Hospital Duluth, MN-WI

The Cook Hospital

The Cook Hospital in Cook, MN publishes cash prices for 306 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 above the Minnesota median for 204 of 304 procedures and below it for 97. By typical cash price it ranks #51 of 84 Minnesota hospitals and #9 of 12 hospitals in the Duluth, MN area, cheapest first. Click a procedure to compare it with other hospitals nearby.

10 5th St SE, Cook, MN, 55723 Collected Sep 27, 2026 Source price file (218) 666-5945

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 241312 · CMS hospital register NPI 1992763858

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Abdominal CT scan without and with contrast CPT 74170 CT abdomen wo/w con	$1,766.16	$2,676.00	$438.00–$876.00	1% above	34%
Abdominal CT scan without and with contrast CPT 74170 CT pancreas multiphase	$2,696.10	$4,085.00	$438.00–$876.00	55% above	34%
Abdominal CT scan without and with contrast CPT 74170 CT renal multiphase	$2,696.10	$4,085.00	$438.00–$876.00	55% above	34%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT abdomen wo/w con	$1,766.16	$2,676.00	$438.00–$876.00	—	34%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT pancreas multiphase	$2,696.10	$4,085.00	$438.00–$876.00	—	34%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT renal multiphase	$2,696.10	$4,085.00	$438.00–$876.00	—	34%
Abdominal X-ray, 2 views CPT 74019 XR abdomen min 2V	$310.86	$471.00	—	10% above	34%
Abdominal X-ray, 2 views inpatient CPT 74019 XR abdomen min 2V	$310.86	$471.00	—	—	34%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ankle RT min 3V,Right side of body	$228.69	$346.50	—	at median	34%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ankle LT min 3V,Left Side of body	$228.69	$346.50	—	at median	34%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ankle RT min 3V,Right side of body	$228.69	$346.50	—	—	34%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ankle LT min 3V,Left Side of body	$228.69	$346.50	—	—	34%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 UPPER EXTREM. CT W/O CONTRAST	$1,164.57	$1,764.50	$262.00–$524.00	8% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT shoulder RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UE LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UE RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT elbow LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT elbow RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT forearm LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT forearm RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT hand LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT hand RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT humerus LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT humerus RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT scapula LT,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT scapula RT,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT shoulder LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT wrist LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT wrist RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 UPPER EXTREM. CT W/O CONTRAST	$1,164.57	$1,764.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT scapula RT,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT wrist LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT forearm RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT shoulder LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT forearm LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT scapula LT,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UE RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT humerus LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UE LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT humerus RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT shoulder RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT elbow RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT wrist RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT hand LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT elbow LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT hand RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Breast ultrasound, complete, one breast one side CPT 76641 US breast RT complete,Right side of body	$496.32	$752.00	—	24% above	34%
Breast ultrasound, complete, one breast one side CPT 76641 US breast LT complete,Left Side of body	$496.32	$752.00	—	24% above	34%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US breast RT complete,Right side of body	$496.32	$752.00	—	—	34%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US breast LT complete,Left Side of body	$496.32	$752.00	—	—	34%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US breast RT limited,Right side of body	$321.42	$487.00	—	2% above	34%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US breast LT limited,Left Side of body	$321.42	$487.00	—	2% above	34%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US breast LT limited,Left Side of body	$321.42	$487.00	—	—	34%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US breast RT limited,Right side of body	$321.42	$487.00	—	—	34%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT angio renal artery	$2,367.42	$3,587.00	$917.00–$1,834.00	7% below	34%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT angio abdomen pelvis bleed	$2,561.79	$3,881.50	$917.00–$1,834.00	1% above	34%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT angio mesenteric artery blo	$2,561.79	$3,881.50	$917.00–$1,834.00	1% above	34%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT angio abdomen pelvis	$2,561.79	$3,881.50	$917.00–$1,834.00	1% above	34%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT angio renal artery	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT angio mesenteric artery blo	$2,561.79	$3,881.50	$917.00–$1,834.00	—	34%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT angio abdomen pelvis	$2,561.79	$3,881.50	$917.00–$1,834.00	—	34%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT angio abdomen pelvis bleed	$2,561.79	$3,881.50	$917.00–$1,834.00	—	34%
CT angiography (CTA) of the head CPT 70496 CT angio head	$1,742.40	$2,640.00	$438.00–$876.00	1% below	34%
CT angiography (CTA) of the head inpatient CPT 70496 CT angio head	$1,742.40	$2,640.00	$438.00–$876.00	—	34%
CT angiography (CTA) of the neck CPT 70498 CT angio neck	$1,742.40	$2,640.00	$438.00–$876.00	1% below	34%
CT angiography (CTA) of the neck inpatient CPT 70498 CT angio neck	$1,742.40	$2,640.00	$438.00–$876.00	—	34%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CHEST CT / PE	$1,758.57	$2,664.50	$438.00–$876.00	3% below	34%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT angio chest	$1,758.57	$2,664.50	$438.00–$876.00	3% below	34%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT angio chest PE protocol	$1,891.89	$2,866.50	$438.00–$876.00	4% above	34%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT angio chest	$1,758.57	$2,664.50	$438.00–$876.00	—	34%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CHEST CT / PE	$1,758.57	$2,664.50	$438.00–$876.00	—	34%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT angio chest PE protocol	$1,891.89	$2,866.50	$438.00–$876.00	—	34%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT kidney stone	$1,789.26	$2,711.00	$584.50–$1,169.00	14% below	34%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT abdomen pelvis wo con	$2,257.53	$3,420.50	$584.50–$1,169.00	9% above	34%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT kidney stone	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT abdomen pelvis wo con	$2,257.53	$3,420.50	$584.50–$1,169.00	—	34%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT abdomen pelvis w con	$2,463.12	$3,732.00	$917.00–$1,834.00	2% below	34%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT abdomen pelvis w con	$2,463.12	$3,732.00	$917.00–$1,834.00	—	34%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT adrenal multiphase	$1,335.18	$2,023.00	$917.00–$1,834.00	51% below	34%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT liver multiphase	$2,696.10	$4,085.00	$917.00–$1,834.00	1% below	34%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT abdomen pelvis wo/w con	$2,714.58	$4,113.00	$917.00–$1,834.00	at median	34%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT urogram	$2,784.21	$4,218.50	$917.00–$1,834.00	2% above	34%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT adrenal multiphase	$1,335.18	$2,023.00	$917.00–$1,834.00	—	34%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT liver multiphase	$2,696.10	$4,085.00	$917.00–$1,834.00	—	34%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT abdomen pelvis wo/w con	$2,714.58	$4,113.00	$917.00–$1,834.00	—	34%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT urogram	$2,784.21	$4,218.50	$917.00–$1,834.00	—	34%
CT scan of the abdomen with contrast CPT 74160 CT abdomen w con	$1,364.22	$2,067.00	$438.00–$876.00	8% below	34%
CT scan of the abdomen with contrast inpatient CPT 74160 CT abdomen w con	$1,364.22	$2,067.00	$438.00–$876.00	—	34%
CT scan of the abdomen without contrast CPT 74150 CT abdomen wo con	$1,109.13	$1,680.50	$262.00–$524.00	6% below	34%
CT scan of the abdomen without contrast inpatient CPT 74150 CT abdomen wo con	$1,109.13	$1,680.50	$262.00–$524.00	—	34%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT facial bones wo con	$1,068.21	$1,618.50	$262.00–$524.00	16% below	34%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT sinus wo con	$1,532.19	$2,321.50	$262.00–$524.00	20% above	34%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT facial bones wo con	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT sinus wo con	$1,532.19	$2,321.50	$262.00–$524.00	—	34%
CT scan of the head or brain, no contrast dye CPT 70450 CT head/brain wo con	$1,164.57	$1,764.50	$262.00–$524.00	7% below	34%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT head/brain wo con	$1,164.57	$1,764.50	$262.00–$524.00	—	34%
CT scan of the head with contrast CPT 70460 CT head/brain w con	$1,295.25	$1,962.50	$438.00–$876.00	at median	34%
CT scan of the head with contrast inpatient CPT 70460 CT head/brain w con	$1,295.25	$1,962.50	$438.00–$876.00	—	34%
CT scan of the head without and with contrast CPT 70470 CT head/brain wo/w con	$1,516.35	$2,297.50	$438.00–$876.00	5% below	34%
CT scan of the head without and with contrast inpatient CPT 70470 CT head/brain wo/w con	$1,516.35	$2,297.50	$438.00–$876.00	—	34%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT lumbar spine wo con	$1,335.18	$2,023.00	$262.00–$524.00	3% below	34%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT lumbar spine wo con	$1,335.18	$2,023.00	$262.00–$524.00	—	34%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT cervical spine wo con	$1,335.18	$2,023.00	$262.00–$524.00	7% below	34%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT cervical spine wo con	$1,335.18	$2,023.00	$262.00–$524.00	—	34%
CT scan of the pelvis, with contrast dye CPT 72193 CT pelvis w con	$1,364.22	$2,067.00	$438.00–$876.00	7% below	34%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT pelvis w con	$1,364.22	$2,067.00	$438.00–$876.00	—	34%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US carotid duplex BI	$757.02	$1,147.00	—	—	34%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US carotid duplex BI	$757.02	$1,147.00	—	—	34%
Chest CT scan without and with contrast CPT 71270 CT chest wo/w con	$1,516.35	$2,297.50	$438.00–$876.00	5% below	34%
Chest CT scan without and with contrast inpatient CPT 71270 CT chest wo/w con	$1,516.35	$2,297.50	$438.00–$876.00	—	34%
Chest X-ray, 2 views CPT 71046 XR chest 2V	$220.77	$334.50	$216.50–$433.00	5% below	34%
Chest X-ray, 2 views inpatient CPT 71046 XR chest 2V	$220.77	$334.50	$216.50–$433.00	—	34%
Chest X-ray, single view CPT 71045 XR chest 1V TB	$214.17	$324.50	—	6% above	34%
Chest X-ray, single view CPT 71045 XR chest 1V portable	$220.77	$334.50	—	9% above	34%
Chest X-ray, single view one side CPT 71045 CHEST, LEFT LATERAL DECUBITUS,Left Side of body	$220.77	$334.50	—	9% above	34%
Chest X-ray, single view one side CPT 71045 CHEST, LATERAL DECUBITUS, RT.,Right side of body	$220.77	$334.50	—	9% above	34%
Chest X-ray, single view inpatient CPT 71045 XR chest 1V TB	$214.17	$324.50	—	—	34%
Chest X-ray, single view inpatient CPT 71045 XR chest 1V portable	$220.77	$334.50	—	—	34%
Chest X-ray, single view inpatient one side CPT 71045 CHEST, LATERAL DECUBITUS, RT.,Right side of body	$220.77	$334.50	—	—	34%
Chest X-ray, single view inpatient one side CPT 71045 CHEST, LEFT LATERAL DECUBITUS,Left Side of body	$220.77	$334.50	—	—	34%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR clavicle RT,Right side of body	$220.77	$334.50	—	9% above	34%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR clavicle LT,Left Side of body	$220.77	$334.50	—	9% above	34%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR clavicle LT,Left Side of body	$220.77	$334.50	—	—	34%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR clavicle RT,Right side of body	$220.77	$334.50	—	—	34%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA spine/hips plus wrist	$560.67	$849.50	—	50% above	34%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA spine/hips plus wrist	$560.67	$849.50	—	—	34%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA wrist	$264.99	$401.50	—	37% above	34%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA wrist	$264.99	$401.50	—	—	34%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT chest wo con	$1,198.89	$1,816.50	$262.00–$524.00	6% below	34%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST HIGH RESOLUTION	$1,198.89	$1,816.50	$262.00–$524.00	6% below	34%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT lung screening follow up	$1,319.34	$1,999.00	$262.00–$524.00	4% above	34%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT chest wo con	$1,198.89	$1,816.50	$262.00–$524.00	—	34%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST HIGH RESOLUTION	$1,198.89	$1,816.50	$262.00–$524.00	—	34%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT lung screening follow up	$1,319.34	$1,999.00	$262.00–$524.00	—	34%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT chest w con	$1,427.91	$2,163.50	$438.00–$876.00	3% below	34%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT chest w con	$1,427.91	$2,163.50	$438.00–$876.00	—	34%
