Hospital Baton Rouge, LA

Baton Rouge General Medical Center

Baton Rouge General Medical Center in Baton Rouge, LA publishes cash prices for 344 common procedures listed here, from its own machine-readable price file updated Mar 26, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Louisiana median for 333 of 342 procedures and below it for 8. By typical cash price it ranks #61 of 67 Louisiana hospitals and #6 of 6 hospitals in the Baton Rouge, LA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

8585 PICARDY AVE, BATON ROUGE, LA 708063842 Collected Sep 27, 2026 Source price file Check a bill from this hospital (225) 387-7767

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 190065 · CMS hospital register NPI 1962537407

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMINAL W/ & W/O CONTRAST	$2,161.88	$3,088.40	$163.38–$2,378.07	112% above	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMINAL W/ & W/O CONTRAST	$2,161.88	$3,088.40	$163.38–$2,378.07	—	30%
Abdominal X-ray, 2 views CPT 74019 X ABD FLAT/ERECT AND/OR DECU	$272.55	$389.35	$22.74–$299.80	56% above	30%
Abdominal X-ray, 2 views inpatient CPT 74019 X ABD FLAT/ERECT AND/OR DECU	$272.55	$389.35	$22.74–$299.80	—	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X ANKLE MIN 3 VIEWS LEFT	$266.49	$380.70	$25.11–$293.14	114% above	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X ANKLE MIN 3 VIEWS RIGHT	$266.49	$380.70	$25.11–$293.14	114% above	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X ANKLE MIN 3 VIEWS RIGHT	$266.49	$380.70	$25.11–$293.14	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X ANKLE MIN 3 VIEWS LEFT	$266.49	$380.70	$25.11–$293.14	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$380.35	$543.35	$102.59–$418.38	117% above	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$380.35	$543.35	$102.59–$418.38	—	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O CONTRAST RT	$948.68	$1,355.25	$97.38–$1,866.00	46% above	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O CONTRAST LT	$948.68	$1,355.25	$97.38–$1,866.00	46% above	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O CONTRAST LT	$948.68	$1,355.25	$97.38–$1,866.00	—	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O CONTRAST RT	$948.68	$1,355.25	$97.38–$1,866.00	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X ESOPHAGRAM	$420.00	$600.00	$67.34–$462.00	95% above	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X ESOPHAGRAM	$420.00	$600.00	$67.34–$462.00	—	30%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN TOTAL BODY	$1,150.35	$1,643.35	$330.32–$1,265.38	109% above	30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN TOTAL BODY	$1,150.35	$1,643.35	$330.32–$1,265.38	—	30%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE LEFT	$443.52	$633.60	$88.65–$487.87	164% above	30%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE RIGHT	$443.52	$633.60	$88.65–$487.87	164% above	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE RIGHT	$443.52	$633.60	$88.65–$487.87	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE LEFT	$443.52	$633.60	$88.65–$487.87	—	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED RT	$376.43	$537.75	$52.33–$414.07	125% above	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED LEFT	$376.43	$537.75	$52.33–$414.07	125% above	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED LEFT	$376.43	$537.75	$52.33–$414.07	—	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED RT	$376.43	$537.75	$52.33–$414.07	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN/PELVIS	$4,848.83	$6,926.90	$289.28–$5,333.71	429% above	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN/PELVIS	$4,848.83	$6,926.90	$289.28–$5,333.71	—	30%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD W & W/O	$2,290.26	$3,271.80	$163.38–$2,519.29	231% above	30%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD W & W/O	$2,290.26	$3,271.80	$163.38–$2,519.29	—	30%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W & W/O	$2,261.49	$3,230.70	$158.83–$2,487.64	224% above	30%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W & W/O	$2,261.49	$3,230.70	$158.83–$2,487.64	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W & W/O	$2,286.52	$3,266.45	$158.83–$2,515.17	161% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W & W/O	$2,286.52	$3,266.45	$158.83–$2,515.17	—	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CORONARY ANGIOGRAM	$1,323.63	$1,890.90	$289.28–$1,866.00	181% above	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CORONARY ANGIOGRAM	$1,323.63	$1,890.90	$289.28–$1,866.00	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CARDIAC W/O(CALCIUM SCORING	$337.65	$482.35	$81.06–$1,866.00	302% above	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CARDIAC W/O(CALCIUM SCORING	$337.65	$482.35	$81.06–$1,866.00	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 PET CT ABDOMEN & PELVIS W/O CONTRAST	$1,694.21	$2,420.30	$101.55–$1,866.00	50% above	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS W/O	$3,115.77	$4,451.10	$101.55–$3,427.35	176% above	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 PET CT ABDOMEN & PELVIS W/O CONTRAST	$1,694.21	$2,420.30	$101.55–$1,866.00	—	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS W/O	$3,115.77	$4,451.10	$101.55–$3,427.35	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 PET CT ABDOMEN & PELVIS W CONTRAST	$2,053.98	$2,934.25	$226.90–$2,259.37	59% above	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W	$3,853.61	$5,505.15	$226.90–$4,238.97	199% above	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 PET CT ABDOMEN & PELVIS W CONTRAST	$2,053.98	$2,934.25	$226.90–$2,259.37	—	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W	$3,853.61	$5,505.15	$226.90–$4,238.97	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W & W/O	$4,473.46	$6,390.65	$289.28–$4,920.80	209% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W & W/O	$4,473.46	$6,390.65	$289.28–$4,920.80	—	30%
CT scan of the abdomen with contrast CPT 74160 PET CT ABDOMEN W CONTRAST	$1,233.37	$1,761.95	$163.38–$1,866.00	43% above	30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMINAL W/ CONTRAST	$1,926.75	$2,752.50	$163.38–$2,119.43	124% above	30%
CT scan of the abdomen with contrast inpatient CPT 74160 PET CT ABDOMEN W CONTRAST	$1,233.37	$1,761.95	$163.38–$1,866.00	—	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMINAL W/ CONTRAST	$1,926.75	$2,752.50	$163.38–$2,119.43	—	30%
CT scan of the abdomen without contrast CPT 74150 PET CT ABDOMEN W/O CONTRAST	$964.85	$1,378.35	$80.91–$1,866.00	27% above	30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,650.46	$2,357.80	$80.91–$1,866.00	117% above	30%
CT scan of the abdomen without contrast inpatient CPT 74150 PET CT ABDOMEN W/O CONTRAST	$964.85	$1,378.35	$80.91–$1,866.00	—	30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,650.46	$2,357.80	$80.91–$1,866.00	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIOFACIAL/SINUS W EXT W/O	$1,666.53	$2,380.75	$88.75–$1,866.00	167% above	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXIOFACIAL/SINUS W EXT W/O	$1,666.53	$2,380.75	$88.75–$1,866.00	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 PET CT BRAIN W/O CONTRAST	$835.21	$1,193.15	$66.93–$1,866.00	27% above	30%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$1,452.78	$2,075.40	$66.93–$1,866.00	122% above	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 PET CT BRAIN W/O CONTRAST	$835.21	$1,193.15	$66.93–$1,866.00	—	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$1,452.78	$2,075.40	$66.93–$1,866.00	—	30%
CT scan of the head with contrast CPT 70460 CT HEAD W/ CONTRAST	$1,677.31	$2,396.15	$163.38–$1,866.00	134% above	30%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/ CONTRAST	$1,677.31	$2,396.15	$163.38–$1,866.00	—	30%
CT scan of the head without and with contrast CPT 70470 PET CT BRAIN W/O AND W CONTRAST	$1,240.26	$1,771.80	$116.02–$1,866.00	36% above	30%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/ & W/O CONTRAST	$1,877.58	$2,682.25	$116.02–$2,065.33	105% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 PET CT BRAIN W/O AND W CONTRAST	$1,240.26	$1,771.80	$116.02–$1,866.00	—	30%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/ & W/O CONTRAST	$1,877.58	$2,682.25	$116.02–$2,065.33	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR W/O CONTRAST	$2,166.71	$3,095.30	$94.67–$2,383.38	187% above	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR W/O CONTRAST	$2,166.71	$3,095.30	$94.67–$2,383.38	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/EXT W/O	$1,606.36	$2,294.80	$82.80–$1,866.00	118% above	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/EXT W/O	$1,606.36	$2,294.80	$82.80–$1,866.00	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 PET CT PELVIS W CONTRAST	$1,170.58	$1,672.25	$163.38–$1,866.00	41% above	30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$2,236.57	$3,195.10	$163.38–$2,460.23	169% above	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PET CT PELVIS W CONTRAST	$1,170.58	$1,672.25	$163.38–$1,866.00	—	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$2,236.57	$3,195.10	$163.38–$2,460.23	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$767.55	$1,096.50	$119.00–$844.31	—	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$767.55	$1,096.50	$119.00–$844.31	—	30%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/ & W/O CONTRAST	$2,397.99	$3,425.70	$158.83–$2,637.79	127% above	30%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/ & W/O CONTRAST	$2,397.99	$3,425.70	$158.83–$2,637.79	—	30%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$224.77	$321.10	$20.30–$247.25	70% above	30%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$224.77	$321.10	$20.30–$247.25	—	30%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$177.03	$252.90	$15.43–$194.73	60% above	30%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$177.03	$252.90	$15.43–$194.73	—	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X CLAVICLE RIGHT	$242.41	$346.30	$27.80–$266.65	107% above	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X CLAVICLE LEFT	$242.41	$346.30	$27.80–$266.65	107% above	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X CLAVICLE RIGHT	$242.41	$346.30	$27.80–$266.65	—	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X CLAVICLE LEFT	$242.41	$346.30	$27.80–$266.65	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABDOMEN RETROPERITONEAL	$532.91	$761.30	$70.49–$586.20	85% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ABDOMEN RETROPERITONEAL	$532.91	$761.30	$70.49–$586.20	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 MA BONE DENSITY HIPS PELVIS SP	$449.40	$642.00	$26.51–$494.34	210% above	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 MA BONE DENSITY HIPS PELVIS SP	$449.40	$642.00	