Halifax Health /UF Health Medical Center
Listed in its price file as “medical center of deltona inc”.
Halifax Health /UF Health Medical Center in Deltona, FL publishes cash prices for 302 common procedures listed here, from its own machine-readable price file updated Aug 5, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Florida median for 209 of 300 procedures and above it for 82. By typical cash price it ranks #49 of 151 Florida hospitals and #1 of 8 hospitals in the Deltona, FL area, cheapest first. Click a procedure to compare it with other hospitals nearby.
3300 Halifax Crossing Blv, Deltona FL 32725 Collected Sep 27, 2026 Source price file (386) 425-4806
Acute care hospital Emergency department CCN 100330 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Florida | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 XRAY ANKLE COMP MIN 3VW | $644.00 | $805.00 | $231.84–$764.75 | 7% above | 20% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XRAY ANKLE,RTCOMP MIN 3VW | $644.00 | $805.00 | $231.84–$764.75 | 7% above | 20% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XRAY ANKLE,LT COMP MIN 3VW | $644.00 | $805.00 | $231.84–$764.75 | 7% above | 20% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XRAY ANKLE,LT COMP MIN 3VW | $644.00 | $805.00 | $231.84–$764.75 | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XRAY ANKLE,RTCOMP MIN 3VW | $644.00 | $805.00 | $231.84–$764.75 | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XRAY ANKLE COMP MIN 3VW | $644.00 | $805.00 | $231.84–$764.75 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 TRANS ASSMT HBO BILAT 1-2 | $245.60 | $307.00 | $88.42–$291.65 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI,SINGLE LEVEL | $840.00 | $1,050.00 | $302.40–$997.50 | 9% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ARTERIAL ABI-SEGMTL DOPPLR LTD | $840.00 | $1,050.00 | $302.40–$997.50 | 9% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 TRANS ASSMT HBO UNILAT 1-2 | $176.80 | $221.00 | $63.65–$209.95 | 81% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 TRANS ASSMT HBO UNILAT 3 OR > | $176.80 | $221.00 | $63.65–$209.95 | 81% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 TRANS ASSMT HBO BILAT 1-2 | $245.60 | $307.00 | $88.42–$291.65 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ARTERIAL ABI-SEGMTL DOPPLR LTD | $840.00 | $1,050.00 | $302.40–$997.50 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI,SINGLE LEVEL | $840.00 | $1,050.00 | $302.40–$997.50 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 TRANS ASSMT HBO UNILAT 3 OR > | $176.80 | $221.00 | $63.65–$209.95 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 TRANS ASSMT HBO UNILAT 1-2 | $176.80 | $221.00 | $63.65–$209.95 | — | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XRAY ESOPHAGUS w/Barium | $840.00 | $1,050.00 | $302.40–$997.50 | 16% below | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM | $840.00 | $1,050.00 | $302.40–$997.50 | 16% below | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XRAY GASTROGRAFIN SW | $840.00 | $1,050.00 | $302.40–$997.50 | 16% below | 20% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XRAY GASTROGRAFIN SW | $840.00 | $1,050.00 | $302.40–$997.50 | — | 20% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM | $840.00 | $1,050.00 | $302.40–$997.50 | — | 20% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XRAY ESOPHAGUS w/Barium | $840.00 | $1,050.00 | $302.40–$997.50 | — | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN WB | $3,612.00 | $4,515.00 | $1,300.32–$4,289.25 | 23% above | 20% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN WB | $3,612.00 | $4,515.00 | $1,300.32–$4,289.25 | — | 20% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE | $371.20 | $464.00 | $133.63–$440.80 | 36% below | 20% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE | $371.20 | $464.00 | $133.63–$440.80 | — | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED | $369.60 | $462.00 | $133.06–$438.90 | 20% below | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,LT UNILAT LYMPH INJ | $369.60 | $462.00 | $133.06–$438.90 | 20% below | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,LT UNILATERAL | $369.60 | $462.00 | $133.06–$438.90 | 20% below | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,RT UNILATERAL | $369.60 | $462.00 | $133.06–$438.90 | 20% below | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,RT UNILAT LYMPH INJ | $369.60 | $462.00 | $133.06–$438.90 | 20% below | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED | $369.60 | $462.00 | $133.06–$438.90 | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,LT UNILAT LYMPH INJ | $369.60 | $462.00 | $133.06–$438.90 | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,RT UNILATERAL | $369.60 | $462.00 | $133.06–$438.90 | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,RT UNILAT LYMPH INJ | $369.60 | $462.00 | $133.06–$438.90 | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,LT UNILATERAL | $369.60 | $462.00 | $133.06–$438.90 | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W AND WO | $4,600.00 | $5,750.00 | $1,656.00–$5,462.50 | 3% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W AND WO | $4,600.00 | $5,750.00 | $1,656.00–$5,462.50 | — | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEARTFLOW/FFRCT | $1,712.00 | $2,140.00 | $616.32–$2,033.00 | 14% below | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HRT CORON W/CONT W/3D | $1,712.00 | $2,140.00 | $616.32–$2,033.00 | 14% below | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HEARTFLOW/FFRCT | $1,712.00 | $2,140.00 | $616.32–$2,033.00 | — | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HRT CORON W/CONT W/3D | $1,712.00 | $2,140.00 | $616.32–$2,033.00 | — | 20% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O CONT W/EVAL CALC | $752.00 | $940.00 | $270.72–$893.00 | 48% above | 20% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O CONT W/EVAL CALC | $752.00 | $940.00 | $270.72–$893.00 | — | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL W/O IV CONTRAST | $6,120.00 | $7,650.00 | $2,203.20–$7,267.50 | 8% below | 20% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL W/O IV CONTRAST | $6,120.00 | $7,650.00 | $2,203.20–$7,267.50 | — | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W IV CONTRAST | $8,168.00 | $10,210.00 | $2,940.48–$9,699.50 | 10% above | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W IV CONTRAST | $8,168.00 | $10,210.00 | $2,940.48–$9,699.50 | — | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL W & W/O IV CONTRAST | $8,156.00 | $10,195.00 | $2,936.16–$9,685.25 | 3% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL W & W/O IV CONTRAST | $8,156.00 | $10,195.00 | $2,936.16–$9,685.25 | — | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN ABDOMEN W | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 11% below | 20% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT SCAN ABDOMEN W | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN ABD W/O | $2,600.00 | $3,250.00 | $936.00–$3,087.50 | 37% below | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT COLONOGRAPHY | $2,600.00 | $3,250.00 | $936.00–$3,087.50 | 37% below | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT COLONOGRAPHY | $2,600.00 | $3,250.00 | $936.00–$3,087.50 | — | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT SCAN ABD W/O | $2,600.00 | $3,250.00 | $936.00–$3,087.50 | — | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN LTD SINUSES | $704.00 | $880.00 | $253.44–$836.00 | 77% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN ORAL RECON-DUAL | $704.00 | $880.00 | $253.44–$836.00 | 77% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN ORAL RECON-SINGLE | $704.00 | $880.00 | $253.44–$836.00 | 77% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN ZYGOMATIC ARCHES | $704.00 | $880.00 | $253.44–$836.00 | 77% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 DENTA SCAN | $704.00 | $880.00 | $253.44–$836.00 | 77% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN TMJ W/O | $704.00 | $880.00 | $253.44–$836.00 | 77% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES WO CON 3D | $2,648.00 | $3,310.00 | $953.28–$3,144.50 | 14% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN SINUSES W/O CONTR | $2,648.00 | $3,310.00 | $953.28–$3,144.50 | 14% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN FACIAL BONES W/O | $2,648.00 | $3,310.00 | $953.28–$3,144.50 | 14% below | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN ORAL RECON-SINGLE | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN TMJ W/O | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 DENTA SCAN | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN ZYGOMATIC ARCHES | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN LTD SINUSES | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN ORAL RECON-DUAL | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN FACIAL BONES W/O | $2,648.00 | $3,310.00 | $953.28–$3,144.50 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN SINUSES W/O CONTR | $2,648.00 | $3,310.00 | $953.28–$3,144.50 | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES WO CON 3D | $2,648.00 | $3,310.00 | $953.28–$3,144.50 | — | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD W/O | $3,120.00 | $3,900.00 | $1,123.20–$3,705.00 | 7% below | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT SCAN HEAD W/O | $3,120.00 | $3,900.00 | $1,123.20–$3,705.00 | — | 20% |
| CT scan of the head with contrast CPT 70460 CT SCAN HEAD WITH | $3,048.00 | $3,810.00 | $1,097.28–$3,619.50 | 21% below | 20% |
| CT scan of the head with contrast CPT 70460 CISTERNOGRAM OF THE BRAIN | $3,049.60 | $3,812.00 | $1,097.86–$3,621.40 | 21% below | 20% |
| CT scan of the head with contrast inpatient CPT 70460 CT SCAN HEAD WITH | $3,048.00 | $3,810.00 | $1,097.28–$3,619.50 | — | 20% |
| CT scan of the head with contrast inpatient CPT 70460 CISTERNOGRAM OF THE BRAIN | $3,049.60 | $3,812.00 | $1,097.86–$3,621.40 | — | 20% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN HEAD BOTH | $3,952.00 | $4,940.00 | $1,422.72–$4,693.00 | 10% below | 20% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT SCAN HEAD BOTH | $3,952.00 | $4,940.00 | $1,422.72–$4,693.00 | — | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN LUM SP/WO | $3,628.00 | $4,535.00 | $1,306.08–$4,308.25 | at median | 20% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SCAN LUM SP/WO | $3,628.00 | $4,535.00 | $1,306.08–$4,308.25 | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN CERV SPWO | $3,940.00 | $4,925.00 | $1,418.40–$4,678.75 | 1% above | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SCAN CERV SPWO | $3,940.00 | $4,925.00 | $1,418.40–$4,678.75 | — | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN PELVIS W | $3,516.00 | $4,395.00 | $1,265.76–$4,175.25 | 16% below | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT SCAN PELVIS W | $3,516.00 | $4,395.00 | $1,265.76–$4,175.25 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID ART BILAT | $1,700.00 | $2,125.00 | $612.00–$2,018.75 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUPLEX SCAN CAROTIDS BIL | $1,700.00 | $2,125.00 | $612.00–$2,018.75 | 38% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID ART BILAT | $1,700.00 | $2,125.00 | $612.00–$2,018.75 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX SCAN CAROTIDS BIL | $1,700.00 | $2,125.00 | $612.00–$2,018.75 | — | 20% |
| Chest X-ray, 2 views both sides CPT 71046 CHEST.DECUB BILATERAL | $744.00 | $930.00 | $267.84–$883.50 | — | 20% |
| Chest X-ray, 2 views CPT 71046 XRAY CHEST,TWO VW,EMPLOYMED | $83.20 | $104.00 | $29.95–$98.80 | 84% below | 20% |
| Chest X-ray, 2 views CPT 71046 XRAY CHEST PA & LAT | $744.00 | $930.00 | $267.84–$883.50 | 45% above | 20% |
| Chest X-ray, 2 views CPT 71046 XRAY CHEST W/NIPPLE | $784.00 | $980.00 | $282.24–$931.00 | 53% above | 20% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 CHEST.DECUB BILATERAL | $744.00 | $930.00 | $267.84–$883.50 | — | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 XRAY CHEST,TWO VW,EMPLOYMED | $83.20 | $104.00 | $29.95–$98.80 | — | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 XRAY CHEST PA & LAT | $744.00 | $930.00 | $267.84–$883.50 | — | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 XRAY CHEST W/NIPPLE | $784.00 | $980.00 | $282.24–$931.00 | — | 20% |
| Chest X-ray, single view CPT 71045 XRAY CHEST,ONE VW,EMPLOYMED | $79.20 | $99.00 | $28.51–$94.05 | 83% below | 20% |
| Chest X-ray, single view CPT 71045 XRAY CHEST AP | $540.00 | $675.00 | $194.40–$641.25 | 16% above | 20% |
| Chest X-ray, single view CPT 71045 XRAY CHEST,LATERAL ONLY | $540.00 | $675.00 | $194.40–$641.25 | 16% above | 20% |
| Chest X-ray, single view CPT 71045 INFANT CHEST WITH ABDOMEN | $540.00 | $675.00 | $194.40–$641.25 | 16% above | 20% |
| Chest X-ray, single view one side CPT 71045 XRAY CHEST DECUB,UNILAT | $540.00 | $675.00 | $194.40–$641.25 | 16% above | 20% |
| Chest X-ray, single view inpatient CPT 71045 XRAY CHEST,ONE VW,EMPLOYMED | $79.20 | $99.00 | $28.51–$94.05 | — | 20% |
| Chest X-ray, single view inpatient CPT 71045 INFANT CHEST WITH ABDOMEN | $540.00 | $675.00 | $194.40–$641.25 | — | 20% |
| Chest X-ray, single view inpatient CPT 71045 XRAY CHEST AP | $540.00 | $675.00 | $194.40–$641.25 | — | 20% |
| Chest X-ray, single view inpatient CPT 71045 XRAY CHEST,LATERAL ONLY | $540.00 | $675.00 | $194.40–$641.25 | — | 20% |
| Chest X-ray, single view inpatient one side CPT 71045 XRAY CHEST DECUB,UNILAT | $540.00 | $675.00 | $194.40–$641.25 | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US SPLEEN | $1,124.00 | $1,405.00 | $404.64–$1,334.75 | 14% below | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US SPLEEN | $1,124.00 | $1,405.00 | $404.64–$1,334.75 | — | 20% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND COMP-SGL GES | $1,184.00 | $1,480.00 | $426.24–$1,406.00 | 13% above | 20% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 ULTRASOUND COMP-SGL GES | $1,184.00 | $1,480.00 | $426.24–$1,406.00 | — | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN THORAX WO | $3,060.00 | $3,825.00 | $1,101.60–$3,633.75 | 20% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT SCAN THORAX WO | $3,060.00 | $3,825.00 | $1,101.60–$3,633.75 | — | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN THORAX WI | $4,088.00 | $5,110.00 | $1,471.68–$4,854.50 | 9% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT SCAN THORAX WI | $4,088.00 | $5,110.00 | $1,471.68–$4,854.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUP SCAN/LOW ART/GRAFT/BI | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US BILAT LOW EXT ART DOP | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LEG ARTERIAL DOPPLER BILAT | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LEG ART BYPASS GRAFT BILAT | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUP SCAN/LOW ART/GRAFT/BI | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LEG ARTERIAL DOPPLER BILAT | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LEG ART BYPASS GRAFT BILAT | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US BILAT LOW EXT ART DOP | $1,432.00 | $1,790.00 | $515.52–$1,700.50 | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS INSUFFICIENCY,BILAT | $628.00 | $785.00 | $226.08–$745.75 | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US BILAT EXTREM VENOUS DO | $1,660.00 | $2,075.00 | $597.60–$1,971.25 | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS INSUFFICIENCY,BILAT | $628.00 | $785.00 | $226.08–$745.75 | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US BILAT EXTREM VENOUS DO | $1,660.00 | $2,075.00 | $597.60–$1,971.25 | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM/TRANSPLANT | $3,176.00 | $3,970.00 | $1,143.36–$3,771.50 | 13% below | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM 2-D W/DOPPLER | $3,176.00 | $3,970.00 | $1,143.36–$3,771.50 | 13% below | 20% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM/TRANSPLANT | $3,176.00 | $3,970.00 | $1,143.36–$3,771.50 | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM 2-D W/DOPPLER | $3,176.00 | $3,970.00 | $1,143.36–$3,771.50 | — | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 3% above | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Knee X-ray, 3 views CPT 73562 XRAY KNEE 3 VWS | $628.00 | $785.00 | $226.08–$745.75 | 24% above | 20% |
| Knee X-ray, 3 views one side CPT 73562 XRAY KNEE RT, 3 VWS | $628.00 | $785.00 | $226.08–$745.75 | 24% above | 20% |
| Knee X-ray, 3 views one side CPT 73562 XRAY KNEE LT, 3 VWS | $628.00 | $785.00 | $226.08–$745.75 | 24% above | 20% |
| Knee X-ray, 3 views inpatient CPT 73562 XRAY KNEE 3 VWS | $628.00 | $785.00 | $226.08–$745.75 | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XRAY KNEE RT, 3 VWS | $628.00 | $785.00 | $226.08–$745.75 | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XRAY KNEE LT, 3 VWS | $628.00 | $785.00 | $226.08–$745.75 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | 4% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | 4% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL,LTD-FAST | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | 4% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | 4% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | 4% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL,LTD-FAST | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LTD | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER | $1,392.00 | $1,740.00 | $501.12–$1,653.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JOINT HIP,RT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JOINT ANKLE,LT W/O CONT | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JOINT ANKLE,RT W/O CONT | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXT JT WO | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JOINT HIP,LT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JOINT KNEE LT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JOINT KNEE RT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | 119% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JOINT ANKLE,RT W/O CONT | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JOINT HIP,RT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JOINT HIP,LT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXT JT WO | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JOINT ANKLE,LT W/O CONT | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JOINT KNEE LT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JOINT KNEE RT W/O CONTRAST | $4,424.00 | $5,530.00 | $1,592.64–$5,253.50 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT KNEE,LT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT KNEE,RT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT ANKLE,RT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT ANKLE,LT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT W & WO | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT HIP RT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT HIP LT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | 41% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT KNEE,LT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT W & WO | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT ANKLE,RT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT KNEE,RT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT ANKLE,LT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JOINT HIP RT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JOINT HIP LT W&W/O CONT | $4,652.00 | $5,815.00 | $1,674.72–$5,524.25 | — | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI ABD WO CONTRAST | $3,844.00 | $4,805.00 | $1,383.84–$4,564.75 | 5% above | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI CHOLANGIOP ANCREATOGR | $3,844.00 | $4,805.00 | $1,383.84–$4,564.75 | 5% above | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD WO CONTRAST | $3,844.00 | $4,805.00 | $1,383.84–$4,564.75 | — | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI CHOLANGIOP ANCREATOGR | $3,844.00 | $4,805.00 | $1,383.84–$4,564.75 | — | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & WO | $4,340.00 | $5,425.00 | $1,562.40–$5,153.75 | 17% below | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & WO | $4,340.00 | $5,425.00 | $1,562.40–$5,153.75 | — | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI-BRAIN WITHOUT CONTRAS | $4,532.00 | $5,665.00 | $1,631.52–$5,381.75 | 20% above | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI HEAD W/OUT CONTRAST TNK | $4,532.00 | $5,665.00 | $1,631.52–$5,381.75 | 20% above | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD W/OUT CONTRAST TNK | $4,532.00 | $5,665.00 | $1,631.52–$5,381.75 | — | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI-BRAIN WITHOUT CONTRAS | $4,532.00 | $5,665.00 | $1,631.52–$5,381.75 | — | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI-BRAIN WITH & W/O CONT | $5,204.00 | $6,505.00 | $1,873.44–$6,179.75 | 3% below | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI-BRAIN WITH & W/O CONT | $5,204.00 | $6,505.00 | $1,873.44–$6,179.75 | — | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONT | $4,472.00 | $5,590.00 | $1,609.92–$5,310.50 | 18% above | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONT | $4,472.00 | $5,590.00 | $1,609.92–$5,310.50 | — | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI-LUMB SP W & W/O CONTR | $6,140.00 | $7,675.00 | $2,210.40–$7,291.25 | 5% below | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI-LUMB SP W & W/O CONTR | $6,140.00 | $7,675.00 | $2,210.40–$7,291.25 | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI-THOR SP WITHOUT CONTR | $4,488.00 | $5,610.00 | $1,615.68–$5,329.50 | 14% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI-THOR SP WITHOUT CONTR | $4,488.00 | $5,610.00 | $1,615.68–$5,329.50 | — | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI-CERV SP W & W/O CONTR | $4,484.00 | $5,605.00 | $1,614.24–$5,324.75 | 20% below | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI-CERV SP W & W/O CONTR | $4,484.00 | $5,605.00 | $1,614.24–$5,324.75 | — | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI-CERV SP WITHOUT CONTR | $4,444.00 | $5,555.00 | $1,599.84–$5,277.25 | 16% above | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI-CERV SP WITHOUT CONTR | $4,444.00 | $5,555.00 | $1,599.84–$5,277.25 | — | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MR PROSTATE W/WO CONTRAST | $5,152.00 | $6,440.00 | $1,854.72–$6,118.00 | 6% above | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W & WO | $5,152.00 | $6,440.00 | $1,854.72–$6,118.00 | 6% above | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR PROSTATE W/WO CONTRAST | $5,152.00 | $6,440.00 | $1,854.72–$6,118.00 | — | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W & WO | $5,152.00 | $6,440.00 | $1,854.72–$6,118.00 | — | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MR PROSTATE WO CONTRAST | $3,460.00 | $4,325.00 | $1,245.60–$4,108.75 | 3% above | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO | $3,460.00 | $4,325.00 | $1,245.60–$4,108.75 | 3% above | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO | $3,460.00 | $4,325.00 | $1,245.60–$4,108.75 | — | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PROSTATE WO CONTRAST | $3,460.00 | $4,325.00 | $1,245.60–$4,108.75 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI STERNOCLAVIC JT,RT W/O CO | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI STERNOCLAVIC JT,LT W/O CO | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JT WO | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT WRIST,RT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT WRIST,LT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT SHOULDER RT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT ELBOW LT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT ELBOW RT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT SHOULDER LT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | 79% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT JT WO | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI STERNOCLAVIC JT,LT W/O CO | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI STERNOCLAVIC JT,RT W/O CO | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT WRIST,RT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT WRIST,LT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JOINT SHOULDER RT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JOINT ELBOW LT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JOINT SHOULDER LT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JOINT ELBOW RT W/O CONT | $3,984.00 | $4,980.00 | $1,434.24–$4,731.00 | — | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYO PERF SPECT MULT TREAD | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | 12% above | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYO PERF TREADMILL SPECT ONLY | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | 12% above | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYO PERF PHARM SPECT ONLY | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | 12% above | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYO PERF SPECT MULT PHARM | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | 12% above | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYO PERF TREADMILL SPECT ONLY | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | — | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYO PERF SPECT MULT TREAD | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | — | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYO PERF SPECT MULT PHARM | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | — | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYO PERF PHARM SPECT ONLY | $7,400.00 | $9,250.00 | $2,664.00–$8,787.50 | — | 20% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT, SKULL BASE TO MID-THIG | $6,516.00 | $8,145.00 | $2,345.76–$7,737.75 | 1% below | 20% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT, SKULL BASE TO MID-THIG | $6,516.00 | $8,145.00 | $2,345.76–$7,737.75 | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LTD/FU | $1,256.00 | $1,570.00 | $452.16–$1,491.50 | 29% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LTD/FU | $1,256.00 | $1,570.00 | $452.16–$1,491.50 | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC ULTRASOUND | $1,460.00 | $1,825.00 | $525.60–$1,733.75 | 3% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMP NON OB | $1,592.00 | $1,990.00 | $573.12–$1,890.50 | 12% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC ULTRASOUND | $1,460.00 | $1,825.00 | $525.60–$1,733.75 | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMP NON OB | $1,592.00 | $1,990.00 | $573.12–$1,890.50 | — | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB ULTRASOUND>14WKS,SGL GES | $1,152.00 | $1,440.00 | $414.72–$1,368.00 | 6% below | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB ULTRASOUND>14WKS,SGL GES | $1,152.00 | $1,440.00 | $414.72–$1,368.00 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PELVIS,PREG<14WKS,SGL GES | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | 52% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PELVIS,PREG<14WKS,SGL GES | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | 52% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 PELVIS,PREG<14WKS,SGL GES | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PELVIS,PREG<14WKS,SGL GES | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PELVIS PREG LTD | $752.00 | $940.00 | $270.72–$893.00 | 12% above | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND-LIMITED | $752.00 | $940.00 | $270.72–$893.00 | 12% above | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB ULTRASOUND LIMITED | $752.00 | $940.00 | $270.72–$893.00 | 12% above | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PELVIS PREG LTD | $752.00 | $940.00 | $270.72–$893.00 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB ULTRASOUND LIMITED | $752.00 | $940.00 | $270.72–$893.00 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND-LIMITED | $752.00 | $940.00 | $270.72–$893.00 | — | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER LTD MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER,RT LTD MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER COMP MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER,LT COMP MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER,RT COMP MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER,LT LTD MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER COMP MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER LTD MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER,RT COMP MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER,LT COMP MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER,RT LTD MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER,LT LTD MIN 2VW | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XRAY SWALLOW FUNC CINE/VIDEO | $1,032.00 | $1,290.00 | $371.52–$1,225.50 | 9% below | 20% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XRAY SWALLOW FUNC CINE/VIDEO | $1,032.00 | $1,290.00 | $371.52–$1,225.50 | — | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL TO COMP NON OB | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | 20% above | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | 20% above | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL TO COMP NON OB | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | — | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $1,340.00 | $1,675.00 | $482.40–$1,591.25 | — | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAG,PREGNANT,TO COMP | $852.00 | $1,065.00 | $306.72–$1,011.75 | 16% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL | $852.00 | $1,065.00 | $306.72–$1,011.75 | 16% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OBS TRANSVAGINAL | $852.00 | $1,065.00 | $306.72–$1,011.75 | 16% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAG,PREGNANT | $852.00 | $1,065.00 | $306.72–$1,011.75 | 16% below | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL | $852.00 | $1,065.00 | $306.72–$1,011.75 | — | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAG,PREGNANT,TO COMP | $852.00 | $1,065.00 | $306.72–$1,011.75 | — | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAG,PREGNANT | $852.00 | $1,065.00 | $306.72–$1,011.75 | — | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OBS TRANSVAGINAL | $852.00 | $1,065.00 | $306.72–$1,011.75 | — | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US UPPER ABD COMP | $1,888.00 | $2,360.00 | $679.68–$2,242.00 | 12% below | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US PELVIS (? PREG/ECTOPIC) | $1,888.00 | $2,360.00 | $679.68–$2,242.00 | 12% below | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US UPPER ABD COMP | $1,888.00 | $2,360.00 | $679.68–$2,242.00 | — | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US PELVIS (? PREG/ECTOPIC) | $1,888.00 | $2,360.00 | $679.68–$2,242.00 | — | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICLE AND SCROTUM | $1,156.00 | $1,445.00 | $416.16–$1,372.75 | at median | 20% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICLE AND SCROTUM | $1,156.00 | $1,445.00 | $416.16–$1,372.75 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID,LT LIMITED | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID,LT | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID,LIMITED | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID,RT LIMITED | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID,RT | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID,LT LIMITED | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID,RT | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID,LT | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID,LIMITED | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID,RT LIMITED | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK | $1,064.00 | $1,330.00 | $383.04–$1,263.50 | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRAY UGI W/KUB | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | 8% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRAY UGI/SM BOWEL | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | 8% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRAY UGI W/OKUB | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | 8% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRAY GASTROGRAFIN GI | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | 8% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY UGI W/OKUB | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY GASTROGRAFIN GI | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY UGI W/KUB | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY UGI/SM BOWEL | $1,088.00 | $1,360.00 | $391.68–$1,292.00 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US LEG,RT VENOUS INSUFF | $612.00 | $765.00 | $220.32–$726.75 | 29% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US LEG,LT VENOUS INSUFF | $612.00 | $765.00 | $220.32–$726.75 | 29% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US ARM,LT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | 57% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US LEG,LT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | 57% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US LEG,RT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | 57% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US ARM,RT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | 57% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS INSUFFICIENCY,UNILAT | $612.00 | $765.00 | $220.32–$726.75 | 29% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UNILAT EXT VENOUS DOP | $984.00 | $1,230.00 | $354.24–$1,168.50 | 15% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US LEG,RT VENOUS INSUFF | $612.00 | $765.00 | $220.32–$726.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US LEG,LT VENOUS INSUFF | $612.00 | $765.00 | $220.32–$726.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US ARM,RT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US ARM,LT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US LEG,RT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US LEG,LT VENOUS DOPPLER | $1,348.00 | $1,685.00 | $485.28–$1,600.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS INSUFFICIENCY,UNILAT | $612.00 | $765.00 | $220.32–$726.75 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UNILAT EXT VENOUS DOP | $984.00 | $1,230.00 | $354.24–$1,168.50 | — | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XRAY WRIST COMP,RT MIN 3VW | $572.00 | $715.00 | $205.92–$679.25 | 1% below | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XRAY WRIST COMP,LT MIN 3VW | $572.00 | $715.00 | $205.92–$679.25 | 1% below | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XRAY WRIST COMP MIN 3VW | $572.00 | $715.00 | $205.92–$679.25 | 1% below | 20% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY WRIST COMP MIN 3VW | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY WRIST COMP,LT MIN 3VW | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY WRIST COMP,RT MIN 3VW | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR INF/CH HIP UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | 27% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XRAY HIP UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | 27% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR INF/CH HIP LT,UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | 27% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY HIP UNI RT 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | 27% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR INF/CH HIP RT,UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | 27% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY HIP UNI LT 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | 27% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XRAY HIP UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR INF/CH HIP UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR INF/CH HIP RT,UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR INF/CH HIP LT,UNI 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY HIP UNI RT 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY HIP UNI LT 2-3VW | $708.00 | $885.00 | $254.88–$840.75 | — | 20% |
| X-ray of the abdomen, 1 view CPT 74018 XRAY ABDOMEN SINGLE AP 1VW | $556.00 | $695.00 | $200.16–$660.25 | 3% below | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XRAY ABDOMEN SINGLE AP 1VW | $556.00 | $695.00 | $200.16–$660.25 | — | 20% |
| X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE TWO VIEWS | $528.00 | $660.00 | $190.08–$627.00 | 28% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE,LT TWO VIEWS | $528.00 | $660.00 | $190.08–$627.00 | 28% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE,RT TWO VIEWS | $528.00 | $660.00 | $190.08–$627.00 | 28% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE,RT ONE VIEW | $528.00 | $660.00 | $190.08–$627.00 | 28% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE,LT ONE VIEW | $528.00 | $660.00 | $190.08–$627.00 | 28% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE ONE VW | $528.00 | $660.00 | $190.08–$627.00 | 28% above | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE ONE VW | $528.00 | $660.00 | $190.08–$627.00 | — | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE,LT TWO VIEWS | $528.00 | $660.00 | $190.08–$627.00 | — | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE,RT ONE VIEW | $528.00 | $660.00 | $190.08–$627.00 | — | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE,LT ONE VIEW | $528.00 | $660.00 | $190.08–$627.00 | — | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE TWO VIEWS | $528.00 | $660.00 | $190.08–$627.00 | — | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE,RT TWO VIEWS | $528.00 | $660.00 | $190.08–$627.00 | — | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER,RT 5th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 XRAY FINGER MIN 2VW | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, LT 1ST DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, RT 4th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, RT 3rd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, RT 2nd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, RT 1ST DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, LT 5th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, LT 4th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, LT 3rd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER, LT 2nd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | 17% below | 20% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER,RT 5th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XRAY FINGER MIN 2VW | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, LT 4th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, LT 5th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, RT 1ST DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, RT 3rd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, LT 1ST DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, LT 2nd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, RT 4th DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, LT 3rd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER, RT 2nd DIGIT MIN 2V | $373.60 | $467.00 | $134.50–$443.65 | — | 20% |
| X-ray of the foot, 2 views CPT 73620 XRAY FOOT ONE VW | $500.00 | $625.00 | $180.00–$593.75 | 15% above | 20% |
| X-ray of the foot, 2 views CPT 73620 XRAY FOOT LTD 2 VWS | $500.00 | $625.00 | $180.00–$593.75 | 15% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XRAY FOOT LT,LTD 2VWS | $500.00 | $625.00 | $180.00–$593.75 | 15% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XRAY FOOT RT,LTD 2VWS | $500.00 | $625.00 | $180.00–$593.75 | 15% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XRAY FOOT LT,ONE VW | $500.00 | $625.00 | $180.00–$593.75 | 15% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XRAY FOOT RT,ONE VW | $500.00 | $625.00 | $180.00–$593.75 | 15% above | 20% |
| X-ray of the foot, 2 views inpatient CPT 73620 XRAY FOOT LTD 2 VWS | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| X-ray of the foot, 2 views inpatient CPT 73620 XRAY FOOT ONE VW | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XRAY FOOT LT,ONE VW | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XRAY FOOT LT,LTD 2VWS | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XRAY FOOT RT,LTD 2VWS | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XRAY FOOT RT,ONE VW | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XRAY FOOT COMP MIN 3VW | $564.00 | $705.00 | $203.04–$669.75 | at median | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XRAY FOOT LT,COMP MIN 3VW | $564.00 | $705.00 | $203.04–$669.75 | at median | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XRAY FOOT RT,COMP MIN 3VW | $564.00 | $705.00 | $203.04–$669.75 | at median | 20% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XRAY FOOT COMP MIN 3VW | $564.00 | $705.00 | $203.04–$669.75 | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XRAY FOOT LT,COMP MIN 3VW | $564.00 | $705.00 | $203.04–$669.75 | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XRAY FOOT RT,COMP MIN 3VW | $564.00 | $705.00 | $203.04–$669.75 | — | 20% |
| X-ray of the hand, 3 or more views CPT 73130 XRAY HAND COMP MIN 3VW | $596.00 | $745.00 | $214.56–$707.75 | 3% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XRAY HAND RT,COMP MIN 3VW | $596.00 | $745.00 | $214.56–$707.75 | 3% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XRAY HAND LT,COMP MIN 3VW | $596.00 | $745.00 | $214.56–$707.75 | 3% above | 20% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XRAY HAND COMP MIN 3VW | $596.00 | $745.00 | $214.56–$707.75 | — | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XRAY HAND RT,COMP MIN 3VW | $596.00 | $745.00 | $214.56–$707.75 | — | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XRAY HAND LT,COMP MIN 3VW | $596.00 | $745.00 | $214.56–$707.75 | — | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 XRAY KNEE 1 OR 2 VW | $604.00 | $755.00 | $217.44–$717.25 | 22% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XRAY KNEE RT,1 OR 2 VW | $604.00 | $755.00 | $217.44–$717.25 | 22% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XRAY KNEE LT,1 OR 2 VW | $604.00 | $755.00 | $217.44–$717.25 | 22% above | 20% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XRAY KNEE 1 OR 2 VW | $604.00 | $755.00 | $217.44–$717.25 | — | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XRAY KNEE LT,1 OR 2 VW | $604.00 | $755.00 | $217.44–$717.25 | — | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XRAY KNEE RT,1 OR 2 VW | $604.00 | $755.00 | $217.44–$717.25 | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XRAY SPINE LUMB LTD 2/3VW | $804.00 | $1,005.00 | $289.44–$954.75 | 7% below | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XRAY SPINE LUMB LTD 2/3VW | $804.00 | $1,005.00 | $289.44–$954.75 | — | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 XRAY SPINE LUMBAR MIN 4VW | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 15% below | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XRAY SPINE LUMBAR MIN 4VW | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XRAY SPINE THOR 2VW | $576.00 | $720.00 | $207.36–$684.00 | 21% below | 20% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XRAY SPINE THOR 2VW | $576.00 | $720.00 | $207.36–$684.00 | — | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XRAY NASAL BONE-MIN 3VWS | $756.00 | $945.00 | $272.16–$897.75 | at median | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XRAY NASAL BONE-MIN 3VWS | $756.00 | $945.00 | $272.16–$897.75 | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XRAY SPINE CERV LTD 2/3VW | $668.00 | $835.00 | $240.48–$793.25 | 11% below | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XRAY SPINE CERV FL/EX 2/3VW | $668.00 | $835.00 | $240.48–$793.25 | 11% below | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XRAY SPINE CERV FL/EX 2/3VW | $668.00 | $835.00 | $240.48–$793.25 | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XRAY SPINE CERV LTD 2/3VW | $668.00 | $835.00 | $240.48–$793.25 | — | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XRAY PELVIS 1 OR 2 VWS | $620.00 | $775.00 | $223.20–$736.25 | 18% below | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XRAY PELVIS 1 OR 2 VWS | $620.00 | $775.00 | $223.20–$736.25 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX | $632.00 | $790.00 | $227.52–$750.50 | 17% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XRAY SACRUM&COCCYX MIN 2V | $632.00 | $790.00 | $227.52–$750.50 | 17% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM | $632.00 | $790.00 | $227.52–$750.50 | 17% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XRAY SACRUM&COCCYX MIN 2V | $632.00 | $790.00 | $227.52–$750.50 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM | $632.00 | $790.00 | $227.52–$750.50 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX | $632.00 | $790.00 | $227.52–$750.50 | — | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Florida | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 FIBRO TEST, ALT R | $28.00 | $35.00 | $10.08–$33.25 | 46% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT) | $39.20 | $49.00 | $14.11–$46.55 | 24% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FIBRO TEST, ALT R | $28.00 | $35.00 | $10.08–$33.25 | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) | $39.20 | $49.00 | $14.11–$46.55 | — | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST) | $39.20 | $49.00 | $14.11–$46.55 | 39% below | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) | $39.20 | $49.00 | $14.11–$46.55 | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE EM R | $36.00 | $45.00 | $12.96–$42.75 | 81% below | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ABC PANEL | $332.80 | $416.00 | $119.81–$395.20 | 75% above | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE EM R | $36.00 | $45.00 | $12.96–$42.75 | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ABC PANEL | $332.80 | $416.00 | $119.81–$395.20 | — | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM IGE RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NETTLE IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TOTAL IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A. FUMIGATUS IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A. TENIUS IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUTS RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON PIGWEED IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. PTERONYSSINUS IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE BOX ELDER IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST INDIVIDUAL R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN, TREE IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 P. NOTATUM IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE OAK IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 C. HERBARUM IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. FARINAE IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MTN CEDAR IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL IGE R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN IGE RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT RAST R | $12.00 | $15.00 | $4.32–$14.25 | 25% above | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUTS RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM IGE RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST INDIVIDUAL R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN IGE RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK IGE RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE RAST R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TOTAL IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NETTLE IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MTN CEDAR IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. FARINAE IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C. HERBARUM IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 P. NOTATUM IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN, TREE IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE OAK IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE BOX ELDER IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. PTERONYSSINUS IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON PIGWEED IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A. FUMIGATUS IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A. TENIUS IGE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP R | $12.00 | $15.00 | $4.32–$14.25 | 56% below | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA R | $19.20 | $24.00 | $6.91–$22.80 | 37% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN | $82.40 | $103.00 | $29.66–$97.85 | 171% above | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA R | $19.20 | $24.00 | $6.91–$22.80 | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN | $82.40 | $103.00 | $29.66–$97.85 | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $275.20 | $344.00 | $99.07–$326.80 | 23% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP | $275.20 | $344.00 | $99.07–$326.80 | — | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PAN CHEM | $177.60 | $222.00 | $63.94–$210.90 | 56% below | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PAN CHEM | $177.60 | $222.00 | $63.94–$210.90 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 A PATH LEVEL IV, GROSS & MIC R | $32.80 | $41.00 | $11.81–$38.95 | 74% below | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 NP LIGHT MICRSCOPY R | $36.00 | $45.00 | $12.96–$42.75 | 71% below | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CYTOLOGY CELL BLOCK | $242.40 | $303.00 | $87.26–$287.85 | 92% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY LEVEL IV | $452.00 | $565.00 | $162.72–$536.75 | 259% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LEVEL IV, ADD SPEC | $452.00 | $565.00 | $162.72–$536.75 | 259% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 A PATH LEVEL IV, GROSS & MIC R | $32.80 | $41.00 | $11.81–$38.95 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 NP LIGHT MICRSCOPY R | $36.00 | $45.00 | $12.96–$42.75 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CYTOLOGY CELL BLOCK | $242.40 | $303.00 | $87.26–$287.85 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH LEVEL IV, ADD SPEC | $452.00 | $565.00 | $162.72–$536.75 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATHOLOGY LEVEL IV | $452.00 | $565.00 | $162.72–$536.75 | — | 20% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD ARD | $270.40 | $338.00 | $97.34–$321.10 | 31% below | 20% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD ARD | $270.40 | $338.00 | $97.34–$321.10 | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW-VEN | $22.40 | $28.00 | $8.06–$26.60 | at median | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $22.40 | $28.00 | $8.06–$26.60 | at median | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $22.40 | $28.00 | $8.06–$26.60 | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW-VEN | $22.40 | $28.00 | $8.06–$26.60 | — | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE SCREEN | $44.80 | $56.00 | $16.13–$53.20 | 26% below | 20% |
