Hospital

Cordova Community Medical Center

Cordova Community Medical Center in Cordova, AK publishes cash prices for 213 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Alaska median for 151 of 212 procedures and above it for 44. By typical cash price it ranks #3 of 15 Alaska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

Po Box 160 - 602 Chase Avenue, Cordova, AK 99574 Collected Sep 27, 2026 Source price file (907) 424-8000

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 021307 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW FRONTAL: FF	$365.50	$731.00	—	4% below	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW FRONTAL: FF	$365.50	$731.00	—	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 TYPE III HOME SLEEP STUDY 95806	$484.00	$968.00	—	9% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 TYPE III HOME SLEEP STUDY 95806	$484.00	$968.00	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 XR ABDOMEN LIMITED	$439.00	$878.00	—	31% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 XR ABDOMEN LIMITED	$439.00	$878.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX EXT VEINS UNI	$772.00	$1,544.00	—	32% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX EXT VEINS UNI	$772.00	$1,544.00	—	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$85.50	$171.00	—	48% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$85.50	$171.00	—	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$41.00	$82.00	—	18% below	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$41.00	$82.00	—	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$135.50	$271.00	—	60% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$135.50	$271.00	—	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST, EACH ALLERGEN	$27.50	$55.00	—	40% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST, EACH ALLERGEN	$27.50	$55.00	—	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 RHEUMATOID ARTHRITIS PANEL	$119.50	$239.00	—	28% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$119.50	$239.00	—	28% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 RHEUMATOID ARTHRITIS PANEL	$119.50	$239.00	—	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$119.50	$239.00	—	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE ANTIBODY	$74.50	$149.00	—	2% below	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN REFLEX TO TITER	$74.50	$149.00	—	2% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN REFLEX TO TITER	$74.50	$149.00	—	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE ANTIBODY	$74.50	$149.00	—	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$228.00	$456.00	—	23% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$228.00	$456.00	—	—	50%
Basic metabolic panel (blood test) CPT 80048 ISTAT BMP	$102.50	$205.00	—	16% below	50%
Basic metabolic panel (blood test) CPT 80048 QUEST BMP	$102.50	$205.00	—	16% below	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$108.00	$216.00	—	12% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 ISTAT BMP	$102.50	$205.00	—	—	50%
Basic metabolic panel (blood test) inpatient CPT 80048 QUEST BMP	$102.50	$205.00	—	—	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$108.00	$216.00	—	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BIOPSY, PATHOLOGY LEVEL IV	$216.50	$433.00	—	17% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BIOPSY, PATHOLOGY LEVEL IV	$216.50	$433.00	—	—	50%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD	$170.50	$341.00	—	21% below	50%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD	$170.50	$341.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$28.00	$56.00	—	23% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$28.00	$56.00	—	—	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD	$35.50	$71.00	—	at median	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD	$35.50	$71.00	—	—	50%
Blood lead test CPT 83655 LEAD TESTING	$49.00	$98.00	—	37% below	50%
Blood lead test CPT 83655 LEAD CAPILLARY	$49.00	$98.00	—	37% below	50%
Blood lead test CPT 83655 LEAD AND ZINC PROTOPORPHYRIN EVAL	$67.00	$134.00	—	13% below	50%
Blood lead test inpatient CPT 83655 LEAD TESTING	$49.00	$98.00	—	—	50%
Blood lead test inpatient CPT 83655 LEAD CAPILLARY	$49.00	$98.00	—	—	50%
Blood lead test inpatient CPT 83655 LEAD AND ZINC PROTOPORPHYRIN EVAL	$67.00	$134.00	—	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, QUAL SERUM	$97.50	$195.00	—	3% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, QUAL SERUM	$97.50	$195.00	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPE	$58.00	$116.00	—	5% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE - QUEST	$58.00	$116.00	—	5% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE - QUEST	$58.00	$116.00	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPE	$58.00	$116.00	—	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 PROVIDENCE CRP	$21.50	$43.00	—	63% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP)	$76.00	$152.00	—	32% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 PROVIDENCE CRP	$21.50	$43.00	—	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (CRP)	$76.00	$152.00	—	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9	$185.00	$370.00	—	20% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9	$185.00	$370.00	—	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA125	$141.00	$282.00	—	19% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125	$141.00	$282.00	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 RNA (QUEST)	$106.00	$212.00	—	at median	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 RNA QUEST	$106.00	$212.00	—	at median	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 CEPHEID PCR TEST	$111.50	$223.00	—	5% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 ABBOTT PCR TEST	$111.50	$223.00	—	5% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 RNA (QUEST)	$106.00	$212.00	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 RNA QUEST	$106.00	$212.00	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 ABBOTT PCR TEST	$111.50	$223.00	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 CEPHEID PCR TEST	$111.50	$223.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$49.00	$98.00	—	66% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis RNA, TMA	$81.00	$162.00	—	43% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA ONLY	$129.50	$259.00	—	9% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AND GONORRHEA (CT/NG)	$129.50	$259.00	—	9% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP PROBE	$49.00	$98.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis RNA, TMA	$81.00	$162.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA ONLY	$129.50	$259.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AND GONORRHEA (CT/NG)	$129.50	$259.00	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 QUEST LIPID	$98.00	$196.00	—	at median	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$103.00	$206.00	—	5% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 QUEST LIPID	$98.00	$196.00	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$103.00	$206.00	—	—	50%
Complete blood count (CBC) with differential CPT 85025 QUEST CBC	$112.50	$225.00	—	7% above	50%
Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED DIFF (IN-HOUSE)	$131.50	$263.00	—	25% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 QUEST CBC	$112.50	$225.00	—	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTOMATED DIFF (IN-HOUSE)	$131.50	$263.00	—	—	50%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM W/PLT	$96.00	$192.00	—	19% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM W/PLT	$96.00	$192.00	—	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 QUEST CMP, PLASMA	$123.50	$247.00	—	24% below	50%
Comprehensive metabolic panel (blood test) CPT 80053 QUEST CMP	$123.50	$247.00	—	24% below	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$130.00	$260.00	—	20% below	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 QUEST CMP	$123.50	$247.00	—	—	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 QUEST CMP, PLASMA	$123.50	$247.00	—	—	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$130.00	$260.00	—	—	50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$271.50	$543.00	—	26% above	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$271.50	$543.00	—	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$113.00	$226.00	—	23% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$113.00	$226.00	—	—	50%
Estradiol blood test CPT 82670 ESTRADIOL, ULTRASENSITIVE (M)	$222.00	$444.00	—	29% above	50%
Estradiol blood test CPT 82670 ESTRADIOL (W)	$222.00	$444.00	—	29% above	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL (W)	$222.00	$444.00	—	—	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL, ULTRASENSITIVE (M)	$222.00	$444.00	—	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH AND LH	$50.50	$101.00	—	74% below	50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$148.00	$296.00	—	24% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH AND LH	$50.50	$101.00	—	—	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$148.00	$296.00	—	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$264.00	$528.00	—	43% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$264.00	$528.00	—	—	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$141.00	$282.00	—	34% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$141.00	$282.00	—	—	50%
