 | $355.00 | $29.48–$337.25 | 25% below | 50% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMPLETE,Technical Component | $177.50 | $355.00 | $29.48–$337.25 | — | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA SCAN WO CCK,Technical Component | $651.50 | $1,303.00 | $214.83–$1,237.85 | 23% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA SCAN WO CCK,Technical Component | $651.50 | $1,303.00 | $214.83–$1,237.85 | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR OS CALCUS | $67.90 | $97.00 | $17.82–$92.15 | 61% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR OS CALCUS | $67.90 | $97.00 | $17.82–$92.15 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY | $275.50 | $551.00 | $92.90–$523.45 | 22% below | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 DICICCO HOME SLEEP STUDY | $275.50 | $551.00 | $92.90–$523.45 | 22% below | 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% |
| 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% |
| 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 | 41% 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% |
| Knee X-ray, 3 views both sides CPT 73562 XR BILAT KNEES CONTRACT,Technical Component | $145.50 | $291.00 | $28.34–$276.45 | — | 50% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR BILAT KNEES CONTRACT,Technical Component | $145.50 | $291.00 | $28.34–$276.45 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD FOR ASCITES,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US COMMON BILE DUCT,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US RT UPPER QUADRANT,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD FOR ASCITES,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US COMMON BILE DUCT,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US RT UPPER QUADRANT,Technical Component | $292.50 | $585.00 | $50.24–$555.75 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US NON VASCULAR EXT LIMITED,Technical Component | $235.00 | $470.00 | $27.49–$446.50 | 21% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US NON VASCULAR EXT LIMITED,Technical Component | $235.00 | $470.00 | $27.49–$446.50 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG CANCER SCREENING,Technical Component | $797.00 | $1,594.00 | $74.32–$1,514.30 | 411% above | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG CANCER SCREENING,Technical Component | $797.00 | $1,594.00 | $74.32–$1,514.30 | — | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST,Technical Component | $1,150.00 | $2,300.00 | $136.51–$2,185.00 | 18% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV HEAD WO CONTRAST,Technical Component | $1,150.00 | $2,300.00 | $136.51–$2,185.00 | 18% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W OR WO CONTRAST | $1,498.70 | $2,141.00 | $136.51–$2,033.95 | 7% above | 30% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV HEAD WO CONTRAST,Technical Component | $1,150.00 | $2,300.00 | $136.51–$2,185.00 | — | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST,Technical Component | $1,150.00 | $2,300.00 | $136.51–$2,185.00 | — | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W OR WO CONTRAST | $1,498.70 | $2,141.00 | $136.51–$2,033.95 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JOINT LOW EXT,Technical Component | $1,199.00 | $2,398.00 | $120.97–$2,278.10 | 8% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JOINT LOW EXT,Technical Component | $1,199.00 | $2,398.00 | $120.97–$2,278.10 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 DIAG IMAGING PROC OF THE RT LOWER EXT | $1,500.10 | $2,143.00 | $240.91–$2,035.85 | 19% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 DIAG IMAGING PROC OF THE RT LOWER EXT | $1,500.10 | $2,143.00 | $240.91–$2,035.85 | — | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI RENAL WO CONTRAST,Technical Component | $833.50 | $1,667.00 | $108.74–$1,583.65 | 34% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST,Technical Component | $833.50 | $1,667.00 | $108.74–$1,583.65 | 34% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP ABD,Technical Component | $833.50 | $1,667.00 | $108.74–$1,583.65 | 34% below | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST,Technical Component | $833.50 | $1,667.00 | $108.74–$1,583.65 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI RENAL WO CONTRAST,Technical Component | $833.50 | $1,667.00 | $108.74–$1,583.65 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP ABD,Technical Component | $833.50 | $1,667.00 | $108.74–$1,583.65 | — | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W WO CONTRAST,Technical Component | $1,606.50 | $3,213.00 | $200.23–$3,052.35 | 18% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W WO,Technical Component | $1,606.50 | $3,213.00 | $200.23–$3,052.35 | 18% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP ABD W WO,Technical Component | $1,709.00 | $3,418.00 | $200.23–$3,247.10 | 12% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI RENAL W WO CONTRAST,Technical Component | $1,709.00 | $3,418.00 | $200.23–$3,247.10 | 12% below | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W WO,Technical Component | $1,606.50 | $3,213.00 | $200.23–$3,052.35 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W WO CONTRAST,Technical Component | $1,606.50 | $3,213.00 | $200.23–$3,052.35 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP ABD W WO,Technical Component | $1,709.00 | $3,418.00 | $200.23–$3,247.10 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI RENAL W WO CONTRAST,Technical Component | $1,709.00 | $3,418.00 | $200.23–$3,247.10 | — | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI HEAD WO,Technical Component | $1,137.00 | $2,274.00 | $109.02–$2,160.30 | 17% below | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD WO,Technical Component | $1,137.00 | $2,274.00 | $109.02–$2,160.30 | — | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD W & WO CONTRAST,Technical Component | $1,769.00 | $3,538.00 | $180.89–$3,361.10 | 9% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD PITUITARY W/WO CONT,Technical Component | $1,769.00 | $3,538.00 | $180.89–$3,361.10 | 9% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD IAC W/WO CONT,Technical Component | $1,769.00 | $3,538.00 | $180.89–$3,361.10 | 9% below | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD PITUITARY W/WO CONT,Technical Component | $1,769.00 | $3,538.00 | $180.89–$3,361.10 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD IAC W/WO CONT,Technical Component | $1,769.00 | $3,538.00 | $180.89–$3,361.10 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD W & WO CONTRAST,Technical Component | $1,769.00 | $3,538.00 | $180.89–$3,361.10 | — | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR WO CONTRAST,Technical Component | $1,234.50 | $2,469.00 | $105.33–$2,345.55 | 9% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO | $1,589.70 | $2,271.00 | $105.33–$2,157.45 | 18% above | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR WO CONTRAST,Technical Component | $1,234.50 | $2,469.00 | $105.33–$2,345.55 | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO | $1,589.70 | $2,271.00 | $105.33–$2,157.45 | — | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W WO CONTRAST,Technical Component | $1,825.50 | $3,651.00 | $181.74–$3,468.45 | 4% below | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W WO CONTRAST,Technical Component | $1,825.50 | $3,651.00 | $181.74–$3,468.45 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO,Technical Component | $1,226.00 | $2,452.00 | $104.48–$2,329.40 | 9% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WO,Technical Component | $1,226.00 | $2,452.00 | $104.48–$2,329.40 | — | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W WO CONTRAST,Technical Component | $1,812.50 | $3,625.00 | $181.46–$3,443.75 | 4% below | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W WO CONTRAST,Technical Component | $1,812.50 | $3,625.00 | $181.46–$3,443.75 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL | $1,005.20 | $1,436.00 | $104.76–$1,364.20 | 31% below | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE WO CONTRAST,Technical Component | $1,210.00 | $2,420.00 | $104.76–$2,299.00 | 17% below | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL | $1,005.20 | $1,436.00 | $104.76–$1,364.20 | — | 30% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE WO CONTRAST,Technical Component | $1,210.00 | $2,420.00 | $104.76–$2,299.00 | — | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W WO,Technical Component | $1,670.00 | $3,340.00 | $198.81–$3,173.00 | 14% below | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W WO,Technical Component | $1,670.00 | $3,340.00 | $198.81–$3,173.00 | — | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO,Technical Component | $1,171.50 | $2,343.00 | $137.19–$2,225.85 | 13% below | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO,Technical Component | $1,171.50 | $2,343.00 | $137.19–$2,225.85 | — | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERVICAL SPINE COMP,Technical Component | $179.00 | $358.00 | $36.02–$340.10 | 36% below | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERVICAL SPINE COMP,Technical Component | $179.00 | $358.00 | $36.02–$340.10 | — | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 CT NECK W CONTRAST,Technical Component | $821.00 | $1,642.00 | $102.49–$1,559.90 | 24% below | 50% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W CONTRAST,Technical Component | $821.00 | $1,642.00 | $102.49–$1,559.90 | — | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 CT NECK WO CONTRAST,Technical Component | $726.00 | $1,452.00 | $77.27–$1,379.40 | 5% above | 50% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK WO CONTRAST,Technical Component | $726.00 | $1,452.00 | $77.27–$1,379.40 | — | 50% |
| Neck soft tissue X-ray CPT 70360 XR SOFT TISSUE NECK 2 VW,Technical Component | $146.00 | $292.00 | $19.24–$277.40 | 20% below | 50% |
| Neck soft tissue X-ray CPT 70360 XR SOFT TISSUE NECK 1 VW,Technical Component | $146.00 | $292.00 | $19.24–$277.40 | 20% below | 50% |
| Neck soft tissue X-ray inpatient CPT 70360 XR SOFT TISSUE NECK 1 VW,Technical Component | $146.00 | $292.00 | $19.24–$277.40 | — | 50% |
| Neck soft tissue X-ray inpatient CPT 70360 XR SOFT TISSUE NECK 2 VW,Technical Component | $146.00 | $292.00 | $19.24–$277.40 | — | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM NUCLEAR STRESS TEST,Technical Component | $2,105.50 | $4,211.00 | $302.23–$4,000.45 | 25% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM NUCLEAR STRESS TEST,Technical Component | $2,105.50 | $4,211.00 | $302.23–$4,000.45 | — | 50% |
| Pelvic CT scan without contrast both sides CPT 72192 CT HIPS BILAT W PELVIS,Technical Component | $809.50 | $1,619.00 | $70.73–$1,538.05 | — | 50% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST,Technical Component | $809.50 | $1,619.00 | $70.73–$1,538.05 | 1% above | 50% |
| Pelvic CT scan without contrast inpatient both sides CPT 72192 CT HIPS BILAT W PELVIS,Technical Component | $809.50 | $1,619.00 | $70.73–$1,538.05 | — | 50% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST,Technical Component | $809.50 | $1,619.00 | $70.73–$1,538.05 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US URINARY BLADDER,Technical Component | $218.00 | $436.00 | $23.51–$414.20 | 30% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US URINARY BLADDER,Technical Component | $218.00 | $436.00 | $23.51–$414.20 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC TRANSABD,Technical Component | $324.50 | $649.00 | $62.19–$616.55 | 21% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC TRANSABD,Technical Component | $324.50 | $649.00 | $62.19–$616.55 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US FULL OB | $526.40 | $752.00 | $76.03–$714.40 | 24% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US FULL OB | $526.40 | $752.00 | $76.03–$714.40 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US FIRST TRIMESTER | $431.20 | $616.00 | $43.42–$585.20 | 42% above | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US FIRST TRIMESTER | $431.20 | $616.00 | $43.42–$585.20 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN DIGITAL BILATERAL,Technical Component | $201.50 | $403.00 | $77.84–$382.85 | — | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN DIGITAL BILATERAL,Technical Component | $201.50 | $403.00 | $77.84–$382.85 | — | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR WATERS SINUSES 3 VIEWS | $98.70 | $141.00 | $23.51–$133.95 | 55% below | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES COMPLETE,Technical Component | $147.00 | $294.00 | $23.51–$279.30 | 33% below | 50% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR WATERS SINUSES 3 VIEWS | $98.70 | $141.00 | $23.51–$133.95 | — | 30% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES COMPLETE,Technical Component | $147.00 | $294.00 | $23.51–$279.30 | — | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 2-3 VW,Technical Component | $172.50 | $345.00 | $23.23–$327.75 | 15% below | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 2-3 VW,Technical Component | $172.50 | $345.00 | $23.23–$327.75 | — | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY "PROTOCOL" | $1,550.00 | $3,100.00 | $588.98–$2,945.00 | 39% below | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY | $1,550.00 | $3,100.00 | $588.98–$2,945.00 | 39% 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 | 39% 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 SPLIT NIGHT STUDY | $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% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS,Technical Component | $936.50 | $1,873.00 | $130.45–$1,779.35 | at median | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO STRESS,Technical Component | $936.50 | $1,873.00 | $130.45–$1,779.35 | — | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 TRAUMA CT T SPINE WO CONTRAST,Technical Component | $808.50 | $1,617.00 | $71.58–$1,536.15 | 2% below | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T SPINE,Technical Component | $808.50 | $1,617.00 | $71.58–$1,536.15 | 2% below | 50% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T SPINE,Technical Component | $808.50 | $1,617.00 | $71.58–$1,536.15 | — | 50% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 TRAUMA CT T SPINE WO CONTRAST,Technical Component | $808.50 | $1,617.00 | $71.58–$1,536.15 | — | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US PELVIS TV,Technical Component | $321.00 | $642.00 | $72.90–$609.90 | 20% below | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIS TV,Technical Component | $321.00 | $642.00 | $72.90–$609.90 | — | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD FULL,Technical Component | $373.50 | $747.00 | $65.79–$709.65 | 15% below | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD FULL,Technical Component | $373.50 | $747.00 | $65.79–$709.65 | — | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM,Technical Component | $306.00 | $612.00 | $58.78–$581.40 | 19% below | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM,Technical Component | $306.00 | $612.00 | $58.78–$581.40 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK,Technical Component | $291.00 | $582.00 | $70.16–$552.90 | 21% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID,Technical Component | $291.00 | $582.00 | $70.16–$552.90 | 21% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID,Technical Component | $291.00 | $582.00 | $70.16–$552.90 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US NECK,Technical Component | $291.00 | $582.00 | $70.16–$552.90 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI WITHOUT KUB SINGLE | $170.10 | $243.00 | $66.68–$230.85 | 55% below | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI WITHOUT KUB SINGLE | $170.10 | $243.00 | $66.68–$230.85 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VENOUS EXT BIL | $1,495.20 | $2,136.00 | $82.01–$2,029.20 | 290% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VENOUS EXT BIL | $1,495.20 | $2,136.00 | $82.01–$2,029.20 | — | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN UPRIGHT VIEW,Technical Component | $145.00 | $290.00 | $18.10–$275.50 | 21% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN SINGLE VIEW,Technical Component | $145.00 | $290.00 | $18.10–$275.50 | 21% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR KUB,Technical Component | $145.00 | $290.00 | $18.10–$275.50 | 21% below | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN SINGLE VIEW,Technical Component | $145.00 | $290.00 | $18.10–$275.50 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR KUB,Technical Component | $145.00 | $290.00 | $18.10–$275.50 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN UPRIGHT VIEW,Technical Component | $145.00 | $290.00 | $18.10–$275.50 | — | 50% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT | $46.20 | $66.00 | $18.10–$62.70 | 71% below | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT | $46.20 | $66.00 | $18.10–$62.70 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR 3V W/INTERPRETATION,Technical Component | $72.00 | $144.00 | $25.50–$136.80 | 67% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR CORP PHYSICAL 3 VW,Technical Component | $175.00 | $350.00 | $25.50–$332.50 | 19% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2-3 VIEWS,Technical Component | $175.00 | $350.00 | $25.50–$332.50 | 19% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR 3V W/INTERPRETATION,Technical Component | $72.00 | $144.00 | $25.50–$136.80 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR CORP PHYSICAL 3 VW,Technical Component | $175.00 | $350.00 | $25.50–$332.50 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2-3 VIEWS,Technical Component | $175.00 | $350.00 | $25.50–$332.50 | — | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE COMP 5V,Technical Component | $214.50 | $429.00 | $34.89–$407.55 | 24% below | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE COMP 5V,Technical Component | $214.50 | $429.00 | $34.89–$407.55 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS,Technical Component | $173.50 | $347.00 | $20.10–$329.65 | 24% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS,Technical Component | $173.50 | $347.00 | $20.10–$329.65 | — | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3 VIEWS,Technical Component | $144.50 | $289.00 | $24.93–$274.55 | 22% below | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES 3 VIEWS,Technical Component | $144.50 | $289.00 | $24.93–$274.55 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL SPINE 2-3 VIEWS,Technical Component | $147.00 | $294.00 | $25.22–$279.30 | 25% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL SPINE CORP,Technical Component | $147.00 | $294.00 | $25.22–$279.30 | 25% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL SPINE CORP,Technical Component | $147.00 | $294.00 | $25.22–$279.30 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL SPINE 2-3 VIEWS,Technical Component | $147.00 | $294.00 | $25.22–$279.30 | — | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 TRAUMA XR PELVIS PORTABLE,Technical Component | $180.50 | $361.00 | $16.96–$342.95 | 8% below | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS,Technical Component | $180.50 | $361.00 | $16.96–$342.95 | 8% below | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS,Technical Component | $180.50 | $361.00 | $16.96–$342.95 | — | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 TRAUMA XR PELVIS PORTABLE,Technical Component | $180.50 | $361.00 | $16.96–$342.95 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR COCCYX MIN 2 VIEWS,Technical Component | $144.50 | $289.00 | $20.38–$274.55 | 19% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM 2 VIEWS,Technical Component | $144.50 | $289.00 | $20.38–$274.55 | 19% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR COCCYX MIN 2 VIEWS,Technical Component | $144.50 | $289.00 | $20.38–$274.55 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM 2 VIEWS,Technical Component | $144.50 | $289.00 | $20.38–$274.55 | — | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH RL | $198.50 | $397.00 | $37.85–$377.15 | 6% above | 50% |
| ACTH blood test inpatient CPT 82024 ACTH RL | $198.50 | $397.00 | $37.85–$377.15 | — | 50% |
| 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 | 34% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST P5P, MAYO | $25.90 | $37.00 | $5.08–$35.15 | 15% below | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST RL | $48.50 | $97.00 | $5.08–$92.15 | 59% 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% |
| Albumin blood test CPT 82040 ALBUMIN, FLUID RL | $6.50 | $13.00 | $3.57–$12.35 | 64% below | 50% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $34.00 | $68.00 | $4.85–$64.60 | 89% above | 50% |
| Albumin blood test CPT 82040 ALBUMIN SERUM RL | $34.00 | $68.00 | $4.85–$64.60 | 89% above | 50% |
| Albumin blood test inpatient CPT 82040 ALBUMIN, FLUID RL | $6.50 | $13.00 | $3.57–$12.35 | — | 50% |
| Albumin blood test inpatient CPT 82040 ALBUMIN SERUM | $34.00 | $68.00 | $4.85–$64.60 | — | 50% |
| Albumin blood test inpatient CPT 82040 ALBUMIN SERUM RL | $34.00 | $68.00 | $4.85–$64.60 | — | 50% |
| Aldosterone blood test CPT 82088 ALDOSTERONE RL | $120.50 | $241.00 | $39.94–$228.95 | 228% above | 50% |
| Aldosterone blood test CPT 82088 ALDOSTERONE URINE 24 HR RL | $203.00 | $406.00 | $39.94–$385.70 | 452% above | 50% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE RL | $120.50 | $241.00 | $39.94–$228.95 | — | 50% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE 24 HR RL | $203.00 | $406.00 | $39.94–$385.70 | — | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE RL | $33.00 | $66.00 | $5.08–$62.70 | 59% above | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $33.00 | $66.00 | $5.08–$62.70 | 59% above | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE | $33.00 | $66.00 | $5.08–$62.70 | — | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE RL | $33.00 | $66.00 | $5.08–$62.70 | — | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BLACKBERRY RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST AVOCADO RL | $7.50 | $15.00 | $4.12–$14.25 | 56% 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 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST APRICOT RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CHUB MACKEREL RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST OVOMUCOID RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASCARIS IGE RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST OVALBUMIN RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITH IgE MAYO RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GUM ARABIC RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BEAN NAVY WHITE RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BAKER'S YEAST RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST SUNFLOWER SEED RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RYE GRAIN RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOXTAIL MILLET RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GLUTEN RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RASPBERRY RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PEAR RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MELONS RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MANDARIN RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST LIME RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BLUEBERRY RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CHICK PEA RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAULIFLOWER RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CABBAGE RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BRUSSEL SPROUTS RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BROCCOLI RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BEETS (BEETROOT) RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BAMBOO SHOOT RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ASPARAGUS RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE RED MAPLE | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST VANILLA RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST SWEET CHESTNUT RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST OREGANO RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CORIANDER RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CLOVE RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BAY LEAF RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BASIL RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PINE NUT RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUSHROOM RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GOAT'S MILK RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RUSSIAN THISTLE RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MULBERRY RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOUNTAIN CEDAR RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST LETTUCE RL | $7.50 | $15.00 | $4.12–$14.25 | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS NIGER | $8.00 | $16.00 | $4.39–$15.20 | 53% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FLAVUS | $8.00 | $16.00 | $4.39–$15.20 | 53% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITH IgE-MAYO | $10.50 | $15.00 | $4.12–$14.25 | 39% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F MONILIFORME IgE RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PENICILLIN RL | $12.50 | $25.00 | $5.12–$23.75 | 27% 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 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE A LACTOALBUMIN MILK RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE CASEIN MILK RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE SYCAMORE RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE B LACTOALBUMIN MILK RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST F MONILIFORME RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ITELMINTHOSPORIUM RL | $12.50 | $25.00 | $5.12–$23.75 | 27% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST LATEX ALLERGEN RL | $13.00 | $26.00 | $5.12–$24.70 | 24% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO IgE RL | $14.00 | $28.00 | $5.12–$26.60 | 18% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BLACK WALNUT RL | $14.00 | $28.00 | $5.12–$26.60 | 18% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GRAPE RL | $16.50 | $33.00 | $5.12–$31.35 | 4% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RHODOTORULA GLUTINUS | $17.00 | $34.00 | $5.12–$32.30 | 1% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OVALBUMIN, IgE RL | $17.00 | $34.00 | $5.12–$32.30 | 1% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD RICE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST COCKROACH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE COMMON SILVER BIRCH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CASEIN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD LACTOGLOBULIN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD ALPHA LACTALB RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BARLEY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD/BLUE CHEESE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHEDDAR CHEESE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE RUSSIAN THISTLE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MOUNTAIN CEDAR RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SALMON | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PERCH OCEAN | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TROUT | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD MACKEREL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD HALIBUT | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS COMMON PIGWEED | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS GOLDENROD | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PAPRIKA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GINGER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD VANILLA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SUGAR CANE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD OYSTER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD LOBSTER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD EGG YOLK RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SCALLOP RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GREEN BEANS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CATFISH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD COCONUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PISTACHIO RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHILI PEPPER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PINEAPPLE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHERRY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CUMIN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAYENNE PEPPER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD ORANGE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GARLIC RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST KIWI FRUIT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST SALMON RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUSTARD RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ONION RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CINNAMON RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BLACK PEPPER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST NUTMEG RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ASPERGILLUS NIGER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TOMATO RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUST MITE D PTERONYSSINUS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUST MITE D MICROCERAS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST DOG DANDER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST COCKSFOOT (ORCHARD GRASS) RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAT DANDER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST AUREOBASIDIUM PULLULANS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ASPERGILLUS