| Blood glucose (sugar) test CPT 82947 2HR/2HR GTT | $44.80 | $56.00 | $16.13–$53.20 | 26% below | 20% |
| Blood glucose (sugar) test CPT 82947 FASTING/2HR GTT | $44.80 | $56.00 | $16.13–$53.20 | 26% below | 20% |
| Blood glucose (sugar) test CPT 82947 I-STAT/GLUCOSE/PRO 5 | $64.80 | $81.00 | $23.33–$76.95 | 7% above | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD | $64.80 | $81.00 | $23.33–$76.95 | 7% above | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $64.80 | $81.00 | $23.33–$76.95 | 7% above | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 FASTING/2HR GTT | $44.80 | $56.00 | $16.13–$53.20 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SCREEN | $44.80 | $56.00 | $16.13–$53.20 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 2HR/2HR GTT | $44.80 | $56.00 | $16.13–$53.20 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $64.80 | $81.00 | $23.33–$76.95 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD | $64.80 | $81.00 | $23.33–$76.95 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 I-STAT/GLUCOSE/PRO 5 | $64.80 | $81.00 | $23.33–$76.95 | — | 20% |
| Blood lead test CPT 83655 LEAD, HEAVY METAL EM R | $4.80 | $6.00 | $1.73–$5.70 | 65% below | 20% |
| Blood lead test CPT 83655 LEAD R | $6.40 | $8.00 | $2.30–$7.60 | 53% below | 20% |
| Blood lead test CPT 83655 LEAD, BLOOD EM R | $6.40 | $8.00 | $2.30–$7.60 | 53% below | 20% |
| Blood lead test CPT 83655 LEAD URINE R | $12.00 | $15.00 | $4.32–$14.25 | 12% below | 20% |
| Blood lead test CPT 83655 LEAD BLOOD R | $12.80 | $16.00 | $4.61–$15.20 | 6% below | 20% |
| Blood lead test CPT 83655 LEAD URINE 24 HR R | $20.00 | $25.00 | $7.20–$23.75 | 47% above | 20% |
| Blood lead test CPT 83655 LEAD EM R | $20.80 | $26.00 | $7.49–$24.70 | 52% above | 20% |
| Blood lead test inpatient CPT 83655 LEAD, HEAVY METAL EM R | $4.80 | $6.00 | $1.73–$5.70 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD, BLOOD EM R | $6.40 | $8.00 | $2.30–$7.60 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD R | $6.40 | $8.00 | $2.30–$7.60 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD URINE R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD R | $12.80 | $16.00 | $4.61–$15.20 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD URINE 24 HR R | $20.00 | $25.00 | $7.20–$23.75 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD EM R | $20.80 | $26.00 | $7.49–$24.70 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST URINE | $272.00 | $340.00 | $97.92–$323.00 | 101% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HCG SUBUNIT | $303.20 | $379.00 | $109.15–$360.05 | 124% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST URINE | $272.00 | $340.00 | $97.92–$323.00 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HCG SUBUNIT | $303.20 | $379.00 | $109.15–$360.05 | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE I | $135.20 | $169.00 | $48.67–$160.55 | 84% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE CB | $135.20 | $169.00 | $48.67–$160.55 | 84% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE CB | $135.20 | $169.00 | $48.67–$160.55 | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE I | $135.20 | $169.00 | $48.67–$160.55 | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACT PROTEIN | $103.20 | $129.00 | $37.15–$122.55 | 9% above | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACT PROTEIN | $103.20 | $129.00 | $37.15–$122.55 | — | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFF TOXIN 027 | $216.80 | $271.00 | $78.05–$257.45 | 75% above | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE DNA AMPLIF | $216.80 | $271.00 | $78.05–$257.45 | 75% above | 20% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFF TOXIN 027 | $216.80 | $271.00 | $78.05–$257.45 | — | 20% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE DNA AMPLIF | $216.80 | $271.00 | $78.05–$257.45 | — | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 R | $12.00 | $15.00 | $4.32–$14.25 | 81% below | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $76.00 | $95.00 | $27.36–$90.25 | 18% above | 20% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $76.00 | $95.00 | $27.36–$90.25 | — | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 R | $12.00 | $15.00 | $4.32–$14.25 | 88% below | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 | $135.20 | $169.00 | $48.67–$160.55 | 36% above | 20% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125 R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125 | $135.20 | $169.00 | $48.67–$160.55 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 AMP PROBE | $83.20 | $104.00 | $29.95–$98.80 | 3% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 PCR R | $100.00 | $125.00 | $36.00–$118.75 | 23% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2, ARIES | $277.60 | $347.00 | $99.94–$329.65 | 242% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 AMP PROBE | $83.20 | $104.00 | $29.95–$98.80 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 PCR R | $100.00 | $125.00 | $36.00–$118.75 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2, ARIES | $277.60 | $347.00 | $99.94–$329.65 | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH AMP DNA R | $39.20 | $49.00 | $14.11–$46.55 | 50% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH,DNA AMP PROBE | $180.00 | $225.00 | $64.80–$213.75 | 131% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH AMP DNA R | $39.20 | $49.00 | $14.11–$46.55 | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH,DNA AMP PROBE | $180.00 | $225.00 | $64.80–$213.75 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CRISK | $27.20 | $34.00 | $9.79–$32.30 | 83% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HEART CHECK | $30.40 | $38.00 | $10.94–$36.10 | 81% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 OP LIPID PROFILE | $38.40 | $48.00 | $13.82–$45.60 | 76% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL SCREEN | $106.40 | $133.00 | $38.30–$126.35 | 32% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $129.60 | $162.00 | $46.66–$153.90 | 17% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CRISK | $27.20 | $34.00 | $9.79–$32.30 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HEART CHECK | $30.40 | $38.00 | $10.94–$36.10 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 OP LIPID PROFILE | $38.40 | $48.00 | $13.82–$45.60 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL SCREEN | $106.40 | $133.00 | $38.30–$126.35 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $129.60 | $162.00 | $46.66–$153.90 | — | 20% |
| Complete blood count (CBC) with differential CPT 85025 OP CBC | $35.20 | $44.00 | $12.67–$41.80 | 54% below | 20% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CT (CBC) | $185.60 | $232.00 | $66.82–$220.40 | 143% above | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 OP CBC | $35.20 | $44.00 | $12.67–$41.80 | — | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE BLOOD CT (CBC) | $185.60 | $232.00 | $66.82–$220.40 | — | 20% |
| Complete blood count (CBC), no differential CPT 85027 HEMATOLOGY STUDY | $36.00 | $45.00 | $12.96–$42.75 | 71% below | 20% |
| Complete blood count (CBC), no differential CPT 85027 CBC,AUTO AND PLATELET CT | $88.80 | $111.00 | $31.97–$105.45 | 30% below | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMATOLOGY STUDY | $36.00 | $45.00 | $12.96–$42.75 | — | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC,AUTO AND PLATELET CT | $88.80 | $111.00 | $31.97–$105.45 | — | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 OP COMPREHENSIVE METABOL | $45.60 | $57.00 | $16.42–$54.15 | 92% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC P | $221.60 | $277.00 | $79.78–$263.15 | 60% below | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 OP COMPREHENSIVE METABOL | $45.60 | $57.00 | $16.42–$54.15 | — | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC P | $221.60 | $277.00 | $79.78–$263.15 | — | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QT | $290.40 | $363.00 | $104.54–$344.85 | 1% below | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QT | $290.40 | $363.00 | $104.54–$344.85 | — | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S R | $13.60 | $17.00 | $4.90–$16.15 | 71% below | 20% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S R | $13.60 | $17.00 | $4.90–$16.15 | — | 20% |
| Estradiol blood test CPT 82670 ESTRADIOL R | $17.60 | $22.00 | $6.34–$20.90 | 58% below | 20% |
| Estradiol blood test CPT 82670 ESTRADIOL PRO R | $24.00 | $30.00 | $8.64–$28.50 | 43% below | 20% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL R | $17.60 | $22.00 | $6.34–$20.90 | — | 20% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL PRO R | $24.00 | $30.00 | $8.64–$28.50 | — | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $109.60 | $137.00 | $39.46–$130.15 | 49% above | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $109.60 | $137.00 | $39.46–$130.15 | — | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, STOOL R | $64.80 | $81.00 | $23.33–$76.95 | 49% below | 20% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, STOOL R | $64.80 | $81.00 | $23.33–$76.95 | — | 20% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $92.80 | $116.00 | $33.41–$110.20 | 47% below | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $92.80 | $116.00 | $33.41–$110.20 | — | 20% |
| Folate (folic acid) blood test CPT 82746 FOLATE, SERUM | $96.00 | $120.00 | $34.56–$114.00 | 41% below | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM | $96.00 | $120.00 | $34.56–$114.00 | — | 20% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 R | $16.00 | $20.00 | $5.76–$19.00 | 83% below | 20% |
| Free T3 thyroid hormone test CPT 84481 T3, FREE | $99.20 | $124.00 | $35.71–$117.80 | 4% above | 20% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 R | $16.00 | $20.00 | $5.76–$19.00 | — | 20% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3, FREE | $99.20 | $124.00 | $35.71–$117.80 | — | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE R | $17.60 | $22.00 | $6.34–$20.90 | 81% below | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE | $68.80 | $86.00 | $24.77–$81.70 | 28% below | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE THYROXINE R | $17.60 | $22.00 | $6.34–$20.90 | — | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE THYROXINE | $68.80 | $86.00 | $24.77–$81.70 | — | 20% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE/PRO R | $9.60 | $12.00 | $3.46–$11.40 | 69% below | 20% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE WITH BIO R | $25.60 | $32.00 | $9.22–$30.40 | 17% below | 20% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE/PRO R | $9.60 | $12.00 | $3.46–$11.40 | — | 20% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE WITH BIO R | $25.60 | $32.00 | $9.22–$30.40 | — | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HEALTH PANEL | $351.20 | $439.00 | $122.92–$439.00 | 39% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HEALTH PANEL | $351.20 | $439.00 | $122.92–$439.00 | — | 20% |
| Glucose tolerance test, 3 samples CPT 82951 O'SULIVAN SCREEN | $141.60 | $177.00 | $50.98–$168.15 | at median | 20% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 1ST THR | $159.20 | $199.00 | $57.31–$189.05 | 12% above | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 O'SULIVAN SCREEN | $141.60 | $177.00 | $50.98–$168.15 | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 1ST THR | $159.20 | $199.00 | $57.31–$189.05 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA RNA R | $20.00 | $25.00 | $7.20–$23.75 | 61% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE,DNA APM PROBE | $180.00 | $225.00 | $64.80–$213.75 | 250% above | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA RNA R | $20.00 | $25.00 | $7.20–$23.75 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE,DNA APM PROBE | $180.00 | $225.00 | $64.80–$213.75 | — | 20% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB R | $8.80 | $11.00 | $3.17–$10.45 | 75% below | 20% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGM R | $17.60 | $22.00 | $6.34–$20.90 | 49% below | 20% |
| H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB R | $8.80 | $11.00 | $3.17–$10.45 | — | 20% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM R | $17.60 | $22.00 | $6.34–$20.90 | — | 20% |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL R | $20.00 | $25.00 | $7.20–$23.75 | 61% below | 20% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL R | $20.00 | $25.00 | $7.20–$23.75 | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA GT PCR R | $40.00 | $50.00 | $14.40–$47.50 | 65% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA QT PCR EM R | $99.20 | $124.00 | $35.71–$117.80 | 13% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT, PCR CSF R | $130.40 | $163.00 | $46.94–$154.85 | 14% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA GT PCR R | $40.00 | $50.00 | $14.40–$47.50 | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA QT PCR EM R | $99.20 | $124.00 | $35.71–$117.80 | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT, PCR CSF R | $130.40 | $163.00 | $46.94–$154.85 | — | 20% |
| HIV-1 and HIV-2 antibody test CPT 86703 SPECIAL SEROLOGY EM R | $7.60 | $9.50 | $2.74–$9.03 | 85% below | 20% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 SPECIAL SEROLOGY EM R | $7.60 | $9.50 | $2.74–$9.03 | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV, 4TH GEN R | $52.00 | $65.00 | $18.72–$61.75 | 38% below | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG WITH HIV I/II ABS | $80.80 | $101.00 | $29.09–$95.95 | 3% below | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV, 4TH GEN R | $52.00 | $65.00 | $18.72–$61.75 | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG WITH HIV I/II ABS | $80.80 | $101.00 | $29.09–$95.95 | — | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV PROFILE R | $29.60 | $37.00 | $10.66–$35.15 | 38% below | 20% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV PROFILE R | $29.60 | $37.00 | $10.66–$35.15 | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $80.00 | $100.00 | $28.80–$95.00 | at median | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $80.00 | $100.00 | $28.80–$95.00 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG EM R | $7.20 | $9.00 | $2.59–$8.55 | 85% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG R | $7.20 | $9.00 | $2.59–$8.55 | 85% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 REFLEX HEP B SURF AG R | $19.20 | $24.00 | $6.91–$22.80 | 60% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG | $77.60 | $97.00 | $27.94–$92.15 | 61% above | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG R | $7.20 | $9.00 | $2.59–$8.55 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG EM R | $7.20 | $9.00 | $2.59–$8.55 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 REFLEX HEP B SURF AG R | $19.20 | $24.00 | $6.91–$22.80 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG | $77.60 | $97.00 | $27.94–$92.15 | — | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB IGG EM R | $11.20 | $14.00 | $4.03–$13.30 | 80% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB, IGG R | $12.00 | $15.00 | $4.32–$14.25 | 79% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV W/ REFLEX TO HCV RNA QT | $13.60 | $17.00 | $4.90–$16.15 | 76% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB | $103.20 | $129.00 | $37.15–$122.55 | 82% above | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB IGG EM R | $11.20 | $14.00 | $4.03–$13.30 | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB, IGG R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV W/ REFLEX TO HCV RNA QT | $13.60 | $17.00 | $4.90–$16.15 | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB | $103.20 | $129.00 | $37.15–$122.55 | — | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA PCR QT R | $99.20 | $124.00 | $35.71–$117.80 | 26% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QT PCR EM R | $99.20 | $124.00 | $35.71–$117.80 | 26% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QT BY PCR | $109.60 | $137.00 | $39.46–$130.15 | 19% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QT PCR R | $109.60 | $137.00 | $39.46–$130.15 | 19% below | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QT PCR EM R | $99.20 | $124.00 | $35.71–$117.80 | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA PCR QT R | $99.20 | $124.00 | $35.71–$117.80 | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QT BY PCR | $109.60 | $137.00 | $39.46–$130.15 | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA QT PCR R | $109.60 | $137.00 | $39.46–$130.15 | — | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLES AB/TORCH R | $6.24 | $7.80 | $2.25–$7.41 | 72% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV I IGG/PRO R | $9.60 | $12.00 | $3.46–$11.40 | 57% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGG R | $11.20 | $14.00 | $4.03–$13.30 | 50% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGM R | $12.00 | $15.00 | $4.32–$14.25 | 46% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM TITER R | $48.80 | $61.00 | $17.57–$57.95 | 119% above | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLES AB/TORCH R | $6.24 | $7.80 | $2.25–$7.41 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I IGG/PRO R | $9.60 | $12.00 | $3.46–$11.40 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGG R | $11.20 | $14.00 | $4.03–$13.30 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGM R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM TITER R | $48.80 | $61.00 | $17.57–$57.95 | — | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV II IGG/PRO R | $9.60 | $12.00 | $3.46–$11.40 | 67% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGG R | $10.40 | $13.00 | $3.74–$12.35 | 64% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGM R | $12.00 | $15.00 | $4.32–$14.25 | 59% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG, HERPES SELECT R | $40.80 | $51.00 | $14.69–$48.45 | 41% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM TITER R | $48.80 | $61.00 | $17.57–$57.95 | 68% above | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV II IGG/PRO R | $9.60 | $12.00 | $3.46–$11.40 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGG R | $10.40 | $13.00 | $3.74–$12.35 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGM R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG, HERPES SELECT R | $40.80 | $51.00 | $14.69–$48.45 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM TITER R | $48.80 | $61.00 | $17.57–$57.95 | — | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP ULTRA QT R | $22.40 | $28.00 | $8.06–$26.60 | 65% below | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP | $23.20 | $29.00 | $8.35–$27.55 | 64% below | 20% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP ULTRA QT R | $22.40 | $28.00 | $8.06–$26.60 | — | 20% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO CRP | $23.20 | $29.00 | $8.35–$27.55 | — | 20% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE SERUM R | $12.00 | $15.00 | $4.32–$14.25 | 77% below | 20% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE R | $16.00 | $20.00 | $5.76–$19.00 | 69% below | 20% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE ULTRAQUANT R | $19.20 | $24.00 | $6.91–$22.80 | 63% below | 20% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE URINE R | $68.00 | $85.00 | $24.48–$80.75 | 30% above | 20% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE SERUM R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE R | $16.00 | $20.00 | $5.76–$19.00 | — | 20% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE ULTRAQUANT R | $19.20 | $24.00 | $6.91–$22.80 | — | 20% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE URINE R | $68.00 | $85.00 | $24.48–$80.75 | — | 20% |
| Insulin blood test CPT 83525 INSULIN R | $13.60 | $17.00 | $4.90–$16.15 | 57% below | 20% |
| Insulin blood test inpatient CPT 83525 INSULIN R | $13.60 | $17.00 | $4.90–$16.15 | — | 20% |
| Iron blood test (serum iron) CPT 83540 SERUM IRON/PROFILE | $18.40 | $23.00 | $6.62–$21.85 | 75% below | 20% |
| Iron blood test (serum iron) CPT 83540 IRON, SERUM | $47.20 | $59.00 | $16.99–$56.05 | 35% below | 20% |