Folate (folic acid) blood test CPT 82746 FOLATE, SERUM	$106.50	$213.00	—	22% below	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM	$106.50	$213.00	—	—	50%
Free T3 thyroid hormone test CPT 84481 T3, FREE	$102.00	$204.00	—	26% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 T3, FREE	$102.00	$204.00	—	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE	$162.00	$324.00	—	16% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE	$162.00	$324.00	—	—	50%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$72.50	$145.00	—	42% below	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$72.50	$145.00	—	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$173.50	$347.00	—	—	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$173.50	$347.00	—	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE 1 HR 50G	$85.50	$171.00	—	23% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE 1 HR 50G	$85.50	$171.00	—	—	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HR 100G	$109.50	$219.00	—	5% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HR 100G	$109.50	$219.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$49.00	$98.00	—	51% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae RNA, TMA	$81.00	$162.00	—	19% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE ONLY	$129.50	$259.00	—	30% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB	$49.00	$98.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae RNA, TMA	$81.00	$162.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE ONLY	$129.50	$259.00	—	—	50%
H. pylori antibody blood test CPT 86677 H PYLORI IGG,IGA,IGM	$145.00	$290.00	—	54% above	50%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG,IGA,IGM	$145.00	$290.00	—	—	50%
H. pylori stool antigen test CPT 87338 H PYLORI AG, EIA STOOL	$180.50	$361.00	—	2% below	50%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG, EIA STOOL	$180.50	$361.00	—	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN W/ REFLEXES	$77.00	$154.00	—	32% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN W/ REFLEXES	$77.00	$154.00	—	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 REFLEX HPV mRNA TEST	$108.50	$217.00	—	5% above	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 REFLEX HPV mRNA TEST	$108.50	$217.00	—	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCATED HEMOGLOBIN	$123.00	$246.00	—	at median	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCATED HEMOGLOBIN	$123.00	$246.00	—	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY QUAL	$91.00	$182.00	—	at median	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY QUAL	$91.00	$182.00	—	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$71.00	$142.00	—	at median	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$71.00	$142.00	—	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$103.50	$207.00	—	8% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$103.50	$207.00	—	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANTITATIVE VIRAL RNA	$182.00	$364.00	—	44% below	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANTITATIVE VIRAL RNA	$182.00	$364.00	—	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX VIRUS TYPE 1	$73.00	$146.00	—	31% above	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX VIRUS TYPE 1	$73.00	$146.00	—	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS TYPE 2	$73.00	$146.00	—	10% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS TYPE 2	$73.00	$146.00	—	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HS-CRP	$113.00	$226.00	—	31% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HS-CRP	$113.00	$226.00	—	—	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$229.50	$459.00	—	9% above	50%
Homocysteine blood test CPT 83090 METHYLMALONIC ACID & HOMOCYSTEINE	$257.50	$515.00	—	23% above	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$229.50	$459.00	—	—	50%
Homocysteine blood test inpatient CPT 83090 METHYLMALONIC ACID & HOMOCYSTEINE	$257.50	$515.00	—	—	50%
Insulin blood test CPT 83525 INSULIN	$118.00	$236.00	—	175% above	50%
Insulin blood test inpatient CPT 83525 INSULIN	$118.00	$236.00	—	—	50%
Iron blood test (serum iron) CPT 83540 IRON	$55.00	$110.00	—	31% below	50%
Iron blood test (serum iron) CPT 83540 IRON, TIBC AND FERRITIN PANEL	$55.00	$110.00	—	31% below	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON, TIBC AND FERRITIN PANEL	$55.00	$110.00	—	—	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$55.00	$110.00	—	—	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON, TOTAL AND TOTAL IRON BINDING CAPAC	$76.00	$152.00	—	at median	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON, TOTAL AND TOTAL IRON BINDING CAPAC	$76.00	$152.00	—	—	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$143.50	$287.00	—	at median	50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$143.50	$287.00	—	—	50%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$129.50	$259.00	—	37% below	50%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$129.50	$259.00	—	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$82.50	$165.00	—	31% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 QUEST LIPASE	$82.50	$165.00	—	31% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 PROVIDENCE LIPASE	$82.50	$165.00	—	31% below	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$82.50	$165.00	—	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 PROVIDENCE LIPASE	$82.50	$165.00	—	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 QUEST LIPASE	$82.50	$165.00	—	—	50%
Liver function blood test panel CPT 80076 QUEST HEPATIC PANEL	$95.00	$190.00	—	at median	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$100.00	$200.00	—	5% above	50%
Liver function blood test panel inpatient CPT 80076 QUEST HEPATIC PANEL	$95.00	$190.00	—	—	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$100.00	$200.00	—	—	50%
Lyme disease antibody test CPT 86618 LYME DISEASE, TOTAL ANTIBODY/REFLEX	$131.50	$263.00	—	12% above	50%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE, TOTAL ANTIBODY/REFLEX	$131.50	$263.00	—	—	50%
Magnesium blood test CPT 83735 MAGNESIUM OTHER SOURCE	$68.50	$137.00	—	5% below	50%
Magnesium blood test CPT 83735 MAGNESIUM	$68.50	$137.00	—	5% below	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM OTHER SOURCE	$68.50	$137.00	—	—	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$68.50	$137.00	—	—	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA MEASLES ANTIBODY	$57.00	$114.00	—	at median	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA MEASLES ANTIBODY	$57.00	$114.00	—	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN RAPID	$77.00	$154.00	—	3% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS SCREEN RAPID	$77.00	$154.00	—	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$123.50	$247.00	—	26% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$123.50	$247.00	—	26% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA FREE AND TOTAL	$123.50	$247.00	—	26% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, POST PROSTATECTOMY	$123.50	$247.00	—	26% below	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$123.50	$247.00	—	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, POST PROSTATECTOMY	$123.50	$247.00	—	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$123.50	$247.00	—	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA FREE AND TOTAL	$123.50	$247.00	—	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP IMAGING SYSTEM PAP	$112.00	$224.00	—	13% above	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP IMAGING SYSTEM PAP	$112.00	$224.00	—	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER: FF	$31.50	$63.00	—	70% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$59.50	$119.00	—	44% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER: FF	$31.50	$63.00	—	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$59.50	$119.00	—	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT W/O CALCIUM	$115.00	$230.00	—	65% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT W/O CALCIUM	$115.00	$230.00	—	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$101.50	$203.00	—	7% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$101.50	$203.00	—	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 QNATAL PANEL	$1,537.50	$3,075.00	—	25% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 QNATAL PANEL	$1,537.50	$3,075.00	—	—	50%
Progesterone blood test CPT 84144 PROGESTERONE	$110.00	$220.00	—	51% below	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$110.00	$220.00	—	—	50%
Prolactin blood test CPT 84146 PROVIDENCE PROLACTIN	$145.50	$291.00	—	26% below	50%
Prolactin blood test CPT 84146 PROLACTIN	$153.00	$306.00	—	22% below	50%