Diagnostic mammogram, both breasts both sides CPT 77066 DX TOMO/CAD/BILATERAL	$386.76	$586.00	—	—	34%
Diagnostic mammogram, both breasts CPT 77066 MAMMOGRAM, DIAGNOSTIC	$386.76	$586.00	—	21% above	34%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX TOMO/CAD/BILATERAL	$386.76	$586.00	—	—	34%
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMOGRAM, DIAGNOSTIC	$386.76	$586.00	—	—	34%
Diagnostic mammogram, one breast one side CPT 77065 DX TOMO/CAD/UNILATERAL-LEFT,Left Side of body	$305.91	$463.50	—	2% below	34%
Diagnostic mammogram, one breast one side CPT 77065 DX TOMO/CAD/UNILATERAL-RIGHT,Right side of body	$305.91	$463.50	—	2% below	34%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX TOMO/CAD/UNILATERAL-LEFT,Left Side of body	$305.91	$463.50	—	—	34%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX TOMO/CAD/UNILATERAL-RIGHT,Right side of body	$305.91	$463.50	—	—	34%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US venous duplex UE BI	$821.04	$1,244.00	—	—	34%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US venous duplex LE BI	$821.04	$1,244.00	—	—	34%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US venous duplex UE BI	$821.04	$1,244.00	—	—	34%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US venous duplex LE BI	$821.04	$1,244.00	—	—	34%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US echo complete	$1,500.84	$2,274.00	$1,052.50–$2,105.00	3% above	34%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US echo complete	$1,500.84	$2,274.00	$1,052.50–$2,105.00	—	34%
Elbow X-ray, 2 views one side CPT 73070 XR elbow LT 2V,Left Side of body	$220.77	$334.50	—	8% above	34%
Elbow X-ray, 2 views one side CPT 73070 XR elbow RT 2V,Right side of body	$220.77	$334.50	—	8% above	34%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR elbow RT 2V,Right side of body	$220.77	$334.50	—	—	34%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR elbow LT 2V,Left Side of body	$220.77	$334.50	—	—	34%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR elbow LT min 3V,Left Side of body	$228.69	$346.50	—	1% below	34%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR elbow RT min 3V,Right side of body	$228.69	$346.50	—	1% below	34%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR elbow RT min 3V,Right side of body	$228.69	$346.50	—	—	34%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR elbow LT min 3V,Left Side of body	$228.69	$346.50	—	—	34%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR zygomatic arches	$305.91	$463.50	—	20% above	34%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR facial bones min 3V	$310.86	$471.00	—	22% above	34%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR zygomatic arches	$305.91	$463.50	—	—	34%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR facial bones min 3V	$310.86	$471.00	—	—	34%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR forearm LT 2V,Left Side of body	$220.77	$334.50	—	9% above	34%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR forearm RT 2V,Right side of body	$220.77	$334.50	—	9% above	34%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR forearm LT 2V,Left Side of body	$220.77	$334.50	—	—	34%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR forearm RT 2V,Right side of body	$220.77	$334.50	—	—	34%
Hand X-ray, 2 views one side CPT 73120 XR hand RT 2V,Right side of body	$310.86	$471.00	—	60% above	34%
Hand X-ray, 2 views one side CPT 73120 XR hand LT 2V,Left Side of body	$310.86	$471.00	—	60% above	34%
Hand X-ray, 2 views inpatient one side CPT 73120 XR hand RT 2V,Right side of body	$310.86	$471.00	—	—	34%
Hand X-ray, 2 views inpatient one side CPT 73120 XR hand LT 2V,Left Side of body	$310.86	$471.00	—	—	34%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR calcaneus LT min 2V,Left Side of body	$220.77	$334.50	—	23% above	34%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR calcaneus RT min 2V,Right side of body	$220.77	$334.50	—	23% above	34%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR calcaneus LT min 2V,Left Side of body	$220.77	$334.50	—	—	34%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR calcaneus RT min 2V,Right side of body	$220.77	$334.50	—	—	34%
Knee X-ray, 3 views one side CPT 73562 XR knee LT 3V,Left Side of body	$246.51	$373.50	—	1% above	34%
Knee X-ray, 3 views one side CPT 73562 XR knee RT 3V,Right side of body	$246.51	$373.50	—	1% above	34%
Knee X-ray, 3 views inpatient one side CPT 73562 XR knee RT 3V,Right side of body	$246.51	$373.50	—	—	34%
Knee X-ray, 3 views inpatient one side CPT 73562 XR knee LT 3V,Left Side of body	$246.51	$373.50	—	—	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT lower leg LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT lower leg RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LE LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LE RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT calcaneus LT,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT calcaneus RT,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ankle LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ankle RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT femur LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT femur RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT knee RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT knee LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT foot LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT foot RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT hip LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT hip RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	19% below	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LE LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT lower leg LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ankle RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT knee LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT foot LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT lower leg RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT knee RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT femur LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT calcaneus RT,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT hip LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT femur RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT calcaneus LT,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT hip RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LE RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ankle LT wo con,Left Side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT foot RT wo con,Right side of body	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US abdomen limited	$416.46	$631.00	—	6% below	34%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$519.42	$787.00	—	17% above	34%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US abdomen limited	$416.46	$631.00	—	—	34%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$519.42	$787.00	—	—	34%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US extremity nonvascular	$323.07	$489.50	—	8% below	34%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 SUPERFICIAL STRUCTURE US	$323.07	$489.50	—	8% below	34%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US superficial structure	$343.86	$521.00	—	2% below	34%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 SUPERFICIAL STRUCTURE US	$323.07	$489.50	—	—	34%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US extremity nonvascular	$323.07	$489.50	—	—	34%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US superficial structure	$343.86	$521.00	—	—	34%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT lung screening low-dose	$856.68	$1,298.00	—	17% above	34%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT lung screening low-dose	$856.68	$1,298.00	—	—	34%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR tibia fibula LT 2V,Left Side of body	$228.69	$346.50	—	8% above	34%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR tibia fibula RT 2V,Right side of body	$228.69	$346.50	—	8% above	34%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR tibia fibula LT 2V,Left Side of body	$228.69	$346.50	—	—	34%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR tibia fibula RT 2V,Right side of body	$228.69	$346.50	—	—	34%
MR angiography (MRA) of the head without contrast CPT 70544 MR angio head wo con	$2,000.13	$3,030.50	$584.50–$1,169.00	6% below	34%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR angio head wo con	$2,000.13	$3,030.50	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JOINT W/O	$1,908.39	$2,891.50	$584.50–$1,169.00	3% below	34%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ankle LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	9% below	34%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR hip RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	9% below	34%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR knee LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	9% below	34%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR knee RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	9% below	34%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ankle RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	9% below	34%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR hip LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	9% below	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JOINT W/O	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR knee RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR hip LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ankle RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ankle LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR hip RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR knee LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JOINT W & W/O	$2,375.34	$3,599.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR knee LT wo/w con,Left Side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR knee RT wo/w con,Right side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR hip RT wo/w con,Right side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR hip LT wo/w con,Left Side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ankle RT wo/w con,Right side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ankle LT wo/w con,Left Side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	8% below	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JOINT W & W/O	$2,375.34	$3,599.00	$917.00–$1,834.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR ankle LT wo/w con,Left Side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR ankle RT wo/w con,Right side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR knee LT wo/w con,Left Side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR hip RT wo/w con,Right side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR hip LT wo/w con,Left Side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR knee RT wo/w con,Right side of body	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of the abdomen without contrast CPT 74181 MR kidney wo con	$1,789.26	$2,711.00	$584.50–$1,169.00	17% below	34%
MRI of the abdomen without contrast CPT 74181 MR abdomen wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	11% below	34%
MRI of the abdomen without contrast inpatient CPT 74181 MR kidney wo con	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the abdomen without contrast inpatient CPT 74181 MR abdomen wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR kidney wo/w con	$2,367.42	$3,587.00	$917.00–$1,834.00	20% below	34%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR abdomen wo/w con	$2,618.88	$3,968.00	$917.00–$1,834.00	11% below	34%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR kidney wo/w con	$2,367.42	$3,587.00	$917.00–$1,834.00	—	34%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR abdomen wo/w con	$2,618.88	$3,968.00	$917.00–$1,834.00	—	34%
MRI of the brain, no contrast dye CPT 70551 MR iac wo con	$1,789.26	$2,711.00	$584.50–$1,169.00	14% below	34%
MRI of the brain, no contrast dye CPT 70551 MR head/brain seizure	$1,908.39	$2,891.50	$584.50–$1,169.00	8% below	34%
MRI of the brain, no contrast dye CPT 70551 MR head/brain wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	8% below	34%
MRI of the brain, no contrast dye inpatient CPT 70551 MR iac wo con	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the brain, no contrast dye inpatient CPT 70551 MR head/brain seizure	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the brain, no contrast dye inpatient CPT 70551 MR head/brain wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the brain, with and without contrast dye CPT 70553 MR iac wo/w con	$2,618.88	$3,968.00	$917.00–$1,834.00	7% below	34%