| Iron blood test (serum iron) CPT 83540 IRON, LIVER TISSUE R | $113.60 | $142.00 | $40.90–$134.90 | 56% above | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 SERUM IRON/PROFILE | $18.40 | $23.00 | $6.62–$21.85 | — | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON, SERUM | $47.20 | $59.00 | $16.99–$56.05 | — | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON, LIVER TISSUE R | $113.60 | $142.00 | $40.90–$134.90 | — | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 IBC/PROFILE | $69.60 | $87.00 | $25.06–$82.65 | 46% below | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IBC/PROFILE | $69.60 | $87.00 | $25.06–$82.65 | — | 20% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $156.00 | $195.00 | $56.16–$185.25 | 69% below | 20% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $156.00 | $195.00 | $56.16–$185.25 | — | 20% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $140.80 | $176.00 | $50.69–$167.20 | 91% above | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE | $140.80 | $176.00 | $50.69–$167.20 | — | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, BODY FLUID R | $12.80 | $16.00 | $4.61–$15.20 | 83% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE SERUM | $198.40 | $248.00 | $71.42–$235.60 | 162% above | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, BODY FLUID R | $12.80 | $16.00 | $4.61–$15.20 | — | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE SERUM | $198.40 | $248.00 | $71.42–$235.60 | — | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $155.20 | $194.00 | $55.87–$184.30 | 60% below | 20% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $155.20 | $194.00 | $55.87–$184.30 | — | 20% |
| Lyme disease antibody test CPT 86618 LYMES ABDY-IGG CSF R | $9.60 | $12.00 | $3.46–$11.40 | 70% below | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYMES ABDY-IGG CSF R | $9.60 | $12.00 | $3.46–$11.40 | — | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM RANDOM UR R | $7.04 | $8.80 | $2.53–$8.36 | 51% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM 24HR UR R | $8.80 | $11.00 | $3.17–$10.45 | 38% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM 24 HR URINE R | $14.40 | $18.00 | $5.18–$17.10 | 1% above | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM FECES R | $48.80 | $61.00 | $17.57–$57.95 | 241% above | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM | $79.20 | $99.00 | $28.51–$94.05 | 454% above | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM RANDOM UR R | $7.04 | $8.80 | $2.53–$8.36 | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM 24HR UR R | $8.80 | $11.00 | $3.17–$10.45 | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HR URINE R | $14.40 | $18.00 | $5.18–$17.10 | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM FECES R | $48.80 | $61.00 | $17.57–$57.95 | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $79.20 | $99.00 | $28.51–$94.05 | — | 20% |
| Measles (rubeola) antibody test CPT 86765 MEASLES IGM AB/PRO R | $9.60 | $12.00 | $3.46–$11.40 | 59% below | 20% |
| Measles (rubeola) antibody test CPT 86765 MEASLES IGG AB/PRO R | $10.40 | $13.00 | $3.74–$12.35 | 55% below | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGM AB/PRO R | $9.60 | $12.00 | $3.46–$11.40 | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGG AB/PRO R | $10.40 | $13.00 | $3.74–$12.35 | — | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST | $170.40 | $213.00 | $61.34–$202.35 | 13% below | 20% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST | $170.40 | $213.00 | $61.34–$202.35 | — | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE R | $8.00 | $10.00 | $2.88–$9.50 | 77% below | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE R | $8.00 | $10.00 | $2.88–$9.50 | — | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA R | $15.20 | $19.00 | $5.47–$18.05 | 75% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC ANTIGE | $103.20 | $129.00 | $37.15–$122.55 | 69% above | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA R | $15.20 | $19.00 | $5.47–$18.05 | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC ANTIGE | $103.20 | $129.00 | $37.15–$122.55 | — | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INT R | $22.40 | $28.00 | $8.06–$26.60 | 79% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT WITH MINERALS R | $25.60 | $32.00 | $9.22–$30.40 | 76% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH/C TERMINAL R | $31.20 | $39.00 | $11.23–$37.05 | 71% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH/N TERMINAL R | $55.20 | $69.00 | $19.87–$65.55 | 49% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $260.00 | $325.00 | $93.60–$308.75 | 141% above | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INT R | $22.40 | $28.00 | $8.06–$26.60 | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT WITH MINERALS R | $25.60 | $32.00 | $9.22–$30.40 | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH/C TERMINAL R | $31.20 | $39.00 | $11.23–$37.05 | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH/N TERMINAL R | $55.20 | $69.00 | $19.87–$65.55 | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $260.00 | $325.00 | $93.60–$308.75 | — | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG/PRO R | $12.00 | $15.00 | $4.32–$14.25 | 73% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT VON WILL R | $25.60 | $32.00 | $9.22–$30.40 | 43% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT | $156.80 | $196.00 | $56.45–$186.20 | 250% above | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT HEPZYME | $156.80 | $196.00 | $56.45–$186.20 | 250% above | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG/PRO R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT VON WILL R | $25.60 | $32.00 | $9.22–$30.40 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT | $156.80 | $196.00 | $56.45–$186.20 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT HEPZYME | $156.80 | $196.00 | $56.45–$186.20 | — | 20% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 VERIFY PRENATAL R | $500.00 | $625.00 | $180.00–$593.75 | at median | 20% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 QNATAL PRENATAL PROFILE R | $1,824.00 | $2,280.00 | $656.64–$2,166.00 | 266% above | 20% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 VERIFY PRENATAL R | $500.00 | $625.00 | $180.00–$593.75 | — | 20% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 QNATAL PRENATAL PROFILE R | $1,824.00 | $2,280.00 | $656.64–$2,166.00 | — | 20% |
| Progesterone blood test CPT 84144 PROGESTERONE R | $12.80 | $16.00 | $4.61–$15.20 | 79% below | 20% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE R | $12.80 | $16.00 | $4.61–$15.20 | — | 20% |
| Prolactin blood test CPT 84146 PROLACTIN R | $10.40 | $13.00 | $3.74–$12.35 | 85% below | 20% |
| Prolactin blood test CPT 84146 PROLACTIN | $93.60 | $117.00 | $33.70–$111.15 | 35% above | 20% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN R | $10.40 | $13.00 | $3.74–$12.35 | — | 20% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $93.60 | $117.00 | $33.70–$111.15 | — | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $121.60 | $152.00 | $43.78–$144.40 | 198% above | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $121.60 | $152.00 | $43.78–$144.40 | — | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST(S) PRESUMPTIVE | $492.00 | $615.00 | $177.12–$584.25 | 392% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST(S) PRESUMPTIVE | $492.00 | $615.00 | $177.12–$584.25 | — | 20% |
| Rapid flu test (influenza antigen) CPT 87804 FLU A | $106.40 | $133.00 | $38.30–$126.35 | 24% below | 20% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A | $106.40 | $133.00 | $38.30–$126.35 | 24% below | 20% |
| Rapid flu test (influenza antigen) CPT 87804 FLU B | $106.40 | $133.00 | $38.30–$126.35 | 24% below | 20% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B | $106.40 | $133.00 | $38.30–$126.35 | 24% below | 20% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A | $106.40 | $133.00 | $38.30–$126.35 | — | 20% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 FLU A | $106.40 | $133.00 | $38.30–$126.35 | — | 20% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 FLU B | $106.40 | $133.00 | $38.30–$126.35 | — | 20% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B | $106.40 | $133.00 | $38.30–$126.35 | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCAL AG,GRP A | $154.40 | $193.00 | $55.58–$183.35 | 13% above | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCAL AG,GRP A | $154.40 | $193.00 | $55.58–$183.35 | — | 20% |
| Rheumatoid factor (RF) test CPT 86431 RF IGM/ANA EVAL R | $16.00 | $20.00 | $5.76–$19.00 | 41% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 RF QUANT | $40.00 | $50.00 | $14.40–$47.50 | 48% above | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF IGM/ANA EVAL R | $16.00 | $20.00 | $5.76–$19.00 | — | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF QUANT | $40.00 | $50.00 | $14.40–$47.50 | — | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY/TORCH R | $6.24 | $7.80 | $2.25–$7.41 | 67% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGM EIA R | $8.00 | $10.00 | $2.88–$9.50 | 58% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 TORCH RUBELLA IGM R | $40.00 | $50.00 | $14.40–$47.50 | 112% above | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $76.80 | $96.00 | $27.65–$91.20 | 307% above | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY/TORCH R | $6.24 | $7.80 | $2.25–$7.41 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGM EIA R | $8.00 | $10.00 | $2.88–$9.50 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 TORCH RUBELLA IGM R | $40.00 | $50.00 | $14.40–$47.50 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA | $76.80 | $96.00 | $27.65–$91.20 | — | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE (WSR) | $81.60 | $102.00 | $29.38–$96.90 | 30% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE (WSR) | $81.60 | $102.00 | $29.38–$96.90 | — | 20% |
| Stool ova and parasites exam CPT 87177 OVA/PARASITE CONCENTRATE | $32.80 | $41.00 | $11.81–$38.95 | 31% below | 20% |
| Stool ova and parasites exam inpatient CPT 87177 OVA/PARASITE CONCENTRATE | $32.80 | $41.00 | $11.81–$38.95 | — | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD STOOL FECES | $56.80 | $71.00 | $20.45–$67.45 | 21% below | 20% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD STOOL FECES | $56.80 | $71.00 | $20.45–$67.45 | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD BY IMMUNOCHEM R | $29.60 | $37.00 | $10.66–$35.15 | 58% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD BY IMMUNOCHEM R | $29.60 | $37.00 | $10.66–$35.15 | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF R | $7.60 | $9.50 | $2.74–$9.03 | 64% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL | $53.60 | $67.00 | $19.30–$63.65 | 151% above | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF R | $7.60 | $9.50 | $2.74–$9.03 | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL | $53.60 | $67.00 | $19.30–$63.65 | — | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON,B R | $50.40 | $63.00 | $18.14–$59.85 | 24% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON,B R | $50.40 | $63.00 | $18.14–$59.85 | — | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE R | $16.80 | $21.00 | $6.05–$19.95 | 54% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTALWITH BIO R | $25.60 | $32.00 | $9.22–$30.40 | 30% below | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE R | $16.80 | $21.00 | $6.05–$19.95 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTALWITH BIO R | $25.60 | $32.00 | $9.22–$30.40 | — | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ABS R | $8.00 | $10.00 | $2.88–$9.50 | 49% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE R | $11.20 | $14.00 | $4.03–$13.30 | 28% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXID/THYROID R | $12.00 | $15.00 | $4.32–$14.25 | 23% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME R | $18.40 | $23.00 | $6.62–$21.85 | 18% above | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ABS R | $8.00 | $10.00 | $2.88–$9.50 | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE R | $11.20 | $14.00 | $4.03–$13.30 | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXID/THYROID R | $12.00 | $15.00 | $4.32–$14.25 | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME R | $18.40 | $23.00 | $6.62–$21.85 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 3RD GENERATION TSH | $124.80 | $156.00 | $44.93–$148.20 | 22% below | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $136.80 | $171.00 | $49.25–$162.45 | 15% below | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 3RD GENERATION TSH | $124.80 | $156.00 | $44.93–$148.20 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $136.80 | $171.00 | $49.25–$162.45 | — | 20% |
| Uric acid blood test CPT 84550 URIC ACID | $43.20 | $54.00 | $15.55–$51.30 | 70% below | 20% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $43.20 | $54.00 | $15.55–$51.30 | — | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE | $132.00 | $165.00 | $47.52–$156.75 | 26% below | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMPLETE | $132.00 | $165.00 | $47.52–$156.75 | — | 20% |
| Urinalysis with microscope exam, manual CPT 81000 UA NON-AUTO WITH MICRO | $14.40 | $18.00 | $5.18–$17.10 | 65% below | 20% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA NON-AUTO WITH MICRO | $14.40 | $18.00 | $5.18–$17.10 | — | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE NITRITE | $16.80 | $21.00 | $6.05–$19.95 | 86% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 UA AUTO W/O MICROSCOPY | $35.20 | $44.00 | $12.67–$41.80 | 71% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE SUGAR QUAL | $40.00 | $50.00 | $14.40–$47.50 | 67% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE PH | $43.20 | $54.00 | $15.55–$51.30 | 64% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE SPECIFIC GRAVITY | $84.80 | $106.00 | $30.53–$100.70 | 30% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 ACETONE URINE | $84.80 | $106.00 | $30.53–$100.70 | 30% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE PROTEIN QUALITATIVE | $84.80 | $106.00 | $30.53–$100.70 | 30% below | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE NITRITE | $16.80 | $21.00 | $6.05–$19.95 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA AUTO W/O MICROSCOPY | $35.20 | $44.00 | $12.67–$41.80 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SUGAR QUAL | $40.00 | $50.00 | $14.40–$47.50 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH | $43.20 | $54.00 | $15.55–$51.30 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 ACETONE URINE | $84.80 | $106.00 | $30.53–$100.70 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PROTEIN QUALITATIVE | $84.80 | $106.00 | $30.53–$100.70 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SPECIFIC GRAVITY | $84.80 | $106.00 | $30.53–$100.70 | — | 20% |
| Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO | $12.80 | $16.00 | $4.61–$15.20 | 50% below | 20% |
| Urinalysis without microscope exam, manual CPT 81002 OCCULT BLOOD URINE | $26.40 | $33.00 | $9.50–$31.35 | 2% above | 20% |
| Urinalysis without microscope exam, manual CPT 81002 BILE URINE | $27.20 | $34.00 | $9.79–$32.30 | 5% above | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO | $12.80 | $16.00 | $4.61–$15.20 | — | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 OCCULT BLOOD URINE | $26.40 | $33.00 | $9.50–$31.35 | — | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 BILE URINE | $27.20 | $34.00 | $9.79–$32.30 | — | 20% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE | $167.20 | $209.00 | $60.19–$198.55 | 40% below | 20% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE | $167.20 | $209.00 | $60.19–$198.55 | — | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 B-12 CYAN RIA | $109.60 | $137.00 | $39.46–$130.15 | 33% below | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B-12 CYAN RIA | $109.60 | $137.00 | $39.46–$130.15 | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY R | $24.00 | $30.00 | $8.64–$28.50 | 51% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D | $157.60 | $197.00 | $56.74–$187.15 | 219% above | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY R | $24.00 | $30.00 | $8.64–$28.50 | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Zinc blood test CPT 84630 ZINC SERUM R | $8.80 | $11.00 | $3.17–$10.45 | 41% below | 20% |
| Zinc blood test inpatient CPT 84630 ZINC SERUM R | $8.80 | $11.00 | $3.17–$10.45 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA QUANT/QUD TS R | $11.20 | $14.00 | $4.03–$13.30 | 89% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG SUBUNIT TITER | $380.80 | $476.00 | $137.09–$452.20 | 269% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA QUANT/QUD TS R | $11.20 | $14.00 | $4.03–$13.30 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG SUBUNIT TITER | $380.80 | $476.00 | $137.09–$452.20 | — | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Florida | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine both sides CPT 64615 BOTOX FACE/MIGRAINE-BILAT | $556.00 | $695.00 | $200.16–$660.25 | — | 20% |
| Botox injections for chronic migraine one side CPT 64615 NEUROLYSIS FACE/TRIGEM/CERV RT | $712.00 | $890.00 | $256.32–$845.50 | 66% above | 20% |
| Botox injections for chronic migraine one side CPT 64615 NEUROLYSIS FACE/TRIGEM/CERV LT | $712.00 | $890.00 | $256.32–$845.50 | 66% above | 20% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 BOTOX FACE/MIGRAINE-BILAT | $556.00 | $695.00 | $200.16–$660.25 | — | 20% |
| Botox injections for chronic migraine inpatient one side CPT 64615 NEUROLYSIS FACE/TRIGEM/CERV RT | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Botox injections for chronic migraine inpatient one side CPT 64615 NEUROLYSIS FACE/TRIGEM/CERV LT | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DISTAL FIBULA FX W/O MAN | $278.40 | $348.00 | $100.22–$330.60 | 62% below | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL TX DISTAL FIBULA FX W/O MAN | $278.40 | $348.00 | $100.22–$330.60 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATAR FX W/O MAN EACH | $372.00 | $465.00 | $133.92–$441.75 | 49% below | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATAR FX W/O MAN EACH | $372.00 | $465.00 | $133.92–$441.75 | — | 20% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 LT HRT CATH W/COR/LT VENT INJ | $16,064.00 | $20,080.00 | $5,783.04–$19,076.00 | 7% above | 20% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 LT HRT CATH W/COR/LT VENT INJ | $16,064.00 | $20,080.00 | $5,783.04–$19,076.00 | — | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $1,804.00 | $2,255.00 | $649.44–$2,142.25 | 22% below | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION | $1,804.00 | $2,255.00 | $649.44–$2,142.25 | — | 20% |
| Catheter ablation for atrial fibrillation CPT 93656 EP/ABL AFIB/PULM VEIN | $50,260.00 | $62,825.00 | $18,093.60–$59,683.75 | 1% above | 20% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 EP/ABL AFIB/PULM VEIN | $50,260.00 | $62,825.00 | $18,093.60–$59,683.75 | — | 20% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $1,492.00 | $1,865.00 | $537.12–$1,771.75 | 25% below | 20% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVICAL | $1,492.00 | $1,865.00 | $537.12–$1,771.75 | 25% below | 20% |
| Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX | $1,492.00 | $1,865.00 | $537.12–$1,771.75 | — | 20% |
| Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVICAL | $1,492.00 | $1,865.00 | $537.12–$1,771.75 | — | 20% |
| Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION | $1,260.00 | $1,575.00 | $453.60–$1,496.25 | 76% above | 20% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION | $1,260.00 | $1,575.00 | $453.60–$1,496.25 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL FX DISTAL RADIA FX W/O MAN | $420.00 | $525.00 | $151.20–$498.75 | 30% below | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CL FX DISTAL RADIA FX W/O MAN | $420.00 | $525.00 | $151.20–$498.75 | — | 20% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/EUS | $2,840.00 | $3,550.00 | $1,022.40–$3,372.50 | 15% below | 20% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/EUS | $2,840.00 | $3,550.00 | $1,022.40–$3,372.50 | — | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 LOOP ELECTRODE BIOPSY,CERVIX | $1,960.00 | $2,450.00 | $705.60–$2,327.50 | 56% below | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 LOOP ELECTRODE BIOPSY,CERVIX | $1,960.00 | $2,450.00 | $705.60–$2,327.50 | — | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO,W/BX CERVIX&ENDOCERVICAL | $572.00 | $715.00 | $205.92–$679.25 | 19% below | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO,W/BX CERVIX&ENDOCERVICAL | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Coronary stent placement, one artery CPT 92928 PTCA & STENT 1ST ARTERY | $23,544.00 | $29,430.00 | $8,475.84–$27,958.50 | 6% below | 20% |
| Coronary stent placement, one artery CPT 92928 SHOCKWAVE,W/CORONARY STENT&PTA | $23,544.00 | $29,430.00 | $8,475.84–$27,958.50 | 6% below | 20% |
| Coronary stent placement, one artery inpatient CPT 92928 SHOCKWAVE,W/CORONARY STENT&PTA | $23,544.00 | $29,430.00 | $8,475.84–$27,958.50 | — | 20% |