Prolactin blood test inpatient CPT 84146 PROVIDENCE PROLACTIN	$145.50	$291.00	—	—	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$153.00	$306.00	—	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/PTT	$66.50	$133.00	—	70% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR	$66.50	$133.00	—	70% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR - COUMADIN MONITORING	$66.50	$133.00	—	70% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROVIDENCE PT/INR	$154.50	$309.00	—	294% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR	$66.50	$133.00	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR - COUMADIN MONITORING	$66.50	$133.00	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/PTT	$66.50	$133.00	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROVIDENCE PT/INR	$154.50	$309.00	—	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 BH DRUG SCREEN, QUALITATIVE	$34.00	$68.00	—	58% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN URINE DIP	$36.00	$72.00	—	56% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN, QUALITATIVE	$36.00	$72.00	—	56% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 BH DRUG SCREEN, QUALITATIVE	$34.00	$68.00	—	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN URINE DIP	$36.00	$72.00	—	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN, QUALITATIVE	$36.00	$72.00	—	—	50%
Rapid flu test (influenza antigen) CPT 87804 CLINIC RAPID FLU TEST	$47.00	$94.00	—	41% below	50%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A&B RAPID SCREEN	$49.50	$99.00	—	38% below	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 CLINIC RAPID FLU TEST	$47.00	$94.00	—	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A&B RAPID SCREEN	$49.50	$99.00	—	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CLINIC RAPID STREP TEST	$61.00	$122.00	—	31% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP RAPID SCREEN	$64.50	$129.00	—	27% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CLINIC RAPID STREP TEST	$61.00	$122.00	—	—	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP RAPID SCREEN	$64.50	$129.00	—	—	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$57.50	$115.00	—	at median	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$57.50	$115.00	—	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$69.00	$138.00	—	10% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$69.00	$138.00	—	—	50%
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$81.50	$163.00	—	22% below	50%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$81.50	$163.00	—	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD THIRD SPECIMEN	$87.50	$175.00	—	43% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FIRST OR ONE SPECIMEN ONLY	$87.50	$175.00	—	43% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SECOND SPECIMEN	$87.50	$175.00	—	43% above	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD THIRD SPECIMEN	$87.50	$175.00	—	—	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FIRST OR ONE SPECIMEN ONLY	$87.50	$175.00	—	—	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SECOND SPECIMEN	$87.50	$175.00	—	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTRY	$117.50	$235.00	—	109% above	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN BY IMMUNO (MEDICARE INSURE)	$117.50	$235.00	—	109% above	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN BY IMMUNO (MEDICARE INSURE)	$117.50	$235.00	—	—	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTRY	$117.50	$235.00	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$55.00	$110.00	—	11% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$55.00	$110.00	—	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON	$184.00	$368.00	—	81% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON	$184.00	$368.00	—	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL (MALE)	$90.50	$181.00	—	at median	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL (FEMALE)	$90.50	$181.00	—	at median	50%
Testosterone blood test, total (not free testosterone) CPT 84403 STEROID PANEL PCOS	$164.50	$329.00	—	82% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL (FEMALE)	$90.50	$181.00	—	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL (MALE)	$90.50	$181.00	—	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 STEROID PANEL PCOS	$164.50	$329.00	—	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY	$144.00	$288.00	—	44% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY	$144.00	$288.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$120.00	$240.00	—	18% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 REFLEX TSH WITH FREE T4	$120.00	$240.00	—	18% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 REFLEX TSH WITH FREE T4	$120.00	$240.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$120.00	$240.00	—	—	50%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis (TV), TMA	$97.00	$194.00	—	1% below	50%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis (TV), TMA	$97.00	$194.00	—	—	50%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$59.00	$118.00	—	at median	50%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$59.00	$118.00	—	—	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, COMPLETE, W REFLEX TO CULTUR	$88.50	$177.00	—	20% below	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, COMPLETE, W REFLEX TO CULTUR	$88.50	$177.00	—	—	50%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS, DIPSTICK CLINIC	$35.50	$71.00	—	57% below	50%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS, DIPSTICK CLINIC	$35.50	$71.00	—	—	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO NO MICRO (IN-HOUSE)	$57.50	$115.00	—	31% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO NO MICRO (IN-HOUSE)	$57.50	$115.00	—	—	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, MANUAL W/O MICRO	$27.00	$54.00	—	32% below	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS, MANUAL W/O MICRO	$27.00	$54.00	—	—	50%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$106.00	$212.00	—	2% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$106.00	$212.00	—	—	50%
Urine pregnancy test, read by color change CPT 81025 HCG, QUAL URINE	$90.00	$180.00	—	1% above	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST, VIS COL	$90.00	$180.00	—	1% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST, VIS COL	$90.00	$180.00	—	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, QUAL URINE	$90.00	$180.00	—	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 (COBALAMIN)	$96.00	$192.00	—	7% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 (COBALAMIN)	$96.00	$192.00	—	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY (FOR VIT D DEF)	$148.50	$297.00	—	1% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY (FOR VIT D DEF)	$148.50	$297.00	—	—	50%
Zinc blood test CPT 84630 ZINC	$113.00	$226.00	—	92% above	50%
Zinc blood test inpatient CPT 84630 ZINC	$113.00	$226.00	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, QUANTITATIVE	$114.50	$229.00	—	8% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, QUANTITATIVE	$114.50	$229.00	—	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLS TX FIBULA FX DISTAL W/O MN: FF	$863.00	$1,726.00	—	8% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLS TX FIBULA FX DISTAL W/O MN: PF	$1,057.50	$2,115.00	—	32% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLS TX FIBULA FX DISTAL W/O MN	$1,057.50	$2,115.00	—	32% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLS TX FIBULA FX DISTAL W/O MN: FF	$863.00	$1,726.00	—	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLS TX FIBULA FX DISTAL W/O MN: PF	$1,057.50	$2,115.00	—	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLS TX FIBULA FX DISTAL W/O MN	$1,057.50	$2,115.00	—	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLS TX METATARSAL W/O MN: FF	$484.50	$969.00	—	12% below	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLS TX METATARSAL W/O MN: PF	$774.00	$1,548.00	—	41% above	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLS TX METATARSAL W/O MN	$774.00	$1,548.00	—	41% above	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLS TX METATARSAL W/O MN: FF	$484.50	$969.00	—	—	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLS TX METATARSAL W/O MN	$774.00	$1,548.00	—	—	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLS TX METATARSAL W/O MN: PF	$774.00	$1,548.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION: PF	$643.00	$1,286.00	—	52% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION: FF	$1,528.00	$3,056.00	—	15% above	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION: PF	$643.00	$1,286.