Hospital Brainerd, MN

Cuyuna Regional Medical Center

Cuyuna Regional Medical Center in Crosby, MN publishes cash prices for 407 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Minnesota median for 241 of 389 procedures and above it for 135. By typical cash price it ranks #34 of 79 Minnesota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

320 E Main St, Crosby, MN, 56441 Collected Sep 27, 2026 Source price file (218) 546-2300

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 3 of 5 CCN 241353 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Cuyuna Regional Medical Center in Crosby, MN:

Jan 28, 2026 Warning notice
May 5, 2026 Corrective action plan requested
Jun 11, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 (IA) RAD XR ANKLE COMPLETE 3 VIEWS OR MORE PORTABLE	$320.28	$942.00	$221.56–$415.00	46% above	66%
Ankle X-ray, complete, 3 or more views CPT 73610 (IA) RAD XR ANKLE COMPLETE 3 VIEWS OR MORE	$320.28	$942.00	$221.56–$415.00	46% above	66%
Ankle X-ray, complete, 3 or more views CPT 73610 HCHG RAD XRAY ANKLE COMPLETE 3 VIEWS OR MORE PORTABLE	$320.28	$942.00	$221.56–$415.00	46% above	66%
Ankle X-ray, complete, 3 or more views CPT 73610 PR RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$320.28	$942.00	$221.56–$415.00	46% above	66%
Ankle X-ray, complete, 3 or more views CPT 73610 HCHG RAD XRAY ANKLE COMPLETE 3 VIEWS OR MORE	$320.28	$942.00	$221.56–$415.00	46% above	66%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$236.98	$697.00	$157.52–$391.02	36% below	66%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HCHG NONINV EXT ART SINGLE LEVEL BILAT	$118.66	$349.00	$78.87–$195.79	—	66%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HCHG NONINV EXT ART SINGLE LEVEL UNI	$118.66	$349.00	$78.87–$195.79	—	66%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$236.98	$697.00	$157.52–$391.02	—	66%
Barium swallow (esophagus X-ray with contrast) CPT 74220 (IA) RAD XR ESOPHAGUS	$212.16	$624.00	$146.76–$415.00	27% below	66%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HCHG RAD XRAY ESOPHAGUS	$212.16	$624.00	$146.76–$415.00	27% below	66%
Barium swallow (esophagus X-ray with contrast) CPT 74220 PR RADEX ESOPHAGUS	$212.16	$624.00	$146.76–$415.00	27% below	66%
Bone scan, whole body (nuclear medicine) CPT 78306 (IA) RAD NM BONE SCAN WHOLE BODY	$1,223.66	$3,599.00	$813.37–$2,019.04	at median	66%
Bone scan, whole body (nuclear medicine) CPT 78306 HCHG RAD NM BONE SCAN WHOLE BODY	$1,223.66	$3,599.00	$813.37–$2,019.04	at median	66%
Breast ultrasound, complete, one breast CPT 76641 HCHG RAD US BREAST COMPLETE	$958.80	$2,820.00	$324.00–$1,218.24	154% above	66%
Breast ultrasound, complete, one breast CPT 76641 (IA) RAD US BREAST COMPLETE	$958.80	$2,820.00	$324.00–$1,218.24	154% above	66%
Breast ultrasound, complete, one breast CPT 76641 PR US BREAST UNI REAL TIME WITH IMAGE COMPLETE	$958.80	$2,820.00	$324.00–$1,218.24	154% above	66%
Breast ultrasound, limited (one breast or one area) CPT 76642 HCHG RAD US BREAST LIMITED	$861.56	$2,534.00	$324.00–$1,094.69	174% above	66%
Breast ultrasound, limited (one breast or one area) CPT 76642 PR US BREAST UNI REAL TIME WITH IMAGE LIMITED	$861.56	$2,534.00	$324.00–$1,094.69	174% above	66%
Breast ultrasound, limited (one breast or one area) CPT 76642 (IA) RAD US BREAST LIMITED	$861.56	$2,534.00	$324.00–$1,094.69	174% above	66%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 PR CT ANGIO CHEST - DUAL READ	$2,077.74	$6,111.00	$1,381.09–$3,428.27	26% above	66%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 (IA) RAD CT ANGIO CHEST	$2,527.22	$7,433.00	$237.00–$3,211.06	53% above	66%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 PR CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$2,527.22	$7,433.00	$237.00–$3,211.06	53% above	66%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HCHG RAD CT ANGIO CHEST	$2,527.22	$7,433.00	$237.00–$3,211.06	53% above	