FUMIGATUS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST SPECIFIC ALLERGEN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 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 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PLANTAIN RIBWORT (PLANTAGO LANCE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 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 | 23% above | 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 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GIANT RAGWEED (AMBROSIA TRIFIDA) RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD LEMON RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD APPLE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD STRAWBERRY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD GRAPEFRUIT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD OLIVE OIL RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PECAN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD WALNUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CASHEW NUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BRAZIL NUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CLAM RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST EGG YOLK RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST C HERBARUM HORMODEND RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST DANDELION RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CODFISH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CRAB RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD ALMOND RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD HAZELNUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHICKEN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PORK RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BEEF RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD POTATO SWEET RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD POTATO WHITE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CELERY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CARROT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD BANANA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PEAS GREEN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PULLARLARIA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST WHITE ASH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CHICKEN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TURKEY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALTERNARIA TENUIS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUGWORT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST SHEEP SORREL RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST COCKLEBUR RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST LAMBS QUARTER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE SWEET GUM RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE POPLAR RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUSTMITE (P) RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PHOMA BETAE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RHIZOPUS NIGRICANS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MUCOR RACEMOS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS ASPERGILLUS RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS CLADOSPORIUM RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS PENICILLUM RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE PIG WEED RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE ENGLISH PLANTAI RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE SHORT RAGWEED RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE GIANT RAGWEED RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WILLOW RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE PIN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE ASH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WALNUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE PECAN HICKORY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE OLIVE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE OAK RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MESQUITE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MELALENCA CAJEP RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE HAZELNUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE ELM RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE COTTONWOOD RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BIRCH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE BEECH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE ALDER RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS WILD RYE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS VELVET RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS TIMOTHY RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS SWEET RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS RED RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS PERENNIAL RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS ORCHARD RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS FOX TAIL RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS MEADOW FESCUE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS JUNE KY BLUE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS WHEAT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS RYE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS CULTIVATED OAT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS COMMON | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS BROME RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS BERMUDA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST DUST MITE (D FARINAE) RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ANIMAL DOG EPITHELIA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ANIMAL CAT EPITHELIA RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST HOUSE DUST RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CHOCOLATE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SHRIMP RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD TUNA FISH RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CITRUS ORANGE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD SOYBEAN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PEANUT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD OAT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD WHEAT RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD CORN RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD MILK RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD EGG WHITE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT PAPER WASP RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT YELLOW HORNET RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT YELLOW JACKET RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT HONEY BEE RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST INSECT WH FCD HORNET RL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PANEL | $21.00 | $42.00 | $5.12–$39.90 | 23% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EPICPCCUM PURPURASCENS RL | $24.50 | $49.00 | $5.12–$46.55 | 43% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOTRYTIS CINEREA IgE RL | $24.50 | $49.00 | $5.12–$46.55 | 43% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOLTYTIS IgE RL | $24.50 | $49.00 | $5.12–$46.55 | 43% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEY IgE RL | $24.50 | $49.00 | $5.12–$46.55 | 43% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS MUCOR | $29.40 | $42.00 | $5.12–$39.90 | 72% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 .RAST/BOX ELDER | $29.40 | $42.00 | $5.12–$39.90 | 72% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST EGG YOLK | $29.40 | $42.00 | $5.12–$39.90 | 72% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ISOCYANATE HDI IgE RL | $38.50 | $77.00 | $5.12–$73.15 | 125% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ISOCYANATE TDI IgE RL | $38.50 | $77.00 | $5.12–$73.15 | 125% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ISOCYANATE MDI IgE RL | $38.50 | $77.00 | $5.12–$73.15 | 125% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CURVULARIA SPICIFERA/BIPOLARIS | $42.00 | $84.00 | $5.12–$79.80 | 145% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSANIVM OXYSPORUM VASIFECTUM RL | $46.25 | $92.50 | $5.12–$87.88 | 170% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS JOHNSON RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOOD PEACH RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST GRASS BAHIA RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE LOCUST RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLDS ALTERNARIA RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST STEMPHYLIUM RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE OAK RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE MULBERRY RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TREE WHITE HICKORY RL | $48.75 | $97.50 | $5.12–$92.62 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST HELMINTHOSPORIUM SAT RL | $52.00 | $104.00 | $5.12–$98.80 | 203% 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 | 268% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RHODOTURULA GLUTINIS RL | $70.50 | $141.00 | $5.12–$133.95 | 311% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TRICHOPHYTON MENTAGROPHYTES IgE RL | $84.00 | $168.00 | $5.12–$159.60 | 390% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OCCUPATIONAL PANEL #2 | $89.60 | $128.00 | $5.12–$121.60 | 423% above | 30% |
| 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 BASIL 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 CLOVE 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 LIME 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 BAKER'S YEAST 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 RAST APRICOT 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 RASPBERRY 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 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 RYE GRAIN 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 ASCARIS IGE 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 RAST MUSHROOM RL | $7.50 | $15.00 | $4.12–$14.25 | — | 50% |
| 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 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 BEAN NAVY WHITE 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 BAMBOO SHOOT 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 BROCCOLI 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 CABBAGE RL | $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 CHICK PEA 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 MOUNTAIN CEDAR 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 SUNFLOWER SEED 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 OVOMUCOID 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 BLUEBERRY 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 RAST AVOCADO 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 RUSSIAN THISTLE 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 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 ASPERGILLUS FLAVUS | $8.00 | $16.00 | $4.39–$15.20 | — | 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 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 IGE B LACTOALBUMIN MILK 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 IGE A LACTOALBUMIN MILK 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 RAST F MONILIFORME 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 RAST ITELMINTHOSPORIUM 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 RAST LATEX ALLERGEN RL | $13.00 | $26.00 | $5.12–$24.70 | — | 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 MANGO IgE 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 OVALBUMIN, IgE RL | $17.00 | $34.00 | $5.12–$32.30 | — | 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 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 GRASS COMMON PIGWEED | $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 PECAN HICKORY 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 OLIVE 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 INSECT HONEY BEE 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 OAK 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 TREE MESQUITE 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 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 FOOD GREEN BEANS 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 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 FOOD CHILI PEPPER RL | $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 PINEAPPLE 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 TREE ELM 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 CAYENNE PEPPER RL | $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 FOOD ORANGE 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 TREE BIRCH 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 SALMON 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 MUSTARD 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 TREE ALDER 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 WILD RYE 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 PANEL | $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 VELVET 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 TIMOTHY 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 SWEET 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 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 FOOD OLIVE OIL 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 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 GRASS RYE 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 FOOD BRAZIL NUT 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 FOOD CLAM 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 GRASS COMMON | $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 GRASS BROME 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 FOOD CRAB 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 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 CHICKEN 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 PORK 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 ANIMAL DOG EPITHELIA 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 POTATO WHITE 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 CELERY 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 HOUSE DUST 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 PEAS GREEN 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 PULLARLARIA 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 FOOD SHRIMP 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 TURKEY 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 ALTERNARIA TENUIS 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 FOOD CITRUS ORANGE 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 FOOD SOYBEAN 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 PEANUT 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 FOOD OAT 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 RHIZOPUS NIGRICANS 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 MUCOR RACEMOS 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 FOOD CORN 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 MOLDS PENICILLUM RL | $21.00 | $42.00 | $5.12–$39.90 | — | 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 PIG WEED 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 TREE ENGLISH PLANTAI 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 FOOD EGG WHITE 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 TREE SHORT RAGWEED 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 COCKROACH 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 TREE GIANT RAGWEED 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 INSECT PAPER WASP 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 TREE WILLOW 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 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 TREE WHITE PIN 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 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 PERCH OCEAN | $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 TROUT | $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 WALNUT 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 GRASS FOX TAIL 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 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 MEADOW FESCUE RL | $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 FOOD APPLE 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 CAT DANDER 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 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 PERENNIAL 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 ORCHARD 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 EPICPCCUM PURPURASCENS 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 HONEY 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 MOLDS MUCOR | $29.40 | $42.00 | $5.12–$39.90 | — | 30% |