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION: FF	$1,528.00	$3,056.00	—	—	50%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$414.00	$828.00	—	55% below	50%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX: PF	$414.00	$828.00	—	55% below	50%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX: FF	$993.50	$1,987.00	—	9% above	50%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$414.00	$828.00	—	—	50%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX: PF	$414.00	$828.00	—	—	50%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX: FF	$993.50	$1,987.00	—	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONAL BLCK: PF	$510.00	$1,020.00	—	4% below	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONAL BLCK	$510.00	$1,020.00	—	4% below	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONAL BLCK: FF	$2,790.50	$5,581.00	—	424% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONAL BLCK	$510.00	$1,020.00	—	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONAL BLCK: PF	$510.00	$1,020.00	—	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONAL BLCK: FF	$2,790.50	$5,581.00	—	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLS TX DIS/RAD FX W/O MAN: FF	$186.50	$373.00	—	62% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLS TX DIS/RAD FX W/O MAN	$835.00	$1,670.00	—	69% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLS TX DIS/RAD FX W/O MAN: PF	$930.00	$1,860.00	—	88% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLS TX DIS/RAD FX W/O MAN: FF	$186.50	$373.00	—	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLS TX DIS/RAD FX W/O MAN	$835.00	$1,670.00	—	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLS TX DIS/RAD FX W/O MAN: PF	$930.00	$1,860.00	—	—	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILAT&CURETT DIAGN/THERA: FF	$2,193.50	$4,387.00	—	at median	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILAT&CURETT DIAGN/THERA: FF	$2,193.50	$4,387.00	—	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT OF LESION - FIRST	$118.00	$236.00	—	48% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT OF LESION - FIRST: PF	$118.00	$236.00	—	48% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT OF FIRST LESION	$130.50	$261.00	—	43% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT OF LESION - FIRST: FF	$145.50	$291.00	—	36% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT OF LESION - FIRST: PF	$118.00	$236.00	—	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT OF LESION - FIRST	$118.00	$236.00	—	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT OF FIRST LESION	$130.50	$261.00	—	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT OF LESION - FIRST: FF	$145.50	$291.00	—	—	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACT CERUMEN/LAVAGE, UNILAT	$41.50	$83.00	—	55% below	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACT CERUMEN/LAVAGE, UNILAT: PF	$41.50	$83.00	—	55% below	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACT CERUMEN/LAVAGE, UNILAT: FF	$114.50	$229.00	—	25% above	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACT CERUMEN/LAVAGE, UNILAT: PF	$41.50	$83.00	—	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACT CERUMEN/LAVAGE, UNILAT	$41.50	$83.00	—	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACT CERUMEN/LAVAGE, UNILAT: FF	$114.50	$229.00	—	—	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACT CERUM W/INST, UNILAT	$126.00	$252.00	—	37% below	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACT CERUM W/INST, UNILAT: PF	$126.00	$252.00	—	37% below	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACT CERUM W/INST, UNILAT: FF	$175.50	$351.00	—	12% below	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE IMPACT CERUM W/INST, UNILAT	$126.00	$252.00	—	—	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE IMPACT CERUM W/INST, UNILAT: PF	$126.00	$252.00	—	—	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE IMPACT CERUM W/INST, UNILAT: FF	$175.50	$351.00	—	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL/ENDOCERVI BX: FF	$301.50	$603.00	—	43% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL/ENDOCERVI BX	$350.00	$700.00	—	34% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL/ENDOCERVI BX: PF	$350.00	$700.00	—	34% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL/ENDOCERVI BX: FF	$301.50	$603.00	—	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL/ENDOCERVI BX: PF	$350.00	$700.00	—	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL/ENDOCERVI BX	$350.00	$700.00	—	—	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE: PF	$333.00	$666.00	—	50% below	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$333.00	$666.00	—	50% below	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE: FF	$479.00	$958.00	—	28% below	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$333.00	$666.00	—	—	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE: PF	$333.00	$666.00	—	—	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE: FF	$479.00	$958.00	—	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D SKIN ABSCESS, SIMPL:FF	$141.00	$282.00	—	64% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D SKIN ABSCESS, SIMPL	$221.00	$442.00	—	44% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INC/DRN ABCSS/CYST SIM DR	$221.00	$442.00	—	44% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INC/DRN ABECSS SIMPLE	$246.50	$493.00	—	37% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INC/DRN ABECSS SIMPLE: PF	$246.50	$493.00	—	37% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE OF ABSCESS	$720.50	$1,441.00	—	83% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INC/DRN ABCSS/CYST SIMP;1	$720.50	$1,441.00	—	83% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INC/DRN ABCESS SIMPLE: FF	$802.50	$1,605.00	—	104% above	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D SKIN ABSCESS, SIMPL:FF	$141.00	$282.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D SKIN ABSCESS, SIMPL	$221.00	$442.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC/DRN ABCSS/CYST SIM DR	$221.00	$442.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC/DRN ABECSS SIMPLE: PF	$246.50	$493.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC/DRN ABECSS SIMPLE	$246.50	$493.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE OF ABSCESS	$720.50	$1,441.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC/DRN ABCSS/CYST SIMP;1	$720.50	$1,441.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC/DRN ABCESS SIMPLE: FF	$802.50	$1,605.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT/CYST	$152.00	$304.00	—	58% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT/CYST PROFEE	$166.50	$333.00	—	54% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT/CYST: FF	$169.50	$339.00	—	53% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT/CYST: PF	$185.50	$371.00	—	49% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON/LIGAMENT/CYST	$152.00	$304.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON/LIGAMENT/CYST PROFEE	$166.50	$333.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON/LIGAMENT/CYST: FF	$169.50	$339.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON/LIGAMENT/CYST: PF	$185.50	$371.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT JOINT	$215.50	$431.00	—	45% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO, MAJOR JT/BURSA/GANGL	$240.00	$480.00	—	39% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO, MAJOR JT/BURSA/GANGL: PF	$240.00	$480.00	—	39% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRN/INJ MAJOR JOINT	$861.50	$1,723.00	—	119% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS JOINT/BURS	$861.50	$1,723.00	—	119% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO, MAJOR JT/BURSA/GANGL: FF	$959.50	$1,919.00	—	143% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT JOINT	$215.50	$431.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO, MAJOR JT/BURSA/GANGL	$240.00	$480.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO, MAJOR JT/BURSA/GANGL: PF	$240.00	$480.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRN/INJ MAJOR JOINT	$861.50	$1,723.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS JOINT/BURS	$861.50	$1,723.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO, MAJOR JT/BURSA/GANGL: FF	$959.50	$1,919.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NON-BIO DRUG DELIVERY IMPLANT	$259.50	$519.00	—	17% below	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT NON-BIO DRUG DELIVERY IMPLANT	$289.50	$579.00	—	7% below	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT NON-BIO DRUG DELIVERY IMPLANT: PF	$289.50	$579.00	—	7% below	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT NON-BIO DRUG DELIVERY IMPLANT: FF	$329.00	$658.00	—	5% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION NON-BIO DRUG DELIVERY IMPLANT	$259.50	$519.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT NON-BIO DRUG DELIVERY IMPLANT: PF	$289.50	$579.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT NON-BIO DRUG DELIVERY IMPLANT	$289.50	$579.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT NON-BIO DRUG DELIVERY IMPLANT: FF	$329.00	$658.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO, INTER JT/BURSA/GANGL: PF	$189.00	$378.00	—	48% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO, INTER JT/BURSA/GANGL	$189.00	$378.00	—	48% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRN/INJ INTERM JOINT/GAN	$625.00	$1,250.00	—	74% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO, INTER JT/BURSA/GANGL: FF	$696.00	$1,392.00	—	93% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO, INTER JT/BURSA/GANGL: PF	$189.00	$378.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO, INTER JT/BURSA/GANGL	$189.00	$378.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRN/INJ INTERM JOINT/GAN	$625.00	$1,250.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO, INTER JT/BURSA/GANGL: FF	$696.00	$1,392.