66%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HCHG RAD CT ABDOMEN PELVIS WO	$2,576.18	$7,577.00	$237.00–$3,273.26	35% above	66%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 (IA) RAD CT ABDOMEN PELVIS WO	$2,576.18	$7,577.00	$237.00–$3,273.26	35% above	66%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 PR CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$2,576.18	$7,577.00	$237.00–$3,273.26	35% above	66%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 PR CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$2,576.18	$7,577.00	$237.00–$3,273.26	5% above	66%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HCHG RAD CT ABDOMEN PELVIS W	$2,576.18	$7,577.00	$237.00–$3,273.26	5% above	66%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 (IA) RAD CT ABDOMEN PELVIS W	$2,576.18	$7,577.00	$237.00–$3,273.26	5% above	66%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HCHG RAD CT ABDOMEN PELVIS WWO	$2,576.18	$7,577.00	$237.00–$3,273.26	at median	66%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 PR CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE	$2,576.18	$7,577.00	$237.00–$3,273.26	at median	66%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 (IA) RAD CT ABDOMEN PELVIS WWO	$2,576.18	$7,577.00	$237.00–$3,273.26	at median	66%
CT scan of the abdomen with contrast CPT 74160 HCHG RAD CT ABDOMEN W	$1,786.70	$5,255.00	$237.00–$2,270.16	22% above	66%
CT scan of the abdomen with contrast CPT 74160 (IA) RAD CT ABDOMEN W	$1,786.70	$5,255.00	$237.00–$2,270.16	22% above	66%
CT scan of the abdomen with contrast CPT 74160 PR CT ABDOMEN W/CONTRAST MATERIAL	$1,803.36	$5,304.00	$237.00–$2,291.33	23% above	66%
CT scan of the abdomen without contrast CPT 74150 (IA) RAD CT ABDOMEN WO	$1,681.64	$4,946.00	$237.00–$2,136.67	43% above	66%
CT scan of the abdomen without contrast CPT 74150 HCHG RAD CT ABDOMEN WO	$1,681.64	$4,946.00	$237.00–$2,136.67	43% above	66%
CT scan of the abdomen without contrast CPT 74150 HCHG RAD CT ABDOMEN WO LIMITED	$1,681.64	$4,946.00	$237.00–$2,136.67	43% above	66%
CT scan of the abdomen without contrast CPT 74150 PR CT ABDOMEN W/O CONTRAST MATERIAL	$1,681.64	$4,946.00	$237.00–$2,136.67	43% above	66%
CT scan of the face and sinuses, no contrast dye CPT 70486 PR CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$1,681.64	$4,946.00	$237.00–$2,136.67	35% above	66%
CT scan of the face and sinuses, no contrast dye CPT 70486 (IA) RAD CT FACIAL BONES AND SINUS WO	$1,681.64	$4,946.00	$237.00–$2,136.67	35% above	66%
CT scan of the face and sinuses, no contrast dye CPT 70486 HCHG CT MAXILLOFACIAL WO CONTRAST	$1,681.64	$4,946.00	$237.00–$2,136.67	35% above	66%
CT scan of the face and sinuses, no contrast dye CPT 70486 HCHG RAD CT FACIAL BONES AND SINUS WO	$1,681.64	$4,946.00	$237.00–$2,136.67	35% above	66%
CT scan of the head or brain, no contrast dye CPT 70450 HCHG RAD CT HEAD BRAIN WO	$1,627.92	$4,788.00	$237.00–$2,068.42	29% above	66%
CT scan of the head or brain, no contrast dye CPT 70450 PR CT HEAD/BRAIN W/O CONTRAST MATERIAL	$1,627.92	$4,788.00	$237.00–$2,068.42	29% above	66%
CT scan of the head or brain, no contrast dye CPT 70450 (IA) RAD CT HEAD BRAIN WO	$1,627.92	$4,788.00	$237.00–$2,068.42	29% above	66%
CT scan of the head with contrast CPT 70460 (IA) RAD CT HEAD BRAIN W	$1,627.92	$4,788.00	$237.00–$2,068.42	25% above	66%
CT scan of the head with contrast CPT 70460 PR CT HEAD/BRAIN W/CONTRAST MATERIAL	$1,627.92	$4,788.00	$237.00–$2,068.42	25% above	66%
CT scan of the head with contrast CPT 70460 HCHG RAD CT HEAD BRAIN W	$1,627.92	$4,788.00	$237.00–$2,068.42	25% above	66%
CT scan of the head without and with contrast CPT 70470 HCHG RAD CT HEAD BRAIN WWO	$1,786.70	$5,255.00	$237.00–$2,270.16	12% above	66%
CT scan of the head without and with contrast CPT 70470 (IA) RAD CT HEAD BRAIN WWO	$1,786.70	$5,255.00	$237.00–$2,270.16	12% above	66%