MRI of the brain, with and without contrast dye CPT 70553 MR head/brain trigeminal	$2,676.96	$4,056.00	$917.00–$1,834.00	5% below	34%
MRI of the brain, with and without contrast dye CPT 70553 MR head/brain for MS	$2,676.96	$4,056.00	$917.00–$1,834.00	5% below	34%
MRI of the brain, with and without contrast dye CPT 70553 MR head/brain wo/w con	$2,676.96	$4,056.00	$917.00–$1,834.00	5% below	34%
MRI of the brain, with and without contrast dye CPT 70553 MR Head/Brain Pituitary	$2,676.96	$4,056.00	$917.00–$1,834.00	5% below	34%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR iac wo/w con	$2,618.88	$3,968.00	$917.00–$1,834.00	—	34%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR head/brain for MS	$2,676.96	$4,056.00	$917.00–$1,834.00	—	34%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR head/brain trigeminal	$2,676.96	$4,056.00	$917.00–$1,834.00	—	34%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Head/Brain Pituitary	$2,676.96	$4,056.00	$917.00–$1,834.00	—	34%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR head/brain wo/w con	$2,676.96	$4,056.00	$917.00–$1,834.00	—	34%
MRI of the lower back, no contrast dye CPT 72148 MR lumbar spine wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	9% below	34%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR lumbar spine wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the lower back, without and then with contrast dye CPT 72158 MR lumbar spine wo/w con	$2,618.88	$3,968.00	$917.00–$1,834.00	at median	34%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR lumbar spine wo/w con	$2,618.88	$3,968.00	$917.00–$1,834.00	—	34%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR thoracic spine wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	8% below	34%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR thoracic spine wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR cervical spine wo/w con	$2,493.81	$3,778.50	$917.00–$1,834.00	1% below	34%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR cervical spine wo/w con	$2,493.81	$3,778.50	$917.00–$1,834.00	—	34%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR cervical spine wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	7% below	34%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR cervical spine wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the pelvis without and with contrast CPT 72197 MR pelvis wo/w con	$2,493.81	$3,778.50	$917.00–$1,834.00	6% below	34%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR pelvis wo/w con	$2,493.81	$3,778.50	$917.00–$1,834.00	—	34%
MRI of the pelvis, no contrast dye CPT 72195 MR sacrum wo con	$1,789.26	$2,711.00	$584.50–$1,169.00	15% below	34%
MRI of the pelvis, no contrast dye CPT 72195 MR pelvis wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	10% below	34%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR sacrum wo con	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR pelvis wo con	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JOINT W/O	$1,908.39	$2,891.50	$584.50–$1,169.00	10% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR elbow RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR elbow LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR forearm RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR shoulder RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR hand RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR wrist LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR wrist RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR hand LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR shoulder LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR forearm LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	16% below	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT JOINT W/O	$1,908.39	$2,891.50	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR hand LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR elbow LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR elbow RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR forearm LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR forearm RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR hand RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR shoulder LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR shoulder RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR wrist LT wo con,Left Side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR wrist RT wo con,Right side of body	$1,789.26	$2,711.00	$584.50–$1,169.00	—	34%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR cervical spine w/ obliques	$305.91	$463.50	—	3% below	34%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR cervical spine w flex/ext	$310.86	$471.00	—	2% below	34%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR cervical spine w/ obliques	$305.91	$463.50	—	—	34%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR cervical spine w flex/ext	$310.86	$471.00	—	—	34%
Neck soft tissue CT scan with contrast CPT 70491 CT soft tissue neck w con	$1,364.22	$2,067.00	$438.00–$876.00	1% above	34%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT soft tissue neck w con	$1,364.22	$2,067.00	$438.00–$876.00	—	34%
Neck soft tissue CT scan without contrast CPT 70490 CT soft tissue neck wo con	$1,087.35	$1,647.50	$262.00–$524.00	5% below	34%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT soft tissue neck wo con	$1,087.35	$1,647.50	$262.00–$524.00	—	34%
Neck soft tissue X-ray CPT 70360 XR soft tissue neck	$220.77	$334.50	—	24% above	34%
Neck soft tissue X-ray inpatient CPT 70360 XR soft tissue neck	$220.77	$334.50	—	—	34%
Pelvic CT scan without contrast CPT 72192 CT sacrum	$1,068.21	$1,618.50	$262.00–$524.00	20% below	34%
Pelvic CT scan without contrast CPT 72192 CT pelvis wo con	$1,176.12	$1,782.00	$262.00–$524.00	12% below	34%
Pelvic CT scan without contrast inpatient CPT 72192 CT sacrum	$1,068.21	$1,618.50	$262.00–$524.00	—	34%
Pelvic CT scan without contrast inpatient CPT 72192 CT pelvis wo con	$1,176.12	$1,782.00	$262.00–$524.00	—	34%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US transperineal	$305.91	$463.50	—	9% below	34%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US pelvic limited	$305.91	$463.50	—	9% below	34%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US bladder	$396.66	$601.00	—	17% above	34%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US transperineal	$305.91	$463.50	—	—	34%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US pelvic limited	$305.91	$463.50	—	—	34%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US bladder	$396.66	$601.00	—	—	34%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US pelvic complete	$396.66	$601.00	—	19% below	34%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US pelvic complete	$396.66	$601.00	—	—	34%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <= 14 weeks fetus	$430.98	$653.00	—	at median	34%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <= 14 weeks fetus	$430.98	$653.00	—	—	34%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB limited	$414.48	$628.00	—	21% above	34%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB limited	$414.48	$628.00	—	—	34%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS RT 2V,Right side of body	$212.85	$322.50	—	6% above	34%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS LT 2V,Left Side of body	$212.85	$322.50	—	6% above	34%
Rib X-ray, one side, 2 views one side CPT 71100 XR ribs LT min 3V w CXR1V,Left Side of body	$220.77	$334.50	—	10% above	34%
Rib X-ray, one side, 2 views one side CPT 71100 XR ribs RT min 3V w CXR1V,Right side of body	$220.77	$334.50	—	10% above	34%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LT 2V,Left Side of body	$212.85	$322.50	—	—	34%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS RT 2V,Right side of body	$212.85	$322.50	—	—	34%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR ribs RT min 3V w CXR1V,Right side of body	$220.77	$334.50	—	—	34%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR ribs LT min 3V w CXR1V,Left Side of body	$220.77	$334.50	—	—	34%
Screening mammogram, both breasts CPT 77067 MM 2D mammo screening	$374.88	$568.00	$378.50–$757.00	13% above	34%
Screening mammogram, both breasts inpatient CPT 77067 MM 2D mammo screening	$374.88	$568.00	$378.50–$757.00	—	34%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR shoulder LT min 2V,Left Side of body	$228.69	$346.50	—	1% below	34%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR shoulder RT min 2V,Right side of body	$228.69	$346.50	—	1% below	34%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR shoulder LT min 2V,Left Side of body	$228.69	$346.50	—	—	34%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR shoulder RT min 2V,Right side of body	$228.69	$346.50	—	—	34%
Sinus X-ray, complete, 3 or more views CPT 70220 XR sinus min 3V	$220.77	$334.50	—	5% below	34%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR sinus min 3V	$220.77	$334.50	—	—	34%
Skull X-ray, fewer than 4 views CPT 70250 SKULL, 3 VIEWS	$310.86	$471.00	—	37% above	34%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL, 3 VIEWS	$310.86	$471.00	—	—	34%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR femur LT 2V,Left Side of body	$228.69	$346.50	—	1% above	34%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR femur RT 2V,Right side of body	$228.69	$346.50	—	1% above	34%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR femur LT 2V,Left Side of body	$228.69	$346.50	—	—	34%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR femur RT 2V,Right side of body	$228.69	$346.50	—	—	34%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT thoracic spine wo con	$1,335.18	$2,023.00	$262.00–$524.00	1% below	34%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT thoracic spine wo con	$1,335.18	$2,023.00	$262.00–$524.00	—	34%
Toe X-ray, 2 or more views one side CPT 73660 XR toe LT min 2V,Left Side of body	$220.77	$334.50	—	19% above	34%
Toe X-ray, 2 or more views one side CPT 73660 XR toe RT min 2V,Right side of body	$220.77	$334.50	—	19% above	34%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR toe LT min 2V,Left Side of body	$220.77	$334.50	—	—	34%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR toe RT min 2V,Right side of body	$220.77	$334.50	—	—	34%
Transvaginal pelvic ultrasound CPT 76830 US transvaginal	$396.66	$601.00	—	1% below	34%
Transvaginal pelvic ultrasound inpatient CPT 76830 US transvaginal	$396.66	$601.00	—	—	34%
Transvaginal ultrasound during pregnancy CPT 76817 US OB transvaginal	$414.48	$628.00	—	17% above	34%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB transvaginal	$414.48	$628.00	—	—	34%
Ultrasound of the abdomen, complete CPT 76700 US abdomen complete	$607.86	$921.00	—	1% above	34%
Ultrasound of the abdomen, complete inpatient CPT 76700 US abdomen complete	$607.86	$921.00	—	—	34%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US thyroid	$496.32	$752.00	—	10% above	34%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US soft tissue head and neck	$496.32	$752.00	—	10% above	34%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US thyroid	$496.32	$752.00	—	—	34%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US soft tissue head and neck	$496.32	$752.00	—	—	34%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR humerus RT	$228.69	$346.50	—	7% above	34%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR humerus LT	$228.69	$346.50	—	7% above	34%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR humerus LT	$228.69	$346.50	—	—	34%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR humerus RT	$228.69	$346.50	—	—	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US venous duplex UE LT,Left Side of body	$553.41	$838.50	—	2% above	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US venous duplex LE RT,Right side of body	$553.41	$838.50	—	2% above	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US venous duplex LE LT,Left Side of body	$553.41	$838.50	—	2% above	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US venous duplex UE RT,Right side of body	$553.41	$838.50	—	2% above	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US venous duplex UE RT,Right side of body	$553.41	$838.50	—	—	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US venous duplex LE RT,Right side of body	$553.41	$838.50	—	—	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US venous duplex UE LT,Left Side of body	$553.41	$838.50	—	—	34%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US venous duplex LE LT,Left Side of body	$553.41	$838.50	—	—	34%
Wrist X-ray, 2 views one side CPT 73100 XR wrist LT 2V,Left Side of body	$220.77	$334.50	—	12% above	34%
Wrist X-ray, 2 views one side CPT 73100 XR wrist RT 2V,Right side of body	$220.77	$334.50	—	12% above	34%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR wrist RT 2V,Right side of body	$220.77	$334.50	—	—	34%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR wrist LT 2V,Left Side of body	$220.77	$334.50	—	—	34%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR wrist LT min 3V,Left Side of body	$228.69	$346.50	—	at median	34%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR wrist RT w scaphoid,Right side of body	$228.69	$346.50	—	at median	34%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR wrist LT w scaphoid,Left Side of body	$228.69	$346.50	—	at median	34%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR wrist RT min 3V,Right side of body	$228.69	$346.50	—	at median	34%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR wrist RT w scaphoid,Right side of body	$228.69	$346.50	—	—	34%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR wrist RT min 3V,Right side of body	$228.69	$346.50	—	—	34%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR wrist LT min 3V,Left Side of body	$228.69	$346.50	—	—	34%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR wrist LT w scaphoid,Left Side of body	$228.69	$346.50	—	—	34%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR hip LT min 2V,Left Side of body	$267.96	$406.00	—	3% below	34%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR hip RT min 2V,Right side of body	$267.96	$406.00	—	3% below	34%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR hip LT min 2V,Left Side of body	$267.96	$406.00	—	—	34%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR hip RT min 2V,Right side of body	$267.96	$406.00	—	—	34%