| Coronary stent placement, one artery inpatient CPT 92928 PTCA & STENT 1ST ARTERY | $23,544.00 | $29,430.00 | $8,475.84–$27,958.50 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMVL CERUMEN W/IRRIGATION/UNI | $312.00 | $390.00 | $112.32–$370.50 | 7% above | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMVL CERUMEN W/IRRIGATION/UNI | $312.00 | $390.00 | $112.32–$370.50 | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 REMVL CERMUN W/ INTRUMENT/UNI | $235.20 | $294.00 | $84.67–$279.30 | 21% above | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMVL CERMUN W/ INTRUMENT/UNI | $235.20 | $294.00 | $84.67–$279.30 | — | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY-ENDOMETRIAL | $300.80 | $376.00 | $108.29–$357.20 | 39% below | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY-ENDOMETRIAL | $300.80 | $376.00 | $108.29–$357.20 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 EPIDURAL INJ C/T SPINE W/IMG | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION 62321 W/FLUORO HPO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION 62321 W/FLUORO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION 62321 W/FLUORO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION 62321 W/FLUORO TL | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION 62321 W/FLUORO HMC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR EPI INJ CERV/THORAC FL GUI | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 35% below | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION 62321 W/FLUORO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION 62321 W/FLUORO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION 62321 W/FLUORO HMC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION 62321 W/FLUORO HPO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION 62321 W/FLUORO TL | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR EPI INJ CERV/THORAC FL GUI | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 EPIDURAL INJ C/T SPINE W/IMG | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG | $768.00 | $960.00 | $276.48–$912.00 | at median | 20% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INJECTION EYE DRUG | $768.00 | $960.00 | $276.48–$912.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ FCT JT L/S SGL LVL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ FACET LUM/SACR LVL 1/64493 | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MEDIAL BRANCH BLK LVL1 64493RT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ FCT JT W/FL L/S SGL LVL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MEDIAL BRANCH BLK LVL1 64493LT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUM/SAC LV1 64493 LT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUM/SAC LV1 64493 RT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 14% below | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MEDIAL BRANCH BLK LVL1 64493LT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ FCT JT L/S SGL LVL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ FCT JT W/FL L/S SGL LVL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MEDIAL BRANCH BLK LVL1 64493RT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ FACET LUM/SACR LVL 1/64493 | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUM/SAC LV1 64493 RT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUM/SAC LV1 64493 LT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 XRAY INJ HSG | $692.00 | $865.00 | $242.20–$865.00 | 64% above | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 XRAY INJ HSG | $692.00 | $865.00 | $242.20–$865.00 | — | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE SIMP | $928.00 | $1,160.00 | $334.08–$1,102.00 | 32% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS | $1,204.00 | $1,505.00 | $433.44–$1,429.75 | 71% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SINGLE/SIMPLE | $1,204.00 | $1,505.00 | $433.44–$1,429.75 | 71% above | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE SIMP | $928.00 | $1,160.00 | $334.08–$1,102.00 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS | $1,204.00 | $1,505.00 | $433.44–$1,429.75 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS SINGLE/SIMPLE | $1,204.00 | $1,505.00 | $433.44–$1,429.75 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON,LIGAMENT,APONEURO | $255.20 | $319.00 | $91.87–$303.05 | 61% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT SGL | $255.20 | $319.00 | $91.87–$303.05 | 61% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $752.00 | $940.00 | $270.72–$893.00 | 15% above | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON/LIGAMENT SGL | $255.20 | $319.00 | $91.87–$303.05 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON,LIGAMENT,APONEURO | $255.20 | $319.00 | $91.87–$303.05 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT | $752.00 | $940.00 | $270.72–$893.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MEDS W/O US LG JOINT | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION HIP/KNEE/SHOULDER | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION JOINT | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT INJECTION 20610 | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJECT-MAJ BURSA/JOINT | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ JNT SHOULDER,HIP,KNEE | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJ MAJOR JNT NO US | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 NERVE BLOCK 20610 | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJ JNT/BURSA W/O US | $744.00 | $930.00 | $267.84–$883.50 | 6% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 NERVE BLK MAJ JOINT 20610 RT | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 NERVE BLK MAJ JOINT 20610 LT | $672.00 | $840.00 | $241.92–$798.00 | 15% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION HIP/KNEE/SHOULDER | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJECT-MAJ BURSA/JOINT | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT INJECTION 20610 | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECTION JOINT | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MEDS W/O US LG JOINT | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ JNT SHOULDER,HIP,KNEE | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 NERVE BLOCK 20610 | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJ MAJOR JNT NO US | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJ JNT/BURSA W/O US | $744.00 | $930.00 | $267.84–$883.50 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 NERVE BLK MAJ JOINT 20610 LT | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 NERVE BLK MAJ JOINT 20610 RT | $672.00 | $840.00 | $241.92–$798.00 | — | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT RX DELIV IMP-SURG | $424.00 | $530.00 | $152.64–$503.50 | 35% above | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT RX DELIV IMP-SURG | $424.00 | $530.00 | $152.64–$503.50 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTERM JNT,TEMP.WRST,ELB 20605 | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP INTERM JNT,TEMP.WRST,20605 | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ MEDS W/O US MED JOINT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ JNT WRIST,ELBOW,ANKLE JNT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ-INTERMED JOINT/BURSA | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ JNT WRIST,ELBOW ANKLE JNT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ JOINT WRIST/ELBOW 20605 LT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ JNT STERNL/CHOND 20605 RT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ JNT TEMP,WRST,ELB 20605 LT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ JOINT WRIST/ELBOW 20605 RT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ JNT STERNL/CHOND 20605 LT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ JNT TEMP,WRST,ELB 20605 RT | $532.00 | $665.00 | $191.52–$631.75 | 27% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INTERM JNT,TEMP.WRST,ELB 20605 | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ JNT WRIST,ELBOW,ANKLE JNT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ-INTERMED JOINT/BURSA | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP INTERM JNT,TEMP.WRST,20605 | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ MEDS W/O US MED JOINT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ JNT WRIST,ELBOW ANKLE JNT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ JNT TEMP,WRST,ELB 20605 RT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ JOINT WRIST/ELBOW 20605 LT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ JNT STERNL/CHOND 20605 RT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ JNT STERNL/CHOND 20605 LT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ JOINT WRIST/ELBOW 20605 RT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ JNT TEMP,WRST,ELB 20605 LT | $532.00 | $665.00 | $191.52–$631.75 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS FGR OR TOE JNT | $130.40 | $163.00 | $46.94–$154.85 | 72% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ MEDS W/O US SM JOINT | $130.40 | $163.00 | $46.94–$154.85 | 72% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ MEDS W/O US SM JOINT | $130.40 | $163.00 | $46.94–$154.85 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS FGR OR TOE JNT | $130.40 | $163.00 | $46.94–$154.85 | — | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER OS | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | 19% above | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER OPHTH UHS OD | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | 19% above | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER OPHTH UHS OS | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | 19% above | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER OD | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | 19% above | 20% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG LASER OS | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | — | 20% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG LASER OD | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | — | 20% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG LASER OPHTH UHS OS | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | — | 20% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG LASER OPHTH UHS OD | $1,536.00 | $1,920.00 | $552.96–$1,824.00 | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPR LAYER S,A,T,E,<2.5 CM | $940.00 | $1,175.00 | $338.40–$1,116.25 | 8% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT TRUNK/EXTREM < 2.5CM | $940.00 | $1,175.00 | $338.40–$1,116.25 | 8% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPR LAYER S,A,T,E,<2.5 CM | $940.00 | $1,175.00 | $338.40–$1,116.25 | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT TRUNK/EXTREM < 2.5CM | $940.00 | $1,175.00 | $338.40–$1,116.25 | — | 20% |
| Left heart catheterization, diagnostic one side CPT 93452 LT HRT CATH W/LT VENT INJ | $10,516.00 | $13,145.00 | $3,785.76–$12,487.75 | 6% above | 20% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 LT HRT CATH W/LT VENT INJ | $10,516.00 | $13,145.00 | $3,785.76–$12,487.75 | — | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 EPIDERAL INJ LUMBSACRAL/Caudal | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 37% below | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION 62323 W/FLUORO HMC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 37% below | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION 62323 W/FLUORO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 37% below | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION 62323 W/FLUORO HPO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 37% below | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION 62323 W/FLUORO TL | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 37% below | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT GUIDED INJ LUM/SAC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 37% below | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT GUIDED INJ LUM/SAC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION 62323 W/FLUORO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION 62323 W/FLUORO HMC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION 62323 W/FLUORO HPO | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION 62323 W/FLUORO TL | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDERAL INJ LUMBSACRAL/Caudal | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION 62322 W/O FLUORO | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | 44% below | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION 62322 W/O FLUORO HMC | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | 44% below | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION 62322 W/O FLUORO TL | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | 44% below | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION 62322 W/O FLUORO HPO | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | 44% below | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION 62322 W/O FLUORO HMC | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | — | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION 62322 W/O FLUORO TL | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | — | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION 62322 W/O FLUORO | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | — | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION 62322 W/O FLUORO HPO | $1,264.00 | $1,580.00 | $455.04–$1,501.00 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 SOMA NERVE BLK 64483 | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 3% below | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NERVE ROOT INJ LUMBOSAC INTL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 3% below | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NERVE ROOT INJ L-SP SGL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 3% below | 20% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 SOMA NERVE BLK LEV1 64483 LT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 3% below | 20% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 SOMA NERVE BLK LEV1 64483 RT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | 3% below | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NERVE ROOT INJ LUMBOSAC INTL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NERVE ROOT INJ L-SP SGL | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 SOMA NERVE BLK 64483 | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 SOMA NERVE BLK LEV1 64483 LT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 SOMA NERVE BLK LEV1 64483 RT | $2,144.00 | $2,680.00 | $771.84–$2,546.00 | — | 20% |
| Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE | $3,980.00 | $4,975.00 | $1,432.80–$4,726.25 | at median | 20% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE | $3,980.00 | $4,975.00 | $1,432.80–$4,726.25 | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION | $244.80 | $306.00 | $88.13–$290.70 | 86% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 BX-LESION;T/A/L 0.5 CM OR LESS | $1,696.00 | $2,120.00 | $610.56–$2,014.00 | 6% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EX BEN LES TK,ARM,L >0.5CM | $1,696.00 | $2,120.00 | $610.56–$2,014.00 | 6% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION | $244.80 | $306.00 | $88.13–$290.70 | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 BX-LESION;T/A/L 0.5 CM OR LESS | $1,696.00 | $2,120.00 | $610.56–$2,014.00 | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EX BEN LES TK,ARM,L >0.5CM | $1,696.00 | $2,120.00 | $610.56–$2,014.00 | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EX OT BEN LES F,E,E,N,L <0.5CM | $316.00 | $395.00 | $113.76–$375.25 | 83% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EX OT BEN LES F,E,E,N,L <0.5CM | $316.00 | $395.00 | $113.76–$375.25 | — | 20% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION POF NAIL PLATE | $596.00 | $745.00 | $214.56–$707.75 | 20% above | 20% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE | $596.00 | $745.00 | $214.56–$707.75 | 20% above | 20% |
| Nail removal (partial or complete), one nail CPT 11730 NAIL AVULSION, SINGLE | $596.00 | $745.00 | $214.56–$707.75 | 20% above | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE | $596.00 | $745.00 | $214.56–$707.75 | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL AVULSION, SINGLE | $596.00 | $745.00 | $214.56–$707.75 | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION POF NAIL PLATE | $596.00 | $745.00 | $214.56–$707.75 | — | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 SOMA NERVE BLK 64405 | $636.00 | $795.00 | $228.96–$755.25 | 36% below | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTH OCCIP NERVE | $636.00 | $795.00 | $228.96–$755.25 | 36% below | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 NERVE ROOT INJ,OCCIPITAL | $636.00 | $795.00 | $228.96–$755.25 | 36% below | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE ROOT INJ,OCCIPITAL | $636.00 | $795.00 | $228.96–$755.25 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANESTH OCCIP NERVE | $636.00 | $795.00 | $228.96–$755.25 | — | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 SOMA NERVE BLK 64405 | $636.00 | $795.00 | $228.96–$755.25 | — | 20% |
| Pacemaker implant (dual chamber) CPT 33208 INSERT ATRIAL/VENT PACER | $16,204.00 | $20,255.00 | $5,833.44–$19,242.25 | 21% below | 20% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT ATRIAL/VENT PACER | $16,204.00 | $20,255.00 | $5,833.44–$19,242.25 | — | 20% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESES W/IMG | $2,260.00 | $2,825.00 | $813.60–$2,683.75 | 19% above | 20% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W IMAGE | $2,260.00 | $2,825.00 | $813.60–$2,683.75 | 19% above | 20% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL,PARCENTESIS W/ IMG | $2,260.00 | $2,825.00 | $813.60–$2,683.75 | 19% above | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL,PARCENTESIS W/ IMG | $2,260.00 | $2,825.00 | $813.60–$2,683.75 | — | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W IMAGE | $2,260.00 | $2,825.00 | $813.60–$2,683.75 | — | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESES W/IMG | $2,260.00 | $2,825.00 | $813.60–$2,683.75 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL/NAIL MATRIX | $948.00 | $1,185.00 | $341.28–$1,125.75 | 25% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL & MATRIX | $948.00 | $1,185.00 | $341.28–$1,125.75 | 25% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL/NAIL MATRIX | $948.00 | $1,185.00 | $341.28–$1,125.75 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL & MATRIX | $948.00 | $1,185.00 | $341.28–$1,125.75 | — | 20% |
| Prostate biopsy CPT 55700 BIOPSY PROSTATE | $1,488.00 | $1,860.00 | $520.80–$1,860.00 | 54% below | 20% |
| Prostate biopsy CPT 55700 BIOPSY PROSTATE NEEDLE/PUNCH | $1,488.00 | $1,860.00 | $520.80–$1,860.00 | 54% below | 20% |
| Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE NEEDLE/PUNCH | $1,488.00 | $1,860.00 | $520.80–$1,860.00 | — | 20% |
| Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE | $1,488.00 | $1,860.00 | $520.80–$1,860.00 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 NEUROLYSIS 64635 | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | 45% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 NEUROLYSIS L/S SGL LVL 64635 | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | 45% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 NEUROLYSIS LUMB/SACRAL SGL LVL | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | 45% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 NEUROLYSIS FACET LUMB/SACR 1ST | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | 45% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 NEUROLYSIS LUMB/SAC 1ST LVL LT | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | 45% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 NEUROLYSIS LUMB/SAC 1ST LVL RT | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | 45% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 NEUROLYSIS FACET LUMB/SACR 1ST | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 NEUROLYSIS L/S SGL LVL 64635 | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 NEUROLYSIS LUMB/SACRAL SGL LVL | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 NEUROLYSIS 64635 | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 NEUROLYSIS LUMB/SAC 1ST LVL RT | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 NEUROLYSIS LUMB/SAC 1ST LVL LT | $1,992.00 | $2,490.00 | $717.12–$2,365.50 | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 FB SUBCUTAN INS/REMOVAL SIMPLE | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 13% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 13% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 INC & REMOVAL FB SUBQ SMPLE | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 13% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL FB SKIN | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 13% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION/RMVL FOREIGN BOD-SUBQ | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 13% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 INCIS/REML FRGN BODY,SQ,SIMPLE | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | 13% above | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REMOVAL FB SKIN | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCIS/REML FRGN BODY,SQ,SIMPLE | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & REMOVAL FB SUBQ SMPLE | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 FB SUBCUTAN INS/REMOVAL SIMPLE | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/RMVL FOREIGN BOD-SUBQ | $1,100.00 | $1,375.00 | $396.00–$1,306.25 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) both sides CPT 50590 LITHOTRIPTER-BILATERAL(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPTER-UNILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | 22% above | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 TW LITHOTRIPTER-BILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | 22% above | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 TW LITHOTRIPTER-UNILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | 22% above | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPTER-BILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | 22% above | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 LITHOTRIPTER-UNILATERAL(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | 22% above | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient both sides CPT 50590 LITHOTRIPTER-BILATERAL(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPTER-UNILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPTER-BILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 TW LITHOTRIPTER-UNILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 TW LITHOTRIPTER-BILATER(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient one side CPT 50590 LITHOTRIPTER-UNILATERAL(ESWL) | $22,308.00 | $27,885.00 | $8,030.88–$26,490.75 | — | 20% |
| Short arm cast (elbow to hand) CPT 29075 APPLICAT CAST ELBOW TO FINGER | $640.00 | $800.00 | $230.40–$760.00 | 13% below | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICAT CAST ELBOW TO FINGER | $640.00 | $800.00 | $230.40–$760.00 | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION FOREARM SPLINT | $616.00 | $770.00 | $221.76–$731.50 | 61% above | 20% |
| Short arm splint (forearm and hand) CPT 29125 STATIC ARM SPLINT APPLICATION | $616.00 | $770.00 | $221.76–$731.50 | 61% above | 20% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SPLINT SHORT ARM | $616.00 | $770.00 | $221.76–$731.50 | 61% above | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SPLINT SHORT ARM | $616.00 | $770.00 | $221.76–$731.50 | — | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION FOREARM SPLINT | $616.00 | $770.00 | $221.76–$731.50 | — | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 STATIC ARM SPLINT APPLICATION | $616.00 | $770.00 | $221.76–$731.50 | — | 20% |
| Short leg splint (calf to foot) CPT 29515 APP OF SHORT LEG SPLINT | $572.00 | $715.00 | $205.92–$679.25 | 24% above | 20% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT | $572.00 | $715.00 | $205.92–$679.25 | 24% above | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 APP OF SHORT LEG SPLINT | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE TRUNK/EXTREM < 2.5CM | $600.00 | $750.00 | $216.00–$712.50 | 19% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR SPL S,N,A,G,T,E<2.5CM | $600.00 | $750.00 | $216.00–$712.50 | 19% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR SPL S,N,A,G,T,E<2.5CM | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE TRUNK/EXTREM < 2.5CM | $600.00 | $750.00 | $216.00–$712.50 | — | 20% |
| Skin biopsy, punch, one lesion CPT 11104 BIOPSY PUNCH SKN;SGL LESION | $382.40 | $478.00 | $137.66–$454.10 | 50% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESIO | $397.60 | $497.00 | $143.14–$472.15 | 48% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $397.60 | $497.00 | $143.14–$472.15 | 48% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 BIOPSY PUNCH SKIN;SGL LESION | $397.60 | $497.00 | $143.14–$472.15 | 48% below | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 BIOPSY PUNCH SKN;SGL LESION | $382.40 | $478.00 | $137.66–$454.10 | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESIO | $397.60 | $497.00 | $143.14–$472.15 | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION | $397.60 | $497.00 | $143.14–$472.15 | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 BIOPSY PUNCH SKIN;SGL LESION | $397.60 | $497.00 | $143.14–$472.15 | — | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/< | $370.40 | $463.00 | $133.34–$439.85 | 78% below | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/< | $370.40 | $463.00 | $133.34–$439.85 | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS UP TO 15 | $170.40 | $213.00 | $61.34–$202.35 | 62% below | 20% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <w15 | $170.40 | $213.00 | $61.34–$202.35 | 62% below | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS <w15 | $170.40 | $213.00 | $61.34–$202.35 | — | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS UP TO 15 | $170.40 | $213.00 | $61.34–$202.35 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 11% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE,DIAGNOTIC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 11% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | 11% above | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE,DIAGNOTIC | $1,668.00 | $2,085.00 | $600.48–$1,980.75 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR SPL S,N,A,G,T,E,2.6-7.5 C | $624.00 | $780.00 | $224.64–$741.00 | 12% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE TRUNK/EXTREM 2.6-7.5 CM | $624.00 | $780.00 | $224.64–$741.00 | 12% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE TRUNK/EXTREM 2.6-7.5 CM | $624.00 | $780.00 | $224.64–$741.00 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR SPL S,N,A,G,T,E,2.6-7.5 C | $624.00 | $780.00 | $224.64–$741.00 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR SPL F,E,E,N,L,<2.5 CM | $572.00 | $715.00 | $205.92–$679.25 | 22% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR SPL F,E,E,N,L,<2.5 CM | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $452.00 | $565.00 | $162.72–$536.75 | 7% below | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES | $452.00 | $565.00 | $162.72–$536.75 | — | 20% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMAGING | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | 1% below | 20% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS/W/INSERTION | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | 1% below | 20% |
| Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS PUNCTURE | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | 1% below | 20% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS PUNC PLEURA | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | 1% below | 20% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS/PUNC PLEURA | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | 1% below | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS PUNC PLEURA | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | — | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS/W/INSERTION | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | — | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS/PUNC PLEURA | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | — | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS PUNCTURE | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | — | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ IMAGING | $1,872.00 | $2,340.00 | $673.92–$2,223.00 | — | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1 OR 2 MUSCL | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT 1/2 MUSCLES | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ PIRIFORMIS MUSCLE LT | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ PIRIFORMIS MUSCLE RT | $712.00 | $890.00 | $256.32–$845.50 | 10% below | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECTION | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PNT 1/2 MUSCLES | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1 OR 2 MUSCL | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ PIRIFORMIS MUSCLE RT | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ PIRIFORMIS MUSCLE LT | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD TRANSMURAL DRAIN CYST | $3,584.00 | $4,480.00 | $1,290.24–$4,256.00 | 43% below | 20% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 EGD TRANSMURAL DRAIN CYST | $3,584.00 | $4,480.00 | $1,290.24–$4,256.00 | — | 20% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVEN ABLATION EXTREM RF,FIR | $12,880.00 | $16,100.00 | $4,636.80–$15,295.00 | 77% above | 20% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF, 1ST VEIN | $12,880.00 | $16,100.00 | $4,636.80–$15,295.00 | 77% above | 20% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS RF, 1ST VEIN | $12,880.00 | $16,100.00 | $4,636.80–$15,295.00 | — | 20% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVEN ABLATION EXTREM RF,FIR | $12,880.00 | $16,100.00 | $4,636.80–$15,295.00 | — | 20% |
| Wart removal, up to 14 warts CPT 17110 DESTR BEN SKN LES 1-14 LESIONS | $142.40 | $178.00 | $51.26–$169.10 | 67% below | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTR BEN SKN LES 1-14 LESIONS | $142.40 | $178.00 | $51.26–$169.10 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN AND SUBQ | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | 8% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SKN & SUBQ TISSUE | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | 8% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT - SKIN & TISSUE | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | 8% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT-SKIN & TISSUE | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | 8% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SKN & SUBQ TISSUE | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT - SKIN & TISSUE | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT-SKIN & TISSUE | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN AND SUBQ | $1,052.00 | $1,315.00 | $378.72–$1,249.25 | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Florida | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 ED-AUTOTRANSFUSION | $704.00 | $880.00 | $253.44–$836.00 | 46% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP ADMIN OF BLOOD 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | 33% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | 33% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | 33% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 ADMIN OF BLOOD 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | 33% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP ADMIN OF BLOOD 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | 10% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 ADMIN OF BLOOD 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | 10% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | 10% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | 10% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP ADMIN OF BLOOD >4 UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | 8% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 ADMIN OF BLOOD >4 UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | 8% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 ADMIN OF BLOOD 4 OR MORE UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | 8% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 4 OR MORE UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | 8% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 ADMIN OF BLOOD 4 OR MORE | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | 8% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 PLATELET TRANSFUSION | $1,332.00 | $1,665.00 | $479.52–$1,581.75 | 3% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP PLATELET TRANSFUSION | $1,332.00 | $1,665.00 | $479.52–$1,581.75 | 3% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 PLATELET TRANSFUSION ONLY | $1,332.00 | $1,665.00 | $479.52–$1,581.75 | 3% above | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED-AUTOTRANSFUSION | $704.00 | $880.00 | $253.44–$836.00 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP ADMIN OF BLOOD 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ADMIN OF BLOOD 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 1-2 UNITS | $872.00 | $1,090.00 | $313.92–$1,035.50 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ADMIN OF BLOOD 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP ADMIN OF BLOOD 3 UNITS | $1,164.00 | $1,455.00 | $419.04–$1,382.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ADMIN OF BLOOD 4 OR MORE | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ADMIN OF BLOOD 4 OR MORE UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ADMIN OF BLOOD >4 UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP ADMIN OF BLOOD >4 UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 4 OR MORE UNITS | $1,196.00 | $1,495.00 | $430.56–$1,420.25 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PLATELET TRANSFUSION | $1,332.00 | $1,665.00 | $479.52–$1,581.75 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PLATELET TRANSFUSION ONLY | $1,332.00 | $1,665.00 | $479.52–$1,581.75 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP PLATELET TRANSFUSION | $1,332.00 | $1,665.00 | $479.52–$1,581.75 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL W/MEDS | $49.60 | $62.00 | $17.86–$58.90 | 84% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY TX W/MEDS SUBSEQUENT | $58.40 | $73.00 | $21.02–$69.35 | 82% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HELIUM/OXYGEN THER EA | $80.80 | $101.00 | $29.09–$95.95 | 75% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY TX W/MEDS INITIAL | $98.40 | $123.00 | $35.42–$116.85 | 69% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 POSITIVE ARWAY PRESSURE SUB TX | $117.60 | $147.00 | $42.34–$139.65 | 63% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MDI SUBSEQUENT TX | $117.60 | $147.00 | $42.34–$139.65 | 63% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 POSITIVE ARWAY PRESSURE INI TX | $117.60 | $147.00 | $42.34–$139.65 | 63% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL WITH MED | $712.00 | $890.00 | $256.32–$845.50 | 125% above | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL W/MEDS | $49.60 | $62.00 | $17.86–$58.90 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY TX W/MEDS SUBSEQUENT | $58.40 | $73.00 | $21.02–$69.35 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HELIUM/OXYGEN THER EA | $80.80 | $101.00 | $29.09–$95.95 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY TX W/MEDS INITIAL | $98.40 | $123.00 | $35.42–$116.85 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL MDI SUBSEQUENT TX | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 POSITIVE ARWAY PRESSURE SUB TX | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 POSITIVE ARWAY PRESSURE INI TX | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL WITH MED | $712.00 | $890.00 | $256.32–$845.50 | — | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION, 1ST HOUR | $1,204.00 | $1,505.00 | $433.44–$1,429.75 | 21% above | 20% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION, 1ST HOUR | $1,204.00 | $1,505.00 | $433.44–$1,429.75 | — | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 TRAUMA ALT FIELD ACT LVL2-NSRG | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED PSY LEVEL VI(CRIT CARE)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 TRAUMA ALT FIELD ACT LVL1-SRG | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED PEDS Lvl VI(Critical Car)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED OB LEVEL VI-(CRIT CARE)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED PSY LEVEL VI(CRITICAL CARE) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED LEVEL VI (CRITICAL CARE)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED LEVEL VI (CRITICAL CARE) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED PEDS Lvl VI (Critical Care) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 ED OB LEVEL VI (CRIT CARE) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | 7% above | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED PSY LEVEL VI(CRIT CARE)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED PSY LEVEL VI(CRITICAL CARE) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED PEDS Lvl VI(Critical Car)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED PEDS Lvl VI (Critical Care) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 TRAUMA ALT FIELD ACT LVL1-SRG | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 TRAUMA ALT FIELD ACT LVL2-NSRG | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED LEVEL VI (CRITICAL CARE)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED LEVEL VI (CRITICAL CARE) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED OB LEVEL VI (CRIT CARE) | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED OB LEVEL VI-(CRIT CARE)-M | $5,304.00 | $6,630.00 | $1,909.44–$6,298.50 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM/TRANSPLANT | $556.00 | $695.00 | $200.16–$660.25 | 36% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM-PEDS | $556.00 | $695.00 | $200.16–$660.25 | 36% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM | $556.00 | $695.00 | $200.16–$660.25 | 36% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM | $556.00 | $695.00 | $200.16–$660.25 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-PEDS | $556.00 | $695.00 | $200.16–$660.25 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM/TRANSPLANT | $556.00 | $695.00 | $200.16–$660.25 | — | 20% |
| Electroconvulsive therapy (ECT), one session CPT 90870 E.C. THERAPY | $536.00 | $670.00 | $192.96–$636.50 | 64% below | 20% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 E.C. THERAPY | $536.00 | $670.00 | $192.96–$636.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED PEDS Level I | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED PSYCH LEVEL I-M | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED OB LEVEL I | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED PSYCH LEVEL I | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL I-M | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED PEDS Level I-M | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED OB LEVEL I-M | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL I | $456.00 | $570.00 | $194.94–$541.50 | 7% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED OB LEVEL I-M | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL I | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL I-M | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED OB LEVEL I | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED PEDS Level I | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED PSYCH LEVEL I-M | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED PSYCH LEVEL I | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED PEDS Level I-M | $456.00 | $570.00 | $194.94–$541.50 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED OB LEVEL II-M | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL II-M | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL II | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED PEDS Level II-M | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED PSYCH LEVEL II-M | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED PSYCH LEVEL II | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED OB LEVEL II | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED PEDS Level II | $628.00 | $785.00 | $268.47–$745.75 | 31% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL II | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED PSYCH LEVEL II-M | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED PSYCH LEVEL II | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED PEDS Level II-M | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED PEDS Level II | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED OB LEVEL II-M | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED OB LEVEL II | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL II-M | $628.00 | $785.00 | $268.47–$745.75 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED OB LEVEL III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED OB LEVEL III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED PSYCH LEVEL III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED PEDS Level III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED PSYCH LEVEL III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED PEDS Level III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | 12% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED PSYCH LEVEL III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED PSYCH LEVEL III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED PEDS Level III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED PEDS Level III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED OB LEVEL III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED OB LEVEL III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL III | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL III-M | $1,360.00 | $1,700.00 | $581.40–$1,615.00 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED OB LEVEL IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED PSYCH LEVEL IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED PSYCH LEVEL IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED OB LEVEL IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED PEDS Level IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED PEDS Level IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | 2% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED PEDS Level IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED OB LEVEL IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED PSYCH LEVEL IV | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED PSYCH LEVEL IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED PEDS Level IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED OB LEVEL IV-M | $2,468.00 | $3,085.00 | $1,055.07–$2,930.75 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED PEDS Level V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED PSYCH LEVEL V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED PSYCH LEVEL V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED OB LEVEL V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED OB LEVEL V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED PEDS Level V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | 31% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED PSYCH LEVEL V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED PEDS Level V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED OB LEVEL V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED OB LEVEL V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED PSYCH LEVEL V-M | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED PEDS Level V | $4,256.00 | $5,320.00 | $1,819.44–$5,054.00 | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST-MEMBER | $572.00 | $715.00 | $205.92–$679.25 | 69% below | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS PHARM/CPC/EKG | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | 8% below | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TREADMILL/CPC/NUC* | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | 8% below | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS PHARM | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | 8% below | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL TEST | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | 8% below | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST-MEMBER | $572.00 | $715.00 | $205.92–$679.25 | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TREADMILL/CPC/NUC* | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL TEST | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS PHARM | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS PHARM/CPC/EKG | $1,704.00 | $2,130.00 | $613.44–$2,023.50 | — | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY 1/2 HR | $186.40 | $233.00 | $67.10–$221.35 | 68% below | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY 1 HR | $186.40 | $233.00 | $67.10–$221.35 | 68% below | 20% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY 1 HR | $186.40 | $233.00 | $67.10–$221.35 | — | 20% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY 1/2 HR | $186.40 | $233.00 | $67.10–$221.35 | — | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY THER 60MIN WO PATIENT | $203.20 | $254.00 | $73.15–$241.30 | 48% below | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY THER 30MIN WO PATIENT | $203.20 | $254.00 | $73.15–$241.30 | 48% below | 20% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THER 30MIN WO PATIENT | $203.20 | $254.00 | $73.15–$241.30 | — | 20% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THER 60MIN WO PATIENT | $203.20 | $254.00 | $73.15–$241.30 | — | 20% |
| Group psychotherapy session CPT 90853 GROUP THERAPY | $32.80 | $41.00 | $11.81–$38.95 | 90% below | 20% |
| Group psychotherapy session CPT 90853 GROUP THERAPY 1 HR | $193.60 | $242.00 | $69.70–$229.90 | 39% below | 20% |
| Group psychotherapy session CPT 90853 GROUP THERAPY (1/2 HR) | $193.60 | $242.00 | $69.70–$229.90 | 39% below | 20% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY | $32.80 | $41.00 | $11.81–$38.95 | — | 20% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY (1/2 HR) | $193.60 | $242.00 | $69.70–$229.90 | — | 20% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 1 HR | $193.60 | $242.00 | $69.70–$229.90 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION ONLY, 1ST HOUR | $696.00 | $870.00 | $250.56–$826.50 | 6% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION,INITIAL 31-60 MIN | $696.00 | $870.00 | $250.56–$826.50 | 6% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION, 1ST HR | $696.00 | $870.00 | $250.56–$826.50 | 6% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION,INITIAL 31-60 MIN | $696.00 | $870.00 | $250.56–$826.50 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION, 1ST HR | $696.00 | $870.00 | $250.56–$826.50 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION ONLY, 1ST HOUR | $696.00 | $870.00 | $250.56–$826.50 | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST MED, 1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION MEDS, 1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST MED, 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 INJ INFUSION 1ST,MED 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY, FIRST HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 OP IV INFUSION MEDS. 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION MEDS,1ST HR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY, 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION MEDS,1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INF MEDS,1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | at median | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY, FIRST HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION 1ST MED, 1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF MEDS,1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION 1ST MED, 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INJ INFUSION 1ST,MED 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION 1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 OP IV INFUSION MEDS. 