CT scan of the head without and with contrast CPT 70470 PR CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$1,786.70	$5,255.00	$237.00–$2,270.16	12% above	66%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HCHG RAD CT SPINE LUMBAR OR SACRUM WO	$2,007.70	$5,905.00	$237.00–$2,550.96	47% above	66%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 (IA) RAD CT SPINE LUMBAR OR SACRUM WO	$2,007.70	$5,905.00	$237.00–$2,550.96	47% above	66%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 PR CT LUMBAR SPINE W/O CONTRAST MATERIAL	$2,007.70	$5,905.00	$237.00–$2,550.96	47% above	66%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 PR CT CERVICAL SPINE W/O CONTRAST MATERIAL	$1,675.52	$4,928.00	$237.00–$2,128.90	24% above	66%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HCHG RAD CT SPINE CERVICAL WO	$1,675.52	$4,928.00	$237.00–$2,128.90	24% above	66%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 (IA) RAD CT SPINE CERVICAL WO	$1,675.52	$4,928.00	$237.00–$2,128.90	24% above	66%
CT scan of the pelvis, with contrast dye CPT 72193 HCHG RAD CT PELVIS W	$1,726.86	$5,079.00	$237.00–$2,194.13	17% above	66%
CT scan of the pelvis, with contrast dye CPT 72193 (IA) RAD CT PELVIS W	$1,726.86	$5,079.00	$237.00–$2,194.13	17% above	66%
CT scan of the pelvis, with contrast dye CPT 72193 PR CT PELVIS W/CONTRAST MATERIAL	$1,726.86	$5,079.00	$237.00–$2,194.13	17% above	66%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 (IA) RAD US CAROTID DUPLEX BILATERAL	$837.42	$2,463.00	$556.64–$1,381.74	—	66%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HCHG RAD US CAROTID DUPLEX BILATERAL	$837.42	$2,463.00	$556.64–$1,381.74	—	66%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HCHG RAD US CAROTID DUPLEX BILATERAL PORTABLE	$837.42	$2,463.00	$556.64–$1,381.74	—	66%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 PR DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$837.42	$2,463.00	$556.64–$1,381.74	—	66%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 (IA) RAD US CAROTID DUPLEX BILATERAL PORTABLE	$837.42	$2,463.00	$556.64–$1,381.74	—	66%
Chest X-ray, 2 views CPT 71046 HCHG RAD XRAY CHEST 2 VIEWS PA AND LATERAL	$237.32	$698.00	$164.17–$415.00	3% above	66%
Chest X-ray, 2 views CPT 71046 HCHG RAD XRAY CHEST 2 VIEWS PA AND LAT PORTABLE	$237.32	$698.00	$164.17–$415.00	3% above	66%
Chest X-ray, 2 views CPT 71046 (IA) RAD XR CHEST 2 VIEWS PA AND LATERAL	$237.32	$698.00	$164.17–$415.00	3% above	66%
Chest X-ray, 2 views CPT 71046 (IA) RAD XR CHEST 2 VIEWS PA AND LAT PORTABLE	$237.32	$698.00	$164.17–$415.00	3% above	66%
Chest X-ray, 2 views CPT 71046 PR RADIOLOGIC EXAM CHEST 2 VIEWS	$237.32	$698.00	$164.17–$415.00	3% above	66%
Chest X-ray, single view CPT 71045 PR RADIOLOGIC EXAM CHEST SINGLE VIEW	$197.88	$582.00	$136.89–$415.00	11% above	66%
Chest X-ray, single view CPT 71045 (IA) RAD XR CHEST FRONTAL 1 VIEW PORTABLE	$197.88	$582.00	$136.89–$415.00	11% above	66%
Chest X-ray, single view CPT 71045 (IA) RAD XR CHEST FRONTAL 1 VIEW	$197.88	$582.00	$136.89–$415.00	11% above	66%
Chest X-ray, single view CPT 71045 HCHG RAD XRAY CHEST FRONTAL 1 VIEW PORTABLE	$197.88	$582.00	$136.89–$415.00	11% above	66%
Chest X-ray, single view CPT 71045 HCHG RAD XRAY CHEST FRONTAL 1 VIEW	$197.88	$582.00	$136.89–$415.00	11% above	66%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HCHG RAD US RETROPERITONEAL COMPLETE	$599.08	$1,762.00	$324.00–$761.18	15% above	66%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HCHG RAD US RETROPERITONEAL COMPLETE PORTABLE	$599.08	$1,762.00	$324.00–$761.18	15% above	66%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 PR US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE	$599.08	$1,762.00	$324.00–$761.18	15% above	66%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 (IA) RAD US RETROPERITONEAL COMPLETE PORTABLE	$599.08	$1,762.00	$324.00–$761.18	15% above	66%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 (IA) RAD US RETROPERITONEAL COMPLETE	$599.08	