X-ray of the abdomen, 1 view CPT 74018 XR abdomen w decubitus	$220.77	$334.50	—	5% above	34%
X-ray of the abdomen, 1 view CPT 74018 XR KUB	$248.49	$376.50	—	18% above	34%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$248.49	$376.50	—	18% above	34%
X-ray of the abdomen, 1 view one side CPT 74018 ABDOMEN, RIGHT LATERAL DECUBIT,Right side of body	$220.77	$334.50	—	5% above	34%
X-ray of the abdomen, 1 view one side CPT 74018 ABDOMEN, LEFT LATERAL DECUBITU,Left Side of body	$220.77	$334.50	—	5% above	34%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR abdomen w decubitus	$220.77	$334.50	—	—	34%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$248.49	$376.50	—	—	34%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR KUB	$248.49	$376.50	—	—	34%
X-ray of the abdomen, 1 view inpatient one side CPT 74018 ABDOMEN, LEFT LATERAL DECUBITU,Left Side of body	$220.77	$334.50	—	—	34%
X-ray of the abdomen, 1 view inpatient one side CPT 74018 ABDOMEN, RIGHT LATERAL DECUBIT,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the ankle, 2 views one side CPT 73600 XR ankle RT 2V,Right side of body	$220.77	$334.50	—	8% above	34%
X-ray of the ankle, 2 views one side CPT 73600 XR ankle LT 2V,Left Side of body	$220.77	$334.50	—	8% above	34%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ankle LT 2V,Left Side of body	$220.77	$334.50	—	—	34%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ankle RT 2V,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the finger(s), 2 or more views one side CPT 73140 THUMB, LEFT,Left Side of body	$220.77	$334.50	—	14% above	34%
X-ray of the finger(s), 2 or more views one side CPT 73140 THUMB,RIGHT,Right side of body	$220.77	$334.50	—	14% above	34%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR finger RT min 2V,Right side of body	$220.77	$334.50	—	14% above	34%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR finger LT min 2V	$220.77	$334.50	—	14% above	34%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 THUMB, LEFT,Left Side of body	$220.77	$334.50	—	—	34%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR finger LT min 2V	$220.77	$334.50	—	—	34%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR finger RT min 2V,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 THUMB,RIGHT,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the foot, 2 views one side CPT 73620 XR foot RT 2V,Right side of body	$220.77	$334.50	—	15% above	34%
X-ray of the foot, 2 views one side CPT 73620 XR foot LT 2V,Left Side of body	$220.77	$334.50	—	15% above	34%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR foot LT 2V,Left Side of body	$220.77	$334.50	—	—	34%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR foot RT 2V,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR foot RT min 3V,Right side of body	$220.77	$334.50	—	at median	34%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR foot LT min 3V,Left Side of body	$220.77	$334.50	—	at median	34%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR foot LT min 3V,Left Side of body	$220.77	$334.50	—	—	34%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR foot RT min 3V,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the hand, 3 or more views one side CPT 73130 XR hand RT min 3V,Right side of body	$220.77	$334.50	—	at median	34%
X-ray of the hand, 3 or more views one side CPT 73130 XR hand LT min 3V,Left Side of body	$220.77	$334.50	—	at median	34%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR hand RT min 3V,Right side of body	$220.77	$334.50	—	—	34%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR hand LT min 3V,Left Side of body	$220.77	$334.50	—	—	34%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR knee LT 2V,Left Side of body	$228.69	$346.50	—	3% above	34%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR knee RT 2V,Right side of body	$228.69	$346.50	—	3% above	34%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR patella RT,Right side of body	$248.49	$376.50	—	12% above	34%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR knee RT 2V,Right side of body	$228.69	$346.50	—	—	34%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR knee LT 2V,Left Side of body	$228.69	$346.50	—	—	34%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR patella RT,Right side of body	$248.49	$376.50	—	—	34%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR lumbar spine 2-3V	$310.86	$471.00	—	22% above	34%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR lumbar spine 2-3V	$310.86	$471.00	—	—	34%
X-ray of the lower back, 4 or more views CPT 72110 XR lumbar spine 6V w bending	$305.91	$463.50	—	10% below	34%
X-ray of the lower back, 4 or more views CPT 72110 XR lumbar spine min 4V	$339.24	$514.00	—	at median	34%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR lumbar spine 6V w bending	$305.91	$463.50	—	—	34%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR lumbar spine min 4V	$339.24	$514.00	—	—	34%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR thoracic spine 2V	$310.86	$471.00	—	32% above	34%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR thoracic spine 2V	$310.86	$471.00	—	—	34%
X-ray of the nasal bones, 3 or more views CPT 70160 XR nasal bones min 3V	$220.77	$334.50	—	1% above	34%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR nasal bones min 3V	$220.77	$334.50	—	—	34%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR cervical spine 3V	$243.21	$368.50	—	2% below	34%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR cervical spine 3V	$243.21	$368.50	—	—	34%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR pelvis 1-2V	$310.86	$471.00	—	41% above	34%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR pelvis 1-2V	$310.86	$471.00	—	—	34%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR sacrum coccyx min 2V	$310.86	$471.00	—	41% above	34%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR sacrum coccyx min 2V	$310.86	$471.00	—	—	34%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ACTH blood test CPT 82024 ACTH, RIA	$121.77	$184.50	—	17% above	34%
ACTH blood test inpatient CPT 82024 ACTH, RIA	$121.77	$184.50	—	—	34%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$48.18	$73.00	—	1% below	34%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$48.18	$73.00	—	—	34%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$43.89	$66.50	—	10% below	34%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$43.89	$66.50	—	—	34%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE	$344.52	$522.00	—	48% above	34%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE	$344.52	$522.00	—	—	34%
Albumin blood test CPT 82040 ALBUMIN, SERUM	$11.88	$18.00	—	58% below	34%
Albumin blood test CPT 82040 ALBUMIN	$42.90	$65.00	—	50% above	34%
Albumin blood test inpatient CPT 82040 ALBUMIN, SERUM	$11.88	$18.00	—	—	34%
Albumin blood test inpatient CPT 82040 ALBUMIN	$42.90	$65.00	—	—	34%
Aldosterone blood test CPT 82088 ALDOSTERONE 24H URINE	$64.35	$97.50	—	10% below	34%
Aldosterone blood test CPT 82088 ALDOSTERONE	$82.83	$125.50	—	15% above	34%
Aldosterone blood test CPT 82088 ALDOSTERONE, LC/MS/MS	$107.91	$163.50	—	50% above	34%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24H URINE	$64.35	$97.50	—	—	34%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$82.83	$125.50	—	—	34%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, LC/MS/MS	$107.91	$163.50	—	—	34%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSPH ISO	$40.92	$62.00	—	8% above	34%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PTASE (ALP)	$50.82	$77.00	—	34% above	34%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE BONE SPEC	$95.04	$144.00	—	150% above	34%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOSPH ISO	$40.92	$62.00	—	—	34%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PTASE (ALP)	$50.82	$77.00	—	—	34%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE BONE SPEC	$95.04	$144.00	—	—	34%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG MIX (YOLK & WHITE) (f245)	$23.76	$36.00	—	20% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 SEASAME SEED	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (e5) IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT (F201) IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT (F36) IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT (F13) IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED (F10) IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT (F202) IGE	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 SALMON	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT	$24.75	$37.50	—	26% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND (F20) IGE	$26.73	$40.50	—	36% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO NUT	$26.73	$40.50	—	36% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (F17) IGE	$26.73	$40.50	—	36% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 COW'S MILK	$26.73	$40.50	—	36% above	34%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE ALPHA 1,3 GALACTOSE	$58.08	$88.00	—	195% above	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG MIX (YOLK & WHITE) (f245)	$23.76	$36.00	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (e5) IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT (F201) IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT (F36) IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT (F13) IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED (F10) IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT (F202) IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SEASAME SEED	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN IGE	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT	$24.75	$37.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND (F20) IGE	$26.73	$40.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW'S MILK	$26.73	$40.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (F17) IGE	$26.73	$40.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO NUT	$26.73	$40.50	—	—	34%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE ALPHA 1,3 GALACTOSE	$58.08	$88.00	—	—	34%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN-MATERNAL	$110.88	$168.00	—	130% above	34%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN-MATERNAL	$110.88	$168.00	—	—	34%
Ammonia blood test CPT 82140 AMMONIA	$113.85	$172.50	—	42% above	34%
Ammonia blood test inpatient CPT 82140 AMMONIA	$113.85	$172.50	—	—	34%
Amylase blood test CPT 82150 AMYLASE	$80.19	$121.50	—	22% above	34%
Amylase blood test CPT 82150 BODY FLUID ALBUMIN	$84.48	$128.00	—	28% above	34%
Amylase blood test inpatient CPT 82150 AMYLASE	$80.19	$121.50	—	—	34%
Amylase blood test inpatient CPT 82150 BODY FLUID ALBUMIN	$84.48	$128.00	—	—	34%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$102.96	$156.00	—	92% above	34%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP	$102.96	$156.00	—	—	34%
Antinuclear antibody (ANA) blood test, screen CPT 86038 FANA	$64.02	$97.00	—	25% above	34%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 FANA	$64.02	$97.00	—	—	34%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP-QUEST	$174.57	$264.50	—	17% above	34%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (B TYPE NATRIURETIC PEPTID	$179.52	$272.00	—	21% above	34%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP-QUEST	$174.57	$264.50	—	—	34%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (B TYPE NATRIURETIC PEPTID	$179.52	$272.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULURE, EYE	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, EAR	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, NOSE	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, SPUTUM	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BODY FLUID	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, THROAT	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, GENITAL	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, WOUND	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, CONFIRMATION (TO MDH)	$85.80	$130.00	—	25% above	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, SPUTUM	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BODY FLUID	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, THROAT	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, EAR	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, CONFIRMATION (TO MDH)	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, WOUND	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, GENITAL	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, NOSE	$85.80	$130.00	—	—	34%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULURE, EYE	$85.80	$130.00	—	—	34%
Basic metabolic panel (blood test) CPT 80048 BMPTL	$141.57	$214.50	$42.50–$85.00	44% above	34%
Basic metabolic panel (blood test) CPT 80048 PROFILE III	$160.71	$243.50	$42.50–$85.00	64% above	34%
Basic metabolic panel (blood test) inpatient CPT 80048 BMPTL	$141.57	$214.50	$42.50–$85.00	—	34%