| 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/BOX ELDER | $29.40 | $42.00 | $5.12–$39.90 | — | 30% |
| 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 TDI 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 GRASS JOHNSON 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 FOOD PEACH 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 STEMPHYLIUM 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 TREE MULBERRY 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 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% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER RL | $109.50 | $219.00 | $16.43–$208.05 | 44% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SINGLE MARKER RL | $109.50 | $219.00 | $16.43–$208.05 | 44% above | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SINGLE MARKER RL | $109.50 | $219.00 | $16.43–$208.05 | — | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER RL | $109.50 | $219.00 | $16.43–$208.05 | — | 50% |
| Ammonia blood test CPT 82140 AMMONIUM, 24 HR, URINE SUPERSATURATION | $22.00 | $44.00 | $12.07–$41.80 | 52% below | 50% |
| Ammonia blood test CPT 82140 AMMONIA, RL | $46.50 | $93.00 | $14.28–$88.35 | 1% above | 50% |
| Ammonia blood test CPT 82140 AMMONIA | $46.50 | $93.00 | $14.28–$88.35 | 1% above | 50% |
| Ammonia blood test inpatient CPT 82140 AMMONIUM, 24 HR, URINE SUPERSATURATION | $22.00 | $44.00 | $12.07–$41.80 | — | 50% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $46.50 | $93.00 | $14.28–$88.35 | — | 50% |
| Ammonia blood test inpatient CPT 82140 AMMONIA, RL | $46.50 | $93.00 | $14.28–$88.35 | — | 50% |
| Amylase blood test CPT 82150 AMYLASE BODY FLUID RL | $14.50 | $29.00 | $6.35–$27.55 | 62% below | 50% |
| Amylase blood test CPT 82150 AMYLASE SERUM | $48.50 | $97.00 | $6.35–$92.15 | 26% above | 50% |
| Amylase blood test CPT 82150 MACRO AMYLASE RL | $108.50 | $217.00 | $6.35–$206.15 | 182% above | 50% |
| Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID RL | $14.50 | $29.00 | $6.35–$27.55 | — | 50% |
| Amylase blood test inpatient CPT 82150 AMYLASE SERUM | $48.50 | $97.00 | $6.35–$92.15 | — | 50% |
| Amylase blood test inpatient CPT 82150 MACRO AMYLASE RL | $108.50 | $217.00 | $6.35–$206.15 | — | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP RL | $25.00 | $50.00 | $12.69–$47.50 | 41% 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 | 2% 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% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GROUP B STREP GENITAL RL | $14.00 | $28.00 | $7.68–$26.60 | 73% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL RL | $19.00 | $38.00 | $8.45–$36.10 | 63% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE INFECTION CONTROL | $23.80 | $34.00 | $8.45–$32.30 | 54% below | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE INFECTION CONT-MRSA NOT NASAL | $26.60 | $38.00 | $8.45–$36.10 | 48% below | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID RL | $40.00 | $80.00 | $8.45–$76.00 | 22% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF FLUID RL | $40.00 | $80.00 | $8.45–$76.00 | 22% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE RL | $44.00 | $88.00 | $8.45–$83.60 | 14% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC-CHARGE ONLY RL | $44.00 | $88.00 | $8.45–$83.60 | 14% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND AEROBIC RL | $44.00 | $88.00 | $8.45–$83.60 | 14% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENERAL RL | $44.00 | $88.00 | $8.45–$83.60 | 14% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM/RESPIR RL | $44.00 | $88.00 | $8.45–$83.60 | 14% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR RL | $44.00 | $88.00 | $8.45–$83.60 | 14% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 RULE OUT MRSA-NASAL ONLY RL | $55.00 | $110.00 | $8.45–$104.50 | 7% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ENVIRONMENTAL | $61.60 | $88.00 | $8.45–$83.60 | 20% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ..TEST CULTURE AFB ISOLATION | $61.60 | $88.00 | $8.45–$83.60 | 20% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP | $61.60 | $88.00 | $8.45–$83.60 | 20% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE LEGIONELLA RL | $77.00 | $110.00 | $8.45–$104.50 | 50% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GROUP B STREP GENITAL RL | $14.00 | $28.00 | $7.68–$26.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL RL | $19.00 | $38.00 | $8.45–$36.10 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE INFECTION CONTROL | $23.80 | $34.00 | $8.45–$32.30 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE INFECTION CONT-MRSA NOT NASAL | $26.60 | $38.00 | $8.45–$36.10 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF FLUID RL | $40.00 | $80.00 | $8.45–$76.00 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID RL | $40.00 | $80.00 | $8.45–$76.00 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR RL | $44.00 | $88.00 | $8.45–$83.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE RL | $44.00 | $88.00 | $8.45–$83.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC-CHARGE ONLY RL | $44.00 | $88.00 | $8.45–$83.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM/RESPIR RL | $44.00 | $88.00 | $8.45–$83.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENERAL RL | $44.00 | $88.00 | $8.45–$83.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND AEROBIC RL | $44.00 | $88.00 | $8.45–$83.60 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 RULE OUT MRSA-NASAL ONLY RL | $55.00 | $110.00 | $8.45–$104.50 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATHETER TIP | $61.60 | $88.00 | $8.45–$83.60 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ..TEST CULTURE AFB ISOLATION | $61.60 | $88.00 | $8.45–$83.60 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ENVIRONMENTAL | $61.60 | $88.00 | $8.45–$83.60 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE LEGIONELLA RL | $77.00 | $110.00 | $8.45–$104.50 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL RL | $62.50 | $125.00 | $8.29–$118.75 | 16% above | 50% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $62.50 | $125.00 | $8.29–$118.75 | 16% above | 50% |
| Basic metabolic panel (blood test) CPT 80048 BMP REOCCURRING | $98.00 | $196.00 | $8.29–$186.20 | 81% above | 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 BASIC METABOLIC PANEL RL | $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% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $20.15 | $40.29 | $4.92–$38.28 | 18% below | 50% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL, MAYO | $26.25 | $37.50 | $4.92–$35.62 | 7% above | 30% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL RL | $48.50 | $97.00 | $4.92–$92.15 | 98% above | 50% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $20.15 | $40.29 | $4.92–$38.28 | — | 50% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL, MAYO | $26.25 | $37.50 | $4.92–$35.62 | — | 30% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL RL | $48.50 | $97.00 | $4.92–$92.15 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK RL | $133.00 | $266.00 | $63.23–$252.70 | 22% 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 | 4% 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 | at median | 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 | 48% above | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 DOT COLLECTION FEE | $17.50 | $35.00 | $9.15–$10.50 | 67% 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 | 55% below | 50% |
| Blood lead test CPT 83655 LEAD URINE 24 HR RL | $36.50 | $73.00 | $11.87–$69.35 | 2% 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 | 17% 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 | 25% 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 | 255% 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% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN FLUID RL | $6.50 | $13.00 | $3.57–$12.35 | 76% below | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $33.00 | $66.00 | $3.87–$62.70 | 20% above | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN RL | $33.00 | $66.00 | $3.87–$62.70 | 20% above | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN FLUID RL | $6.50 | $13.00 | $3.57–$12.35 | — | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $33.00 | $66.00 | $3.87–$62.70 | — | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN RL | $33.00 | $66.00 | $3.87–$62.70 | — | 50% |
| C-peptide blood test CPT 84681 C-PEPTIDE RL | $59.50 | $119.00 | $20.39–$113.05 | 19% below | 50% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE RL | $59.50 | $119.00 | $20.39–$113.05 | — | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP SCREEN | $37.50 | $75.00 | $5.08–$71.25 | 23% above | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP SCREEN RL | $37.50 | $75.00 | $5.08–$71.25 | 23% above | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP TITER | $52.50 | $75.00 | $5.08–$71.25 | 72% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 .CRP, QUANTITATIVE | $54.60 | $78.00 | $5.08–$74.10 | 79% above | 30% |
| 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 SCREEN | $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 | 73% 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 | 34% 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 | 4% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 CAMC | $125.00 | $250.00 | $50.28–$237.50 | 16% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 QLABS | $125.00 | $250.00 | $50.28–$237.50 | 16% 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 | 46% 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 | 457% 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% |
| Calcium blood test, total CPT 82310 CALCIUM SERUM RL | $48.50 | $97.00 | $5.06–$92.15 | 92% above | 50% |
| Calcium blood test, total CPT 82310 CALCIUM SERUM | $48.50 | $97.00 | $5.06–$92.15 | 92% above | 50% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM | $48.50 | $97.00 | $5.06–$92.15 | — | 50% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM RL | $48.50 | $97.00 | $5.06–$92.15 | — | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA RL | $117.50 | $235.00 | $18.58–$223.25 | 13% above | 50% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA RL | $117.50 | $235.00 | $18.58–$223.25 | — | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IGG TITER RL | $14.00 | $28.00 | $7.68–$26.60 | 63% below | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB IGG IMMUNE SCREEN RL | $59.50 | $119.00 | $12.62–$113.05 | 56% above | 50% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IGG TITER RL | $14.00 | $28.00 | $7.68–$26.60 | — | 50% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB IGG IMMUNE SCREEN RL | $59.50 | $119.00 | $12.62–$113.05 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .CHLAMYDIA, URINE | $42.70 | $61.00 | $16.74–$57.95 | 25% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, PCR RL | $44.00 | $88.00 | $24.15–$83.60 | 22% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CYTOLOGY CHLAMYDIA (CT) RL | $49.50 | $99.00 | $27.17–$94.05 | 13% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE RL | $51.50 | $103.00 | $28.26–$97.85 | 9% below | 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 | 6% above | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/DIFF, RL | $44.00 | $88.00 | $7.61–$83.60 | 6% 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 | 36% below | 50% |
| Complete blood count (CBC), no differential CPT 85027 CBC MANUAL DIFF | $44.00 | $88.00 | $6.34–$83.60 | 25% 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 | $62.50 | $125.00 | $10.35–$118.75 | 28% above | 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) inpatient CPT 80053 COMPREHENSIVE PANEL | $62.50 | $125.00 | $10.35–$118.75 | — | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE PANEL RL | $62.50 | $125.00 | $10.35–$118.75 | — | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 CK REOCCURRING | $43.00 | $86.00 | $6.38–$81.70 | 1% below | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 CK RL | $48.50 | $97.00 | $6.38–$92.15 | 11% above | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 CK | $48.50 | $97.00 | $6.38–$92.15 | 11% above | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK REOCCURRING | $43.00 | $86.00 | $6.38–$81.70 | — | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK RL | $48.50 | $97.00 | $6.38–$92.15 | — | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK | $48.50 | $97.00 | $6.38–$92.15 | — | 50% |
| Creatinine blood test CPT 82565 CREATININE FLUID RL | $10.00 | $20.00 | $5.02–$19.00 | 66% below | 50% |
| Creatinine blood test CPT 82565 POC CREATININE | $37.00 | $74.00 | $5.02–$70.30 | 25% above | 50% |
| Creatinine blood test CPT 82565 CREATININE SERUM | $37.00 | $74.00 | $5.02–$70.30 | 25% above | 50% |
| Creatinine blood test inpatient CPT 82565 CREATININE FLUID RL | $10.00 | $20.00 | $5.02–$19.00 | — | 50% |
| Creatinine blood test inpatient CPT 82565 POC CREATININE | $37.00 | $74.00 | $5.02–$70.30 | — | 50% |