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION MEDS,1ST HR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY, 1ST HR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION MEDS,1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION MEDS, 1ST HOUR | $772.00 | $965.00 | $277.92–$916.75 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP IM INJ NON-NARCOTIC | $42.40 | $53.00 | $15.26–$50.35 | 76% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION-ANTIBIOTIC | $43.20 | $54.00 | $15.55–$51.30 | 75% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP INJECTION-ANTIBIOTIC | $43.20 | $54.00 | $15.55–$51.30 | 75% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP INJECTION IM/SQ | $51.20 | $64.00 | $18.43–$60.80 | 71% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ | $51.20 | $64.00 | $18.43–$60.80 | 71% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUB-Q INJECTION | $66.40 | $83.00 | $23.90–$78.85 | 62% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ PARAVERTEBRAL BLOCK | $113.60 | $142.00 | $40.90–$134.90 | 35% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUB-Q Injection | $181.60 | $227.00 | $65.38–$215.65 | 3% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ INTRAMUSCULAR | $181.60 | $227.00 | $65.38–$215.65 | 3% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMIN OF INJECTION (SUB/IM) | $181.60 | $227.00 | $65.38–$215.65 | 3% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUB Q OR IM | $181.60 | $227.00 | $65.38–$215.65 | 3% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SUB Q OR IM | $181.60 | $227.00 | $65.38–$215.65 | 3% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMIN INJ (SUB/IM) | $181.60 | $227.00 | $65.38–$215.65 | 3% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP IM INJ NON-NARCOTIC | $42.40 | $53.00 | $15.26–$50.35 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION-ANTIBIOTIC | $43.20 | $54.00 | $15.55–$51.30 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP INJECTION-ANTIBIOTIC | $43.20 | $54.00 | $15.55–$51.30 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP INJECTION IM/SQ | $51.20 | $64.00 | $18.43–$60.80 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ | $51.20 | $64.00 | $18.43–$60.80 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUB-Q INJECTION | $66.40 | $83.00 | $23.90–$78.85 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ PARAVERTEBRAL BLOCK | $113.60 | $142.00 | $40.90–$134.90 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ADMIN OF INJECTION (SUB/IM) | $181.60 | $227.00 | $65.38–$215.65 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ INTRAMUSCULAR | $181.60 | $227.00 | $65.38–$215.65 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUB Q OR IM | $181.60 | $227.00 | $65.38–$215.65 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUB-Q Injection | $181.60 | $227.00 | $65.38–$215.65 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUB Q OR IM | $181.60 | $227.00 | $65.38–$215.65 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ADMIN INJ (SUB/IM) | $181.60 | $227.00 | $65.38–$215.65 | — | 20% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $256.00 | $320.00 | $92.16–$304.00 | 10% below | 20% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $256.00 | $320.00 | $92.16–$304.00 | — | 20% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NVR CND TST 7-8 STUDIES | $920.00 | $1,150.00 | $331.20–$1,092.50 | 19% below | 20% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NVR CND TST 7-8 STUDIES | $920.00 | $1,150.00 | $331.20–$1,092.50 | — | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15 MIN/PT | $155.20 | $194.00 | $55.87–$184.30 | 4% above | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15 MIN | $155.20 | $194.00 | $55.87–$184.30 | 4% above | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15 MIN/OT | $155.20 | $194.00 | $55.87–$184.30 | 4% above | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEURORMUSCULAR RE-EDUCATION | $155.20 | $194.00 | $55.87–$184.30 | 4% above | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15 MIN | $155.20 | $194.00 | $55.87–$184.30 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURORMUSCULAR RE-EDUCATION | $155.20 | $194.00 | $55.87–$184.30 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15 MIN/PT | $155.20 | $194.00 | $55.87–$184.30 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15 MIN/OT | $155.20 | $194.00 | $55.87–$184.30 | — | 20% |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT NEW-LEVEL 3 W/TX | $141.60 | $177.00 | $49.56–$177.00 | 73% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 PRE-TRANSPL CONSULT LVL 3-NEW | $196.80 | $246.00 | $68.88–$246.00 | 62% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 POST-TRANSPL VISIT NEW LEVEL 3 | $196.80 | $246.00 | $68.88–$246.00 | 62% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 PRE-TRANSPL VISIT NEW LEVEL 3 | $196.80 | $246.00 | $68.88–$246.00 | 62% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 POST-TRANSPL CONSULT LVL 3-NEW | $196.80 | $246.00 | $68.88–$246.00 | 62% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT NEW-LEVEL 3 | $212.80 | $266.00 | $74.48–$266.00 | 59% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 WND CTR VST NEW INTER | $212.80 | $266.00 | $74.48–$266.00 | 59% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT NEW LEVEL 3 | $212.80 | $266.00 | $74.48–$266.00 | 59% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 CONSULT NEW LVL 3 | $212.80 | $266.00 | $74.48–$266.00 | 59% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 OUTPATIENT VISIT LEVEL 2 | $212.80 | $266.00 | $74.48–$266.00 | 59% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 OUTPATIENT VST LVL 2-NEW | $212.80 | $266.00 | $74.48–$266.00 | 59% below | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OP VISIT NEW-LEVEL 3 W/TX | $141.60 | $177.00 | $49.56–$177.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PRE-TRANSPL VISIT NEW LEVEL 3 | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PRE-TRANSPL CONSULT LVL 3-NEW | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 POST-TRANSPL VISIT NEW LEVEL 3 | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 POST-TRANSPL CONSULT LVL 3-NEW | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OP VISIT NEW-LEVEL 3 | $212.80 | $266.00 | $74.48–$266.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OUTPATIENT VISIT LEVEL 2 | $212.80 | $266.00 | $74.48–$266.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OUTPATIENT VST LVL 2-NEW | $212.80 | $266.00 | $74.48–$266.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WND CTR VST NEW INTER | $212.80 | $266.00 | $74.48–$266.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT NEW LEVEL 3 | $212.80 | $266.00 | $74.48–$266.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 CONSULT NEW LVL 3 | $212.80 | $266.00 | $74.48–$266.00 | — | 20% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT NEW-LEVEL 4 W/TX | $157.60 | $197.00 | $55.16–$197.00 | 77% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT NEW-LEVEL 4 | $157.60 | $197.00 | $55.16–$197.00 | 77% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 WND CTR VST NEW EXT | $177.60 | $222.00 | $62.16–$222.00 | 74% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 CONSULT NEW LVL 4 | $197.60 | $247.00 | $69.16–$247.00 | 72% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT NEW LEVEL 4 | $197.60 | $247.00 | $69.16–$247.00 | 72% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 POST-TRANSPL CONSULT LVL 4-NEW | $314.40 | $393.00 | $110.04–$393.00 | 55% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 PRE-TRANSPL CONSULT LVL 4-NEW | $314.40 | $393.00 | $110.04–$393.00 | 55% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 POST-TRANSPL VISIT NEW LEVEL 4 | $314.40 | $393.00 | $110.04–$393.00 | 55% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 PRE-TRANSPL VISIT NEW LEVEL 4 | $314.40 | $393.00 | $110.04–$393.00 | 55% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 OUTPATIENT VST LVL 3-NEW | $314.40 | $393.00 | $110.04–$393.00 | 55% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 OUTPATIENT VISIT LEVEL 3-NEW | $314.40 | $393.00 | $110.04–$393.00 | 55% below | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT NEW-LEVEL 4 W/TX | $157.60 | $197.00 | $55.16–$197.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT NEW-LEVEL 4 | $157.60 | $197.00 | $55.16–$197.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WND CTR VST NEW EXT | $177.60 | $222.00 | $62.16–$222.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT NEW LEVEL 4 | $197.60 | $247.00 | $69.16–$247.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 CONSULT NEW LVL 4 | $197.60 | $247.00 | $69.16–$247.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 POST-TRANSPL VISIT NEW LEVEL 4 | $314.40 | $393.00 | $110.04–$393.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PRE-TRANSPL CONSULT LVL 4-NEW | $314.40 | $393.00 | $110.04–$393.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 POST-TRANSPL CONSULT LVL 4-NEW | $314.40 | $393.00 | $110.04–$393.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PRE-TRANSPL VISIT NEW LEVEL 4 | $314.40 | $393.00 | $110.04–$393.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OUTPATIENT VST LVL 3-NEW | $314.40 | $393.00 | $110.04–$393.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OUTPATIENT VISIT LEVEL 3-NEW | $314.40 | $393.00 | $110.04–$393.00 | — | 20% |
| New patient office visit, about 60 minutes CPT 99205 WND CTR VST NEW COMPLEX | $145.60 | $182.00 | $50.96–$182.00 | 81% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT NEW-LEVEL 5 | $240.00 | $300.00 | $84.00–$300.00 | 69% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT NEW-LEVEL 5 W/TX | $240.00 | $300.00 | $84.00–$300.00 | 69% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 CONSULT NEW LVL 5 | $276.80 | $346.00 | $96.88–$346.00 | 64% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT NEW LEVEL 5 | $276.80 | $346.00 | $96.88–$346.00 | 64% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 POST-TRANSPL CONSULT LVL 5-NEW | $392.80 | $491.00 | $137.48–$491.00 | 49% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 POST-TRANSPL VISIT NEW LEVEL 5 | $392.80 | $491.00 | $137.48–$491.00 | 49% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 PRE-TRANSPL CONSULT LVL 5-NEW | $392.80 | $491.00 | $137.48–$491.00 | 49% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 PRE-TRANSPL VISIT NEW LEVEL 5 | $392.80 | $491.00 | $137.48–$491.00 | 49% below | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WND CTR VST NEW COMPLEX | $145.60 | $182.00 | $50.96–$182.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT NEW-LEVEL 5 | $240.00 | $300.00 | $84.00–$300.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT NEW-LEVEL 5 W/TX | $240.00 | $300.00 | $84.00–$300.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 CONSULT NEW LVL 5 | $276.80 | $346.00 | $96.88–$346.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT NEW LEVEL 5 | $276.80 | $346.00 | $96.88–$346.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 POST-TRANSPL CONSULT LVL 5-NEW | $392.80 | $491.00 | $137.48–$491.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 POST-TRANSPL VISIT NEW LEVEL 5 | $392.80 | $491.00 | $137.48–$491.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PRE-TRANSPL CONSULT LVL 5-NEW | $392.80 | $491.00 | $137.48–$491.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PRE-TRANSPL VISIT NEW LEVEL 5 | $392.80 | $491.00 | $137.48–$491.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT NEW-LEVEL 2 W/TX | $110.40 | $138.00 | $38.64–$138.00 | 59% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT NEW LEVEL 2 | $126.40 | $158.00 | $44.24–$158.00 | 53% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CONSULT NEW LVL 2 | $126.40 | $158.00 | $44.24–$158.00 | 53% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WND CTR VST NEW LMTD | $150.40 | $188.00 | $52.64–$188.00 | 44% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT NEW-LEVEL 2 | $168.00 | $210.00 | $58.80–$210.00 | 37% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 POST-TRANSPL CONSULT LVL 2-NEW | $168.80 | $211.00 | $59.08–$211.00 | 37% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 PRE-TRANSPL VISIT NEW LEVEL 2 | $168.80 | $211.00 | $59.08–$211.00 | 37% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 PRE-TRANSPL CONSULT LVL 2-NEW | $168.80 | $211.00 | $59.08–$211.00 | 37% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 POST-TRANSPL VISIT NEW LEVEL 2 | $168.80 | $211.00 | $59.08–$211.00 | 37% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP VISIT NEW-LEVEL 2 W/TX | $110.40 | $138.00 | $38.64–$138.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CONSULT NEW LVL 2 | $126.40 | $158.00 | $44.24–$158.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT NEW LEVEL 2 | $126.40 | $158.00 | $44.24–$158.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WND CTR VST NEW LMTD | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP VISIT NEW-LEVEL 2 | $168.00 | $210.00 | $58.80–$210.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PRE-TRANSPL VISIT NEW LEVEL 2 | $168.80 | $211.00 | $59.08–$211.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PRE-TRANSPL CONSULT LVL 2-NEW | $168.80 | $211.00 | $59.08–$211.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 POST-TRANSPL VISIT NEW LEVEL 2 | $168.80 | $211.00 | $59.08–$211.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 POST-TRANSPL CONSULT LVL 2-NEW | $168.80 | $211.00 | $59.08–$211.00 | — | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INITIAL NUTRITION ASSESSMENT | $96.80 | $121.00 | $34.85–$114.95 | 13% above | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION EVAL 15 MIN | $96.80 | $121.00 | $34.85–$114.95 | 13% above | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITIONAL THERAPY ASSESSMENT | $96.80 | $121.00 | $34.85–$114.95 | 13% above | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION EVAL 15 MIN | $96.80 | $121.00 | $34.85–$114.95 | — | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITIONAL THERAPY ASSESSMENT | $96.80 | $121.00 | $34.85–$114.95 | — | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INITIAL NUTRITION ASSESSMENT | $96.80 | $121.00 | $34.85–$114.95 | — | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL-LOW COMP | $436.00 | $545.00 | $156.96–$517.75 | 11% below | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 EVAL/OT 30MIN | $436.00 | $545.00 | $156.96–$517.75 | 11% below | 20% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 EVAL/OT 30MIN | $436.00 | $545.00 | $156.96–$517.75 | — | 20% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL-LOW COMP | $436.00 | $545.00 | $156.96–$517.75 | — | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 EVAL/PT 45MIN | $504.00 | $630.00 | $181.44–$598.50 | 8% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL-HIGH COMP | $504.00 | $630.00 | $181.44–$598.50 | 8% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 EVAL/PT 45MIN | $504.00 | $630.00 | $181.44–$598.50 | — | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL-HIGH COMP | $504.00 | $630.00 | $181.44–$598.50 | — | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL-LOW COMP | $508.00 | $635.00 | $182.88–$603.25 | 13% above | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 EVAL/PT 20MIN | $508.00 | $635.00 | $182.88–$603.25 | 13% above | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL-LOW COMP | $508.00 | $635.00 | $182.88–$603.25 | — | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 EVAL/PT 20MIN | $508.00 | $635.00 | $182.88–$603.25 | — | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL-MOD COMP | $504.00 | $630.00 | $181.44–$598.50 | 3% above | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVAL/PT 30MIN | $504.00 | $630.00 | $181.44–$598.50 | 3% above | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL-MOD COMP | $504.00 | $630.00 | $181.44–$598.50 | — | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 EVAL/PT 30MIN | $504.00 | $630.00 | $181.44–$598.50 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY | $120.80 | $151.00 | $43.49–$143.45 | 13% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN | $120.80 | $151.00 | $43.49–$143.45 | 13% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN | $120.80 | $151.00 | $43.49–$143.45 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY | $120.80 | $151.00 | $43.49–$143.45 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCEDURE 15 MIN | $157.60 | $197.00 | $56.74–$187.15 | at median | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 15 MIN/OT | $157.60 | $197.00 | $56.74–$187.15 | at median | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERC 15 MIN | $157.60 | $197.00 | $56.74–$187.15 | at median | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE (TELE) | $157.60 | $197.00 | $56.74–$187.15 | at median | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE | $157.60 | $197.00 | $56.74–$187.15 | at median | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 15 MIN/PT | $157.60 | $197.00 | $56.74–$187.15 | at median | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 15 MIN/PT | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCEDURE 15 MIN | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE (TELE) | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 15 MIN/OT | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERC 15 MIN | $157.60 | $197.00 | $56.74–$187.15 | — | 20% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS | $211.20 | $264.00 | $76.03–$250.80 | 46% below | 20% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRVCS | $211.20 | $264.00 | $76.03–$250.80 | — | 20% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHER 30MIN PATIENT/FAMIL | $167.20 | $209.00 | $60.19–$198.55 | 57% below | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHER 30MIN PATIENT/FAMIL | $167.20 | $209.00 | $60.19–$198.55 | — | 20% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHER 45MIN PATIENT/FAMIL | $240.00 | $300.00 | $86.40–$285.00 | 39% below | 20% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHER 45MIN PATIENT/FAMIL | $240.00 | $300.00 | $86.40–$285.00 | — | 20% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHER 60MIN PATIENT/FAMIL | $444.00 | $555.00 | $159.84–$527.25 | 6% below | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHER 60MIN PATIENT/FAMIL | $444.00 | $555.00 | $159.84–$527.25 | — | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 CESSATION-SMOKING >3-10 MIN | $39.20 | $49.00 | $14.11–$46.55 | 37% below | 20% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 CESSATION-SMOKING >3-10 MIN | $39.20 | $49.00 | $14.11–$46.55 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WND CTR VST EST.COMPLEX | $152.00 | $190.00 | $53.20–$190.00 | 77% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT ESTABLISHED-LEVEL 5 | $214.40 | $268.00 | $75.04–$268.00 | 67% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT ESTAB-LEVEL 5 W/TX | $214.40 | $268.00 | $75.04–$268.00 | 67% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT EST LEVEL 5 | $247.20 | $309.00 | $86.52–$309.00 | 62% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 PRE-TRANSPL VISIT EST LEVEL 5 | $369.60 | $462.00 | $129.36–$462.00 | 43% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 POST-TRANSPL VISIT EST LEVEL 5 | $369.60 | $462.00 | $129.36–$462.00 | 43% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WND CTR VST EST.COMPLEX | $152.00 | $190.00 | $53.20–$190.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT ESTABLISHED-LEVEL 5 | $214.40 | $268.00 | $75.04–$268.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT ESTAB-LEVEL 5 W/TX | $214.40 | $268.00 | $75.04–$268.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT EST LEVEL 5 | $247.20 | $309.00 | $86.52–$309.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 POST-TRANSPL VISIT EST LEVEL 5 | $369.60 | $462.00 | $129.36–$462.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PRE-TRANSPL VISIT EST LEVEL 5 | $369.60 | $462.00 | $129.36–$462.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT EST LEVEL 3 | $135.20 | $169.00 | $47.32–$169.00 | 63% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT ESTAB-LEVEL 3 W/TX | $156.00 | $195.00 | $54.60–$195.00 | 57% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 POST-TRANSPL VISIT EST LEVEL 3 | $175.20 | $219.00 | $61.32–$219.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 SUTURE LYSIS OS | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PRE-TRANSPL VISIT EST LEVEL 3 | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PAT VISIT 15 MIN W/PHYS | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT VISIT 15 W/PHYS | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WND CTR VST EST.INTERMEDIATE | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT ESTABLISHED-LEVEL 3 | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 SUTURE LYSIS OD | $176.80 | $221.00 | $61.88–$221.00 | 51% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT EST LEVEL 3 | $135.20 | $169.00 | $47.32–$169.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT ESTAB-LEVEL 3 W/TX | $156.00 | $195.00 | $54.60–$195.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 POST-TRANSPL VISIT EST LEVEL 3 | $175.20 | $219.00 | $61.32–$219.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SUTURE LYSIS OD | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PT VISIT 15 W/PHYS | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PAT VISIT 15 MIN W/PHYS | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT ESTABLISHED-LEVEL 3 | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PRE-TRANSPL VISIT EST LEVEL 3 | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SUTURE LYSIS OS | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WND CTR VST EST.INTERMEDIATE | $176.80 | $221.00 | $61.88–$221.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT ESTABLISHED-LEVEL 4 | $121.60 | $152.00 | $42.56–$152.00 | 77% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT ESTAB-LEVEL 4 W/TX | $121.60 | $152.00 | $42.56–$152.00 | 77% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT EST LEVEL 4 | $152.00 | $190.00 | $53.20–$190.00 | 72% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WND CTR VST EST.EXTENDED | $222.40 | $278.00 | $77.84–$278.00 | 59% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OUTPATIENT VISIT LEVEL 3-EST | $222.40 | $278.00 | $77.84–$278.00 | 59% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PRE-TRANSPL VISIT EST LEVEL 4 | $222.40 | $278.00 | $77.84–$278.00 | 59% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 POST-TRANSPL VISIT EST LEVEL 4 | $225.60 | $282.00 | $78.96–$282.00 | 58% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT ESTABLISHED-LEVEL 4 | $121.60 | $152.00 | $42.56–$152.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT ESTAB-LEVEL 4 W/TX | $121.60 | $152.00 | $42.56–$152.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT EST LEVEL 4 | $152.00 | $190.00 | $53.20–$190.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WND CTR VST EST.EXTENDED | $222.40 | $278.00 | $77.84–$278.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PRE-TRANSPL VISIT EST LEVEL 4 | $222.40 | $278.00 | $77.84–$278.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OUTPATIENT VISIT LEVEL 3-EST | $222.40 | $278.00 | $77.84–$278.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 POST-TRANSPL VISIT EST LEVEL 4 | $225.60 | $282.00 | $78.96–$282.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 MD OFFICE VISIT & EVALUAT | $34.40 | $43.00 | $12.04–$43.00 | 90% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DRAIN REMOVAL | $143.20 | $179.00 | $50.12–$179.00 | 59% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPATIENT VST LVL 1-EST | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT VISIT 10 MIN W/PHYS | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT EST LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WND CTR VST EST.LIMITED | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT ESTAB-LEVEL 2 W/TX | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PRE-TRANSPL VISIT EST LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 POST-TRANSPL VISIT EST LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPATIENT VISIT LEVEL 1 | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PAT VISIT 10 MIN W/PHYS | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT ESTABLISHED-LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | 57% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 MD OFFICE VISIT & EVALUAT | $34.40 | $43.00 | $12.04–$43.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 DRAIN REMOVAL | $143.20 | $179.00 | $50.12–$179.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WND CTR VST EST.LIMITED | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OUTPATIENT VST LVL 1-EST | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PAT VISIT 10 MIN W/PHYS | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PT VISIT 10 MIN W/PHYS | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT EST LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OUTPATIENT VISIT LEVEL 1 | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 POST-TRANSPL VISIT EST LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PRE-TRANSPL VISIT EST LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT ESTAB-LEVEL 2 W/TX | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT ESTABLISHED-LEVEL 2 | $150.40 | $188.00 | $52.64–$188.00 | — | 20% |
| Speech and language evaluation CPT 92523 LANG EVAL W/O DYSARTHRIA EVAL | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation CPT 92523 LANGUAGE EVAL 15/ST | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation CPT 92523 LANGUAGE EVAL 60/ST | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation CPT 92523 EVAL-SOUND PRODUCE.LANG (TELE) | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation CPT 92523 LANGUAGE EVAL 30/ST | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation CPT 92523 EVAL-SOUND PRODUCE.LANG COMP/E | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation CPT 92523 LANG EVAL W/DYSARTHRIA EVAL | $516.00 | $645.00 | $185.76–$612.75 | 12% below | 20% |