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ BURSA JOIN/GAN	$154.00	$308.00	—	60% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO,SM JT/BURSA/GANGL: PF	$164.50	$329.00	—	57% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO,SM JT/BURSA/GANGL	$164.50	$329.00	—	57% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO,SM JT/BURSA/GANGL: FF	$172.00	$344.00	—	55% below	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ BURSA JOIN/GAN	$154.00	$308.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO,SM JT/BURSA/GANGL	$164.50	$329.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO,SM JT/BURSA/GANGL: PF	$164.50	$329.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO,SM JT/BURSA/GANGL: FF	$172.00	$344.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS OF WND <=2.5CM: FF	$428.50	$857.00	—	42% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS OF WND 2.5 PROFEE:FF	$454.50	$909.00	—	38% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS OF WND 2.5 PROFEE	$458.50	$917.00	—	38% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS OF WND <=2.5CM	$511.00	$1,022.00	—	30% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS OF WND <=2.5CM: PF	$511.00	$1,022.00	—	30% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS OF WND <=2.5CM: FF	$428.50	$857.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS OF WND 2.5 PROFEE:FF	$454.50	$909.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS OF WND 2.5 PROFEE	$458.50	$917.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS OF WND <=2.5CM	$511.00	$1,022.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS OF WND <=2.5CM: PF	$511.00	$1,022.00	—	—	50%
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORTION COMPLETE: FF	$279.50	$559.00	—	93% below	50%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORTION COMPLETE: FF	$279.50	$559.00	—	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REM OF SKIN LESION 0.5CM	$265.00	$530.00	—	61% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REM OF SKIN LESION 0.5CM: PF	$265.00	$530.00	—	61% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REM OF SKIN LESION 0.5CM: FF	$572.50	$1,145.00	—	15% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REM OF SKIN LESION 0.5CM	$265.00	$530.00	—	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REM OF SKIN LESION 0.5CM: PF	$265.00	$530.00	—	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REM OF SKIN LESION 0.5CM: FF	$572.50	$1,145.00	—	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REM BENIGN LESN TO 1.0 CM	$327.50	$655.00	—	69% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REM BENIGN LESN TO 1.0 CM: PF	$327.50	$655.00	—	69% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REM BENIGN LESN TO 1.0 CM: FF	$1,055.00	$2,110.00	—	at median	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 REM BENIGN LESN TO 1.0 CM	$327.50	$655.00	—	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 REM BENIGN LESN TO 1.0 CM: PF	$327.50	$655.00	—	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 REM BENIGN LESN TO 1.0 CM: FF	$1,055.00	$2,110.00	—	—	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL NAIL PLATE, SINGL: FF	$142.00	$284.00	—	60% below	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL NAIL PLATE, SINGL	$155.00	$310.00	—	56% below	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL NAIL PLATE, SINGL: PF	$188.50	$377.00	—	47% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL NAIL PLATE, SINGL: FF	$142.00	$284.00	—	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL NAIL PLATE, SINGL	$155.00	$310.00	—	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL NAIL PLATE, SINGL: PF	$188.50	$377.00	—	—	50%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION NERVE BLOCK	$678.00	$1,356.00	—	17% below	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION NERVE BLOCK	$678.00	$1,356.00	—	—	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING: PF	$412.50	$825.00	—	68% below	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$412.50	$825.00	—	68% below	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING: FF	$1,038.50	$2,077.00	—	19% below	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$412.50	$825.00	—	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING: PF	$412.50	$825.00	—	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING: FF	$1,038.50	$2,077.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REM NAIL BED PART OR COMP: FF	$421.00	$842.00	—	53% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REM NAIL BED PART OR COMP	$422.50	$845.00	—	53% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REM NAIL BED PART OR COMP: PF	$470.50	$941.00	—	47% below	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REM NAIL BED PART OR COMP: FF	$421.00	$842.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REM NAIL BED PART OR COMP	$422.50	$845.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REM NAIL BED PART OR COMP: PF	$470.50	$941.00	—	—	50%
Removal of a foreign object under the skin, simple CPT 10120 INC/REMOVE FB,SUBQ, SMP:FF	$205.00	$410.00	—	65% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INC/REMOVE FB,SUBQ, SMP	$281.00	$562.00	—	52% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INC/REM FB,SUBQ,SIMPLE	$313.00	$626.00	—	47% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INC/REM FB,SUBQ,SIMPLE: PF	$313.00	$626.00	—	47% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INC/REM FB,SUBQ,SIMPLE: FF	$504.00	$1,008.00	—	15% below	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/REMOVE FB,SUBQ, SMP:FF	$205.00	$410.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/REMOVE FB,SUBQ, SMP	$281.00	$562.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/REM FB,SUBQ,SIMPLE	$313.00	$626.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/REM FB,SUBQ,SIMPLE: PF	$313.00	$626.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/REM FB,SUBQ,SIMPLE: FF	$504.00	$1,008.00	—	—	50%
Short arm cast (elbow to hand) CPT 29075 APPLY OF SHORT ARM CAST	$273.00	$546.00	—	37% below	50%
Short arm cast (elbow to hand) CPT 29075 APPLY OF SHORT ARM CAST: PF	$273.00	$546.00	—	37% below	50%
Short arm cast (elbow to hand) CPT 29075 APPLY OF SHORT ARM CAST: FF	$387.50	$775.00	—	10% below	50%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY OF SHORT ARM CAST	$273.00	$546.00	—	—	50%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY OF SHORT ARM CAST: PF	$273.00	$546.00	—	—	50%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY OF SHORT ARM CAST: FF	$387.50	$775.00	—	—	50%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT	$204.00	$408.00	—	23% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT: PF	$204.00	$408.00	—	23% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT: FF	$397.50	$795.00	—	50% above	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT	$204.00	$408.00	—	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT: PF	$204.00	$408.00	—	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT: FF	$397.50	$795.00	—	—	50%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST: FF	$190.00	$380.00	—	56% below	50%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$305.50	$611.00	—	29% below	50%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST: PF	$305.50	$611.00	—	29% below	50%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST: FF	$190.00	$380.00	—	—	50%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$305.50	$611.00	—	—	50%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST: PF	$305.50	$611.00	—	—	50%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT: PF	$225.00	$450.00	—	18% below	50%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$225.00	$450.00	—	18% below	50%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT: FF	$414.50	$829.00	—	51% above	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT: PF	$225.00	$450.00	—	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT	$225.00	$450.00	—	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT: FF	$414.50	$829.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR S-FICIAL WND 2.5CM	$240.00	$480.00	—	44% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR S-FICIAL WND <=2.5CM: FF	$253.50	$507.00	—	41% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WOUND CARE	$368.00	$736.00	—	14% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP SUPERFIC WND <2.5 PHY	$368.00	$736.00	—	14% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR S-FICIAL WND <=2.5CM: PF	$410.50	$821.00	—	4% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR S-FICIAL WND <=2.5CM	$410.50	$821.00	—	4% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR S-FICIAL WND 2.5CM	$240.00	$480.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR S-FICIAL WND <=2.5CM: FF	$253.50	$507.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 WOUND CARE	$368.00	$736.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP SUPERFIC WND <2.5 PHY	$368.00	$736.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR S-FICIAL WND <=2.5CM: PF	$410.50	$821.