| Creatinine blood test inpatient CPT 82565 CREATININE SERUM | $37.00 | $74.00 | $5.02–$70.30 | — | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV SCREEN RL | $35.00 | $70.00 | $14.10–$66.50 | 31% below | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IgG Ab TITER RL | $70.50 | $141.00 | $14.10–$133.95 | 40% above | 50% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV SCREEN RL | $35.00 | $70.00 | $14.10–$66.50 | — | 50% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IgG Ab TITER RL | $70.50 | $141.00 | $14.10–$133.95 | — | 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 | at median | 50% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S RL | $93.00 | $186.00 | $21.79–$176.70 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES RL | $19.50 | $39.00 | $10.70–$38.22 | 36% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 THC URINE DRUG RL | $19.50 | $39.00 | $10.70–$38.22 | 36% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BARBITURATES REF LAB RL | $19.50 | $39.00 | $10.70–$38.22 | 36% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE REF LAB RL | $19.50 | $39.00 | $10.70–$38.22 | 36% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINES REF LAB RL | $19.50 | $39.00 | $10.70–$38.22 | 36% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, SINGLE DRUG CLASS EA DRU RL | $20.00 | $40.00 | $10.98–$39.20 | 34% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINES REF LAB RL | $26.00 | $52.00 | $14.27–$50.96 | 14% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATE | $44.00 | $88.00 | $24.15–$83.60 | 45% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN LEVEL | $67.50 | $135.00 | $37.04–$128.25 | 122% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE OR METHAMPHET RL | $75.00 | $150.00 | $41.16–$142.50 | 147% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINES RL | $81.50 | $163.00 | $44.73–$154.85 | 168% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 PERCOCET URINE RL | $119.00 | $238.00 | $60.90–$226.10 | 292% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MEPROBAMATE LEVEL RL | $125.00 | $250.00 | $60.90–$237.50 | 311% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST, PRESUMPTIVE RL | $153.00 | $306.00 | $60.90–$290.70 | 404% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CONFIRMATION SCREEN | $179.00 | $358.00 | $60.90–$340.10 | 489% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES FREE AND TOTAL, SERUM, MAYO RL | $407.00 | $814.00 | $60.90–$773.30 | 1240% above | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COCAINE REF LAB RL | $19.50 | $39.00 | $10.70–$38.22 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BARBITURATES REF LAB RL | $19.50 | $39.00 | $10.70–$38.22 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC URINE DRUG RL | $19.50 | $39.00 | $10.70–$38.22 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OPIATES RL | $19.50 | $39.00 | $10.70–$38.22 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINES REF LAB RL | $19.50 | $39.00 | $10.70–$38.22 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, SINGLE DRUG CLASS EA DRU RL | $20.00 | $40.00 | $10.98–$39.20 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINES REF LAB RL | $26.00 | $52.00 | $14.27–$50.96 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATE | $44.00 | $88.00 | $24.15–$83.60 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN LEVEL | $67.50 | $135.00 | $37.04–$128.25 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE OR METHAMPHET RL | $75.00 | $150.00 | $41.16–$142.50 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINES RL | $81.50 | $163.00 | $44.73–$154.85 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PERCOCET URINE RL | $119.00 | $238.00 | $60.90–$226.10 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEPROBAMATE LEVEL RL | $125.00 | $250.00 | $60.90–$237.50 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST, PRESUMPTIVE RL | $153.00 | $306.00 | $60.90–$290.70 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CONFIRMATION SCREEN | $179.00 | $358.00 | $60.90–$340.10 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OPIATES FREE AND TOTAL, SERUM, MAYO RL | $407.00 | $814.00 | $60.90–$773.30 | — | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES URINE | $28.00 | $40.00 | $6.87–$38.00 | 14% below | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES SERUM | $48.50 | $97.00 | $6.87–$92.15 | 49% above | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES URINE | $28.00 | $40.00 | $6.87–$38.00 | — | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES SERUM | $48.50 | $97.00 | $6.87–$92.15 | — | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EB VCA IGM RL | $55.50 | $111.00 | $17.78–$105.45 | 9% below | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EB VCA IGG RL | $55.50 | $111.00 | $17.78–$105.45 | 9% below | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VCA IGG RL | $55.50 | $111.00 | $17.78–$105.45 | — | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VCA IGM RL | $55.50 | $111.00 | $17.78–$105.45 | — | 50% |
| Estradiol blood test CPT 82670 ESTRADIOL FREE RL | $54.50 | $109.00 | $27.38–$103.55 | 37% below | 50% |
| Estradiol blood test CPT 82670 ESTRADIOL SERUM RL | $113.25 | $226.50 | $27.38–$215.18 | 32% 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 | 10% 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 | 158% 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 | 7% above | 50% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $75.00 | $150.00 | $13.36–$142.50 | 7% above | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN RL | $75.00 | $150.00 | $13.36–$142.50 | — | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $75.00 | $150.00 | $13.36–$142.50 | — | 50% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN RL | $27.50 | $55.00 | $9.53–$52.25 | 46% below | 50% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN RL | $27.50 | $55.00 | $9.53–$52.25 | — | 50% |
| Folate (folic acid) blood test CPT 82746 FOLATE, SERUM | $44.00 | $88.00 | $14.41–$83.60 | 38% below | 50% |
| Folate (folic acid) blood test CPT 82746 FOLATE SERUM RL | $44.00 | $88.00 | $14.41–$83.60 | 38% below | 50% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $61.60 | $88.00 | $14.41–$83.60 | 13% 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 | 82% 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 RL | $52.50 | $105.00 | $8.84–$99.75 | 9% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $52.50 | $105.00 | $8.84–$99.75 | 9% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY DIALYSIS | $129.50 | $185.00 | $8.84–$175.75 | 123% 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 | 68% below | 50% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE AND TOTAL, RL | $131.50 | $263.00 | $24.96–$249.85 | 86% 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% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT, MAYO RL | $18.75 | $37.50 | $7.06–$35.62 | 46% below | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $48.50 | $97.00 | $7.06–$92.15 | 40% above | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT RL | $48.50 | $97.00 | $7.06–$92.15 | 40% above | 50% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT, MAYO RL | $18.75 | $37.50 | $7.06–$35.62 | — | 50% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT | $48.50 | $97.00 | $7.06–$92.15 | — | 50% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT RL | $48.50 | $97.00 | $7.06–$92.15 | — | 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 | 29% 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 | 63% 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 | 63% 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 | 2% 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 | 28% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CYTOLOGY GC RL | $49.50 | $99.00 | $27.17–$94.05 | 19% 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 | 15% 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 | 52% below | 50% |
| H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODIES | $40.60 | $58.00 | $15.92–$55.10 | 24% below | 30% |
| H. pylori antibody blood test CPT 86677 H-PYLORI GAST BIOPSY | $41.50 | $83.00 | $16.51–$78.85 | 22% 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 | 27% 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 | 23% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA RL | $285.50 | $571.00 | $83.40–$542.45 | 13% 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 | 47% 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 | 24% 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% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $13.00 | $26.00 | $2.32–$24.70 | 7% below | 50% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $13.00 | $26.00 | $2.32–$24.70 | — | 50% |
| Hepatitis B core antibody test (total) CPT 86704 HEP-B CORE ANTI HBCAB RL | $15.00 | $30.00 | $8.23–$28.50 | 70% below | 50% |
| Hepatitis B core antibody test (total) CPT 86704 HEP Bc TOTAL | $37.50 | $75.00 | $11.81–$71.25 | 25% below | 50% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP-B CORE ANTI HBCAB RL | $15.00 | $30.00 | $8.23–$28.50 | — | 50% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP Bc TOTAL | $37.50 | $75.00 | $11.81–$71.25 | — | 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 | 28% 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 SURFACE ANTIG RL | $33.00 | $66.00 | $10.12–$62.70 | 5% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SCREENING RL | $33.00 | $66.00 | $10.12–$62.70 | 5% 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 | 2% above | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY RL | $59.50 | $119.00 | $13.98–$113.05 | 2% above | 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 antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY, SCREENING 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 | 77% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA (PCR) RL | $315.00 | $630.00 | $41.98–$598.50 | 58% 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 | 3% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 .HERPES SIMPLEX 2 IGM | $65.10 | $93.00 | $18.96–$88.35 | 36% 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 | 34% 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 | at median | 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 | 185% 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 | 24% above | 50% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE(LH) RL | $104.00 | $208.00 | $18.15–$197.60 | — | 50% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE | $36.00 | $72.00 | $11.34–$68.40 | 37% below | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE | $36.00 | $72.00 | $11.34–$68.40 | — | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID RL | $8.00 | $16.00 | $4.39–$15.20 | 58% below | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $48.50 | $97.00 | $5.92–$92.15 | 155% above | 50% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID RL | $8.00 | $16.00 | $4.39–$15.20 | — | 50% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $48.50 | $97.00 | $5.92–$92.15 | — | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE RL | $44.00 | $88.00 | $6.75–$83.60 | 9% above | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $44.00 | $88.00 | $6.75–$83.60 | 9% 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 | $141.00 | $282.00 | $8.01–$267.90 | 198% above | 50% |
| Liver function blood test panel CPT 80076 HEPATIC (LIVER) PANEL RL | $141.00 | $282.00 | $8.01–$267.90 | 198% above | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC (LIVER) PANEL | $141.00 | $282.00 | $8.01–$267.90 | — | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC (LIVER) PANEL RL | $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 | 206% 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 URINE | $10.00 | $20.00 | $5.49–$19.00 | 49% below | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM, 24 HR, URINE SUPERSATURATION | $10.00 | $20.00 | $5.49–$19.00 | 49% below | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM | $36.50 | $73.00 | $6.57–$69.35 | 87% above | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24 HOUR RL | $55.50 | $111.00 | $6.57–$105.45 | 185% 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 | 54% below | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY RL | $67.50 | $135.00 | $12.62–$128.25 | 72% 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 | at median | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST | $35.00 | $70.00 | $5.08–$66.50 | — | 50% |
| Mumps immunity blood test CPT 86735 MUMPS SEROLOGY RL | $16.50 | $33.00 | $9.06–$31.35 | 63% below | 50% |
| Mumps immunity blood test CPT 86735 MUMPS SCREEN IgG RL | $18.00 | $36.00 | $9.88–$34.20 | 60% below | 50% |
| Mumps immunity blood test CPT 86735 MUMPS IGM RL | $19.50 | $39.00 | $10.70–$37.05 | 56% below | 50% |
| Mumps immunity blood test CPT 86735 MUMPS (ANTIBODY) AB IMMUNE STATUS RL | $59.50 | $119.00 | $12.79–$113.05 | 34% above | 50% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS SEROLOGY RL | $16.50 | $33.00 | $9.06–$31.35 | — | 50% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS SCREEN IgG RL | $18.00 | $36.00 | $9.88–$34.20 | — | 50% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGM RL | $19.50 | $39.00 | $10.70–$37.05 | — | 50% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS (ANTIBODY) AB IMMUNE STATUS RL | $59.50 | $119.00 | $12.79–$113.05 | — | 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 | 32% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE RL | $68.00 | $136.00 | $18.02–$129.20 | 14% above | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA RL | $95.20 | $136.00 | $18.02–$129.20 | 59% 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 | 68% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL RL DIAGNOSTIC RL | $68.00 | $136.00 | $18.02–$129.20 | 8% above | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL DIAGNOSTIC | $68.00 | $136.00 | $18.02–$129.20 | 8% 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 RL | $141.50 | $283.00 | $40.45–$268.85 | 7% below | 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 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 | 43% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT REOCCURRING | $167.50 | $335.00 | $5.89–$318.25 | 304% 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% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM | $33.00 | $66.00 | $4.65–$62.70 | 5% above | 50% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM RL | $33.00 | $66.00 | $4.65–$62.70 | 5% above | 50% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM RL | $33.00 | $66.00 | $4.65–$62.70 | — | 50% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM | $33.00 | $66.00 | $4.65–$62.70 | — | 50% |
| Potassium blood test CPT 84132 POTASSIUM, FLUID RL | $4.50 | $9.00 | $2.47–$8.55 | 83% below | 50% |
| Potassium blood test CPT 84132 POTASSIUM SERUM RL | $48.50 | $97.00 | $4.66–$92.15 | 80% above | 50% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $48.50 | $97.00 | $4.66–$92.15 | 80% above | 50% |
| Potassium blood test inpatient CPT 84132 POTASSIUM, FLUID RL | $4.50 | $9.00 | $2.47–$8.55 | — | 50% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM RL | $48.50 | $97.00 | $4.66–$92.15 | — | 50% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $48.50 | $97.00 | $4.66–$92.15 | — | 50% |