$26.51–$494.34	—	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 MA BONE DENSITY SKELETON EXT	$179.27	$256.10	$27.75–$197.20	118% above	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 MA BONE DENSITY SKELETON EXT	$179.27	$256.10	$27.75–$197.20	—	30%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB COMPLETE+FETAL DETAIL	$561.02	$801.45	$103.95–$617.12	111% above	30%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB COMPLETE+FETAL DETAIL	$561.02	$801.45	$103.95–$617.12	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 PET CT CHEST W/O CONTRAST	$936.78	$1,338.25	$86.25–$1,866.00	23% above	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST SCAN	$1,663.48	$2,376.40	$86.25–$1,866.00	118% above	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 PET CT CHEST W/O CONTRAST	$936.78	$1,338.25	$86.25–$1,866.00	—	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST SCAN	$1,663.48	$2,376.40	$86.25–$1,866.00	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 PET CT CHEST W CONTRAST	$1,202.29	$1,717.55	$111.65–$1,866.00	40% above	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST SCAN W/CONTRAST	$2,070.01	$2,957.15	$111.65–$2,277.01	142% above	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 PET CT CHEST W CONTRAST	$1,202.29	$1,717.55	$111.65–$1,866.00	—	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST SCAN W/CONTRAST	$2,070.01	$2,957.15	$111.65–$2,277.01	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$272.72	$389.60	$97.89–$299.99	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$272.72	$389.60	$97.89–$299.99	—	30%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI	$220.71	$315.30	$76.29–$242.78	81% above	30%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI	$220.71	$315.30	$76.29–$242.78	81% above	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI	$220.71	$315.30	$76.29–$242.78	—	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI	$220.71	$315.30	$76.29–$242.78	—	30%
Duplex ultrasound of the leg arteries, both legs CPT 93925 PERIPH GFTS BIL LWR EXTS	$562.73	$803.90	$159.00–$762.10	24% above	30%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 PERIPH GFTS BIL LWR EXTS	$562.73	$803.90	$159.00–$762.10	—	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$832.23	$1,188.90	$159.00–$915.45	93% above	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$832.23	$1,188.90	$159.00–$915.45	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,907.47	$2,724.95	$192.19–$2,098.21	150% above	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$1,907.47	$2,724.95	$192.19–$2,098.21	—	30%
Elbow X-ray, 2 views one side CPT 73070 X ELBOW 2 VIEWS LEFT	$180.50	$257.85	$20.33–$198.54	38% above	30%
Elbow X-ray, 2 views one side CPT 73070 X ELBOW 2 VIEWS RIGHT	$180.50	$257.85	$20.33–$198.54	38% above	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 X ELBOW 2 VIEWS LEFT	$180.50	$257.85	$20.33–$198.54	—	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 X ELBOW 2 VIEWS RIGHT	$180.50	$257.85	$20.33–$198.54	—	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X ELBOW LEFT	$258.65	$369.50	$22.53–$284.52	95% above	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X ELBOW RIGHT	$258.65	$369.50	$22.53–$284.52	95% above	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X ELBOW RIGHT	$258.65	$369.50	$22.53–$284.52	—	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X ELBOW LEFT	$258.65	$369.50	$22.53–$284.52	—	30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$1,750.18	$2,500.25	$94.67–$1,925.19	188% above	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$1,750.18	$2,500.25	$94.67–$1,925.19	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 X FACIAL BONES CMPT MIN 3 VIEW	$312.20	$446.00	$40.63–$343.42	99% above	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X FACIAL BONES CMPT MIN 3 VIEW	$312.20	$446.00	$40.63–$343.42	—	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X FOREARM 2 VIEWS LEFT	$249.59	$356.55	$19.26–$274.54	117% above	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X FOREARM 2 VIEWS RIGHT	$249.59	$356.55	$19.26–$274.54	117% above	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X FOREARM 2 VIEWS RIGHT	$249.59	$356.55	$19.26–$274.54	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X FOREARM 2 VIEWS LEFT	$249.59	$356.55	$19.26–$274.54	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM CHOLESCINTIGRAM (HIDA)	$1,347.47	$1,924.95	$279.22–$1,482.21	131% above	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM CHOLESCINTIGRAM (HIDA)	$1,347.47	$1,924.95	$279.22–$1,482.21	—	30%
Hand X-ray, 2 views one side CPT 73120 X HAND 2 VIEWS LEFT	$211.51	$302.15	$21.01–$269.35	101% above	30%
Hand X-ray, 2 views one side CPT 73120 X HAND 2 VIEWS RIGHT	$211.51	$302.15	$21.01–$269.35	101% above	30%
Hand X-ray, 2 views inpatient one side CPT 73120 X HAND 2 VIEWS LEFT	$211.51	$302.15	$21.01–$269.35	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 X HAND 2 VIEWS RIGHT	$211.51	$302.15	$21.01–$269.35	—	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X HEEL RIGHT	$218.09	$311.55	$25.09–$239.89	98% above	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X HEEL LEFT	$218.09	$311.55	$25.09–$239.89	98% above	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X HEEL LEFT	$218.09	$311.55	$25.09–$239.89	—	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X HEEL RIGHT	$218.09	$311.55	$25.09–$239.89	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT & RESP EFFT	$951.23	$1,358.90	$172.89–$3,214.00	307% above	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT & RESP EFFT	$951.23	$1,358.90	$172.89–$3,214.00	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 NOCTURNAL POLSOMNOGRAPHY CPAP	$3,204.81	$4,578.30	$799.91–$3,839.00	118% above	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 NOCTURNAL POLSOMNOGRAPHY CPAP	$3,204.81	$4,578.30	$799.91–$3,839.00	—	30%
Knee X-ray, 3 views one side CPT 73562 X KNEE LEFT 3 VIEWS	$260.82	$372.60	$28.80–$286.90	90% above	30%
Knee X-ray, 3 views one side CPT 73562 X KNEE RIGHT 3 VIEWS	$260.82	$372.60	$28.80–$286.90	90% above	30%
Knee X-ray, 3 views inpatient one side CPT 73562 X KNEE LEFT 3 VIEWS	$260.82	$372.60	$28.80–$286.90	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 X KNEE RIGHT 3 VIEWS	$260.82	$372.60	$28.80–$286.90	—	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 X KNEE COMPLETE LEFT	$373.35	$533.35	$29.70–$410.68	137% above	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 X KNEE COMPLETE RIGHT	$373.35	$533.35	$29.70–$410.68	137% above	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X KNEE COMPLETE LEFT	$373.35	$533.35	$29.70–$410.68	—	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X KNEE COMPLETE RIGHT	$373.35	$533.35	$29.70–$410.68	—	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT W/O CONTRAST RT	$1,397.94	$1,997.05	$80.37–$1,866.00	129% above	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT W/O CONTRAST LT	$1,397.94	$1,997.05	$80.37–$1,866.00	129% above	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT W/O CONTRAST RT	$1,397.94	$1,997.05	$80.37–$1,866.00	—	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT W/O CONTRAST LT	$1,397.94	$1,997.05	$80.37–$1,866.00	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$645.44	$922.05	$60.34–$709.98	149% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$645.44	$922.05	$60.34–$709.98	—	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$393.75	$562.50	$31.61–$433.13	127% above	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$393.75	$562.50	$31.61–$433.13	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LOW DOSE	$963.10	$1,375.85	$97.38–$1,866.00	546% above	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LOW DOSE	$963.10	$1,375.85	$97.38–$1,866.00	—	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X TIBIA/FIBULA 2VIEWS LEFT	$247.70	$353.85	$21.00–$272.46	106% above	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X TIBIA/FIBULA 2VIEWS RIGHT	$247.70	$353.85	$21.00–$272.46	106% above	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X TIBIA/FIBULA 2VIEWS RIGHT	$247.70	$353.85	$21.00–$272.46	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X TIBIA/FIBULA 2VIEWS LEFT	$247.70	$353.85	$21.00–$272.46	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$1,955.94	$2,794.20	$222.25–$2,367.00	133% above	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$1,955.94	$2,794.20	$222.25–$2,367.00	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LO EXT ANY JOINT W/O LT	$2,213.30	$3,161.85	$138.78–$2,434.62	155% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LO EXT ANY JOINT W/O RT	$2,213.30	$3,161.85	$138.78–$2,434.62	155% above	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LO EXT ANY JOINT W/O LT	$2,213.30	$3,161.85	$138.78–$2,434.62	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LO EXT ANY JOINT W/O RT	$2,213.30	$3,161.85	$138.78–$2,434.62	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LO EXT ANY JNT W & W/O RT	$2,704.91	$3,864.15	$324.97–$2,975.40	118% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LO EXT ANY JNT W & W/O LT	$2,704.91	$3,864.15	$324.97–$2,975.40	118% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LO EXT ANY JNT W & W/O RT	$2,704.91	$3,864.15	$324.97–$2,975.40	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LO EXT ANY JNT W & W/O LT	$2,704.91	$3,864.15	$324.97–$2,975.40	—	30%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,265.76	$3,236.80	$222.25–$2,492.34	148% above	30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,265.76	$3,236.80	$222.25–$2,492.34	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & W/O	$3,494.58	$4,992.25	$245.28–$3,844.03	177% above	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & W/O	$3,494.58	$4,992.25	$245.28–$3,844.03	—	30%