Basic metabolic panel (blood test) inpatient CPT 80048 PROFILE III	$160.71	$243.50	$42.50–$85.00	—	34%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$49.50	$75.00	—	9% above	34%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$49.50	$75.00	—	—	34%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE, LEVEL IV,Technical Component	$222.75	$337.50	$103.50–$207.00	64% above	34%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE, LEVEL IV,Technical Component	$222.75	$337.50	$103.50–$207.00	—	34%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD	$135.30	$205.00	—	16% above	34%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD	$135.30	$205.00	—	—	34%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE/SPEC. COLLECTION	$25.08	$38.00	$20.00–$40.00	19% above	34%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE/SPEC. COLLECTION	$25.08	$38.00	$20.00–$40.00	—	34%
Blood glucose (sugar) test CPT 82947 GLUCOSE, RANDOM (TL)	$52.47	$79.50	—	14% above	34%
Blood glucose (sugar) test CPT 82947 GLUCOSE, RANDOM	$52.47	$79.50	—	14% above	34%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, RANDOM (TL)	$52.47	$79.50	—	—	34%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, RANDOM	$52.47	$79.50	—	—	34%
Blood lead test CPT 83655 LEAD, CAPILLARY	$72.93	$110.50	—	58% above	34%
Blood lead test CPT 83655 LEAD LEVEL, ADULT	$73.26	$111.00	—	59% above	34%
Blood lead test CPT 83655 LEAD, URINE	$78.87	$119.50	—	71% above	34%
Blood lead test inpatient CPT 83655 LEAD, CAPILLARY	$72.93	$110.50	—	—	34%
Blood lead test inpatient CPT 83655 LEAD LEVEL, ADULT	$73.26	$111.00	—	—	34%
Blood lead test inpatient CPT 83655 LEAD, URINE	$78.87	$119.50	—	—	34%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, SERUM	$72.60	$110.00	—	4% above	34%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, SERUM TL	$72.60	$110.00	—	4% above	34%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, SERUM	$72.60	$110.00	—	—	34%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, SERUM TL	$72.60	$110.00	—	—	34%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, ABO GROUP	$97.35	$147.50	—	84% above	34%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING, ABO GROUP	$97.35	$147.50	—	—	34%
Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN	$51.48	$78.00	—	15% above	34%
Blood urea nitrogen (BUN) test CPT 84520 BUN (TL)	$51.48	$78.00	—	15% above	34%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA NITROGEN	$51.48	$78.00	—	—	34%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (TL)	$51.48	$78.00	—	—	34%
C-peptide blood test CPT 84681 C-PEPTIDE	$137.28	$208.00	—	67% above	34%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$137.28	$208.00	—	—	34%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP-QUEST	$65.34	$99.00	—	5% above	34%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP-QUEST	$65.34	$99.00	—	—	34%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFF. TOXIN B	$116.82	$177.00	—	12% below	34%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFF. TOXIN B	$116.82	$177.00	—	—	34%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9, CARBOHYDRATE ANTIGEN	$110.22	$167.00	—	8% above	34%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9, CARBOHYDRATE ANTIGEN	$110.22	$167.00	—	—	34%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$143.88	$218.00	—	42% above	34%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$143.88	$218.00	—	—	34%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID IDTL-ABBOTT ID NOW TL	$84.48	$128.00	$102.50–$205.00	29% below	34%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 ABBOTT ID NOW	$84.48	$128.00	$102.50–$205.00	29% below	34%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID CEPHEID	$183.48	$278.00	$102.50–$205.00	54% above	34%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 RNA (COVID-19), QUA	$210.21	$318.50	$102.50–$205.00	76% above	34%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 ABBOTT ID NOW	$84.48	$128.00	$102.50–$205.00	—	34%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID IDTL-ABBOTT ID NOW TL	$84.48	$128.00	$102.50–$205.00	—	34%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID CEPHEID	$183.48	$278.00	$102.50–$205.00	—	34%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 RNA (COVID-19), QUA	$210.21	$318.50	$102.50–$205.00	—	34%
Calcium blood test, total CPT 82310 CALCIUM TOTAL BLOOD	$47.52	$72.00	—	1% below	34%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL BLOOD	$47.52	$72.00	—	—	34%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$94.38	$143.00	—	6% below	34%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA,PERITONEAL FLUID	$109.56	$166.00	—	10% above	34%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$94.38	$143.00	—	—	34%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA,PERITONEAL FLUID	$109.56	$166.00	—	—	34%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$80.19	$121.50	—	47% above	34%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG ANTIBODY	$111.54	$169.00	—	105% above	34%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$80.19	$121.50	—	—	34%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG ANTIBODY	$111.54	$169.00	—	—	34%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA RNA,TMA, THRT	$74.58	$113.00	—	21% below	34%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TO RNA, TMA UROGENI	$85.80	$130.00	—	9% below	34%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA RNA,TMA, THRT	$74.58	$113.00	—	—	34%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TO RNA, TMA UROGENI	$85.80	$130.00	—	—	34%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHOLESTEROL, TOTAL	$32.34	$49.00	$53.50–$107.00	66% below	34%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HDL CHOLESTEROL	$35.31	$53.50	$53.50–$107.00	63% below	34%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 TRIGLYCERIDES	$54.78	$83.00	$53.50–$107.00	42% below	34%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL-QUEST	$129.69	$196.50	$53.50–$107.00	37% above	34%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 PROFILE, LIPID	$129.69	$196.50	$53.50–$107.00	37% above	34%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHOLESTEROL, TOTAL	$32.34	$49.00	$53.50–$107.00	—	34%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HDL CHOLESTEROL	$35.31	$53.50	$53.50–$107.00	—	34%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 TRIGLYCERIDES	$54.78	$83.00	$53.50–$107.00	—	34%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 PROFILE, LIPID	$129.69	$196.50	$53.50–$107.00	—	34%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL-QUEST	$129.69	$196.50	$53.50–$107.00	—	34%
Complete blood count (CBC) with differential CPT 85025 CBC (COMPLETE BLOOD COUNT)	$113.19	$171.50	$39.00–$78.00	36% above	34%
Complete blood count (CBC) with differential CPT 85025 CBCTL	$113.19	$171.50	$39.00–$78.00	36% above	34%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCTL	$113.19	$171.50	$39.00–$78.00	—	34%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC (COMPLETE BLOOD COUNT)	$113.19	$171.50	$39.00–$78.00	—	34%
Complete blood count (CBC), no differential CPT 85027 CBCWOD TL	$86.79	$131.50	—	32% above	34%
Complete blood count (CBC), no differential CPT 85027 CBC, W/O DIFF	$86.79	$131.50	—	32% above	34%
Complete blood count (CBC), no differential inpatient CPT 85027 CBCWOD TL	$86.79	$131.50	—	—	34%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC, W/O DIFF	$86.79	$131.50	—	—	34%
Comprehensive metabolic panel (blood test) CPT 80053 PROFILE (COMPREHENSIVE)	$174.57	$264.50	$53.00–$106.00	62% above	34%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 PROFILE (COMPREHENSIVE)	$174.57	$264.50	$53.00–$106.00	—	34%
Cortisol blood test, total CPT 82533 CORTISOL, TOTAL	$92.40	$140.00	—	72% above	34%
Cortisol blood test, total CPT 82533 CORTISOL, AM	$108.24	$164.00	—	101% above	34%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, TOTAL	$92.40	$140.00	—	—	34%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, AM	$108.24	$164.00	—	—	34%
Creatine kinase (CK) blood test, total CPT 82550 CK	$77.22	$117.00	—	30% above	34%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK	$77.22	$117.00	—	—	34%
Creatinine blood test CPT 82565 CREAT (TL)	$53.13	$80.50	—	9% above	34%
Creatinine blood test CPT 82565 CREATININE, SERUM	$53.13	$80.50	—	9% above	34%
Creatinine blood test inpatient CPT 82565 CREATININE, SERUM	$53.13	$80.50	—	—	34%
Creatinine blood test inpatient CPT 82565 CREAT (TL)	$53.13	$80.50	—	—	34%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG ANITBODY	$90.42	$137.00	—	45% above	34%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG ANITBODY	$90.42	$137.00	—	—	34%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE	$100.98	$153.00	—	at median	34%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$108.24	$164.00	—	8% above	34%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE	$100.98	$153.00	—	—	34%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$108.24	$164.00	—	—	34%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$160.05	$242.50	—	177% above	34%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$160.05	$242.50	—	—	34%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL,U	$76.23	$115.50	—	6% above	34%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONIT, FENTANYL / W CONF.	$76.89	$116.50	—	7% above	34%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITOR	$81.84	$124.00	—	14% above	34%
Drug screen by lab instrument (any number of drug classes) CPT 80307 CLONAZEPAM UR METABOLITE SCRN	$148.17	$224.50	—	107% above	34%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COMPREHENSIVE DRUG ANALYSIS	$285.12	$432.00	—	298% above	34%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COMP DRUG ANALYSIS W/MEDS	$285.12	$432.00	—	298% above	34%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL,U	$76.23	$115.50	—	—	34%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONIT, FENTANYL / W CONF.	$76.89	$116.50	—	—	34%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITOR	$81.84	$124.00	—	—	34%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CLONAZEPAM UR METABOLITE SCRN	$148.17	$224.50	—	—	34%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COMP DRUG ANALYSIS W/MEDS	$285.12	$432.00	—	—	34%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COMPREHENSIVE DRUG ANALYSIS	$285.12	$432.00	—	—	34%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$176.55	$267.50	—	128% above	34%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$176.55	$267.50	—	—	34%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG IGG AB	$112.53	$170.50	—	119% above	34%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG IGM AB	$121.11	$183.50	—	136% above	34%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG IGG AB	$112.53	$170.50	—	—	34%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG IGM AB	$121.11	$183.50	—	—	34%
Estradiol blood test CPT 82670 ESTRADIOL	$167.97	$254.50	—	153% above	34%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$167.97	$254.50	—	—	34%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$101.64	$154.00	—	22% above	34%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$101.64	$154.00	—	—	34%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN,STOOL	$178.53	$270.50	—	87% above	34%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN,STOOL	$178.53	$270.50	—	—	34%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$98.01	$148.50	—	4% above	34%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$98.01	$148.50	—	—	34%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY, CLAUSS	$100.32	$152.00	—	109% above	34%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY, CLAUSS	$100.32	$152.00	—	—	34%
Folate (folic acid) blood test CPT 82746 FOLATE, SERUM	$88.77	$134.50	—	4% above	34%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM	$88.77	$134.50	—	—	34%
Free T3 thyroid hormone test CPT 84481 T3, FREE	$169.29	$256.50	—	63% above	34%
Free T3 thyroid hormone test inpatient CPT 84481 T3, FREE	$169.29	$256.50	—	—	34%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE	$96.69	$146.50	—	40% above	34%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE, DIRECT DIALYSIS	$103.95	$157.50	—	50% above	34%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4, QUEST REFLEX	$110.22	$167.00	—	59% above	34%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE	$96.69	$146.50	—	—	34%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE, DIRECT DIALYSIS	$103.95	$157.50	—	—	34%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4, QUEST REFLEX	$110.22	$167.00	—	—	34%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$110.88	$168.00	—	75% above	34%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$110.88	$168.00	—	—	34%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$38.28	$58.00	—	17% below	34%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$38.28	$58.00	—	—	34%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST, 2 HOUR	$107.25	$162.50	—	6% above	34%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HOUR	$126.72	$192.00	—	25% above	34%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST, 2 HOUR	$107.25	$162.50	—	—	34%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HOUR	$126.72	$192.00	—	—	34%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE RNA,TMA,THRT	$74.58	$113.00	—	13% below	34%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE	$114.51	$173.50	—	33% above	34%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE RNA,TMA,THRT	$74.58	$113.00	—	—	34%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE	$114.51	$173.50	—	—	34%