| Progesterone blood test CPT 84144 PROGESTERONE RL | $59.00 | $118.00 | $20.44–$112.10 | 41% 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 | 132% 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 | 67% below | 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 | 65% above | 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 | 65% 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 | 95% 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 | 247% above | 50% |
| 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 | 456% above | 30% |
| 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 | 456% 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 URINE PS DIP INSTANT TEST | $202.30 | $289.00 | $12.35–$274.55 | — | 30% |
| 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 flu test (influenza antigen) CPT 87804 INFLUENZA A/B | $27.50 | $55.00 | $15.09–$52.25 | 41% 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% |
| Renin blood test CPT 84244 RENIN PLASMA RL | $70.00 | $140.00 | $21.55–$133.00 | 21% above | 50% |
| Renin blood test inpatient CPT 84244 RENIN PLASMA RL | $70.00 | $140.00 | $21.55–$133.00 | — | 50% |
| Rh blood typing CPT 86901 BB RH TYPE RL | $51.00 | $102.00 | $2.93–$96.90 | 78% above | 50% |
| Rh blood typing CPT 86901 BB RH TYPE | $51.00 | $102.00 | $2.93–$96.90 | 78% above | 50% |
| Rh blood typing inpatient CPT 86901 BB RH TYPE | $51.00 | $102.00 | $2.93–$96.90 | — | 50% |
| Rh blood typing inpatient CPT 86901 BB RH TYPE RL | $51.00 | $102.00 | $2.93–$96.90 | — | 50% |
| Rheumatoid factor (RF) test CPT 86431 QUANT RHEUMATOID FACTOR MEASUREMENT | $12.60 | $18.00 | $4.94–$17.10 | 65% below | 30% |
| Rheumatoid factor (RF) test CPT 86431 RA TITER | $34.00 | $68.00 | $5.56–$64.60 | 5% 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 | 72% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM (TITER) RL | $56.50 | $113.00 | $14.10–$107.35 | 14% above | 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% |
| Sodium blood test CPT 84295 SODIUM | $10.00 | $20.00 | $4.71–$19.00 | 62% below | 50% |
| Sodium blood test CPT 84295 SODIUM SERUM | $48.50 | $97.00 | $4.71–$92.15 | 87% above | 50% |
| Sodium blood test CPT 84295 SODIUM SERUM RL | $48.50 | $97.00 | $4.71–$92.15 | 87% above | 50% |
| Sodium blood test inpatient CPT 84295 SODIUM | $10.00 | $20.00 | $4.71–$19.00 | — | 50% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM | $48.50 | $97.00 | $4.71–$92.15 | — | 50% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM RL | $48.50 | $97.00 | $4.71–$92.15 | — | 50% |
| Stool ova and parasites exam CPT 87177 TAPE/HOOKWORM | $13.00 | $26.00 | $7.13–$24.70 | 73% below | 50% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES | $73.50 | $105.00 | $8.72–$99.75 | 53% 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 | 28% above | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES, SCREEN | $28.70 | $41.00 | $4.29–$38.95 | 79% 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 | 90% 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 antibody test (Treponema pallidum) CPT 86780 QUEST TREPONEMA PALLIDUM SEROLOGY RL | $18.54 | $26.48 | $7.26–$25.16 | 40% below | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TP-PA | $20.00 | $40.00 | $10.98–$38.00 | 35% below | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM SEROLOGY RL | $44.00 | $88.00 | $12.98–$83.60 | 42% above | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABS | $51.80 | $74.00 | $12.98–$70.30 | 67% above | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 QUEST TREPONEMA PALLIDUM SEROLOGY RL | $18.54 | $26.48 | $7.26–$25.16 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TP-PA | $20.00 | $40.00 | $10.98–$38.00 | — | 50% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM SEROLOGY RL | $44.00 | $88.00 | $12.98–$83.60 | — | 50% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ABS | $51.80 | $74.00 | $12.98–$70.30 | — | 30% |
| 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 | $101.00 | $202.00 | $25.29–$191.90 | 15% above | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL RL | $101.00 | $202.00 | $25.29–$191.90 | 15% 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 | 11% above | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE ANTIBODY RL | $91.50 | $183.00 | $14.26–$173.85 | 26% 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 RL | $50.00 | $100.00 | $16.46–$95.00 | 23% below | 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 inpatient CPT 84443 TSH RL | $50.00 | $100.00 | $16.46–$95.00 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $50.00 | $100.00 | $16.46–$95.00 | — | 50% |
| Total IgE blood test CPT 82785 IMMUNO-IGE RL | $14.50 | $29.00 | $7.96–$27.55 | 73% below | 50% |
| Total IgE blood test inpatient CPT 82785 IMMUNO-IGE RL | $14.50 | $29.00 | $7.96–$27.55 | — | 50% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM RL | $16.50 | $33.00 | $4.26–$31.35 | 30% below | 50% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL, MAYO | $26.25 | $37.50 | $4.26–$35.62 | 12% above | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM | $48.50 | $97.00 | $4.26–$92.15 | 106% above | 50% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM RL | $16.50 | $33.00 | $4.26–$31.35 | — | 50% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL, MAYO | $26.25 | $37.50 | $4.26–$35.62 | — | 30% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM | $48.50 | $97.00 | $4.26–$92.15 | — | 50% |
| Total thyroxine (T4) blood test CPT 84436 T4 | $29.00 | $58.00 | $6.73–$55.10 | 36% below | 50% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 | $29.00 | $58.00 | $6.73–$55.10 | — | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 | $78.50 | $157.00 | $13.90–$149.15 | at median | 50% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 | $78.50 | $157.00 | $13.90–$149.15 | — | 50% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $58.00 | $116.00 | $12.50–$110.20 | 4% above | 50% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $58.00 | $116.00 | $12.50–$110.20 | — | 50% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES RL | $16.50 | $33.00 | $5.63–$31.35 | 44% below | 50% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES, MAYO | $26.25 | $37.50 | $5.63–$35.62 | 10% below | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $70.00 | $140.00 | $5.63–$133.00 | 139% above | 50% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES BODY FLUID RL | $143.50 | $287.00 | $5.63–$272.65 | 390% above | 50% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES RL | $16.50 | $33.00 | $5.63–$31.35 | — | 50% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES, MAYO | $26.25 | $37.50 | $5.63–$35.62 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $70.00 | $140.00 | $5.63–$133.00 | — | 50% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BODY FLUID RL | $143.50 | $287.00 | $5.63–$272.65 | — | 50% |
| Troponin test, quantitative CPT 84484 TROPONIN I | $75.00 | $150.00 | $12.22–$142.50 | at median | 50% |
| Troponin test, quantitative CPT 84484 TROPONIN I REOCCURRING | $106.50 | $213.00 | $12.22–$202.35 | 42% above | 50% |
| Troponin test, quantitative CPT 84484 TROPONIN I RL | $119.00 | $238.00 | $12.22–$226.10 | 59% above | 50% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I | $75.00 | $150.00 | $12.22–$142.50 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I REOCCURRING | $106.50 | $213.00 | $12.22–$202.35 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I RL | $119.00 | $238.00 | $12.22–$226.10 | — | 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 | 61% 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 | 15% above | 50% |
| Urine culture for bacteria, with colony count CPT 87086 TEST CULTURE URINE | $94.50 | $135.00 | $7.91–$128.25 | 61% 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 microalbumin (albumin) test CPT 82043 MICROALBUMIN | $52.50 | $105.00 | $5.66–$99.75 | 59% above | 50% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN, 24 HR URINE RL | $52.50 | $105.00 | $5.66–$99.75 | 59% above | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN, 24 HR URINE RL | $52.50 | $105.00 | $5.66–$99.75 | — | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN | $52.50 | $105.00 | $5.66–$99.75 | — | 50% |
| Urine pregnancy test, read by color change CPT 81025 BRIGHTER FUTURES URINE PREGNANCY TEST | $7.75 | $15.50 | $4.25–$14.72 | 65% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 CL URINE PREGNANCY TEST | $40.50 | $81.00 | $8.44–$76.95 | 82% above | 50% |
| Urine pregnancy test, read by color change CPT 81025 HCG URINE | $48.50 | $97.00 | $8.44–$92.15 | 118% 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 | 8% 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 | 38% below | 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 | 24% above | 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 | 24% 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% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1, 25-DIHYDROXY RL | $228.00 | $456.00 | $37.73–$433.20 | 196% above | 50% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1, 25-DIHYDROXY RL | $228.00 | $456.00 | $37.73–$433.20 | — | 50% |
| Zinc blood test CPT 84630 ZINC, SERUM RL | $20.00 | $40.00 | $10.98–$38.00 | 49% below | 50% |
| Zinc blood test CPT 84630 ZINC URINE RL | $73.00 | $146.00 | $11.16–$138.70 | 87% 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 | 34% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT | $48.50 | $97.00 | $14.75–$92.15 | 34% below | 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% |
| 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% |
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 | 500% above | 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 | 208% above | 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 | 93% above | 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 TX OF DISTAL FIBULA FRACTURE | $560.50 | $1,121.00 | $307.60–$1,064.95 | 84% 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 | 91% 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 | 102% 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 | 12% below | 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 | $840.00 | $1,680.00 | $142.83–$1,596.00 | 21% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $878.00 | $1,756.00 | $142.83–$1,668.20 | 17% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOLOGY CARDIOVERSION ELECTIVE | $1,122.00 | $2,244.00 | $142.83–$2,131.80 | 6% 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 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 | at median | 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 | 88% 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 | at median | 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 | $135.50 | $271.00 | $81.30–$367.31 | 57% 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 | 13% above | 50% |
| Colonoscopy with polyp removal CPT 45385 BIOPSY SING/MULT STOMACH | $2,429.00 | $3,470.00 | $454.33–$3,296.50 | 67% 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 | 62% 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 | 1% below | 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 | at median | 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 | 31% above | 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 | 11% 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 | 70% 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 | 57% 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 | 34% 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 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 | 12% 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 | 51% below | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGAT/LAVAGE | $41.00 | $82.00 | $14.69–$77.90 | 51% 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 | 19% below | 30% |
| Earwax removal with instruments, one ear CPT 69210 EAR CLEANING | $57.40 | $82.00 | $22.50–$77.90 | 19% below | 30% |
| Earwax removal with instruments, one ear CPT 69210 EAR CLEANING | $97.50 | $195.00 | $44.49–$185.25 | 38% above | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN UNI W/INSTRUM | $122.50 | $175.00 | $44.49–$166.25 | 73% 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% |
| 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 | 75% 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 | 95% 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 | 93% 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 | 251% 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 | 23% 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 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 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 | 22% 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 | 5% 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 | 25% above | 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 | 8% above | 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 | 34% 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 | at median | 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 I&D ABSCESS-SIMPLE-SING | $99.40 | $142.00 | $42.60–$134.90 | 58% 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 SIMPLE | $150.50 | $215.00 | $59.00–$204.25 | 36% 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 | 37% above | 50% |
| 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 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 | 7% 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 TREATMENT | $67.90 | $97.00 | $29.10–$92.15 | 80% 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 | 6% above | 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 | 18% above | 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 | 82% 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 | 80% 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 | 67% 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 | 55% 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 | 16% 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 | 34% 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 INTERMEDIATE JOINT INJECTION | $92.40 | $132.00 | $36.22–$125.40 | 73% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JNT INJECT INTERMEDIAT | $136.50 | $195.00 | $52.94–$185.25 | 60% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHOCENTESIS INT JOINT | $375.50 | $751.00 | $52.94–$713.45 | 9% 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 | 13% above | 50% |