MRI of the brain, no contrast dye CPT 70551 MRI HEAD W/O CONTRAST	$1,999.17	$2,855.95	$119.57–$2,367.00	91% above	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD W/O CONTRAST	$1,999.17	$2,855.95	$119.57–$2,367.00	—	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD W/ & W/O CONTRAST	$3,286.96	$4,695.65	$218.66–$3,615.65	139% above	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD W/ & W/O CONTRAST	$3,286.96	$4,695.65	$218.66–$3,615.65	—	30%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR W/O CONTRAST	$1,935.54	$2,765.05	$133.15–$2,367.00	87% above	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR W/O CONTRAST	$1,935.54	$2,765.05	$133.15–$2,367.00	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W/ & W/O CONTRAST	$3,400.57	$4,857.95	$234.60–$3,740.62	147% above	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W/ & W/O CONTRAST	$3,400.57	$4,857.95	$234.60–$3,740.62	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC W/O CONTRAST	$2,309.20	$3,298.85	$222.25–$2,540.11	141% above	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC W/O CONTRAST	$2,309.20	$3,298.85	$222.25–$2,540.11	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W/ & W/O CONT	$3,970.86	$5,672.65	$315.90–$4,367.94	189% above	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W/ & W/O CONT	$3,970.86	$5,672.65	$315.90–$4,367.94	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL W/O CONTRAST	$1,951.29	$2,787.55	$121.43–$2,367.00	106% above	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL W/O CONTRAST	$1,951.29	$2,787.55	$121.43–$2,367.00	—	30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W & W/O	$2,706.20	$3,866.00	$244.32–$2,976.82	164% above	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W & W/O	$2,706.20	$3,866.00	$244.32–$2,976.82	—	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$2,074.52	$2,963.60	$150.97–$2,367.00	152% above	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$2,074.52	$2,963.60	$150.97–$2,367.00	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT ANY JOINT W/O RT	$2,262.05	$3,231.50	$141.89–$2,488.26	164% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT ANY JOINT W/O LT	$2,262.05	$3,231.50	$141.89–$2,488.26	164% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT ANY JOINT W/O LT	$2,262.05	$3,231.50	$141.89–$2,488.26	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT ANY JOINT W/O RT	$2,262.05	$3,231.50	$141.89–$2,488.26	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X CERVICAL SP 4 OR 5 VIEWS	$384.65	$549.50	$35.37–$423.12	89% above	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X CERVICAL SP 4 OR 5 VIEWS	$384.65	$549.50	$35.37–$423.12	—	30%
Neck soft tissue CT scan with contrast CPT 70491 PET CT SOFT TISSUE NECK W CONTRAST	$1,119.06	$1,598.65	$122.11–$1,866.00	62% above	30%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TISSUE W/	$2,049.99	$2,928.55	$122.11–$2,254.98	196% above	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 PET CT SOFT TISSUE NECK W CONTRAST	$1,119.06	$1,598.65	$122.11–$1,866.00	—	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK SOFT TISSUE W/	$2,049.99	$2,928.55	$122.11–$2,254.98	—	30%
Neck soft tissue CT scan without contrast CPT 70490 PET CT SOFT TISSUE NECK W/O CONTRAST	$873.95	$1,248.50	$94.67–$1,866.00	29% above	30%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE W/O	$1,425.17	$2,035.95	$94.67–$1,866.00	111% above	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 PET CT SOFT TISSUE NECK W/O CONTRAST	$873.95	$1,248.50	$94.67–$1,866.00	—	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TISSUE W/O	$1,425.17	$2,035.95	$94.67–$1,866.00	—	30%
Neck soft tissue X-ray CPT 70360 X NECK SOFT TISSUE	$235.69	$336.70	$22.02–$259.26	90% above	30%
Neck soft tissue X-ray inpatient CPT 70360 X NECK SOFT TISSUE	$235.69	$336.70	$22.02–$259.26	—	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$2,723.25	$3,890.35	$498.91–$3,057.33	130% above	30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$2,723.25	$3,890.35	$498.91–$3,057.33	—	30%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 BB PET NETSPOT	$5,398.44	$7,712.05	$1,130.00–$5,938.28	177% above	30%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 BB PET NETSPOT	$5,398.44	$7,712.05	$1,130.00–$5,938.28	—	30%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$1,700.41	$2,429.15	$97.38–$1,870.45	146% above	30%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$1,700.41	$2,429.15	$97.38–$1,870.45	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER RESIDUAL	$416.71	$595.30	$24.12–$458.38	149% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER RESIDUAL	$416.71	$595.30	$24.12–$458.38	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC	$606.20	$866.00	$73.57–$666.82	116% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC	$606.20	$866.00	$73.57–$666.82	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB COMPLETE >14WKS	$531.79	$759.70	$87.54–$584.97	109% above	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB COMPLETE >14WKS	$531.79	$759.70	$87.54–$584.97	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB COMPLETE <14 WKS	$476.42	$680.60	$90.86–$524.06	108% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB COMPLETE <14 WKS	$476.42	$680.60	$90.86–$524.06	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$290.92	$415.60	$64.64–$320.01	68% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$290.92	$415.60	$64.64–$320.01	—	30%
Rib X-ray, one side, 2 views one side CPT 71100 X RIBS UNI NO CHEST 2 VWS LT	$237.27	$338.95	$22.74–$260.99	68% above	30%
Rib X-ray, one side, 2 views one side CPT 71100 X RIBS UNI NO CHEST 2 VWS RT	$237.27	$338.95	$22.74–$260.99	68% above	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X RIBS UNI NO CHEST 2 VWS LT	$237.27	$338.95	$22.74–$260.99	—	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X RIBS UNI NO CHEST 2 VWS RT	$237.27	$338.95	$22.74–$260.99	—	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X RIBS UNI 3 VIEWS W/CHEST RT	$314.93	$449.90	$28.44–$346.42	113% above	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X RIBS UNI 3 VIEWS W/CHEST LT	$314.93	$449.90	$28.44–$346.42	113% above	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X RIBS UNI 3 VIEWS W/CHEST RT	$314.93	$449.90	$28.44–$346.42	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X RIBS UNI 3 VIEWS W/CHEST LT	$314.93	$449.90	$28.44–$346.42	—	30%
Screening mammogram, both breasts CPT 77067 MA MAMMOGRAM DG SCREENING	$239.61	$342.30	$80.72–$263.57	88% above	30%
Screening mammogram, both breasts inpatient CPT 77067 MA MAMMOGRAM DG SCREENING	$239.61	$342.30	$80.72–$263.57	—	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X SHOULDER LEFT	$276.89	$395.55	$20.30–$304.57	110% above	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X SHOULDER RIGHT	$276.89	$395.55	$20.30–$304.57	110% above	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X SHOULDER RIGHT	$276.89	$395.55	$20.30–$304.57	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X SHOULDER LEFT	$276.89	$395.55	$20.30–$304.57	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 X SINUSES COMPLETE MIN 3 VIEWS	$291.06	$415.80	$24.87–$320.17	78% above	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X SINUSES COMPLETE MIN 3 VIEWS	$291.06	$415.80	$24.87–$320.17	—	30%
Skull X-ray, fewer than 4 views CPT 70250 X SKULL LESS THAN 4 VIEWS	$255.47	$364.95	$24.87–$281.01	93% above	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 X SKULL LESS THAN 4 VIEWS	$255.47	$364.95	$24.87–$281.01	—	30%
Sleep study in a lab (polysomnography) CPT 95810 NOCTURNAL POLYSOMNOGRAPHY	$3,062.85	$4,375.50	$799.91–$3,839.00	104% above	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 NOCTURNAL POLYSOMNOGRAPHY	$3,062.85	$4,375.50	$799.91–$3,839.00	—	30%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$1,398.39	$1,997.70	$214.21–$1,538.23	123% above	30%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE MCR	$1,431.19	$2,044.55	$214.21–$1,574.30	128% above	30%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE	$1,398.39	$1,997.70	$214.21–$1,538.23	—	30%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE MCR	$1,431.19	$2,044.55	$214.21–$1,574.30	—	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X FEMUR LT 2 OR MORE VIEWS	$242.45	$346.35	$31.75–$266.69	103% above	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X FEMUR RT 2 OR MORE VIEWS	$242.45	$346.35	$31.75–$266.69	103% above	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X FEMUR RT 2 OR MORE VIEWS	$242.45	$346.35	$31.75–$266.69	—	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X FEMUR LT 2 OR MORE VIEWS	$242.45	$346.35	$31.75–$266.69	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC W/O CONTRAST	$1,637.55	$2,339.35	$97.38–$1,866.00	116% above	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC W/O CONTRAST	$1,637.55	$2,339.35	$97.38–$1,866.00	—	30%
Toe X-ray, 2 or more views one side CPT 73660 X TOE(S) RIGHT	$199.99	$285.70	$21.56–$219.99	78% above	30%
Toe X-ray, 2 or more views one side CPT 73660 X TOE(S) LEFT	$199.99	$285.70	$21.56–$219.99	78% above	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 X TOE(S) RIGHT	$199.99	$285.70	$21.56–$219.99	—	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 X TOE(S) LEFT	$199.99	$285.70	$21.56–$219.99	—	30%
Transvaginal pelvic ultrasound CPT 76830 TRANS VAG/NON PREGNANT	$407.65	$582.35	$85.40–$448.41	91% above	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANS VAG/NON PREGNANT	$407.65	$582.35	$85.40–$448.41	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 TRANS VAG/PREGNANT	$418.99	$598.55	$73.09–$460.88	131% above	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANS VAG/PREGNANT	$418.99	$598.55	$73.09–$460.88	—	30%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$746.34	$1,066.20	$79.49–$820.97	147% above	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$746.34	$1,066.20	$79.49–$820.97	—	30%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$622.02	$888.60	$70.22–$684.22	188% above	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$622.02	$888.60	$70.22–$684.22	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$589.75	$842.50	$85.40–$648.73	134% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$589.75	$842.50	$85.40–$648.73	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X GI SERIES W ESOPHAGUS	$555.98	$794.25	$99.76–$611.57	119% above	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X GI SERIES W ESOPHAGUS	$555.98	$794.25	$99.76–$611.57	—	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X HUMERUS RIGHT	$224.98	$321.40	$23.31–$247.48	76% above	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X HUMERUS LEFT	$224.98	$321.40	$23.31–$247.48	76% above	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 X HUMERUS LEFT	$224.98	$321.40	$23.31–$247.48	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 X HUMERUS RIGHT	$224.98	$321.40	$23.31–$247.48	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$494.13	$705.90	$97.38–$543.54	92% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$494.13	$705.90	$97.38–$543.54	—	30%
Wrist X-ray, 2 views one side CPT 73100 X WRIST 2 VIEWS RIGHT	$176.96	$252.80	$24.47–$194.66	62% above	30%
Wrist X-ray, 2 views one side CPT 73100 X WRIST 2 VIEWS LEFT	$176.96	$252.80	$24.47–$194.66	62% above	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 X WRIST 2 VIEWS RIGHT	$176.96	$252.80	$24.47–$194.66	—	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 X WRIST 2 VIEWS LEFT	$176.96	$252.80	$24.47–$194.66	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X WRIST MIN 3 VIEWS LEFT	$257.43	$367.75	$27.27–$283.17	115% above	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X WRIST MIN 3 VIEWS RIGHT	$257.43	$367.75	$27.27–$283.17	115% above	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X WRIST MIN 3 VIEWS LEFT	$257.43	$367.75	$27.27–$283.17	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X WRIST MIN 3 VIEWS RIGHT	$257.43	$367.75	$27.27–$283.17	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$243.43	$347.75	$31.09–$267.77	92% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$243.43	$347.75	$31.09–$267.77	92% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$243.43	$347.75	$31.09–$267.77	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$243.43	$347.75	$31.09–$267.77	—	30%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$261.70	$373.85	$19.30–$287.86	116% above	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADEX ABDOMEN 1 VIEW	$261.70	$373.85	$19.30–$287.86	—	30%