| Speech and language evaluation inpatient CPT 92523 LANG EVAL W/DYSARTHRIA EVAL | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech and language evaluation inpatient CPT 92523 LANGUAGE EVAL 15/ST | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech and language evaluation inpatient CPT 92523 EVAL-SOUND PRODUCE.LANG COMP/E | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech and language evaluation inpatient CPT 92523 EVAL-SOUND PRODUCE.LANG (TELE) | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech and language evaluation inpatient CPT 92523 LANGUAGE EVAL 30/ST | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech and language evaluation inpatient CPT 92523 LANG EVAL W/O DYSARTHRIA EVAL | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech and language evaluation inpatient CPT 92523 LANGUAGE EVAL 60/ST | $516.00 | $645.00 | $185.76–$612.75 | — | 20% |
| Speech therapy session, individual CPT 92507 SPEECH LANG VOICE TX 1-60 MIN | $187.20 | $234.00 | $67.39–$222.30 | 51% below | 20% |
| Speech therapy session, individual CPT 92507 SPEECH LANG VOICE TX 1-75 MIN | $200.00 | $250.00 | $72.00–$237.50 | 48% below | 20% |
| Speech therapy session, individual CPT 92507 SPEECH LANG VOICE TX 1-90 MIN | $262.40 | $328.00 | $94.46–$311.60 | 32% below | 20% |
| Speech therapy session, individual CPT 92507 LANGUAGE TREATMENT 15MIN/ST | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 SPEECH LANG VOICE TX 1-45 MIN | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 SPEECH LANG VOICE TX 1-30 MIN | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 SPEECH LANG VOICE TX 1-15 MIN | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 TX-SPEECH LANGUAGE (TELE) | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 TX-SPEECH LANGUAGE | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 LANGUAGE TREATMENT 60 MIN/ST | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual CPT 92507 LANGUAGE TREATMENT 30 MIN/ST | $271.20 | $339.00 | $97.63–$322.05 | 29% below | 20% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH LANG VOICE TX 1-60 MIN | $187.20 | $234.00 | $67.39–$222.30 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH LANG VOICE TX 1-75 MIN | $200.00 | $250.00 | $72.00–$237.50 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH LANG VOICE TX 1-90 MIN | $262.40 | $328.00 | $94.46–$311.60 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 TX-SPEECH LANGUAGE | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH LANG VOICE TX 1-45 MIN | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH LANG VOICE TX 1-30 MIN | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 LANGUAGE TREATMENT 60 MIN/ST | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 LANGUAGE TREATMENT 15MIN/ST | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH LANG VOICE TX 1-15 MIN | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 TX-SPEECH LANGUAGE (TELE) | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Speech therapy session, individual inpatient CPT 92507 LANGUAGE TREATMENT 30 MIN/ST | $271.20 | $339.00 | $97.63–$322.05 | — | 20% |
| Spirometry (breathing test) CPT 94010 VENTILATION STUDY | $484.00 | $605.00 | $174.24–$574.75 | 45% above | 20% |
| Spirometry (breathing test) inpatient CPT 94010 VENTILATION STUDY | $484.00 | $605.00 | $174.24–$574.75 | — | 20% |
| Spirometry before and after a bronchodilator CPT 94060 VENT STDY PRE/PST | $752.00 | $940.00 | $270.72–$893.00 | 17% below | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 VENT STDY PRE/PST | $752.00 | $940.00 | $270.72–$893.00 | — | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15 MIN/OT | $161.60 | $202.00 | $58.18–$191.90 | 8% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY | $161.60 | $202.00 | $58.18–$191.90 | 8% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY (TELE) | $161.60 | $202.00 | $58.18–$191.90 | 8% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 15 MIN | $161.60 | $202.00 | $58.18–$191.90 | 8% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15 MIN/PT | $161.60 | $202.00 | $58.18–$191.90 | 8% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV DIRECT 15MIN | $161.60 | $202.00 | $58.18–$191.90 | 8% above | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 15 MIN | $161.60 | $202.00 | $58.18–$191.90 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15 MIN/OT | $161.60 | $202.00 | $58.18–$191.90 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15 MIN/PT | $161.60 | $202.00 | $58.18–$191.90 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY | $161.60 | $202.00 | $58.18–$191.90 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY (TELE) | $161.60 | $202.00 | $58.18–$191.90 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV DIRECT 15MIN | $161.60 | $202.00 | $58.18–$191.90 | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY,THERAPEUT | $331.20 | $414.00 | $119.23–$393.30 | 1% below | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $331.20 | $414.00 | $119.23–$393.30 | 1% below | 20% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY | $331.20 | $414.00 | $119.23–$393.30 | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY,THERAPEUT | $331.20 | $414.00 | $119.23–$393.30 | — | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Florida | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 VACC (23-24) 30MCG | $248.80 | $311.00 | $87.08–$311.00 | 4% above | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 VACC (23-24) 30MCG | $248.80 | $311.00 | $87.08–$311.00 | 4% above | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 VACC (23-24) 30MCG | $248.80 | $311.00 | $87.08–$311.00 | — | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 VACC (23-24) 30MCG | $248.80 | $311.00 | $87.08–$311.00 | — | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VACCINE-VARICELLA | $88.80 | $111.00 | $31.08–$111.00 | 72% below | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE | $372.80 | $466.00 | $130.48–$466.00 | 18% above | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE | $372.80 | $466.00 | $130.48–$466.00 | 18% above | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VACCINE-VARICELLA | $88.80 | $111.00 | $31.08–$111.00 | — | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE | $372.80 | $466.00 | $130.48–$466.00 | — | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE | $372.80 | $466.00 | $130.48–$466.00 | — | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PAPILLOMAVIRUS 9 VACCINE 0.5ML | $612.80 | $766.00 | $214.48–$766.00 | 34% below | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PAPILLOMAVIRUS 9 VACCINE 0.5ML | $612.80 | $766.00 | $214.48–$766.00 | 34% below | 20% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PAPILLOMAVIRUS 9 VACCINE 0.5ML | $612.80 | $766.00 | $214.48–$766.00 | — | 20% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PAPILLOMAVIRUS 9 VACCINE 0.5ML | $612.80 | $766.00 | $214.48–$766.00 | — | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 VACCINE-HEPATITIS A | $80.80 | $101.00 | $28.28–$101.00 | 53% below | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 50U/ML SYR | $171.20 | $214.00 | $59.92–$214.00 | at median | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 50U/ML SYR | $171.20 | $214.00 | $59.92–$214.00 | at median | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VAC 1440U/ML VIAL | $179.20 | $224.00 | $62.72–$224.00 | 4% above | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VAC 1440U/ML VIAL | $179.20 | $224.00 | $62.72–$224.00 | 4% above | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VACCINE-HEPATITIS A | $80.80 | $101.00 | $28.28–$101.00 | — | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 50U/ML SYR | $171.20 | $214.00 | $59.92–$214.00 | — | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 50U/ML SYR | $171.20 | $214.00 | $59.92–$214.00 | — | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VAC 1440U/ML VIAL | $179.20 | $224.00 | $62.72–$224.00 | — | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VAC 1440U/ML VIAL | $179.20 | $224.00 | $62.72–$224.00 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VACCINE-HEPATITIS B | $55.20 | $69.00 | $19.32–$69.00 | 76% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE 20 MCG/ML | $151.20 | $189.00 | $52.92–$189.00 | 35% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE 20 MCG/ML | $151.20 | $189.00 | $52.92–$189.00 | 35% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B ADULT VAC 10MCG/1ML VIAL | $178.40 | $223.00 | $62.44–$223.00 | 24% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B ADULT VAC 10MCG/1ML VIAL | $178.40 | $223.00 | $62.44–$223.00 | 24% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VACCINE-HEPATITIS B | $55.20 | $69.00 | $19.32–$69.00 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE 20 MCG/ML | $151.20 | $189.00 | $52.92–$189.00 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE 20 MCG/ML | $151.20 | $189.00 | $52.92–$189.00 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B ADULT VAC 10MCG/1ML VIAL | $178.40 | $223.00 | $62.44–$223.00 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B ADULT VAC 10MCG/1ML VIAL | $178.40 | $223.00 | $62.44–$223.00 | — | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA H-D VIRUS VAC INJ | $144.00 | $180.00 | $50.40–$180.00 | 48% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA H-D VIRUS VAC INJ | $144.00 | $180.00 | $50.40–$180.00 | 48% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA H-D VIRUS VAC INJ | $144.00 | $180.00 | $50.40–$180.00 | — | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA H-D VIRUS VAC INJ | $144.00 | $180.00 | $50.40–$180.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINE-MMR | $55.20 | $69.00 | $19.32–$69.00 | 76% below | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASL/MUMPS/RUB VAC 0.5ML VIAL | $196.80 | $246.00 | $68.88–$246.00 | 13% below | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACC PF | $196.80 | $246.00 | $68.88–$246.00 | 13% below | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASL/MUMPS/RUB VAC 0.5ML VIAL | $196.80 | $246.00 | $68.88–$246.00 | 13% below | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACC PF | $196.80 | $246.00 | $68.88–$246.00 | 13% below | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINE-MMR | $55.20 | $69.00 | $19.32–$69.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VACC PF | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASL/MUMPS/RUB VAC 0.5ML VIAL | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASL/MUMPS/RUB VAC 0.5ML VIAL | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VACC PF | $196.80 | $246.00 | $68.88–$246.00 | — | 20% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VACC 0.5ML | $319.20 | $399.00 | $111.72–$399.00 | 39% below | 20% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VACC 0.5ML | $319.20 | $399.00 | $111.72–$399.00 | 39% below | 20% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJ VACC 0.5ML | $319.20 | $399.00 | $111.72–$399.00 | — | 20% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJ VACC 0.5ML | $319.20 | $399.00 | $111.72–$399.00 | — | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP | $477.60 | $597.00 | $167.16–$597.00 | 36% below | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP | $477.60 | $597.00 | $167.16–$597.00 | 36% below | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP | $477.60 | $597.00 | $167.16–$597.00 | — | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP | $477.60 | $597.00 | $167.16–$597.00 | — | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL-20 VACCINE 0.5 ML | $558.40 | $698.00 | $195.44–$698.00 | 41% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL-20 VACCINE 0.5 ML | $558.40 | $698.00 | $195.44–$698.00 | 41% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL-20 VACCINE 0.5 ML | $558.40 | $698.00 | $195.44–$698.00 | — | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL-20 VACCINE 0.5 ML | $558.40 | $698.00 | $195.44–$698.00 | — | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC 23MCG/0.5ML | $253.60 | $317.00 | $88.76–$317.00 | 36% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC 23MCG/0.5ML | $253.60 | $317.00 | $88.76–$317.00 | 36% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC 23MCG/0.5ML | $253.60 | $317.00 | $88.76–$317.00 | — | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC 23MCG/0.5ML | $253.60 | $317.00 | $88.76–$317.00 | — | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML | $1,107.20 | $1,384.00 | $387.52–$1,384.00 | 29% below | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML | $1,107.20 | $1,384.00 | $387.52–$1,384.00 | 29% below | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML | $1,107.20 | $1,384.00 | $387.52–$1,384.00 | — | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML | $1,107.20 | $1,384.00 | $387.52–$1,384.00 | — | 20% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF A & B/PF 120 MCG | $630.40 | $788.00 | $220.64–$788.00 | 10% below | 20% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF A & B/PF 120 MCG | $630.40 | $788.00 | $220.64–$788.00 | 10% below | 20% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACC PREF A & B/PF 120 MCG | $630.40 | $788.00 | $220.64–$788.00 | — | 20% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACC PREF A & B/PF 120 MCG | $630.40 | $788.00 | $220.64–$788.00 | — | 20% |
| Rabies vaccine, one dose CPT 90675 RABIES VACC CHICK EMB 2.5 UNIT | $882.40 | $1,103.00 | $78.90–$714.76 | 29% below | 20% |
| Rabies vaccine, one dose CPT 90675 RABIES VACC CHICK EMB 2.5 UNIT | $882.40 | $1,103.00 | $317.66–$1,047.85 | 29% below | 20% |
| Rabies vaccine, one dose CPT 90675 RABIES VAC DIPL CELL 2.5IU/ML | $924.80 | $1,156.00 | $332.93–$1,098.20 | 26% below | 20% |
| Rabies vaccine, one dose CPT 90675 RABIES VAC DIPL CELL 2.5IU/ML | $924.80 | $1,156.00 | $78.90–$714.76 | 26% below | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC CHICK EMB 2.5 UNIT | $882.40 | $1,103.00 | $317.66–$1,047.85 | — | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC CHICK EMB 2.5 UNIT | $882.40 | $1,103.00 | $317.66–$1,047.85 | — | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC DIPL CELL 2.5IU/ML | $924.80 | $1,156.00 | $332.93–$1,098.20 | — | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC DIPL CELL 2.5IU/ML | $924.80 | $1,156.00 | $332.93–$1,098.20 | — | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER 50 MCG/0.5 ML | $424.80 | $531.00 | $148.68–$531.00 | 22% above | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER 50 MCG/0.5 ML | $424.80 | $531.00 | $148.68–$531.00 | 22% above | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER 50 MCG/0.5 ML | $424.80 | $531.00 | $148.68–$531.00 | — | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER 50 MCG/0.5 ML | $424.80 | $531.00 | $148.68–$531.00 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPHTH TOX ADULT 0.5ML | $155.20 | $194.00 | $54.32–$194.00 | at median | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPHTH TOX ADULT 0.5ML | $155.20 | $194.00 | $54.32–$194.00 | at median | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPHTH TOX ADULT 0.5ML | $155.20 | $194.00 | $54.32–$194.00 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPHTH TOX ADULT 0.5ML | $155.20 | $194.00 | $54.32–$194.00 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP | $64.80 | $81.00 | $22.68–$81.00 | 72% below | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH/TET/ACL PERT BOOST 0.5ML | $100.80 | $126.00 | $35.28–$126.00 | 56% below | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH/TET/ACL PERT BOOST 0.5ML | $100.80 | $126.00 | $35.28–$126.00 | 56% below | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP | $64.80 | $81.00 | $22.68–$81.00 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH/TET/ACL PERT BOOST 0.5ML | $100.80 | $126.00 | $35.28–$126.00 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH/TET/ACL PERT BOOST 0.5ML | $100.80 | $126.00 | $35.28–$126.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN FLU | $16.80 | $21.00 | $6.05–$19.95 | 86% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF VACCINE | $16.80 | $21.00 | $6.05–$19.95 | 86% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-FLU | $16.80 | $21.00 | $6.05–$19.95 | 86% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-PAPILLOMARVIRUS | $80.00 | $100.00 | $28.80–$95.00 | 35% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-MENINGITIDIS | $80.00 | $100.00 | $28.80–$95.00 | 35% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ Monkeypox | $113.60 | $142.00 | $40.90–$134.90 | 8% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-HEM B | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-MMR | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-PNEUMOVAX | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-HEP A | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-RABIES | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-TETANUS/DIPHERIA | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUN TETANUS/DIPHERIA | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-POLIO | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUN-TETANUS/DIPHERIA | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-MENINGOCOCCAL | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-TETANUS | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-DPT | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-RSV | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN HEPATITIS B | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-PNEU | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-HEPATITIS B | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-HEPATITUS B | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN PNEU | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-PNEUMOCOCCAL | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-Zoster | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-INFANRIX | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ-IMMUN-HEPATITIS A | $117.60 | $147.00 | $42.34–$139.65 | 5% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN FLU | $16.80 | $21.00 | $6.05–$19.95 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-FLU | $16.80 | $21.00 | $6.05–$19.95 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF VACCINE | $16.80 | $21.00 | $6.05–$19.95 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-MENINGITIDIS | $80.00 | $100.00 | $28.80–$95.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-PAPILLOMARVIRUS | $80.00 | $100.00 | $28.80–$95.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ Monkeypox | $113.60 | $142.00 | $40.90–$134.90 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN PNEU | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN HEPATITIS B | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-TETANUS | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-MENINGOCOCCAL | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-POLIO | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-HEPATITIS A | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUN-TETANUS/DIPHERIA | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-RABIES | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-HEM B | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-Zoster | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-TETANUS/DIPHERIA | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-HEPATITUS B | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUN TETANUS/DIPHERIA | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-INFANRIX | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-MMR | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-RSV | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-PNEU | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-PNEUMOVAX | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-DPT | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-PNEUMOCOCCAL | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-HEP A | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ-IMMUN-HEPATITIS B | $117.60 | $147.00 | $42.34–$139.65 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-FLU | $11.20 | $14.00 | $3.92–$14.00 | 91% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN ADDL-FLU | $11.20 | $14.00 | $3.92–$14.00 | 91% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ Monkeypox-addl | $44.80 | $56.00 | $15.68–$56.00 | 62% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-PNEU ADDTL | $126.40 | $158.00 | $44.24–$158.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-PAPILVIRUS/ADDTL | $126.40 | $158.00 | $44.24–$158.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN PNEU ADDTL | $126.40 | $158.00 | $44.24–$158.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-addl MENINGITIDIS | $126.40 | $158.00 | $44.24–$158.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-HEPATITIS A | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-HEM B | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-HEPATITIS B | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-MENINGOCOCCAL | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-HEP B | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-PNEUMOVAX | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-EACH ADD VAC OR TOXI | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-FLU-PNEU-ADDTL | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN PNEUM-ADDTL | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-PNEUMOCOCCAL | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-PNEUMO | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-PNEUMOCOCCAL ADDTL | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-POLIO | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-MMR | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-INFANRIX | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-addl Zoster | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDTL-MENINGOCOCCAL | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-DPT | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-TETANUS | $127.20 | $159.00 | $44.52–$159.00 | 7% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ-IMMUN-ADDL-RSV | $134.40 | $168.00 | $47.04–$168.00 | 13% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-FLU | $11.20 | $14.00 | $3.92–$14.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN ADDL-FLU | $11.20 | $14.00 | $3.92–$14.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ Monkeypox-addl | $44.80 | $56.00 | $15.68–$56.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN PNEU ADDTL | $126.40 | $158.00 | $44.24–$158.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-addl MENINGITIDIS | $126.40 | $158.00 | $44.24–$158.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-PAPILVIRUS/ADDTL | $126.40 | $158.00 | $44.24–$158.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-PNEU ADDTL | $126.40 | $158.00 | $44.24–$158.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-MENINGOCOCCAL | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-DPT | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-POLIO | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-FLU-PNEU-ADDTL | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-PNEUMOCOCCAL | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-EACH ADD VAC OR TOXI | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-PNEUMOVAX | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-PNEUMOCOCCAL ADDTL | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-PNEUMO | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-HEP B | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-TETANUS | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-MMR | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDTL-MENINGOCOCCAL | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-INFANRIX | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-HEPATITIS A | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-addl Zoster | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-HEPATITIS B | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-HEM B | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN PNEUM-ADDTL | $127.20 | $159.00 | $44.52–$159.00 | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ-IMMUN-ADDL-RSV | $134.40 | $168.00 | $47.04–$168.00 | — | 20% |
Source file: https://halifax.pt.panaceainc.com/MRFDownload/halifax/deltona