| 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 | 18% 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 | 11% 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 | 4% below | 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 | 2% 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 | 32% 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 | 21% 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 | 30% 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 OF WOUNDS SATE 2.5CM OR < | $243.50 | $487.00 | $133.63–$462.65 | 43% 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 | 43% above | 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 | 17% 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 | 13% 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 | 73% 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 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 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 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 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 FEENLM 0.5CM OR LESS | $132.00 | $264.00 | $72.44–$250.80 | 81% 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 FEENLM 0.5CM OR LESS | $207.90 | $297.00 | $81.50–$282.15 | 70% below | 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 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 | $107.00 | $214.00 | $58.72–$203.30 | 60% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL SIMPLE SGL | $277.00 | $554.00 | $100.85–$526.30 | 3% 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 | 8% above | 50% |
| 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 | 11% 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 | 17% 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 | 56% below | 50% |
| 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 | 21% 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 | 23% above | 50% |
| 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 | 13% 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 | 15% 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 | $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 | 74% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB | $123.20 | $176.00 | $48.29–$167.20 | 68% 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 | 45% above | 50% |
| 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 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 | 4% 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 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 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 | 28% 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 | 43% 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 | $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 SPLINT SHORT ARM-STATIC | $58.80 | $84.00 | $23.05–$79.80 | 68% below | 30% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC | $110.00 | $220.00 | $60.37–$209.00 | 40% below | 50% |
| 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 CAST SHORT LEG | $99.40 | $142.00 | $38.96–$134.90 | 69% below | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG | $99.40 | $142.00 | $38.96–$134.90 | — | 30% |
| Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG | $229.00 | $458.00 | $75.51–$435.10 | 1% below | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SHORT LEG | $229.00 | $458.00 | $75.51–$435.10 | — | 50% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LI | $169.00 | $338.00 | $92.75–$321.10 | 91% below | 50% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LI | $169.00 | $338.00 | $92.75–$321.10 | — | 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 < | $89.00 | $178.00 | $48.84–$169.10 | 69% below | 50% |
| 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 | 52% 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 | 52% 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 | 3% above | 50% |
| 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 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 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 | $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 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 tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG | $88.20 | $126.00 | $34.57–$119.70 | 55% 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 | 53% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS | $94.50 | $135.00 | $40.50–$128.25 | 52% 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 | 30% below | 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% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR, DIAGNOSTIC | $868.50 | $1,737.00 | $150.96–$1,650.15 | 14% below | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE | $888.00 | $1,776.00 | $150.96–$1,687.20 | 12% 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 2.6CM 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 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 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 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 | 71% 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 | 63% 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 | 48% 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 TANGNTL BX SKIN SINGLE LES | $84.06 | $120.09 | $32.96–$114.09 | 76% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY | $93.00 | $186.00 | $51.04–$176.70 | 73% below | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SUBCUTANEOUS SKIN LESION | $136.50 | $195.00 | $53.51–$185.25 | 61% below | 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 | 32% 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 | 66% 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 | 1% 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 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 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 | 20% 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 | 20% 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 | 69% 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 | 102% above | 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 | 44% 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 | 4% 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 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 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 DBRDMT SUBQ TIS 1ST 20SQCM/< | $533.50 | $1,067.00 | $119.52–$1,013.65 | 42% above | 50% |
| 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) 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 | 88% 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 MDI INITIAL | $239.50 | $479.00 | $7.58–$455.05 | 17% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INDUCED SPUTUM COLLECTION | $239.50 | $479.00 | $7.58–$455.05 | 17% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL CHARGE INITIAL | $239.50 | $479.00 | $7.58–$455.05 | 17% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUBSEQUENT | $239.50 | $479.00 | $7.58–$455.05 | 17% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV 1 | $335.30 | $479.00 | $7.58–$455.05 | 64% 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 MDI INITIAL | $239.50 | $479.00 | $7.58–$455.05 | — | 50% |
| 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 MDI SUBSEQUENT | $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 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 ER FACILITY FEE-CRITICAL | $844.00 | $1,688.00 | $290.87–$1,603.60 | 33% 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 | 22% below | 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 | 81% below | 50% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 BL EKG | $75.00 | $150.00 | $14.18–$142.50 | 50% below | 50% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 BL EKG IME | $88.50 | $177.00 | $14.18–$168.15 | 41% below | 50% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 **BL EKG | $105.00 | $150.00 | $14.18–$142.50 | 30% below | 30% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 **BL EKG IME | $123.90 | $177.00 | $14.18–$168.15 | 17% 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 | 18% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG STAT & EMERGENCY ROOM | $99.50 | $199.00 | $6.15–$189.05 | 18% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE | $99.50 | $199.00 | $6.15–$189.05 | 18% 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 ER FACILITY FEE-BRIEF | $59.50 | $119.00 | $11.02–$113.05 | 63% 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 | 56% below | 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 RHC FACILITY FEE-LIMITED | $95.20 | $136.00 | $37.32–$129.20 | 62% 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 | 46% below | 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 RHC FACILITY FEE-INTERMED | $117.60 | $168.00 | $46.10–$159.60 | 71% 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 | 47% below | 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 RHC FACILITY FEE-EXTENDED | $128.80 | $184.00 | $50.49–$174.80 | 81% below | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER FACILITY FEE-EXTENDED | $350.00 | $700.00 | $118.88–$665.00 | 49% below | 50% |
| 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 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 RHC FACILITY FEE-HIGH COM | $317.10 | $453.00 | $124.30–$430.35 | 67% 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 | 49% below | 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 | 19% 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 | 23% 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 | 21% 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 | 11% 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 | 27% 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 | 87% above | 50% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $105.00 | $210.00 | $28.94–$199.50 | 96% 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% |
| 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 | 84% 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 | 36% 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 | 15% 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% |
| IV push of a medicine, first drug CPT 96374 INTRAVENOUS PUSH SINGLE/INITIALSUB/DRUG | $33.50 | $67.00 | $18.38–$63.65 | 84% below | 50% |
| IV push of a medicine, first drug CPT 96374 INTRAVENOUS PUSH,SINGLE/INITIAL,SUB/DRUG | $37.10 | $53.00 | $14.54–$50.35 | 82% below | 30% |
| IV push of a medicine, first drug CPT 96374 INTRAVENOUS PUSH SINGLE INITIAL SUB DRUG | $183.74 | $367.48 | $33.28–$349.11 | 10% below | 50% |
| IV push of a medicine, first drug inpatient CPT 96374 INTRAVENOUS PUSH,SINGLE/INITIAL,SUB/DRUG | $37.10 | $53.00 | $14.54–$50.35 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 INTRAVENOUS PUSH SINGLE INITIAL SUB DRUG | $183.74 | $367.48 | $33.28–$349.11 | — | 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 | 82% below | 50% |
| 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 | 82% 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 | 81% 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 | 57% 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 | 15% 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 | 4% above | 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 | 51% 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 NEW OFFICE VISIT LEVEL 3 | $82.00 | $164.00 | $45.00–$155.80 | 1% below | 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 | 28% 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 | 29% 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 | 36% 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 | 37% 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 | 67% 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 | 67% 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 | 90% 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 | 92% 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 | 134% above | 30% |
| 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 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 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 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 NEW PT OFFICE VISIT LVL 4 45-59 MINUTES | $106.00 | $212.00 | $58.17–$201.40 | 16% 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 | 36% 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 | 62% above | 30% |
| New patient office visit, about 45 minutes CPT 99204 NEW OFFICE VISIT LEVEL 4 | $151.20 | $216.00 | $59.27–$205.20 | 65% 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 | 74% above | 50% |
| New patient office visit, about 45 minutes CPT 99204 DERMATOLOGY NEW OFFICE VISIT LEVEL 4 | $175.00 | $250.00 | $68.60–$237.50 | 91% above | 30% |
| 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 | 91% 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 | 110% 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 | 137% 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 | 137% 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 | 194% 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 | 232% above | 30% |
| 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 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 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 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 MINUTES | $150.00 | $300.00 | $82.32–$285.00 | 22% above | 50% |
| 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 | 22% 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 EVAL AND MANAGEMENT NEW LVL 2 15-29 MIN | $54.50 | $109.00 | $29.91–$103.55 | 20% 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 | 1% below | 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 | 11% 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 | 23% 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 | 46% 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 | 99% 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 | 99% 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 | 104% 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 | 179% above | 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 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 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 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 | 45% 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 | 46% 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 | 54% 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 MANUAL THER TECHNIQUE | $43.00 | $86.00 | $23.60–$81.70 | 36% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THER TECHNIQUE | $43.00 | $86.00 | $23.60–$81.70 | 36% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Postural Drainage | $66.50 | $95.00 | $25.64–$90.25 | at median | 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 | 34% 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 | 15% 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 | 15% 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 | 1% 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 | 1% 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 | 24% 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 | 14% 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 PSYCHIATRIC DIAGNOSTIC EVAL W/MED SERV | $192.50 | $385.00 | $105.64–$365.75 | 3% below | 50% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAGNOSTIC EVAL WITH MED SERVICES | $204.00 | $408.00 | $111.96–$387.60 | 3% above | 50% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAGNOSTIC EVAL WITH MED SERVICES | $210.00 | $300.00 | $82.32–$285.00 | 6% above | 30% |