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR S-FICIAL WND <=2.5CM	$410.50	$821.00	—	—	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SMPL CLOSE SNGL LESION: FF	$136.00	$272.00	—	67% below	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SMPL CLOSE SNGL LESION	$256.00	$512.00	—	37% below	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SMPL CLOSE SNGL LESION: PF	$256.00	$512.00	—	37% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SMPL CLOSE SNGL LESION: FF	$136.00	$272.00	—	—	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SMPL CLOSE SNGL LESION	$256.00	$512.00	—	—	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SMPL CLOSE SNGL LESION: PF	$256.00	$512.00	—	—	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION INC MARG, <0.5CM: PF	$419.00	$838.00	—	63% below	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION INC MARG, <0.5CM	$419.00	$838.00	—	63% below	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION INC MARG, <0.5CM	$419.00	$838.00	—	—	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION INC MARG, <0.5CM: PF	$419.00	$838.00	—	—	50%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAG UP TO 15: PF	$200.50	$401.00	—	43% below	50%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAG UP TO 15	$200.50	$401.00	—	43% below	50%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAG UP TO 15: FF	$216.50	$433.00	—	38% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAG UP TO 15	$200.50	$401.00	—	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAG UP TO 15: PF	$200.50	$401.00	—	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAG UP TO 15: FF	$216.50	$433.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$480.50	$961.00	—	38% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG: PF	$480.50	$961.00	—	38% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG: FF	$1,328.00	$2,656.00	—	70% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$480.50	$961.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG: PF	$480.50	$961.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG: FF	$1,328.00	$2,656.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR S-FICIAL WND 7.5CM	$376.00	$752.00	—	43% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR S-FICIAL WND 2.6-7.5 CM: FF	$419.00	$838.00	—	37% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR S-FICIAL WND 7.5 DR	$438.00	$876.00	—	34% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR S-FICIAL WND 2.6-7.5 CM: PF	$488.00	$976.00	—	26% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR S-FICIAL WND 2.6-7.5 CM	$488.00	$976.00	—	26% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR S-FICIAL WND 7.5CM	$376.00	$752.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR S-FICIAL WND 2.6-7.5 CM: FF	$419.00	$838.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR S-FICIAL WND 7.5 DR	$438.00	$876.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR S-FICIAL WND 2.6-7.5 CM: PF	$488.00	$976.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR S-FICIAL WND 2.6-7.5 CM	$488.00	$976.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR S-FICIAL WND 2.5CM	$235.64	$471.27	—	50% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR S-FICIAL WND <=2.5CM: FF	$263.50	$527.00	—	44% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR S-FICIAL WND 2.CM	$416.00	$832.00	—	11% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR S-FICIAL WND <=2.5CM: PF	$463.50	$927.00	—	1% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR S-FICIAL WND <=2.5CM	$463.50	$927.00	—	1% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR S-FICIAL WND 2.5CM	$235.64	$471.27	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR S-FICIAL WND <=2.5CM: FF	$263.50	$527.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR S-FICIAL WND 2.CM	$416.00	$832.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR S-FICIAL WND <=2.5CM: PF	$463.50	$927.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR S-FICIAL WND <=2.5CM	$463.50	$927.00	—	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION: FF	$128.00	$256.00	—	64% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION: PF	$219.00	$438.00	—	38% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$219.00	$438.00	—	38% below	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION: FF	$128.00	$256.00	—	—	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION: PF	$219.00	$438.00	—	—	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$219.00	$438.00	—	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE: PF	$211.50	$423.00	—	40% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE	$211.50	$423.00	—	40% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT, SNGL/MULTI	$440.00	$880.00	—	25% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE: FF	$505.50	$1,011.00	—	43% above	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE	$211.50	$423.00	—	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE: PF	$211.50	$423.00	—	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT, SNGL/MULTI	$440.00	$880.00	—	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE: FF	$505.50	$1,011.00	—	—	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 CLIN VASECTOMY PROCEDURE	$568.00	$1,136.00	—	77% below	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 CLIN VASECTOMY PROCEDURE: PF	$568.00	$1,136.00	—	77% below	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 CLIN VASECTOMY PROCEDURE: FF	$2,168.50	$4,337.00	—	13% below	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 CLIN VASECTOMY PROCEDURE	$568.00	$1,136.00	—	—	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 CLIN VASECTOMY PROCEDURE: PF	$568.00	$1,136.00	—	—	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 CLIN VASECTOMY PROCEDURE: FF	$2,168.50	$4,337.00	—	—	50%
Wart removal, up to 14 warts CPT 17110 DEST MOLLUSC/FLT WART<14	$48.00	$96.00	—	80% below	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT FLT WRT/MOLL <=14: FF	$54.00	$108.00	—	78% below	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT FLT WRT/MOLL <=14	$208.50	$417.00	—	15% below	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT FLT WRT/MOLL <=14: PF	$208.50	$417.00	—	15% below	50%
Wart removal, up to 14 warts inpatient CPT 17110 DEST MOLLUSC/FLT WART<14	$48.00	$96.00	—	—	50%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT FLT WRT/MOLL <=14: FF	$54.00	$108.00	—	—	50%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT FLT WRT/MOLL <=14: PF	$208.50	$417.00	—	—	50%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT FLT WRT/MOLL <=14	$208.50	$417.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT,SKIN,SUBQ TIS	$236.50	$473.00	—	53% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRIDMENT,SKIN SUBQ TISS: FF	$264.00	$528.00	—	47% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRIDMENT,SKIN SUBQ TISS: PF	$301.50	$603.00	—	40% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRIDMENT,SKIN SUBQ TISS	$301.50	$603.00	—	40% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT,SKIN,SUBQ TIS	$236.50	$473.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRIDMENT,SKIN SUBQ TISS: FF	$264.00	$528.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRIDMENT,SKIN SUBQ TISS: PF	$301.50	$603.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRIDMENT,SKIN SUBQ TISS	$301.50	$603.00	—	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD	$1,181.50	$2,363.00	—	3% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD	$1,181.50	$2,363.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT: PF	$57.50	$115.00	—	86% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PULMOAIDE TREATMENT	$123.00	$246.00	—	69% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT: FF	$125.50	$251.00	—	68% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT	$270.50	$541.00	—	32% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT: PF	$57.50	$115.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PULMOAIDE TREATMENT	$123.00	$246.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT: FF	$125.50	$251.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT	$270.50	$541.00	—	—	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMINISTRATION <1HR	$439.00	$878.00	—	51% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY ADMIN <1HR	$439.00	$878.00	—	51% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMINISTRATION <1HR	$439.00	$878.00	—	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY ADMIN <1HR	$439.00	$878.00	—	—	50%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE FIRST 30-74 MIN	$927.50	$1,855.00	—	42% below	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$3,947.00	$7,894.00	—	147% above	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE FIRST 30-74 MIN	$927.50	$1,855.00	—	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$3,947.00	$7,894.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY W/O INTERPRETATION	$154.50	$309.00	—	56% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD	$154.50	$309.00	—	56% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD	$154.50	$309.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY W/O INTERPRETATION	$154.50	$309.00	—	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PHYSICIAN VISIT 99281	$129.50	$259.00	—	38% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT 99281	$215.00	$430.00	—	3% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER PHYSICIAN VISIT 99282	$223.00	$446.00	—	41% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT 99282	$404.00	$808.00	—	8% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER PHYSICIAN VISIT 99283	$435.00	$870.00	—	19% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT 99283	$728.00	$1,456.00	—	35% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER PHYSICIAN VISIT 99284	$709.50	$1,419.00	—	16% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT 99284	$1,448.50	$2,897.00	—	72% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER PHYSICIAN VISIT 99285	$1,163.00	$2,326.00	—	24% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT 99285	$2,588.00	$5,176.00	—	68% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 EKG TREADMIL TRACING ONLY	$958.50	$1,917.00	—	at median	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EKG TREADMIL TRACING ONLY	$958.50	$1,917.00	—	—	50%