H. pylori stool antigen test CPT 87338 H PYLORI, STOOL ANTIGEN	$150.15	$227.50	—	38% above	34%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI, STOOL ANTIGEN	$150.15	$227.50	—	—	34%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 RNA, QUANT, RT-PCR	$291.39	$441.50	—	154% above	34%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RNA, QUANT, RT-PCR	$291.39	$441.50	—	—	34%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1,2	$78.54	$119.00	—	3% above	34%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1&2 AB,AG WITH REFLEX	$335.28	$508.00	—	340% above	34%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1,2	$78.54	$119.00	—	—	34%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1&2 AB,AG WITH REFLEX	$335.28	$508.00	—	—	34%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV SCREEN	$166.65	$252.50	—	31% above	34%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA W REFLEX HPV 16,18	$166.65	$252.50	—	31% above	34%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV SCREEN	$166.65	$252.50	—	—	34%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA W REFLEX HPV 16,18	$166.65	$252.50	—	—	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1C-QUEST	$56.10	$85.00	$39.00–$78.00	11% below	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN	$71.61	$108.50	$39.00–$78.00	13% above	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 A1C-QUEST	$56.10	$85.00	$39.00–$78.00	—	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN	$71.61	$108.50	$39.00–$78.00	—	34%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$38.28	$58.00	—	15% above	34%
Hemoglobin blood test CPT 85018 HGBTL	$38.28	$58.00	—	15% above	34%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$38.28	$58.00	—	—	34%
Hemoglobin blood test inpatient CPT 85018 HGBTL	$38.28	$58.00	—	—	34%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB, TOTAL	$71.61	$108.50	—	2% above	34%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB, TOTAL	$71.61	$108.50	—	—	34%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HBS ANTIBODY (HEP B SURFACE)	$73.92	$112.00	—	4% above	34%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HBS ANTIBODY (HEP B SURFACE)	$73.92	$112.00	—	—	34%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBS ANTIGEN	$64.02	$97.00	—	11% above	34%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBS ANTIGEN	$64.02	$97.00	—	—	34%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS ANTIBODY	$108.90	$165.00	—	29% above	34%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY	$108.90	$165.00	—	—	34%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANTITATIVE PCR	$428.34	$649.00	—	234% above	34%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANTITATIVE PCR	$428.34	$649.00	—	—	34%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgM	$51.48	$78.00	—	10% above	34%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1	$88.11	$133.50	—	88% above	34%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgM	$51.48	$78.00	—	—	34%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1	$88.11	$133.50	—	—	34%
Herpes blood test, HSV-2 antibody CPT 86696 HSV IgM	$51.48	$78.00	—	10% below	34%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2	$88.11	$133.50	—	54% above	34%
Herpes blood test, HSV-2 antibody CPT 86696 HSV2 IGG, REFLEX TO HSV2 INHIB	$104.94	$159.00	—	84% above	34%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV IgM	$51.48	$78.00	—	—	34%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2	$88.11	$133.50	—	—	34%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV2 IGG, REFLEX TO HSV2 INHIB	$104.94	$159.00	—	—	34%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-QUAN.	$67.32	$102.00	—	9% below	34%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN-QUAN.	$67.32	$102.00	—	—	34%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$170.94	$259.00	—	81% above	34%
Homocysteine blood test CPT 83090 HOMOCYSTEIN	$193.38	$293.00	—	105% above	34%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$170.94	$259.00	—	—	34%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEIN	$193.38	$293.00	—	—	34%
Insulin blood test CPT 83525 INSULIN, SERUM	$61.05	$92.50	—	9% above	34%
Insulin blood test inpatient CPT 83525 INSULIN, SERUM	$61.05	$92.50	—	—	34%
Iron blood test (serum iron) CPT 83540 IRON	$34.32	$52.00	—	34% below	34%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$34.32	$52.00	—	—	34%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY	$79.53	$120.50	—	23% above	34%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY	$79.53	$120.50	—	—	34%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$139.59	$211.50	—	32% above	34%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE	$139.59	$211.50	—	—	34%
LH (luteinizing hormone) test CPT 83002 LH	$101.64	$154.00	—	22% above	34%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$101.64	$154.00	—	—	34%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$80.19	$121.50	—	1% below	34%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$80.19	$121.50	—	—	34%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$38.94	$59.00	—	15% below	34%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD, BODY FLUID	$45.54	$69.00	—	at median	34%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$38.94	$59.00	—	—	34%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD, BODY FLUID	$45.54	$69.00	—	—	34%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$88.11	$133.50	—	32% above	34%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$88.11	$133.50	—	—	34%
Liver function blood test panel CPT 80076 PROFILE, LIVER	$142.23	$215.50	—	40% above	34%
Liver function blood test panel inpatient CPT 80076 PROFILE, LIVER	$142.23	$215.50	—	—	34%
Lyme disease antibody test CPT 86618 LYME DISEASE	$134.64	$204.00	—	106% above	34%
Lyme disease antibody test CPT 86618 LYME DIS AB W/REFL IA IGG,IGM	$154.44	$234.00	—	136% above	34%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE	$134.64	$204.00	—	—	34%
Lyme disease antibody test inpatient CPT 86618 LYME DIS AB W/REFL IA IGG,IGM	$154.44	$234.00	—	—	34%
Magnesium blood test CPT 83735 TOT VOLUME	$23.76	$36.00	—	43% below	34%
Magnesium blood test CPT 83735 MAGNESIUM	$66.66	$101.00	—	60% above	34%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$83.16	$126.00	—	100% above	34%
Magnesium blood test inpatient CPT 83735 TOT VOLUME	$23.76	$36.00	—	—	34%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$66.66	$101.00	—	—	34%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$83.16	$126.00	—	—	34%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY IGM	$98.01	$148.50	—	155% above	34%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY IGG	$98.01	$148.50	—	155% above	34%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY (IgG)	$102.30	$155.00	—	166% above	34%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY IGG	$98.01	$148.50	—	—	34%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY IGM	$98.01	$148.50	—	—	34%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY (IgG)	$102.30	$155.00	—	—	34%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TL	$60.06	$91.00	—	17% above	34%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO	$60.06	$91.00	—	17% above	34%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TL	$60.06	$91.00	—	—	34%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO	$60.06	$91.00	—	—	34%
Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBOGY (IgG)	$99.66	$151.00	—	122% above	34%
Mumps immunity blood test CPT 86735 ENCEPHALITIS COMP. PANEL, CSF	$1,490.94	$2,259.00	—	3216% above	34%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS ANTIBOGY (IgG)	$99.66	$151.00	—	—	34%
Mumps immunity blood test inpatient CPT 86735 ENCEPHALITIS COMP. PANEL, CSF	$1,490.94	$2,259.00	—	—	34%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$67.32	$102.00	—	17% above	34%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$67.32	$102.00	—	—	34%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$67.32	$102.00	—	24% below	34%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, ULTRASENSITIVE	$115.17	$174.50	—	31% above	34%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA - DIAGNOSTIC	$115.17	$174.50	—	31% above	34%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL (QST)	$115.17	$174.50	—	31% above	34%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$67.32	$102.00	—	—	34%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA - DIAGNOSTIC	$115.17	$174.50	—	—	34%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL (QST)	$115.17	$174.50	—	—	34%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, ULTRASENSITIVE	$115.17	$174.50	—	—	34%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT	$191.73	$290.50	—	61% above	34%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT	$191.73	$290.50	—	—	34%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION SURFACE INDUCED	$37.62	$57.00	—	37% below	34%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA SCREEN	$53.79	$81.50	—	10% below	34%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$69.63	$105.50	—	17% above	34%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 COAGULATION SURFACE INDUCED	$37.62	$57.00	—	—	34%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA SCREEN	$53.79	$81.50	—	—	34%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$69.63	$105.50	—	—	34%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS, SERUM	$50.16	$76.00	—	37% above	34%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS, SERUM	$50.16	$76.00	—	—	34%
Potassium blood test CPT 84132 POTASSIUM, SERUM	$38.94	$59.00	—	13% below	34%
Potassium blood test CPT 84132 POTASSIUM, BLOOD (TL)	$38.94	$59.00	—	13% below	34%
Potassium blood test inpatient CPT 84132 POTASSIUM, SERUM	$38.94	$59.00	—	—	34%
Potassium blood test inpatient CPT 84132 POTASSIUM, BLOOD (TL)	$38.94	$59.00	—	—	34%
Progesterone blood test CPT 84144 PROGESTERONE	$96.69	$146.50	—	14% above	34%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$96.69	$146.50	—	—	34%
Prolactin blood test CPT 84146 PROLACTIN, UNDILUTED	$120.12	$182.00	—	43% above	34%
Prolactin blood test CPT 84146 PROLACTIN	$122.43	$185.50	—	46% above	34%
Prolactin blood test inpatient CPT 84146 PROLACTIN, UNDILUTED	$120.12	$182.00	—	—	34%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$122.43	$185.50	—	—	34%
Prothrombin time (PT/INR) clotting test CPT 85610 INR TL	$49.50	$75.00	—	57% above	34%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$49.50	$75.00	—	57% above	34%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR TL	$49.50	$75.00	—	—	34%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$49.50	$75.00	—	—	34%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREENTL	$183.81	$278.50	—	215% above	34%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN MULT DRUG CLASS	$183.81	$278.50	—	215% above	34%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN MULT DRUG CLASS	$183.81	$278.50	—	—	34%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREENTL	$183.81	$278.50	—	—	34%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTL	$54.78	$83.00	—	2% above	34%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$58.08	$88.00	—	8% above	34%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTL	$54.78	$83.00	—	—	34%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP	$58.08	$88.00	—	—	34%
Renin blood test CPT 84244 PLASMA RENIN ACTIVITY LC/MS/MS	$93.39	$141.50	—	100% above	34%
Renin blood test CPT 84244 RENIN	$97.02	$147.00	—	107% above	34%
Renin blood test inpatient CPT 84244 PLASMA RENIN ACTIVITY LC/MS/MS	$93.39	$141.50	—	—	34%
Renin blood test inpatient CPT 84244 RENIN	$97.02	$147.00	—	—	34%
Rh blood typing CPT 86901 BLOOD TYPING, RH TYPE	$48.84	$74.00	—	13% above	34%
Rh blood typing inpatient CPT 86901 BLOOD TYPING, RH TYPE	$48.84	$74.00	—	—	34%
Rheumatoid factor (RF) test CPT 86431 RA, QUANTITATIVE (TITER)	$89.43	$135.50	—	84% above	34%
Rheumatoid factor (RF) test inpatient CPT 86431 RA, QUANTITATIVE (TITER)	$89.43	$135.50	—	—	34%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE STATUS	$57.42	$87.00	—	21% above	34%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IMMUNE STATUS	$57.42	$87.00	—	—	34%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ERYTHROCYTE SEDIMENTATION TL	$46.86	$71.00	—	20% above	34%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR AUTO TL	$46.86	$71.00	—	20% above	34%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE (ESR) AUTO	$46.86	$71.00	—	20% above	34%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE (ESR) AUTO	$46.86	$71.00	—	—	34%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR AUTO TL	$46.86	$71.00	—	—	34%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ERYTHROCYTE SEDIMENTATION TL	$46.86	$71.00	—	—	34%
Sodium blood test CPT 84295 SODIUM, BLOOD (TL)	$33.66	$51.00	—	26% below	34%
Sodium blood test CPT 84295 SODIUM, BLOOD	$35.97	$54.50	—	21% below	34%
Sodium blood test inpatient CPT 84295 SODIUM, BLOOD (TL)	$33.66	$51.00	—	—	34%
Sodium blood test inpatient CPT 84295 SODIUM, BLOOD	$35.97	$54.50	—	—	34%
Stool ova and parasites exam CPT 87177 DIRECT OR CONCENT. DRY FOR O&P	$69.63	$105.50	—	61% above	34%
Stool ova and parasites exam inpatient CPT 87177 DIRECT OR CONCENT. DRY FOR O&P	$69.63	$105.50	—	—	34%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD OCCULT FECAL HGB 1-3	$81.18	$123.00	—	41% above	34%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IMMUNO FECAL OCCULT,DIAGTL	$81.18	$123.00	—	41% above	34%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD OCCULT FECAL HGB 1-3	$81.18	$123.00	—	—	34%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IMMUNO FECAL OCCULT,DIAGTL	$81.18	$123.00	—	—	34%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS	$74.58	$113.00	—	42% above	34%