| 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 | 2% 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 | 13% below | 50% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45MIN W/PATIENT AND/OR FAM | $131.00 | $262.00 | $71.89–$248.90 | 5% 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 | 47% below | 50% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINUTES WITH PATIENT | $192.00 | $384.00 | $105.37–$364.80 | 1% above | 50% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY ONLY 60 MINUTES | $197.00 | $394.00 | $108.11–$374.30 | 4% above | 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 | 62% below | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 **TOBACCO USE COUNSEL 3-10 MIN | $56.00 | $80.00 | $14.48–$76.00 | 53% above | 30% |
| 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% |
| 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 | 3% 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 | 3% 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 | 47% 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 | 78% 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 | 99% 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 | 122% 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 | 188% 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 | 273% above | 30% |
| 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 EST PT OFFICE VISIT LEVEL 3 20-29 MINS | $48.50 | $97.00 | $26.62–$92.15 | 38% 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 | 35% below | 50% |
| 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 | 10% below | 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 | 10% 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 | 13% above | 30% |
| 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 | 28% above | 50% |
| 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 | 28% 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 | 29% 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 | 29% 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 | 51% 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 | 79% 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 | 81% above | 30% |
| 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 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 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 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 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 EST PT OFFICE VISIT LEVEL 4 30-34 MINS | $93.10 | $133.00 | $36.50–$126.35 | 5% below | 30% |
| 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 | 15% 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 | 15% 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 | 20% 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 | 24% 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 | 32% above | 30% |
| 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 | 45% above | 50% |
| 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 | 45% 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 | 61% 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 | 68% 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 | 97% 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 | 104% above | 30% |
| 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 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 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 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 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 EVAL AND MANAGEMENT EST LVL 2 10-19 MIN | $36.00 | $72.00 | $19.76–$68.40 | 44% 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 | 27% 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 | 27% 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 | 22% 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 | 18% 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 | 7% below | 30% |
| 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 | 2% below | 50% |
| 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 | 2% below | 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 | 36% 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 | 37% 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 | 48% 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 | 112% above | 30% |
| 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 10-19 MINUTES | $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 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 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 CONSULTATION (40 MIN) | $119.00 | $238.00 | $65.31–$226.10 | 6% above | 50% |
| 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 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% |
| 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 | 82% below | 30% |
| Spirometry (breathing test) CPT 94010 BL Spirometry Pre IME | $40.00 | $80.00 | $21.95–$76.00 | 81% below | 50% |
| Spirometry (breathing test) CPT 94010 SBL SPIROMETRY PRE | $45.00 | $90.00 | $24.70–$85.50 | 78% below | 50% |
| Spirometry (breathing test) CPT 94010 **PFT - PRE-SPIROMETRY -BREATHING CAPACI | $56.00 | $80.00 | $21.95–$76.00 | 73% below | 30% |
| Spirometry (breathing test) CPT 94010 BL IME SPIROMETRY PRE | $56.00 | $80.00 | $21.95–$76.00 | 73% below | 30% |
| Spirometry (breathing test) CPT 94010 PFT SIMPLE | $182.00 | $364.00 | $26.41–$345.80 | 12% below | 50% |
| Spirometry (breathing test) CPT 94010 BL Spirometry Pre | $200.00 | $400.00 | $26.41–$380.00 | 3% below | 50% |
| Spirometry (breathing test) CPT 94010 BL SPIROMETRY PRE | $280.00 | $400.00 | $26.41–$380.00 | 35% 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 BL IME SPIROMETRY PRE | $56.00 | $80.00 | $21.95–$76.00 | — | 30% |
| 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 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 | 76% below | 30% |
| Spirometry before and after a bronchodilator CPT 94060 BL Spirometry Pre VS Post IME | $106.00 | $212.00 | $38.25–$201.40 | 73% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 BL Spirometry Pre VS Post | $325.00 | $650.00 | $38.25–$617.50 | 16% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 PFT PRE AND POST | $350.00 | $700.00 | $38.25–$665.00 | 10% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 BL SPIROMETRY PRE VS POST | $385.00 | $550.00 | $38.25–$522.50 | 1% below | 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 inpatient CPT 93015 CARDIOVASCULAR STRESS | $118.50 | $237.00 | $65.03–$225.15 | — | 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 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 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 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 VARICELLA (VARIVAX) VAC (1Y+): 0.5ML | $244.08 | $488.16 | $133.95–$463.75 | 23% above | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL VARICELLA LIVE (VARIVAX) VACCINE | $244.08 | $488.16 | $133.95–$463.75 | 23% above | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA (VARIVAX) VAC (1Y+): 0.5ML | $244.08 | $488.16 | $133.95–$463.75 | — | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIP TET PERT POL VAC (4-6Y): 0.5ML | $90.30 | $180.60 | $49.56–$171.57 | 38% above | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 CL DIPTH PERT TET POLIO VAC(KINRIX) 0.5M | $90.30 | $180.60 | $49.56–$171.57 | 38% above | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIP TET PERT POL VAC (4-6Y): 0.5ML | $90.30 | $180.60 | $49.56–$171.57 | — | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 CL DIPTH/PERT/TETAN(DAPTACEL)VIAL: 0.5ML | $75.16 | $150.32 | $41.25–$142.80 | 139% above | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 CL HEP B/DP(A)T/POL(PEDIARIX)VACC: 0.5ML | $141.35 | $282.69 | $77.57–$268.56 | 54% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL (DTaP POL HIB)VAC(6W-4Y): 0.5ML | $213.70 | $427.40 | $117.28–$406.03 | 102% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 CL DP(A)T-POLIO/HIB CONJ-TET/PF(PENTACEL | $213.70 | $427.40 | $117.28–$406.03 | 102% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL (DTaP POL HIB)VAC(6W-4Y): 0.5ML | $213.70 | $427.40 | $117.28–$406.03 | — | 50% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 CL INFLUENZA EGG FREE (FLUBLOK): 0.5ML | $204.27 | $408.54 | $96.20–$388.11 | at median | 50% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 INFLUENZA EGG FREE (FLUBLOK) VAC: 0.5ML | $204.27 | $408.54 | $96.20–$388.11 | at median | 50% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 INFLUENZA EGG FREE (FLUBLOK) VAC: 0.5ML | $204.27 | $408.54 | $96.20–$388.11 | — | 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 | 13% below | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV (GARDISIL) VACCINE 0.5ML VIAL | $384.30 | $549.00 | $150.65–$521.55 | 21% 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 | 52% 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 A vaccine, child and teen dose (2-dose schedule) CPT 90633 ADM HEPATITIS VACCINE (HEP A) 2ND INJECT | $13.30 | $19.00 | $5.21–$18.05 | 63% below | 30% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 CL HEPATITIS A(HAVRIX)PED VACC: 720ELU | $58.82 | $117.63 | $32.28–$111.75 | 64% above | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 ADM HEPATITIS VACCINE (HEP A) 2ND INJECT | $13.30 | $19.00 | $5.21–$18.05 | — | 30% |
| 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% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 CL HEP B(ENGERIX-B)INJ: 10MCG/0.5ML PED | $45.41 | $90.81 | $24.92–$86.27 | 42% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B(ENGERIX-B)0-19Y VAC: 10MCG/0.5ML | $53.97 | $107.94 | $29.62–$102.54 | 69% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B(ENGERIX-B)0-19Y VAC: 10MCG/0.5ML | $53.97 | $107.94 | $29.62–$102.54 | — | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 CL HAEMOPH B (HIBERIX) VAC(6W-4Y): 0.5ML | $22.82 | $45.63 | $12.52–$43.35 | 34% above | 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 | 26% 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 | 26% 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 | 13% 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 | 37% 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% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 CL MEAS/MUMP/RUB/VARIC(PROQUAD)VAC 0.5ML | $386.81 | $773.61 | $212.28–$734.93 | 28% above | 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 CL MENINGOCOC (MENACTRA) 4MCG/0.5ML VAC | $323.21 | $461.73 | $126.69–$438.64 | 107% above | 30% |
| 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 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 MENINGOCOC (MENACTRA) 4MCG/0.5ML VACCINE | $323.21 | $461.73 | $126.69–$438.64 | — | 30% |
| 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 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 | 19% 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 | 41% 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 | 86% 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, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13 (PREVNAR 13) VAC: 0.5ML | $507.15 | $724.50 | $198.80–$688.28 | 145% above | 30% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 CL PNEUMOCOCCAL 13-VALENT CONJ VAC 0.5ML | $507.15 | $724.50 | $198.80–$688.28 | 145% above | 30% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13 (PREVNAR 13) VAC: 0.5ML | $507.15 | $724.50 | $198.80–$688.28 | — | 30% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 CL PNEUMOCOCCAL 13-VALENT CONJ VAC 0.5ML | $507.15 | $724.50 | $198.80–$688.28 | — | 30% |
| 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 | 23% 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 | 36% 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 | 142% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL PNEUMOVAX-23 VACCINE VIAL | $322.84 | $461.20 | $126.56–$438.14 | 195% 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% |
| Polio vaccine, inactivated (IPV) CPT 90713 IPV VIAL POLIO | $17.50 | $25.00 | $6.86–$23.75 | 57% below | 30% |
| Polio vaccine, inactivated (IPV) CPT 90713 CL POLIOMYELITIS (IPOL) VAC: 0.5ML | $63.08 | $126.15 | $34.61–$119.84 | 54% above | 50% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV VIAL POLIO | $17.50 | $25.00 | $6.86–$23.75 | — | 30% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 CL NIRSEVIMAB(BEYFORTUS)INJ:100MG/ML 1ML | $1,001.04 | $2,002.08 | $549.37–$1,901.98 | 27% above | 50% |
| 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% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS RV1 (ROTARIX) ORAL VAC: 1.5ML | $199.37 | $398.73 | $109.41–$378.79 | 33% above | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 CL ROTAVIRUS(ROTATEQ)SUSP: 2ML TUBE | $227.75 | $325.35 | $89.28–$309.08 | 52% above | 30% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS RV1 (ROTARIX) ORAL VAC: 1.5ML | $199.37 | $398.73 | $109.41–$378.79 | — | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 CL ROTAVIRUS(ROTATEQ)SUSP: 2ML TUBE | $227.75 | $325.35 | $89.28–$309.08 | — | 30% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 CL ROTAVIRUS VAC(ROTARIX) ORAL W/DILUENT | $200.84 | $401.67 | $110.22–$381.59 | 105% above | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER (SHINGRIX) VAC (50Y+): 0.5ML | $272.54 | $545.07 | $149.57–$517.82 | 29% above | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL VARICELLA (SHINGRIX) 50MCG/0.5ML VACC | $272.54 | $545.07 | $149.57–$517.82 | 29% 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 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 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 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 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 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 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 TYPHOID VACC(TYPHIM VI)SYR: 25MCG/0.5ML | $238.96 | $341.37 | $93.67–$324.30 | 69% above | 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) 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 | 69% below | 30% |
| 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 | 63% below | 50% |
| 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 | 63% 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 | 63% 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 | 63% 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 | 63% 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 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 OF PNEUMOCOCCAL 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 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 | 46% 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 | 43% 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 | 35% 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 | 35% 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% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.bmh.org/wp-content/uploads/2026/04/550477361_boone-memorial-hospital-inc._standardcharges-1.csv