Eye exam, returning patient, intermediate CPT 92012 EYE EXAM ESTAB PAT COMPRE	$188.00	$376.00	—	22% below	50%
Eye exam, returning patient, intermediate inpatient CPT 92012 EYE EXAM ESTAB PAT COMPRE	$188.00	$376.00	—	—	50%
Family therapy with the patient, 50 minutes CPT 90847 PSYCH FAMILY W/PATIENT	$185.50	$371.00	—	44% below	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCH 60 MIN W/PT	$185.50	$371.00	—	44% below	50%
Family therapy without the patient, 50 minutes CPT 90846 PSYCH FAMILY W/O PATIENT	$187.50	$375.00	—	27% below	50%
Family therapy without the patient, 50 minutes CPT 90846 PSYCH FAMILY W/O PATIENT 60 MINS	$187.50	$375.00	—	27% below	50%
Group psychotherapy session CPT 90853 PSYCH GROUP	$151.50	$303.00	—	17% above	50%
Group psychotherapy session CPT 90853 PSYCHOTHERAPY - GROUP 60 MIN	$151.50	$303.00	—	17% above	50%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 ECG 24 HR MONITORING	$231.00	$462.00	—	62% below	50%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 ECG 24 HR MONITORING	$231.00	$462.00	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF HYD INITIAL TO 1HR	$250.50	$501.00	—	61% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF HYD INITIAL TO 1HR	$250.50	$501.00	—	—	50%
IV infusion of a medicine, first hour CPT 96365 IN INF INITIAL TO 1HR	$250.50	$501.00	—	58% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INF INITIAL TO 1HR	$250.50	$501.00	—	58% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF INITIAL TO 1HR	$250.50	$501.00	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IN INF INITIAL TO 1HR	$250.50	$501.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION	$104.50	$209.00	—	20% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC DIAG INJECTION IM/SQ	$110.00	$220.00	—	16% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECTION	$104.50	$209.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC DIAG INJECTION IM/SQ	$110.00	$220.00	—	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYC INTERVIEW/EXAM	$248.00	$496.00	—	46% below	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DX INTERVIEW	$248.00	$496.00	—	46% below	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAG INTERVIE/EXAM	$248.00	$496.00	—	46% below	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 SOUND ALT PSYCH DIAGNOSTIC EVALUATION	$346.00	$692.00	—	24% below	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$346.00	$692.00	—	24% below	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DX INTERVIEW	$248.00	$496.00	—	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYC INTERVIEW/EXAM	$248.00	$496.00	—	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAG INTERVIE/EXAM	$248.00	$496.00	—	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$346.00	$692.00	—	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 SOUND ALT PSYCH DIAGNOSTIC EVALUATION	$346.00	$692.00	—	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 PT LTC NEUROMUSCULAR REED	$130.50	$261.00	—	23% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT LTC NEUROMUSCULAR REED	$130.50	$261.00	—	—	50%
New patient office visit, about 30 minutes CPT 99203 OFFICE OUTPNT VISIT NEW	$145.50	$291.00	—	55% below	50%
New patient office visit, about 30 minutes CPT 99203 99203 NEW PATIENT MF	$153.00	$306.00	—	53% below	50%
New patient office visit, about 30 minutes CPT 99203 OUTPATIENT VISIT	$212.00	$424.00	—	35% below	50%
New patient office visit, about 30 minutes CPT 99203 99203 NEW PATIENT MP	$223.00	$446.00	—	31% below	50%
New patient office visit, about 30 minutes CPT 99203 99203 NEW PATIENT	$223.00	$446.00	—	31% below	50%
New patient office visit, about 45 minutes CPT 99204 99204 NEW PATIENT MF	$224.00	$448.00	—	59% below	50%
New patient office visit, about 45 minutes CPT 99204 99204 NEW PATIENT	$340.00	$680.00	—	37% below	50%
New patient office visit, about 45 minutes CPT 99204 99204 NEW PATIENT MP	$340.00	$680.00	—	37% below	50%
New patient office visit, about 60 minutes CPT 99205 99205 NEW PATIENT MF	$266.00	$532.00	—	61% below	50%
New patient office visit, about 60 minutes CPT 99205 99205 NEW PATIENT MP	$440.50	$881.00	—	36% below	50%
New patient office visit, about 60 minutes CPT 99205 99205 NEW PATIENT PROFEE	$440.50	$881.00	—	36% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 NEW PATIENT: FF	$107.00	$214.00	—	57% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 NEW PATIENT MP	$138.00	$276.00	—	45% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OUTPNT VISIT NEW	$138.00	$276.00	—	45% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 NEW PATIENT: PF	$145.00	$290.00	—	42% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION THERAPY: FF	$69.00	$138.00	—	11% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION THERAPY: PF	$88.00	$176.00	—	14% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION THERAPY: FF	$69.00	$138.00	—	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION THERAPY: PF	$88.00	$176.00	—	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT LTC MANUAL THERAPY 15 MIN	$133.50	$267.00	—	23% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT LTC MANUAL THERAPY 15 MIN	$133.50	$267.00	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT LTC THERAPEUTIC EXR 15MIN	$112.00	$224.00	—	37% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXER 15 MIN W/GP	$112.00	$224.00	—	37% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT LTC THERAPEUTIC EXR 15MIN	$112.00	$224.00	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXER 15 MIN W/GP	$112.00	$224.00	—	—	50%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENT MED 18-39 NEW PATIENT:FF	$164.50	$329.00	—	57% below	50%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENT MED 18-39 NEW PATIENT	$255.50	$511.00	—	34% below	50%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE MED 40-64 YRS:FF	$188.50	$377.00	—	59% below	50%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE MED 40-64 YRS	$280.00	$560.00	—	39% below	50%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENT MED OVER 65 NEW PATIENT:FF	$164.50	$329.00	—	65% below	50%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENT MED OVER 65 NEW PATIENT	$308.00	$616.00	—	34% below	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENT MED 18-39 ESTAB:FF	$124.50	$249.00	—	65% below	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENT MED 18-39 ESTAB	$212.00	$424.00	—	41% below	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENT MED 40-64 ESTAB:FF	$148.50	$297.00	—	65% below	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENT MED 40-64 ESTAB	$240.00	$480.00	—	43% below	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENT MED ADULT 65 YRS+	$153.00	$306.00	—	62% below	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENT MED 65YRS+	$259.50	$519.00	—	35% below	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENT MED OVER 65 ESTAB	$259.50	$519.00	—	35% below	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 LTC ANNUAL CPX	$259.50	$519.00	—	35% below	50%
Psychiatric evaluation with medical services CPT 90792 PSYCH EXAM W INTERPRETER	$298.50	$597.00	—	49% below	50%
Psychiatric evaluation with medical services CPT 90792 INTERACTIVE PSYC DX EXAM	$298.50	$597.00	—	49% below	50%
Psychiatric evaluation with medical services CPT 90792 PSYCH EXAM W/INTERPRETER	$298.50	$597.00	—	49% below	50%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG INTERVIE/EXAM	$298.50	$597.00	—	49% below	50%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG INTERVIE/EXAM	$298.50	$597.00	—	—	50%
Psychiatric evaluation with medical services inpatient CPT 90792 INTERACTIVE PSYC DX EXAM	$298.50	$597.00	—	—	50%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH EXAM W INTERPRETER	$298.50	$597.00	—	—	50%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH EXAM W/INTERPRETER	$298.50	$597.00	—	—	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY-CRISIS INITIAL 60 MIN	$167.00	$334.00	—	58% below	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY-CRISIS INITIAL 60 MIN	$167.00	$334.00	—	—	50%
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL PSYCH 30 MINUTES	$81.00	$162.00	—	42% below	50%
Psychotherapy session, 30 minutes CPT 90832 IND PSYCH W/E&M 20-30 NEW	$121.50	$243.00	—	14% below	50%