Syphilis antibody test (Treponema pallidum) CPT 86780 T PALLIDUM AB BY PA	$96.69	$146.50	—	84% above	34%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS	$74.58	$113.00	—	—	34%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T PALLIDUM AB BY PA	$96.69	$146.50	—	—	34%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (VDRL)	$37.62	$57.00	—	15% above	34%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (VDRL)	$37.62	$57.00	—	—	34%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$252.45	$382.50	—	111% above	34%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$252.45	$382.50	—	—	34%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$114.18	$173.00	—	81% above	34%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTFBTM.3	$118.80	$180.00	—	88% above	34%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$132.99	$201.50	—	110% above	34%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, FEMALE	$165.99	$251.50	—	163% above	34%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$114.18	$173.00	—	—	34%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTFBTM.3	$118.80	$180.00	—	—	34%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$132.99	$201.50	—	—	34%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, FEMALE	$165.99	$251.50	—	—	34%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBIDIES	$93.72	$142.00	—	78% above	34%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBIDIES	$93.72	$142.00	—	—	34%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH WITH REFLEX TO T4	$93.72	$142.00	$67.00–$134.00	at median	34%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$105.27	$159.50	$67.00–$134.00	12% above	34%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADING REFLEX	$105.27	$159.50	$67.00–$134.00	12% above	34%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH WITH REFLEX TO T4	$93.72	$142.00	$67.00–$134.00	—	34%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADING REFLEX	$105.27	$159.50	$67.00–$134.00	—	34%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$105.27	$159.50	$67.00–$134.00	—	34%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$64.68	$98.00	—	26% above	34%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$64.68	$98.00	—	—	34%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$47.52	$72.00	—	39% above	34%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$47.52	$72.00	—	—	34%
Total thyroxine (T4) blood test CPT 84436 T4, TOTAL	$35.97	$54.50	—	17% below	34%
Total thyroxine (T4) blood test inpatient CPT 84436 T4, TOTAL	$35.97	$54.50	—	—	34%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3	$97.35	$147.50	—	40% above	34%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3	$97.35	$147.50	—	—	34%
Transferrin blood test CPT 84466 TRANSFERRIN	$78.21	$118.50	—	10% above	34%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$78.21	$118.50	—	—	34%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS RNA, QUAL TMA MALE	$125.07	$189.50	—	149% above	34%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA	$148.83	$225.50	—	197% above	34%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS RNA, QUAL TMA MALE	$125.07	$189.50	—	—	34%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS RNA	$148.83	$225.50	—	—	34%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$55.44	$84.00	—	30% above	34%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$55.44	$84.00	—	—	34%
Troponin test, quantitative CPT 84484 TROPONIN I	$123.09	$186.50	—	21% above	34%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$123.09	$186.50	—	—	34%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$46.20	$70.00	—	1% above	34%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$46.20	$70.00	—	—	34%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, TL	$59.40	$90.00	—	15% above	34%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W REFLEX TL	$59.40	$90.00	—	15% above	34%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W REFLEX	$59.40	$90.00	—	15% above	34%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, COMPLETE	$59.40	$90.00	—	15% above	34%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W REFLEX	$59.40	$90.00	—	—	34%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W REFLEX TL	$59.40	$90.00	—	—	34%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, COMPLETE	$59.40	$90.00	—	—	34%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, TL	$59.40	$90.00	—	—	34%
Urinalysis without microscope exam, automated CPT 81003 UA SCREENTL	$38.28	$58.00	—	47% above	34%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY, URINE	$38.28	$58.00	—	47% above	34%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, SCREEN	$38.28	$58.00	—	47% above	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY, URINE	$38.28	$58.00	—	—	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, SCREEN	$38.28	$58.00	—	—	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA SCREENTL	$38.28	$58.00	—	—	34%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN, RANDOM URINE WO CREAT	$60.72	$92.00	—	4% above	34%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE RANDOM	$63.03	$95.50	—	8% above	34%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN (URINE)	$78.87	$119.50	—	35% above	34%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN, RANDOM URINE WO CREAT	$60.72	$92.00	—	—	34%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE RANDOM	$63.03	$95.50	—	—	34%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN (URINE)	$78.87	$119.50	—	—	34%
Urine pregnancy test, read by color change CPT 81025 HCG, URINE TL	$78.87	$119.50	—	96% above	34%
Urine pregnancy test, read by color change CPT 81025 HCG, URINE	$78.87	$119.50	—	96% above	34%
Urine pregnancy test, read by color change CPT 81025 HCG, URINETL	$78.87	$119.50	—	96% above	34%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, URINE TL	$78.87	$119.50	—	—	34%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, URINETL	$78.87	$119.50	—	—	34%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, URINE	$78.87	$119.50	—	—	34%
Vitamin B12 (cobalamin) blood test CPT 82607 B12 ASSAY	$90.42	$137.00	—	2% above	34%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12 ASSAY	$90.42	$137.00	—	—	34%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXYVITAMIN D, 2&3	$173.25	$262.50	—	78% above	34%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D, 25-HYDROXY, TOTAL-QUEST	$181.83	$275.50	—	86% above	34%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 D2 D3-25HYDROXYVITD	$264.33	$400.50	—	171% above	34%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXYVITAMIN D, 2&3	$173.25	$262.50	—	—	34%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D, 25-HYDROXY, TOTAL-QUEST	$181.83	$275.50	—	—	34%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 D2 D3-25HYDROXYVITD	$264.33	$400.50	—	—	34%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1,25-DIHYDROXY	$239.25	$362.50	—	209% above	34%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1,25-DIHYDROXY	$239.25	$362.50	—	—	34%
Zinc blood test CPT 84630 ZINC	$75.24	$114.00	—	150% above	34%
Zinc blood test inpatient CPT 84630 ZINC	$75.24	$114.00	—	—	34%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, QUANT.	$110.22	$167.00	—	31% above	34%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT UMCM	$125.07	$189.50	—	49% above	34%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, QUANT.	$110.22	$167.00	—	—	34%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT UMCM	$125.07	$189.50	—	—	34%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Botox injections for chronic migraine CPT 64615 Botox for migraine	$514.80	$780.00	—	15% below	34%
Botox injections for chronic migraine inpatient CPT 64615 Botox for migraine	$514.80	$780.00	—	—	34%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION, ELECTIVE	$1,028.28	$1,558.00	$286.00	4% below	34%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION, ELECTIVE	$1,028.28	$1,558.00	$286.00	—	34%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TREAT DISTAL RAD W/O MAN	$427.68	$648.00	$286.00	13% below	34%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TREAT DISTAL RAD W/O MAN	$427.68	$648.00	$286.00	—	34%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/ REMOVAL; SNARE	$2,013.33	$3,050.50	$2,251.00–$4,502.00	56% above	34%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/ REMOVAL; SNARE	$2,013.33	$3,050.50	$2,251.00–$4,502.00	—	34%
Colonoscopy with tissue sample CPT 45380 COLONSCPY, W/BIOPSY, SG/MULT	$1,974.39	$2,991.50	$2,251.00–$4,502.00	50% above	34%
Colonoscopy with tissue sample inpatient CPT 45380 COLONSCPY, W/BIOPSY, SG/MULT	$1,974.39	$2,991.50	$2,251.00–$4,502.00	—	34%
Colonoscopy, diagnostic CPT 45378 COLONOSCPY,DX W/WO COLLCT SPEC	$1,777.38	$2,693.00	$1,743.50–$3,487.00	47% above	34%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCPY,DX W/WO COLLCT SPEC	$1,777.38	$2,693.00	$1,743.50–$3,487.00	—	34%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMVL IMPCTD CERMN W/IRR UNI	$120.12	$182.00	$286.00	52% above	34%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMVL IMPCTD CERMN W/IRR UNI	$120.12	$182.00	$286.00	—	34%
Earwax removal with instruments, one ear CPT 69210 REMVL IMPCTD CERMEN INSTRU UNI	$120.12	$182.00	$286.00	4% below	34%
Earwax removal with instruments, one ear inpatient CPT 69210 REMVL IMPCTD CERMEN INSTRU UNI	$120.12	$182.00	$286.00	—	34%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 FL THORACIC ESI	$1,382.04	$2,094.00	—	19% above	34%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 FL CERVICAL ESI	$1,437.48	$2,178.00	—	24% above	34%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CT cervical epi. steroid inj	$1,731.18	$2,623.00	—	49% above	34%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CT thoracic epid. steroid inj.	$1,731.18	$2,623.00	—	49% above	34%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 FL THORACIC ESI	$1,382.04	$2,094.00	—	—	34%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 FL CERVICAL ESI	$1,437.48	$2,178.00	—	—	34%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CT cervical epi. steroid inj	$1,731.18	$2,623.00	—	—	34%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CT thoracic epid. steroid inj.	$1,731.18	$2,623.00	—	—	34%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT lumbar facet joint inj sing	$642.51	$973.50	—	56% below	34%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FL LUMBAR FACET 1LVL UNI	$697.62	$1,057.00	—	52% below	34%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT lumbar facet joint inj sing	$642.51	$973.50	—	—	34%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FL LUMBAR FACET 1LVL UNI	$697.62	$1,057.00	—	—	34%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMO,DX W/WO COLECTN OF SPECI	$1,430.22	$2,167.00	—	66% above	34%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMO,DX W/WO COLECTN OF SPECI	$1,430.22	$2,167.00	—	—	34%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS SIMPLE OR SINGL	$257.07	$389.50	$286.00	10% below	34%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS SIMPLE OR SINGL	$257.07	$389.50	$286.00	—	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION, MAJOR JOINT	$496.32	$752.00	—	37% above	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ ER JOINT(HIP,KNEE,SHOULDER	$496.32	$752.00	$286.00	37% above	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR injection shoulder LT,Left Side of body	$496.32	$752.00	—	37% above	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR injection hip LT,Left Side of body	$496.32	$752.00	—	37% above	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR injection shoulder RT,Right side of body	$496.32	$752.00	—	37% above	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR injection hip RT,Right side of body	$496.32	$752.00	—	37% above	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ ER JOINT(HIP,KNEE,SHOULDER	$496.32	$752.00	$286.00	—	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECTION, MAJOR JOINT	$496.32	$752.00	—	—	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR injection hip RT,Right side of body	$496.32	$752.00	—	—	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR injection shoulder LT,Left Side of body	$496.32	$752.00	—	—	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR injection shoulder RT,Right side of body	$496.32	$752.00	—	—	34%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR injection hip LT,Left Side of body	$496.32	$752.00	—	—	34%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ ER JOINT(WRIST,ELBW,ANKLE)	$479.16	$726.00	$286.00	57% above	34%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ ER JOINT(WRIST,ELBW,ANKLE)	$479.16	$726.00	$286.00	—	34%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ ER SINGLE JOINT(FINGER/TOE	$479.16	$726.00	$286.00	48% above	34%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ ER SINGLE JOINT(FINGER/TOE	$479.16	$726.00	$286.00	—	34%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE 2.5 CM & <	$627.33	$950.50	$286.00	38% above	34%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE 2.5 CM & <	$627.33	$950.50	$286.00	—	34%
Lower-back epidural injection, with imaging guidance CPT 62323 FL LUMBAR ESI	$1,382.04	$2,094.00	—	23% above	34%
Lower-back epidural injection, with imaging guidance CPT 62323 CT lumbar epidural steroid inj	$1,731.18	$2,623.00	—	54% above	34%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 FL LUMBAR ESI	$1,382.04	$2,094.00	—	—	34%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT lumbar epidural steroid inj	$1,731.18	$2,623.00	—	—	34%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORMNL EPIDURAL LUMB/SACR	$1,249.38	$1,893.00	—	3% below	34%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORMNL EPIDURAL LUMB/SACR	$1,249.38	$1,893.00	—	—	34%