X-ray of the ankle, 2 views one side CPT 73600 X ANKLE 2 VIEWS RT	$183.93	$262.75	$23.63–$202.32	70% above	30%
X-ray of the ankle, 2 views one side CPT 73600 X ANKLE 2 VIEWS LT	$183.93	$262.75	$23.63–$202.32	70% above	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X ANKLE 2 VIEWS LT	$183.93	$262.75	$23.63–$202.32	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X ANKLE 2 VIEWS RT	$183.93	$262.75	$23.63–$202.32	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 X FINGER(S) LEFT	$197.37	$281.95	$29.00–$217.10	92% above	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 X FINGER(S) RIGHT	$197.37	$281.95	$29.00–$217.10	92% above	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 X FINGER(S) RIGHT	$197.37	$281.95	$29.00–$217.10	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 X FINGER(S) LEFT	$197.37	$281.95	$29.00–$217.10	—	30%
X-ray of the foot, 2 views one side CPT 73620 X FOOT LEFT AP/LAT	$253.30	$361.85	$18.91–$278.62	135% above	30%
X-ray of the foot, 2 views one side CPT 73620 X FOOT RIGHT AP/LAT	$253.30	$361.85	$18.91–$278.62	135% above	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 X FOOT LEFT AP/LAT	$253.30	$361.85	$18.91–$278.62	—	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 X FOOT RIGHT AP/LAT	$253.30	$361.85	$18.91–$278.62	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X FOOT MIN 3 VIEWS RIGHT	$280.84	$401.20	$22.39–$308.92	127% above	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X FOOT MIN 3 VIEWS LEFT	$280.84	$401.20	$22.39–$308.92	127% above	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X FOOT MIN 3 VIEWS LEFT	$280.84	$401.20	$22.39–$308.92	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X FOOT MIN 3 VIEWS RIGHT	$280.84	$401.20	$22.39–$308.92	—	30%
X-ray of the hand, 3 or more views one side CPT 73130 X HAND MIN 3 VIEWS RIGHT	$256.31	$366.15	$24.13–$281.94	102% above	30%
X-ray of the hand, 3 or more views one side CPT 73130 X HAND MIN 3 VIEWS LEFT	$256.31	$366.15	$24.13–$281.94	102% above	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X HAND MIN 3 VIEWS RIGHT	$256.31	$366.15	$24.13–$281.94	—	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X HAND MIN 3 VIEWS LEFT	$256.31	$366.15	$24.13–$281.94	—	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 X KNEE LIMITED RIGHT AP/LAT	$263.69	$376.70	$23.44–$290.06	132% above	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 X KNEE LIMITED LEFT AP/LAT	$263.69	$376.70	$23.44–$290.06	132% above	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X KNEE LIMITED LEFT AP/LAT	$263.69	$376.70	$23.44–$290.06	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X KNEE LIMITED RIGHT AP/LAT	$263.69	$376.70	$23.44–$290.06	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X LUMBAR SPINE AP AND LATERAL	$353.33	$504.75	$24.83–$388.66	132% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X LUMBAR SPINE AP AND LATERAL	$353.33	$504.75	$24.83–$388.66	—	30%
X-ray of the lower back, 4 or more views CPT 72110 X LUMBOSACRAL MIN OF 4 VIEWS	$344.61	$492.30	$34.80–$379.07	59% above	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X LUMBOSACRAL MIN OF 4 VIEWS	$344.61	$492.30	$34.80–$379.07	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X THORACIC SPINE 2 VIEWS	$286.86	$409.80	$22.39–$315.55	86% above	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X THORACIC SPINE 2 VIEWS	$286.86	$409.80	$22.39–$315.55	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 X NASAL BONES CMPT MIN 3 VIEWS	$214.87	$306.95	$32.66–$236.35	83% above	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X NASAL BONES CMPT MIN 3 VIEWS	$214.87	$306.95	$32.66–$236.35	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X CERVICAL SP 3 VIEWS OR LESS	$332.29	$474.70	$25.80–$365.52	131% above	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X CERVICAL SP 3 VIEWS OR LESS	$332.29	$474.70	$25.80–$365.52	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 X PELVIS	$216.06	$308.65	$18.81–$269.35	64% above	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X PELVIS	$216.06	$308.65	$18.81–$269.35	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X SACRUM/COCCYX	$260.02	$371.45	$21.35–$286.02	86% above	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X SACRUM/COCCYX	$260.02	$371.45	$21.35–$286.02	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$171.33	$244.75	$19.31–$188.46	58% above	30%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE	$171.33	$244.75	$19.31–$188.46	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT SGPT	$49.56	$70.80	$2.65–$54.52	147% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT SGPT	$49.56	$70.80	$2.65–$54.52	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST SGOT	$49.56	$70.80	$2.59–$54.52	154% above	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST SGOT	$49.56	$70.80	$2.59–$54.52	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$224.88	$321.25	$23.82–$247.36	103% above	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$224.88	$321.25	$23.82–$247.36	—	30%
Albumin blood test CPT 82040 ALBUMIN SERUM	$38.78	$55.40	$2.48–$42.66	148% above	30%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$38.78	$55.40	$2.48–$42.66	—	30%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$216.86	$309.80	$20.38–$238.55	124% above	30%
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$216.86	$309.80	$20.38–$238.55	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$35.56	$50.80	$2.59–$39.12	90% above	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$35.56	$50.80	$2.59–$39.12	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$16.21	$23.15	$2.61–$17.83	55% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$16.21	$23.15	$2.61–$17.83	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$94.47	$134.95	$8.39–$103.91	75% above	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$94.47	$134.95	$8.39–$103.91	—	30%
Ammonia blood test CPT 82140 AMMONIA	$52.64	$75.20	$7.29–$57.90	5% above	30%
Ammonia blood test inpatient CPT 82140 AMMONIA	$52.64	$75.20	$7.29–$57.90	—	30%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$70.39	$100.55	$3.24–$77.42	215% above	30%
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE	$70.39	$100.55	$3.24–$77.42	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRUL PEPTIDE IGG ABS	$145.81	$208.30	$6.48–$160.39	220% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRUL PEPTIDE IGG ABS	$145.81	$208.30	$6.48–$160.39	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTINUCLEAR ANTIBODY	$45.85	$65.50	$6.05–$50.44	3% above	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ANTINUCLEAR ANTIBODY	$45.85	$65.50	$6.05–$50.44	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B-TYPE NATRIURETIC PEPT	$146.83	$209.75	$19.63–$161.51	120% above	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B-TYPE NATRIURETIC PEPT	$146.83	$209.75	$19.63–$161.51	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$96.95	$138.50	$4.31–$106.65	232% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$96.95	$138.50	$4.31–$106.65	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$154.32	$220.45	$4.23–$169.75	340% above	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$154.32	$220.45	$4.23–$169.75	—	30%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$31.43	$44.90	$2.51–$34.57	86% above	30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$31.43	$44.90	$2.51–$34.57	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY LEVEL IV	$140.67	$200.95	$33.76–$154.73	66% above	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY LEVEL IV	$140.67	$200.95	$33.76–$154.73	—	30%
Blood culture for bacteria CPT 87040 CULT BLOOD	$89.08	$127.25	$5.16–$97.98	98% above	30%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD	$89.08	$127.25	$5.16–$97.98	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$19.53	$27.90	$3.00–$21.48	136% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$19.53	$27.90	$3.00–$21.48	—	30%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$58.38	$83.40	$1.97–$64.22	316% above	30%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$58.38	$83.40	$1.97–$64.22	—	30%
Blood lead test CPT 83655 ASSAY OF LEAD	$102.73	$146.75	$6.06–$113.00	264% above	30%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$102.73	$146.75	$6.06–$113.00	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$89.22	$127.45	$3.76–$98.14	178% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$89.22	$127.45	$3.76–$98.14	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$27.30	$39.00	$2.99–$130.13	40% below	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$27.30	$39.00	$2.99–$130.13	—	30%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$39.45	$56.35	$1.98–$43.39	135% above	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN	$39.45	$56.35	$1.98–$43.39	—	30%
C-peptide blood test CPT 84681 C-PEPTIDE	$87.43	$124.90	$10.41–$96.17	58% above	30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$87.43	$124.90	$10.41–$96.17	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP C-REACTIVE PROTEIN	$39.66	$56.65	$2.59–$43.62	71% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP C-REACTIVE PROTEIN	$39.66	$56.65	$2.59–$43.62	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$126.95	$181.35	$18.64–$139.64	70% above	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$126.95	$181.35	$18.64–$139.64	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 TUMOR ANTIGEN	$123.73	$176.75	$10.41–$136.10	152% above	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 TUMOR ANTIGEN	$123.73	$176.75	$10.41–$136.10	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 TUMOR ANTIGEN	$143.75	$205.35	$10.41–$158.12	170% above	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 TUMOR ANTIGEN	$143.75	$205.35	$10.41–$158.12	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 NAA, AMP PROBE TECH	$50.16	$71.65	$25.66–$77.00	32% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (NON-CDC LAB) HIGH THROUGHPUT	$129.64	$185.20	$25.66–$142.60	75% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 NAA, AMP PROBE TECH	$50.16	$71.65	$25.66–$77.00	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (NON-CDC LAB) HIGH THROUGHPUT	$129.64	$185.20	$25.66–$142.60	—	30%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$63.84	$91.20	$2.58–$70.22	221% above	30%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$63.84	$91.20	$2.58–$70.22	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA CARCINOEMBRYONIC AG	$113.54	$162.20	$9.48–$124.89	92% above	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA CARCINOEMBRYONIC AG	$113.54	$162.20	$9.48–$124.89	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$68.11	$97.30	$6.44–$74.92	76% above	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY	$68.11	$97.30	$6.44–$74.92	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TACHOMATIS, PHAR SWAB NAA	$128.31	$183.30	$17.55–$141.14	111% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TACHOMATIS, PHAR SWAB NAA	$128.31	$183.30	$17.55–$141.14	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$122.26	$174.65	$6.70–$134.48	144% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$122.26	$174.65	$6.70–$134.48	—	30%
Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFFERENTIAL	$70.49	$100.70	$3.89–$77.54	162% above	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFFERENTIAL	$70.49	$100.70	$3.89–$77.54	—	30%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFFERENTIAL	$59.92	$85.60	$3.24–$65.91	114% above	30%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFFERENTIAL	$59.92	$85.60	$3.24–$65.91	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$171.89	$245.55	$5.28–$189.07	124% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$171.89	$245.55	$5.28–$189.07	—	30%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$148.19	$211.70	$8.15–$163.01	289% above	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$148.19	$211.70	$8.15–$163.01	—	30%
Creatine kinase (CK) blood test, total CPT 82550 CK TOTAL	$48.06	$68.65	$3.26–$52.86	115% above	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK TOTAL	$48.06	$68.65	$3.26–$52.86	—	30%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$52.89	$75.55	$2.56–$58.17	202% above	30%
Creatinine blood test inpatient CPT 82565 ASSAY OF CREATININE	$52.89	$75.55	$2.56–$58.17	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY IGG	$95.83	$136.90	$7.20–$105.41	143% above	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY IGG	$95.83	$136.90	$7.20–$105.41	—	30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$111.48	$159.25	$5.09–$122.62	123% above	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$111.48	$159.25	$5.09–$122.62	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE SERUM	$148.79	$212.55	$11.12–$163.66	156% above	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE SERUM	$148.79	$212.55	$11.12–$163.66	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV ANY NUMBER BY INSTRMT	$233.87	$334.10	$31.07–$257.26	642% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV ANY NUMBER BY INSTRMT	$233.87	$334.10	$31.07–$257.26	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$89.81	$128.30	$3.51–$98.79	135% above	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$89.81	$128.30	$3.51–$98.79	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA	$132.23	$188.90	$9.07–$145.45	161% above	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR CAPSID VCA	$132.23	$188.90	$9.07–$145.45	—	30%
Estradiol blood test CPT 82670 ESTRADIOL	$141.72	$202.45	$13.97–$155.89	129% above	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$141.72	$202.45	$13.97–$155.89	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$90.55	$129.35	$9.29–$99.60	58% above	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$90.55	$129.35	$9.29–$99.60	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 FECAL CALPROTECTIN	$211.26	$301.80	$9.82–$232.39	102% above	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 FECAL CALPROTECTIN	$211.26	$301.80	$9.82–$232.39	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$78.47	$112.10	$6.82–$86.32	70% above	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$78.47	$112.10	$6.82–$86.32	—	30%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$100.73	$143.90	$4.86–$110.80	224% above	30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$100.73	$143.90	$4.86–$110.80	—	30%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$78.12	$111.60	$7.35–$85.93	96% above	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$78.12	$111.60	$7.35–$85.93	—	30%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$52.68	$75.25	$8.47–$57.94	16% above	30%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$52.68	$75.25	$8.47–$57.94	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$54.50	$77.85	$4.51–$59.94	56% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$54.50	$77.85	$4.51–$59.94	—	30%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$73.08	$104.40	$12.74–$80.39	17% above	30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$73.08	$104.40	$12.74–$80.39	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP GAMMA GLUT TRANS	$54.88	$78.40	$3.60–$60.37	120% above	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP GAMMA GLUT TRANS	$54.88	$78.40	$3.60–$60.37	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$356.16	$508.80	$36.41–$391.78	85% above	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$356.16	$508.80	$36.41–$391.78	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$57.26	$81.80	$2.38–$62.99	251% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST	$57.26	$81.80	$2.38–$62.99	—	30%
Glucose tolerance test, 3 samples CPT 82951 GTT 3SPEC INCLUDES GLU	$85.47	$122.10	$6.44–$94.02	90% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3SPEC INCLUDES GLU	$85.47	$122.10	$6.44–$94.02	—	30%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY	$111.41	$159.15	$8.43–$122.55	144% above	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY	$111.41	$159.15	$8.43–$122.55	—	30%
H. pylori stool antigen test CPT 87338 H. PYLORI AG STOOL	$163.70	$233.85	$5.57–$180.06	169% above	30%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI AG STOOL	$163.70	$233.85	$5.57–$180.06	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$354.24	$506.05	$42.55–$389.66	100% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$354.24	$506.05	$42.55–$389.66	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 SINGLE ASSAY	$54.81	$78.30	$6.86–$60.29	61% above	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 SINGLE ASSAY	$54.81	$78.30	$6.86–$60.29	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W HIV 1/2 AB, SINGLE RESULT	$89.01	$127.15	$12.04–$97.91	80% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W HIV 1/2 AB, SINGLE RESULT	$89.01	$127.15	$12.04–$97.91	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS, HIGH RISK	$97.27	$138.95	$17.55–$106.99	72% above	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMAVIRUS, HIGH RISK	$97.27	$138.95	$17.55–$106.99	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED	$66.26	$94.65	$4.86–$72.88	100% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED	$66.26	$94.65	$4.86–$72.88	—	30%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$43.93	$62.75	$1.19–$48.32	302% above	30%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$43.93	$62.75	$1.19–$48.32	—	30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL	$94.40	$134.85	$6.03–$103.83	227% above	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL	$94.40	$134.85	$6.03–$103.83	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$69.23	$98.90	$5.37–$76.15	138% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$69.23	$98.90	$5.37–$76.15	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$64.05	$91.50	$5.17–$70.46	75% above	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$64.05	$91.50	$5.17–$70.46	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$78.54	$112.20	$7.14–$86.39	75% above	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$78.54	$112.20	$7.14–$86.39	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$320.32	$457.60	$21.42–$352.35	160% above	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$320.32	$457.60	$21.42–$352.35	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$46.62	$66.60	$6.60–$51.28	59% above	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$46.62	$66.60	$6.60–$51.28	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$55.09	$78.70	$9.68–$60.60	24% above	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$55.09	$78.70	$9.68–$60.60	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN HIGH SENS	$37.17	$53.10	$6.48–$40.89	15% below	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C REACTIVE PROTEIN HIGH SENS	$37.17	$53.10	$6.48–$40.89	—	30%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$127.05	$181.50	$8.96–$139.76	122% above	30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$127.05	$181.50	$8.96–$139.76	—	30%
Insulin blood test CPT 83525 INSULIN TOTAL	$72.03	$102.90	$5.72–$79.23	106% above	30%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$72.03	$102.90	$5.72–$79.23	—	30%
Iron blood test (serum iron) CPT 83540 IRON	$44.66	$63.80	$3.24–$49.13	106% above	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$44.66	$63.80	$3.24–$49.13	—	30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$44.24	$63.20	$4.37–$48.66	35% above	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$44.24	$63.20	$4.37–$48.66	—	30%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$109.87	$156.95	$4.34–$120.85	87% above	30%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$109.87	$156.95	$4.34–$120.85	—	30%
LH (luteinizing hormone) test CPT 83002 LUTEININZING HORMONE	$129.15	$184.50	$9.26–$142.07	139% above	30%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEININZING HORMONE	$129.15	$184.50	$9.26–$142.07	—	30%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$77.49	$110.70	$5.79–$85.24	174% above	30%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID	$77.49	$110.70	$5.79–$85.24	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$44.59	$63.70	$3.02–$49.05	113% above	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME	$44.59	$63.70	$3.02–$49.05	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$79.77	$113.95	$3.45–$87.74	194% above	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$79.77	$113.95	$3.45–$87.74	—	30%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$113.44	$162.05	$4.09–$124.78	121% above	30%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$113.44	$162.05	$4.09–$124.78	—	30%
Lyme disease antibody test CPT 86618 B BURDORFERI IGG AB	$78.72	$112.45	$8.52–$86.59	56% above	30%
Lyme disease antibody test inpatient CPT 86618 B BURDORFERI IGG AB	$78.72	$112.45	$8.52–$86.59	—	30%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$55.27	$78.95	$3.35–$60.79	147% above	30%