Psychotherapy session, 30 minutes CPT 90832 IND PSYCH 20-30 MIN	$121.50	$243.00	—	14% below	50%
Psychotherapy session, 45 minutes CPT 90834 IND PSYCH 45-50 MIN	$118.00	$236.00	—	34% below	50%
Psychotherapy session, 45 minutes CPT 90834 IND PSYCH W/E&M 45-50 NEW	$118.00	$236.00	—	34% below	50%
Psychotherapy session, 45 minutes CPT 90834 IND PSYCH 38-52 MINUTES	$132.00	$264.00	—	26% below	50%
Psychotherapy session, 60 minutes CPT 90837 IND PSYCH 75-80 MIN	$148.50	$297.00	—	51% below	50%
Psychotherapy session, 60 minutes CPT 90837 IND PSYCH E&M 75-80M	$148.50	$297.00	—	51% below	50%
Psychotherapy session, 60 minutes CPT 90837 IND PSYCH 60 MINUTES	$148.50	$297.00	—	51% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION 3-10:FF	$31.00	$62.00	—	47% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION	$31.00	$62.00	—	47% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION 3-10	$42.00	$84.00	—	28% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION 3-10:FF	$31.00	$62.00	—	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION	$31.00	$62.00	—	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION 3-10	$42.00	$84.00	—	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 EST PATIENT	$292.50	$585.00	—	45% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 EST PATIENT MP	$292.50	$585.00	—	45% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 EST PATIENT MF	$346.00	$692.00	—	34% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEHEALTH 99213 EST PATIENT	$85.00	$170.00	—	61% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 EST PATIENT MF	$89.50	$179.00	—	59% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DOT PHYSICAL	$89.50	$179.00	—	59% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP SERVICES PRO FEE INTM	$134.50	$269.00	—	39% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OUTPNT VISIT ESTAB	$141.50	$283.00	—	35% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 EST PATIENT MP	$141.50	$283.00	—	35% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 EST PATIENT	$141.50	$283.00	—	35% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEHEALTH 99214 EST PATIENT	$150.00	$300.00	—	54% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 EST PATIENT MF	$157.50	$315.00	—	51% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP SERVICES PRO FEE EXP	$198.00	$396.00	—	39% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 EST PATIENT MP	$208.00	$416.00	—	36% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 EST PATIENT	$208.00	$416.00	—	36% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SCHOOL SPORTS/CAMP PHYSICAL	$20.00	$40.00	—	87% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HOSP OP PHYSICIAN	$68.00	$136.00	—	56% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP SERVICES PRO FEE LMTD	$68.00	$136.00	—	56% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 EST PATIENT	$68.00	$136.00	—	56% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 EST PATIENT MP	$71.50	$143.00	—	53% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TELEHEALTH 99212 EST PATIENT	$74.50	$149.00	—	51% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 EST PATIENT MF	$74.50	$149.00	—	51% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT, LEVEL III:FF	$141.50	$283.00	—	66% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT, LEVEL III	$280.00	$560.00	—	34% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$280.00	$560.00	—	34% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT, LEVEL IV:FF	$141.50	$283.00	—	76% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT, LEVEL IV	$394.00	$788.00	—	33% below	50%
Speech and language evaluation CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPR	$365.00	$730.00	—	42% below	50%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPR	$365.00	$730.00	—	—	50%
Speech therapy session, individual CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PR	$319.00	$638.00	—	30% below	50%
Speech therapy session, individual inpatient CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PR	$319.00	$638.00	—	—	50%
Spirometry (breathing test) CPT 94010 SPIROMETRY: PF	$33.50	$67.00	—	90% below	50%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$93.50	$187.00	—	73% below	50%
Spirometry (breathing test) CPT 94010 SPIROMETRY: FF	$98.50	$197.00	—	72% below	50%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY: PF	$33.50	$67.00	—	—	50%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$93.50	$187.00	—	—	50%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY: FF	$98.50	$197.00	—	—	50%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPM PRE/POST SPIRO	$747.50	$1,495.00	—	5% above	50%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY, PRE/POST TREA	$747.50	$1,495.00	—	5% above	50%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPM PRE/POST SPIRO: FF	$785.00	$1,570.00	—	11% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPM PRE/POST SPIRO	$747.50	$1,495.00	—	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY, PRE/POST TREA	$747.50	$1,495.00	—	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPM PRE/POST SPIRO: FF	$785.00	$1,570.00	—	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA	$55.50	$111.00	—	66% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA	$55.50	$111.00	—	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPEUTIC	$211.50	$423.00	—	7% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY, THERAPEUTIC	$211.50	$423.00	—	—	50%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 STRESS TEST	$304.50	$609.00	—	57% below	50%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 STRESS TEST	$304.50	$609.00	—	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Covid Vaccine-Moderna	$282.53	$565.05	—	24% above	50%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Covid Vaccine-Moderna	$282.53	$565.05	—	—	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Covid Vaccine-Pfizer	$268.75	$537.50	—	31% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Covid Vaccine-Pfizer	$268.75	$537.50	—	—	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax (Varicella) Vaccine	$379.23	$758.45	—	47% above	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax (Varicella) Vaccine	$379.23	$758.45	—	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV (Gardasil 9) Vaccine	$464.88	$929.75	—	at median	50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV (Gardasil 9) Vaccine	$464.88	$929.75	—	—	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/B VACCINE ADULT IM	$112.50	$225.00	—	24% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A/B VACCINE ADULT IM	$112.50	$225.00	—	—	50%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A (Havrix) Vaccine	$187.08	$374.15	—	41% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A (Havrix) Vaccine	$187.08	$374.15	—	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B (Recombivax) Vaccine	$115.10	$230.20	—	5% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B (Recombivax) Vaccine	$115.10	$230.20	—	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza HD	$40.72	$81.43	—	76% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza HD	$40.72	$81.43	—	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II W/Diluent Vaccine	$197.38	$394.75	—	at median	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR II W/Diluent Vaccine	$197.38	$394.75	—	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal (Menctra) Vaccine	$236.15	$472.30	—	1% below	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal (Menctra) Vaccine	$236.15	$472.30	—	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal 20 (Prevnar) Vaccine	$530.48	$1,060.95	—	20% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal 20 (Prevnar) Vaccine	$530.48	$1,060.95	—	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal (Pneumovax 23) Vaccine	$248.18	$496.35	—	41% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal (Pneumovax 23) Vaccine	$248.18	$496.35	—	—	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV Vaccine	$585.05	$1,170.10	—	at median	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV Vaccine	$585.05	$1,170.10	—	—	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix Vaccine	$437.28	$874.55	—	79% above	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Shingrix Vaccine	$437.28	$874.55	—	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, Dipth, Pertussis (Adacel) Vacc	$117.65	$235.30	—	36% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus, Dipth, Pertussis (Adacel) Vacc	$117.65	$235.30	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FEE	$31.00	$62.00	—	61% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN SNGL VACCINE	$31.00	$62.00	—	61% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FEE	$31.00	$62.00	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN SNGL VACCINE	$31.00	$62.00	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN ADDITIONAL VACCINE	$28.00	$56.00	—	44% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN ADDITIONAL VACCINE	$28.00	$56.00	—	—	50%

Source file: https://www.cdvcmc.com/wp-content/uploads/2026/03/920139171_cordova-community-medical-center_standardcharges.csv