Nail removal (partial or complete), one nail CPT 11730 AVULSN NAIL PL PART/COM;SIMPLE	$378.18	$573.00	$286.00	41% above	34%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSN NAIL PL PART/COM;SIMPLE	$378.18	$573.00	$286.00	—	34%
Occipital nerve block (injection for headaches) CPT 64405 INJ GREATER OCCIPITAL NRVE BLK	$663.96	$1,006.00	—	11% above	34%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GREATER OCCIPITAL NRVE BLK	$663.96	$1,006.00	—	—	34%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGE	$1,498.53	$2,270.50	$286.00	61% above	34%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGE	$1,498.53	$2,270.50	$286.00	—	34%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL PERMANENT REMOVL	$489.06	$741.00	$286.00	5% below	34%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL PERMANENT REMOVL	$489.06	$741.00	$286.00	—	34%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB SIMPLE	$499.95	$757.50	$286.00	25% above	34%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FB SIMPLE	$499.95	$757.50	$286.00	—	34%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCREENING COLONOSCOPY	$1,612.05	$2,442.50	$1,525.50–$3,051.00	33% above	34%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCREENING COLONOSCOPY	$1,612.05	$2,442.50	$1,525.50–$3,051.00	—	34%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONOSCPY HIGH RISK	$1,612.05	$2,442.50	$1,525.50–$3,051.00	33% above	34%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCREENING COLONOSCPY HIGH RISK	$1,612.05	$2,442.50	$1,525.50–$3,051.00	—	34%
Short arm cast (elbow to hand) CPT 29075 APPL CAST ELBOW FINGER SHRT AR	$445.50	$675.00	$286.00	89% above	34%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL CAST ELBOW FINGER SHRT AR	$445.50	$675.00	$286.00	—	34%
Short arm splint (forearm and hand) CPT 29125 APLICATN SHORT ARM SPLT STATIC	$195.69	$296.50	$286.00	2% below	34%
Short arm splint (forearm and hand) inpatient CPT 29125 APLICATN SHORT ARM SPLT STATIC	$195.69	$296.50	$286.00	—	34%
Short leg cast (below the knee) CPT 29405 APL SHORT LEG CAST,NON-WALKING	$478.50	$725.00	$286.00	67% above	34%
Short leg cast (below the knee) inpatient CPT 29405 APL SHORT LEG CAST,NON-WALKING	$478.50	$725.00	$286.00	—	34%
Short leg splint (calf to foot) CPT 29515 APLICATN SHORT LEG SPLT CAL/FT	$278.85	$422.50	$286.00	25% above	34%
Short leg splint (calf to foot) inpatient CPT 29515 APLICATN SHORT LEG SPLT CAL/FT	$278.85	$422.50	$286.00	—	34%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR 2.5CM AND LESS	$263.01	$398.50	$286.00	5% below	34%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR 2.5CM AND LESS	$263.01	$398.50	$286.00	—	34%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR/DIAGNOS	$1,254.00	$1,900.00	$286.00	73% above	34%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR/DIAGNOS	$1,254.00	$1,900.00	$286.00	—	34%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6 TO 7.5 CM	$271.59	$411.50	$286.00	13% below	34%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR 2.6 TO 7.5 CM	$271.59	$411.50	$286.00	—	34%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR 2.5CM AND LESS	$271.59	$411.50	$286.00	5% below	34%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR 2.5CM AND LESS	$271.59	$411.50	$286.00	—	34%
Thoracentesis with imaging guidance CPT 32555 US thoracentesis	$538.56	$816.00	—	42% below	34%
Thoracentesis with imaging guidance inpatient CPT 32555 US thoracentesis	$538.56	$816.00	—	—	34%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger point 1-2	$338.58	$513.00	—	7% above	34%
Trigger point injections, 1 or 2 muscles CPT 20552 SINGLE/MULT TRIGGER PTS, 1OR2	$479.16	$726.00	$286.00	52% above	34%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger point 1-2	$338.58	$513.00	—	—	34%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 SINGLE/MULT TRIGGER PTS, 1OR2	$479.16	$726.00	$286.00	—	34%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY, SINGLE OR MULTPL	$1,844.70	$2,795.00	$1,729.00–$3,458.00	64% above	34%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY, SINGLE OR MULTPL	$1,844.70	$2,795.00	$1,729.00–$3,458.00	—	34%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W/ DIRECTED INJECTION	$1,596.54	$2,419.00	—	25% above	34%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W/ DIRECTED INJECTION	$1,596.54	$2,419.00	—	—	34%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ESOPHAGOGASTRODUODENOSCOPY	$2,858.79	$4,331.50	—	62% above	34%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ESOPHAGOGASTRODUODENOSCOPY	$2,858.79	$4,331.50	—	—	34%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD;DX, W/WO COLLECTN OF SPECI	$1,756.92	$2,662.00	$1,729.00–$3,458.00	61% above	34%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD;DX, W/WO COLLECTN OF SPECI	$1,756.92	$2,662.00	$1,729.00–$3,458.00	—	34%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDE SUBQ FRST 20SQ CM OR LES	$483.78	$733.00	$286.00	8% above	34%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDE SUBQ FRST 20SQ CM OR LES	$483.78	$733.00	$286.00	—	34%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - OP	$759.99	$1,151.50	—	7% above	34%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - ER	$771.21	$1,168.50	—	8% above	34%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$771.21	$1,168.50	—	8% above	34%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - OP	$759.99	$1,151.50	—	—	34%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$771.21	$1,168.50	—	—	34%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - ER	$771.21	$1,168.50	—	—	34%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATN TRTMNT (NEBULIZER) ER	$320.10	$485.00	—	174% above	34%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMNT (NEBULIZER	$347.16	$526.00	—	197% above	34%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATN TRTMNT (NEBULIZER) ER	$320.10	$485.00	—	—	34%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMNT (NEBULIZER	$347.16	$526.00	—	—	34%
Chemotherapy IV infusion, first hour CPT 96413 IV ADMIN CHEMO/REMI UP TO 1 HR	$600.60	$910.00	—	17% above	34%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV ADMIN CHEMO/REMI UP TO 1 HR	$600.60	$910.00	—	—	34%
Critical care, first 30 to 74 minutes CPT 99291 E.R. CRITICAL CARE 1ST 74"	$1,520.97	$2,304.50	$286.00	5% below	34%
Critical care, first 30 to 74 minutes inpatient CPT 99291 E.R. CRITICAL CARE 1ST 74"	$1,520.97	$2,304.50	$286.00	—	34%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12 lead	$171.60	$260.00	$116.50–$233.00	at median	34%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 ECG 12 lead EKG - Right sided	$171.60	$260.00	$116.50–$233.00	at median	34%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12 lead	$171.60	$260.00	$116.50–$233.00	—	34%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient one side CPT 93005 ECG 12 lead EKG - Right sided	$171.60	$260.00	$116.50–$233.00	—	34%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL 1	$207.57	$314.50	$286.00	2% above	34%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM LEVEL 1	$207.57	$314.50	$286.00	—	34%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL 2	$335.94	$509.00	$286.00	18% above	34%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY ROOM LEVEL 2	$335.94	$509.00	$286.00	—	34%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL 3	$542.85	$822.50	$286.00	13% above	34%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM LEVEL 3	$542.85	$822.50	$286.00	—	34%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL 4	$714.12	$1,082.00	$286.00	7% below	34%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM LEVEL 4	$714.12	$1,082.00	$286.00	—	34%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL 5	$1,163.91	$1,763.50	$286.00	3% above	34%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM LEVEL 5	$1,163.91	$1,763.50	$286.00	—	34%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDR 31-60 MIN ER	$250.14	$379.00	—	9% below	34%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDR 31-60 MIN SCH OP	$385.11	$583.50	—	41% above	34%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS HYDR 31-60 MIN ER	$250.14	$379.00	—	—	34%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS HYDR 31-60 MIN SCH OP	$385.11	$583.50	—	—	34%
IV infusion of a medicine, first hour CPT 96365 IV INFUS. W/MEDS. 1ST HR. ER	$371.58	$563.00	—	13% above	34%
IV infusion of a medicine, first hour CPT 96365 IV W/MED 1ST HR OP	$385.11	$583.50	—	17% above	34%
IV infusion of a medicine, first hour CPT 96365 IV INFUS MEDS 1ST HR OP/PRO	$385.11	$583.50	—	17% above	34%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS. W/MEDS. 1ST HR. ER	$371.58	$563.00	—	—	34%
IV infusion of a medicine, first hour inpatient CPT 96365 IV W/MED 1ST HR OP	$385.11	$583.50	—	—	34%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS MEDS 1ST HR OP/PRO	$385.11	$583.50	—	—	34%
IV push of a medicine, first drug CPT 96374 IV PUSH, SINGLE OR INITIAL DRU	$211.53	$320.50	$286.00	10% above	34%
IV push of a medicine, first drug CPT 96374 IV PUSH, SINGLE OR INITIAL(OP)	$385.11	$583.50	—	100% above	34%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH, SINGLE OR INITIAL DRU	$211.53	$320.50	$286.00	—	34%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH, SINGLE OR INITIAL(OP)	$385.11	$583.50	—	—	34%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ - IM OR SUBQ (ER)	$93.72	$142.00	$286.00	21% above	34%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ, IM OR SUBQ (OP)	$114.51	$173.50	—	48% above	34%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ - IM OR SUBQ (ER)	$93.72	$142.00	$286.00	—	34%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ, IM OR SUBQ (OP)	$114.51	$173.50	—	—	34%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NCS 7-8 STUDIES	$403.92	$612.00	—	11% below	34%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NCS 7-8 STUDIES	$403.92	$612.00	—	—	34%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT W/RD INITIAL ASSESS 15 MIN	$37.62	$57.00	—	40% below	34%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT W/RD INITIAL ASSESS 15 MIN	$37.62	$57.00	—	—	34%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$278.19	$421.50	—	70% above	34%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$278.19	$421.50	—	—	34%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$214.17	$324.50	—	5% above	34%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$214.17	$324.50	—	—	34%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Flu vaccine(Fluad) 0.5ml PFS	$81.97	$124.20	$83.49–$125.24	6% above	34%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Flu vaccine(Fluad) 0.5ml PFS	$81.97	$124.20	$83.49–$125.24	—	34%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Covid vaccine (Spikevax)0.5ml	$253.67	$384.35	$161.65–$323.30	38% above	34%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Covid vaccine (Spikevax)0.5ml	$253.67	$384.35	$161.65–$323.30	—	34%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria influenza vaccine 3yr	$25.61	$38.80	$22.35–$33.53	16% above	34%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria influenza vaccine 3yr	$25.61	$38.80	$22.35–$33.53	—	34%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis B Vaccine	$263.84	$399.75	$134.82–$269.64	81% above	34%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hepatitis B Vaccine	$263.84	$399.75	$134.82–$269.64	—	34%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB2 ADMIN	$131.34	$199.00	$70.38–$140.76	17% above	34%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB2 ADMIN	$131.34	$199.00	$70.38–$140.76	—	34%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEU13 ADMIN	$296.01	$448.50	$257.99–$515.98	3% above	34%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEU13 ADMIN	$296.01	$448.50	$257.99–$515.98	—	34%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 VACCINE	$496.21	$751.84	$298.04–$596.08	23% above	34%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 VACCINE	$496.21	$751.84	$298.04–$596.08	—	34%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEMO ADMIN	$189.09	$286.50	$133.47–$266.94	26% above	34%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEMO ADMIN	$189.09	$286.50	$133.47–$266.94	—	34%
Rabies vaccine, one dose CPT 90675 RABAVERT 1 MG (RABIES VACCINE)	$778.76	$1,179.94	$327.78–$655.56	37% above	34%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT 1 MG (RABIES VACCINE)	$778.76	$1,179.94	$327.78–$655.56	—	34%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Varicella-Zoster 50mcg/0.5ml	$330.38	$500.58	$201.85–$403.70	37% above	34%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Varicella-Zoster 50mcg/0.5ml	$330.38	$500.58	$201.85–$403.70	—	34%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPH TOX 1 EA	$75.00	$113.63	$33.48–$66.96	18% above	34%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPH TOX 1 EA	$75.00	$113.63	$33.48–$66.96	—	34%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL	$117.09	$177.41	$38.63–$77.26	49% above	34%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL	$117.09	$177.41	$38.63–$77.26	—	34%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ - IM VAC/TOX 1 VACCINE	$81.84	$124.00	$286.00	94% above	34%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ, IM VAC/TOX (OP)	$81.84	$124.00	—	94% above	34%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ, IM VAC/TOX (OP)	$81.84	$124.00	—	—	34%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ - IM VAC/TOX 1 VACCINE	$81.84	$124.00	$286.00	—	34%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADDITIONAL VACCINE	$29.04	$44.00	$286.00	5% above	34%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EACH ADDITIONAL VACCINE	$29.04	$44.00	$286.00	—	34%

Source file: https://www.cookhospital.org/wp-content/uploads/2026/08/410964895_the-cook-hospital_standardcharges.csv