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$55.27	$78.95	$3.35–$60.79	—	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$62.20	$88.85	$6.44–$68.41	92% above	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$62.20	$88.85	$6.44–$68.41	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO HETEROPHILE SCREEN	$54.01	$77.15	$2.59–$59.41	135% above	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO HETEROPHILE SCREEN	$54.01	$77.15	$2.59–$59.41	—	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$58.49	$83.55	$6.53–$64.33	90% above	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$58.49	$83.55	$6.53–$64.33	—	30%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$154.07	$220.10	$23.91–$169.48	89% above	30%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$154.07	$220.10	$23.91–$169.48	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$86.00	$122.85	$9.20–$94.59	76% above	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$86.00	$122.85	$9.20–$94.59	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$90.20	$128.85	$9.20–$99.21	104% above	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$90.20	$128.85	$9.20–$99.21	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATHOLOGY VAG W AUTO SYSTEM	$74.24	$106.05	$13.31–$81.66	71% above	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATHOLOGY VAG W AUTO SYSTEM	$74.24	$106.05	$13.31–$81.66	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO, INTERPERATION MANUAL BY PHYSICIAN	$60.45	$86.35	$10.13–$66.49	103% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTO, INTERPERATION MANUAL BY PHYSICIAN	$60.45	$86.35	$10.13–$66.49	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$197.40	$282.00	$20.64–$217.14	115% above	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$197.40	$282.00	$20.64–$217.14	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PARTIAL THROMB TIME	$55.65	$79.50	$3.01–$61.22	168% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PARTIAL THROMB TIME	$55.65	$79.50	$3.01–$61.22	—	30%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS	$45.89	$65.55	$2.37–$50.47	172% above	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS	$45.89	$65.55	$2.37–$50.47	—	30%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$36.75	$52.50	$2.38–$40.43	108% above	30%
Potassium blood test inpatient CPT 84132 ASSAY OF SERUM POTASSIUM	$36.75	$52.50	$2.38–$40.43	—	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$1,823.22	$2,604.60	$379.53–$2,005.54	304% above	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPLOIDY	$1,823.22	$2,604.60	$379.53–$2,005.54	—	30%
Progesterone blood test CPT 84144 PROGESTERONE SERUM	$103.60	$148.00	$10.43–$113.96	86% above	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE SERUM	$103.60	$148.00	$10.43–$113.96	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$140.95	$201.35	$9.69–$155.04	115% above	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$140.95	$201.35	$9.69–$155.04	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PT PROTHROMBIN TIME	$42.14	$60.20	$2.15–$46.35	191% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT PROTHROMBIN TIME	$42.14	$60.20	$2.15–$46.35	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV ANY NUMBER DIREC OPTIAL	$29.61	$42.30	$6.30–$32.57	25% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV ANY NUMBER DIREC OPTIAL	$29.61	$42.30	$6.30–$32.57	—	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$41.58	$59.40	$8.28–$45.74	79% above	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$41.58	$59.40	$8.28–$45.74	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP GROUP A RAPID SCREEN	$45.54	$65.05	$8.27–$50.09	72% above	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP GROUP A RAPID SCREEN	$45.54	$65.05	$8.27–$50.09	—	30%
Renin blood test CPT 84244 RENIN	$141.02	$201.45	$11.00–$155.12	134% above	30%
Renin blood test inpatient CPT 84244 RENIN	$141.02	$201.45	$11.00–$155.12	—	30%
Rh blood typing CPT 86901 BLOOD TYPING RH D	$44.38	$63.40	$2.99–$48.82	107% above	30%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH D	$44.38	$63.40	$2.99–$48.82	—	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN	$37.56	$53.65	$2.84–$41.31	60% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUAN	$37.56	$53.65	$2.84–$41.31	—	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$91.74	$131.05	$7.20–$100.91	174% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$91.74	$131.05	$7.20–$100.91	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$34.02	$48.60	$1.35–$37.42	87% above	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$34.02	$48.60	$1.35–$37.42	—	30%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$49.88	$71.25	$2.41–$54.86	179% above	30%
Sodium blood test inpatient CPT 84295 ASSAY OF SERUM SODIUM	$49.88	$71.25	$2.41–$54.86	—	30%
Stool ova and parasites exam CPT 87177 OVA AND PARASITE SMEAR	$61.39	$87.70	$4.45–$67.53	103% above	30%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITE SMEAR	$61.39	$87.70	$4.45–$67.53	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL SCRN ONLY	$21.04	$30.05	$2.19–$23.14	46% above	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL SCRN ONLY	$21.04	$30.05	$2.19–$23.14	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD; IMMUNOASSAY	$59.64	$85.20	$7.96–$65.60	135% above	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD; IMMUNOASSAY	$59.64	$85.20	$7.96–$65.60	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS	$63.53	$90.75	$6.62–$69.88	124% above	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS	$63.53	$90.75	$6.62–$69.88	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$47.43	$67.75	$2.14–$52.17	248% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$47.43	$67.75	$2.14–$52.17	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUNATIFERON TB GOLD	$231.98	$331.40	$30.99–$255.18	85% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUNATIFERON TB GOLD	$231.98	$331.40	$30.99–$255.18	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$135.42	$193.45	$12.91–$148.96	126% above	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$135.42	$193.45	$12.91–$148.96	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EA	$100.00	$142.85	$7.28–$109.99	159% above	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EA	$100.00	$142.85	$7.28–$109.99	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$113.79	$162.55	$8.40–$125.16	176% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$113.79	$162.55	$8.40–$125.16	—	30%
Total IgE blood test CPT 82785 IGE GAMMAGLOBULIN	$84.63	$120.90	$8.23–$93.09	120% above	30%
Total IgE blood test inpatient CPT 82785 IGE GAMMAGLOBULIN	$84.63	$120.90	$8.23–$93.09	—	30%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$26.95	$38.50	$2.18–$29.65	75% above	30%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$26.95	$38.50	$2.18–$29.65	—	30%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL	$40.46	$57.80	$3.44–$44.51	57% above	30%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL	$40.46	$57.80	$3.44–$44.51	—	30%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$91.56	$130.80	$7.09–$100.72	108% above	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$91.56	$130.80	$7.09–$100.72	—	30%
Transferrin blood test CPT 84466 TRANSFERRIN	$86.73	$123.90	$6.38–$95.40	113% above	30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$86.73	$123.90	$6.38–$95.40	—	30%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMP PROBE	$127.05	$181.50	$17.55–$139.76	130% above	30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMP PROBE	$127.05	$181.50	$17.55–$139.76	—	30%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$68.43	$97.75	$2.87–$75.27	186% above	30%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES	$68.43	$97.75	$2.87–$75.27	—	30%
Troponin test, quantitative CPT 84484 TROPONIN I QUANTITATIVE	$124.15	$177.35	$6.24–$136.56	195% above	30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANTITATIVE	$124.15	$177.35	$6.24–$136.56	—	30%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$46.03	$65.75	$2.26–$50.63	163% above	30%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$46.03	$65.75	$2.26–$50.63	—	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICRO	$58.42	$83.45	$1.59–$64.26	140% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICRO	$58.42	$83.45	$1.59–$64.26	—	30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$32.41	$46.30	$1.13–$35.65	267% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$32.41	$46.30	$1.13–$35.65	—	30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$23.59	$33.70	$1.74–$25.95	235% above	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$23.59	$33.70	$1.74–$25.95	—	30%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE MIDSTREAM	$71.30	$101.85	$4.04–$78.42	94% above	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE MIDSTREAM	$71.30	$101.85	$4.04–$78.42	—	30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24 HR URINE	$32.34	$46.20	$2.89–$35.57	64% above	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24 HR URINE	$32.34	$46.20	$2.89–$35.57	—	30%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$91.56	$130.80	$4.31–$100.72	349% above	30%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$91.56	$130.80	$4.31–$100.72	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$78.12	$111.60	$7.54–$85.93	95% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$78.12	$111.60	$7.54–$85.93	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$144.83	$206.90	$14.80–$159.31	87% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$144.83	$206.90	$14.80–$159.31	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1 25-	$119.63	$170.90	$19.25–$131.59	17% above	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1 25-	$119.63	$170.90	$19.25–$131.59	—	30%
Zinc blood test CPT 84630 ZINC SERUM	$75.53	$107.90	$5.70–$83.08	130% above	30%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$75.53	$107.90	$5.70–$83.08	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QUANTITATIVE	$131.78	$188.25	$7.53–$144.95	165% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM QUANTITATIVE	$131.78	$188.25	$7.53–$144.95	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MAMMO STEROTACT BX 1ST LESION	$1,755.57	$2,507.95	$1,076.43–$7,581.00	132% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 MAMMO STEROTACT BX 1ST LESION	$1,755.57	$2,507.95	$1,076.43–$7,581.00	—	30%
Cardiac catheterization with coronary angiogram one side CPT 93458 LEFT HEART CATH	$10,161.52	$14,516.45	$3,019.82–$32,659.00	116% above	30%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 LEFT HEART CATH	$10,161.52	$14,516.45	$3,019.82–$32,659.00	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,108.00	$1,582.85	$118.58–$1,289.22	84% above	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,108.00	$1,582.85	$118.58–$1,289.22	—	30%
Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$42,712.01	$61,017.15	$6,386.00–$49,110.04	164% above	30%
Catheter ablation for atrial fibrillation inpatient CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$42,712.01	$61,017.15	$6,386.00–$49,110.04	—	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION-IP	$819.53	$1,170.75	$608.79–$5,475.00	28% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION-IP	$819.53	$1,170.75	$608.79–$5,475.00	—	30%
Coronary stent placement, one artery CPT 92928 STENT W/WO PTCA	$11,096.75	$15,852.50	$672.29–$23,812.06	25% above	30%
Coronary stent placement, one artery inpatient CPT 92928 STENT W/WO PTCA	$11,096.75	$15,852.50	$672.29–$23,812.06	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,741.88	$2,488.40	$273.40–$2,916.00	166% above	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,741.88	$2,488.40	$273.40–$2,916.00	—	30%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$66.68	$95.25	$49.53–$1,172.00	3% above	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX	$66.68	$95.25	$49.53–$1,172.00	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL/THORACIC INJECTION	$1,179.92	$1,685.60	$120.62–$2,916.00	56% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL/THORACIC INJECTION	$1,179.92	$1,685.60	$120.62–$2,916.00	—	30%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET JT LUM/SAC UNI 1ST	$1,340.68	$1,915.25	$800.89–$2,916.00	86% above	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET JT LUM/SAC UNI 1ST	$1,340.68	$1,915.25	$800.89–$2,916.00	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$713.86	$1,019.80	$410.50–$1,172.00	440% above	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETER FOR HYSTEROGRAPHY	$713.86	$1,019.80	$410.50–$1,172.00	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$253.47	$362.10	$153.93–$1,172.00	16% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$253.47	$362.10	$186.89–$1,399.00	16% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D SC ABSCESS SIMPLE	$438.97	$627.10	$186.89–$1,172.00	101% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$253.47	$362.10	$153.93–$1,172.00	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$253.47	$362.10	$186.89–$1,399.00	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D SC ABSCESS SIMPLE	$438.97	$627.10	$186.89–$1,172.00	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ZZ X INJ JT/BURSA SHO HIP KNEE	$638.61	$912.30	$129.75–$2,916.00	147% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JOINT	$638.61	$912.30	$285.92–$1,172.00	147% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JOINT	$638.61	$912.30	$285.92–$1,172.00	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ZZ X INJ JT/BURSA SHO HIP KNEE	$638.61	$912.30	$129.75–$2,916.00	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$475.97	$679.95	$108.39–$2,916.00	84% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMED JOINT	$475.97	$679.95	$285.92–$1,172.00	84% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMED JOINT	$475.97	$679.95	$285.92–$1,172.00	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$475.97	$679.95	$108.39–$2,916.00	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ZZ X ARTH-TESIS SM(FINGER TOE	$139.65	$199.50	$103.74–$2,916.00	46% below	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ZZ X ARTH-TESIS SM(FINGER TOE	$139.65	$199.50	$103.74–$2,916.00	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INT 2.5 CM OR LESS	$438.10	$625.85	$290.00–$1,172.00	25% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INT 2.5 CM OR LESS	$438.10	$625.85	$290.00–$1,172.00	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR/SACRAL INJECTION	$2,545.80	$3,636.85	$109.84–$2,916.00	228% above	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR/SACRAL INJECTION	$2,545.80	$3,636.85	$109.84–$2,916.00	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORA EPIDURAL L/S	$1,365.67	$1,950.95	$823.88–$2,916.00	122% above	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORA EPIDURAL L/S	$1,365.67	$1,950.95	$823.88–$2,916.00	—	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$272.93	$389.90	$186.89–$1,399.00	82% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$272.93	$389.90	$186.89–$1,399.00	—	30%
Pacemaker implant (dual chamber) CPT 33208 INSERT PM DUAL W/O VENOGRAM	$5,421.92	$7,745.60	$4,027.71–$33,789.00	49% below	30%
Pacemaker implant (dual chamber) CPT 33208 INSERT PM DUAL W/VENOGRAM	$6,857.31	$9,796.15	$5,094.00–$33,789.00	35% below	30%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT PM DUAL W/O VENOGRAM	$5,421.92	$7,745.60	$4,027.71–$33,789.00	—	30%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT PM DUAL W/VENOGRAM	$6,857.31	$9,796.15	$5,094.00–$33,789.00	—	30%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,590.33	$2,271.90	$844.85–$4,206.00	170% above	30%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,590.33	$2,271.90	$844.85–$4,206.00	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$573.37	$819.10	$290.00–$1,172.00	38% above	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$573.37	$819.10	$290.00–$1,172.00	—	30%
Prostate biopsy CPT 55700 MRI PROSTATE BIOPSY	$2,760.42	$3,943.45	$1,136.38–$5,248.00	262% above	30%
Prostate biopsy inpatient CPT 55700 MRI PROSTATE BIOPSY	$2,760.42	$3,943.45	$1,136.38–$5,248.00	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT NERVE LUM/SAC SINGLE	$2,381.72	$3,402.45	$1,172.00–$9,681.00	134% above	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT NERVE LUM/SAC SINGLE	$2,381.72	$3,402.45	$1,172.00–$9,681.00	—	30%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$397.08	$567.25	$294.97–$1,399.00	43% above	30%
Removal of a foreign object under the skin, simple CPT 10120 REM OF FB SC SIMPLE	$397.08	$567.25	$290.00–$1,172.00	43% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REM OF FB SC SIMPLE	$397.08	$567.25	$290.00–$1,172.00	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$397.08	$567.25	$294.97–$1,399.00	—	30%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$11,726.16	$16,751.65	$3,191.86–$13,610.00	192% above	30%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$11,726.16	$16,751.65	$3,191.86–$13,610.00	—	30%
Short arm splint (forearm and hand) one side CPT 29125 APPLY FOREARM SPLINT - RIGHT	$301.63	$430.90	$123.93–$331.79	129% above	30%
Short arm splint (forearm and hand) one side CPT 29125 APPLY FOREARM SPLINT - LEFT	$301.63	$430.90	$120.47–$331.79	129% above	30%
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLY FOREARM SPLINT - LEFT	$301.63	$430.90	$120.47–$331.79	—	30%
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLY FOREARM SPLINT - RIGHT	$301.63	$430.90	$123.93–$331.79	—	30%
Short leg splint (calf to foot) CPT 29515 APPLY LOWER LEG SPLINT	$230.13	$328.75	$151.37–$321.40	49% above	30%
Short leg splint (calf to foot) one side CPT 29515 APPLY LOWER LEG SPLINT LT	$230.13	$328.75	$151.37–$321.40	49% above	30%
Short leg splint (calf to foot) one side CPT 29515 APPLY LOWER LEG SPLINT RT	$230.13	$328.75	$151.37–$321.40	49% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY LOWER LEG SPLINT	$230.13	$328.75	$151.37–$321.40	—	30%
Short leg splint (calf to foot) inpatient one side CPT 29515 APPLY LOWER LEG SPLINT LT	$230.13	$328.75	$151.37–$321.40	—	30%
Short leg splint (calf to foot) inpatient one side CPT 29515 APPLY LOWER LEG SPLINT RT	$230.13	$328.75	$151.37–$321.40	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE < 2.5 CM	$471.42	$673.45	$186.89–$1,172.00	138% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE < 2.5 CM	$471.42	$673.45	$186.89–$1,172.00	—	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$260.40	$372.00	$175.55–$1,399.00	16% below	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$260.40	$372.00	$175.55–$1,399.00	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP DIAGNOSTIC	$542.43	$774.90	$402.95–$2,916.00	18% above	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$1,053.68	$1,505.25	$290.00–$1,502.12	130% above	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP DIAGNOSTIC	$542.43	$774.90	$402.95–$2,916.00	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$1,053.68	$1,505.25	$290.00–$1,502.12	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE 2.6 - 7.5 CM	$518.32	$740.45	$186.89–$570.15	164% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE 2.6 - 7.5 CM	$518.32	$740.45	$186.89–$570.15	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE 2.5 CM OR LESS	$373.35	$533.35	$186.89–$419.91	92% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE 2.5 CM OR LESS	$373.35	$533.35	$186.89–$419.91	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$260.40	$372.00	$142.67–$1,399.00	35% above	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$260.40	$372.00	$142.67–$1,399.00	—	30%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$2,000.85	$2,858.35	$584.33–$2,916.00	209% above	30%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$2,000.85	$2,858.35	$584.33–$2,916.00	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BRST BX W PLCMT 1ST LESION	$1,755.57	$2,507.95	$635.60–$7,581.00	57% above	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BRST BX W PLCMT 1ST LESION	$1,755.57	$2,507.95	$635.60–$7,581.00	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBQ TISS 20CM2 OR <	$565.81	$808.30	$290.00–$3,685.00	36% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$565.81	$808.30	$378.66–$5,248.00	36% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$565.81	$808.30	$378.66–$5,248.00	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBQ TISS 20CM2 OR <	$565.81	$808.30	$290.00–$3,685.00	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 PTB4 TRANSFUSION 3 UNITS	$636.48	$909.25	$254.00–$1,172.00	34% above	30%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$650.09	$928.70	$254.00–$1,172.00	37% above	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PTB4 TRANSFUSION 3 UNITS	$636.48	$909.25	$254.00–$1,172.00	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPNT	$650.09	$928.70	$254.00–$1,172.00	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$82.78	$118.25	$61.49–$1,048.00	12% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$82.78	$118.25	$61.49–$442.09	12% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$82.78	$118.25	$61.49–$1,048.00	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$82.78	$118.25	$61.49–$442.09	—	30%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$623.14	$890.20	$307.68–$685.45	113% above	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$623.14	$890.20	$307.68–$685.45	—	30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$2,124.75	$3,035.35	$769.44–$4,083.00	153% above	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$2,124.75	$3,035.35	$769.44–$4,083.00	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG MCR	$117.71	$168.15	$12.39–$349.00	44% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$257.88	$368.40	$12.39–$349.00	215% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG IN ICU	$257.95	$368.50	$12.39–$349.00	215% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG IN EMERGENCY DEPT	$309.46	$442.08	$12.39–$349.00	278% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG MCR	$117.71	$168.15	$12.39–$349.00	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$257.88	$368.40	$12.39–$349.00	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG IN ICU	$257.95	$368.50	$12.39–$349.00	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG IN EMERGENCY DEPT	$309.46	$442.08	$12.39–$349.00	—	30%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$857.12	$1,224.45	$500.00–$942.83	64% above	30%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY	$857.12	$1,224.45	$500.00–$942.83	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$303.00	$432.85	$54.72–$413.00	127% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$303.00	$432.85	$54.72–$413.00	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$390.08	$557.25	$143.02–$681.48	129% above	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$390.08	$557.25	$143.02–$681.48	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$592.45	$846.35	$254.28–$1,189.44	120% above	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$592.45	$846.35	$254.28–$1,189.44	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$1,042.16	$1,488.80	$388.67–$2,200.00	145% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$1,042.16	$1,488.80	$388.67–$2,200.00	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,525.44	$2,179.20	$554.73–$3,172.00	186% above	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,525.44	$2,179.20	$554.73–$3,172.00	—	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$657.65	$939.50	$48.41–$723.42	93% above	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$657.65	$939.50	$48.41–$723.42	—	30%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$277.83	$396.90	$120.18–$305.61	122% above	30%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY WITH PT IOP	$277.83	$396.90	$165.33–$305.61	122% above	30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY WITH PT IOP	$277.83	$396.90	$165.33–$305.61	—	30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PT 50 MIN	$277.83	$396.90	$120.18–$305.61	—	30%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PT PHP	$262.40	$374.85	$165.33–$300.00	99% above	30%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY WITHOUT PT IOP	$262.40	$374.85	$165.33–$288.63	99% above	30%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY WITHOUT PT OP	$262.40	$374.85	$116.10–$288.63	99% above	30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY WITHOUT PT OP	$262.40	$374.85	$116.10–$288.63	—	30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY W/O PT PHP	$262.40	$374.85	$165.33–$300.00	—	30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY WITHOUT PT IOP	$262.40	$374.85	$165.33–$288.63	—	30%
Group psychotherapy session CPT 90853 GROUP THERAPY IOP	$183.12	$261.60	$94.63–$201.43	88% above	30%
Group psychotherapy session CPT 90853 GROUP THERAPY OP	$183.12	$261.60	$52.38–$201.43	88% above	30%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY IOP	$183.12	$261.60	$94.63–$201.43	—	30%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY OP	$183.12	$261.60	$52.38–$201.43	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$339.01	$484.30	$192.60–$875.00	100% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$339.01	$484.30	$192.60–$875.00	—	30%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$351.68	$502.40	$192.60–$875.00	67% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$351.68	$502.40	$192.60–$875.00	—	30%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$196.32	$280.45	$145.83–$875.00	78% above	30%
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$196.32	$280.45	$145.83–$875.00	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SC/IM	$103.64	$148.05	$62.94–$175.00	84% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX INJ SQ/IM	$103.64	$148.05	$21.46–$2,367.00	84% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$103.64	$148.05	$65.20–$875.00	84% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SC/IM	$103.64	$148.05	$62.94–$175.00	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$103.64	$148.05	$65.20–$875.00	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TX INJ SQ/IM	$103.64	$148.05	$21.46–$2,367.00	—	30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$240.73	$343.90	$165.33–$287.00	103% above	30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$240.73	$343.90	$165.33–$287.00	—	30%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN	$142.70	$203.85	$49.74–$175.00	87% above	30%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30 MIN	$142.70	$203.85	$49.74–$175.00	—	30%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN	$172.38	$246.25	$54.20–$189.61	86% above	30%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45 MIN	$172.38	$246.25	$54.20–$189.61	—	30%
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN	$196.11	$280.15	$59.79–$215.72	71% above	30%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60 MIN	$196.11	$280.15	$59.79–$215.72	—	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$115.54	$165.05	$39.67–$175.00	94% above	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15 MIN	$115.54	$165.05	$39.67–$175.00	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION ASSESSMENT PER 15 MINUTES	$49.14	$70.20	$29.39–$170.00	59% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION ASSESSMENT PER 15 MIN HIC	$55.37	$79.10	$29.39–$170.00	79% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT ASSESS INDIV /15 MIN	$64.37	$91.95	$29.39–$170.00	109% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION ASSESSMENT PER 15 MINUTES	$49.14	$70.20	$29.39–$170.00	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION ASSESSMENT PER 15 MIN HIC	$55.37	$79.10	$29.39–$170.00	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT ASSESS INDIV /15 MIN	$64.37	$91.95	$29.39–$170.00	—	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS 60 MIN HIC	$280.32	$400.45	$163.74–$308.35	196% above	30%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS 60 MIN HIC	$280.32	$400.45	$163.74–$308.35	—	30%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN PHP	$196.04	$280.05	$145.63–$300.00	106% above	30%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN IOP	$196.04	$280.05	$145.63–$215.64	106% above	30%
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES	$196.04	$280.05	$78.93–$215.64	106% above	30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN PHP	$196.04	$280.05	$145.63–$300.00	—	30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN IOP	$196.04	$280.05	$145.63–$215.64	—	30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX W PT 30 MINUTES	$196.04	$280.05	$78.93–$215.64	—	30%
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES	$207.48	$296.40	$105.01–$228.23	57% above	30%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN IOP	$207.48	$296.40	$154.13–$228.23	57% above	30%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN PHP	$207.48	$296.40	$154.13–$300.00	57% above	30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN IOP	$207.48	$296.40	$154.13–$228.23	—	30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN PHP	$207.48	$296.40	$154.13–$300.00	—	30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX W PT 45 MINUTES	$207.48	$296.40	$105.01–$228.23	—	30%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN IOP	$256.76	$366.80	$165.33–$282.44	126% above	30%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN PHP	$256.76	$366.80	$165.33–$300.00	126% above	30%
Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MINUTES	$256.76	$366.80	$157.00–$282.44	126% above	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX W PT 60 MINUTES	$256.76	$366.80	$157.00–$282.44	—	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN PHP	$256.76	$366.80	$165.33–$300.00	—	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN IOP	$256.76	$366.80	$165.33–$282.44	—	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESS 3-10 MIN SYMPT	$50.05	$71.50	$34.90–$170.00	161% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESS 3-10 MIN SYMPT	$50.05	$71.50	$34.90–$170.00	—	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN	$172.38	$246.25	$53.64–$189.61	128% above	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40 MIN	$172.38	$246.25	$53.64–$189.61	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$126.00	$180.00	$36.89–$175.00	122% above	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20 MIN	$126.00	$180.00	$36.89–$175.00	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$142.80	$204.00	$46.38–$175.00	116% above	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN	$142.80	$204.00	$46.38–$175.00	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$107.87	$154.10	$30.74–$175.00	101% above	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10 MIN	$107.87	$154.10	$30.74–$175.00	—	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 INITIAL CONSULT NO F/U	$125.83	$179.75	$41.92–$175.00	at median	30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 INITIAL CONSULT NO F/U	$125.83	$179.75	$41.92–$175.00	—	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 INITIAL CONSULT WITH F/U	$152.01	$217.15	$45.82–$175.00	3% above	30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 INITIAL CONSULT WITH F/U	$152.01	$217.15	$45.82–$175.00	—	30%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$151.41	$216.30	$112.48–$1,048.00	19% above	30%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$151.41	$216.30	$112.48–$1,048.00	—	30%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE AND POST	$468.62	$669.45	$26.96–$1,048.00	110% above	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE AND POST	$468.62	$669.45	$26.96–$1,048.00	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$198.45	$283.50	$123.93–$3,685.00	91% above	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$198.45	$283.50	$123.93–$3,685.00	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS B VACCINE ADMIN.	$66.26	$94.65	$19.31–$89.00	64% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$83.86	$119.80	$19.31–$92.25	108% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS B VACCINE ADMIN.	$66.26	$94.65	$19.31–$89.00	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$83.86	$119.80	$19.31–$92.25	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$69.58	$99.40	$14.92–$89.00	153% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD	$69.58	$99.40	$14.92–$89.00	—	30%

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.brgeneral.org/sites/default/files/721025017_baton-rouge-general-medical-center_standardcharges.zip