$1,762.00	$324.00–$761.18	15% above	66%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HCHG RAD DEXA BONE DENSITY 1/> SITE AXIAL SKELETON	$123.42	$363.00	$85.38–$415.00	61% below	66%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 (IA) RAD XR DEXA BONE DENSITY 1 SITE AXIAL SKELETON	$123.42	$363.00	$85.38–$415.00	61% below	66%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 PR DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$174.08	$512.00	$120.42–$415.00	44% below	66%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 (IA) RAD XR DEXA BONE DENSITY 2 SITES AXIAL SKELETON	$174.08	$512.00	$120.42–$415.00	44% below	66%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HCHG RAD DEXA BONE DENSITY 1/> PERIPHERAL SKELETON	$123.42	$363.00	$85.38–$415.00	36% below	66%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 (IA) RAD XR DEXA BONE DENSITY PERIPHERAL SKELETON	$123.42	$363.00	$85.38–$415.00	36% below	66%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 PR DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$123.42	$363.00	$85.38–$415.00	36% below	66%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 (IA) RAD US OB FETAL ANATOMY SINGLE GESTATION	$343.06	$1,009.00	$237.32–$679.00	24% below	66%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 PR US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$343.06	$1,009.00	$237.32–$679.00	24% below	66%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HCHG RAD US OB FETAL ANATOMY SINGLE GESTATION	$343.06	$1,009.00	$237.32–$679.00	24% below	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG RAD CT CHEST WO CONTRAST DIAGNOSTIC LIMITED	$406.64	$1,196.00	$237.00–$1,443.00	68% below	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG RAD CT CHEST WO CONTRAST DIAGNOSTIC LOW DOSE	$406.64	$1,196.00	$237.00–$1,443.00	68% below	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 (IA) RAD CT CHEST WO CONTRAST LOW DOSE DIAGNOSTIC	$406.64	$1,196.00	$237.00–$1,443.00	68% below	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 (IA) RAD CT CHEST LTD WO CONTRAST DIAGNOSTIC	$406.64	$1,196.00	$237.00–$1,443.00	68% below	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 (IA) RAD CT CHEST WO CONTRAST ADD ON DIAGNOSTIC	$1,803.36	$5,304.00	$237.00–$2,291.33	44% above	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 (IA) RAD CT CHEST WO CONTRAST DIAGNOSTIC	$1,803.36	$5,304.00	$237.00–$2,291.33	44% above	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG RAD CT CHEST WO CONTRAST DIAGNOSTIC ADD-ON	$1,803.36	$5,304.00	$237.00–$2,291.33	44% above	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG RAD CT CHEST WO CONTRAST DIAGNOSTIC	$1,803.36	$5,304.00	$237.00–$2,291.33	44% above	66%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 PR DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$2,086.24	$6,136.00	$237.00–$2,650.75	66% above	66%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 (IA) RAD CT CHEST WO CONTRAST LOW DOSE DIAGNOSTIC	$405.96	$1,194.00	$237.00–$1,443.00	—	66%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HCHG RAD CT CHEST WO CONTRAST DIAGNOSTIC LOW DOSE	$405.96	$1,194.00	$237.00–$1,443.00	—	66%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 PR DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$2,086.24	$6,136.00	$237.00–$2,650.75	40% above	66%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 (IA) RAD CT CHEST W CONTRAST ADD ON DIAGNOSTIC	$2,086.24	$6,136.00	$237.00–$2,650.75	40% above	66%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 (IA) RAD CT CHEST W CONTRAST DIAGNOSTIC	$2,086.24	$6,136.00	$237.00–$2,650.75	40% above	66%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HCHG RAD CT CHEST W CONTRAST DIAGNOSTIC ADD-ON	$2,086.24	$6,136.00	$237.00–$2,650.75	40% above	66%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HCHG RAD CT CHEST W CONTRAST DIAGNOSTIC	$2,086.24	$6,136.00	$237.00–$2,650.75	40% above	66%
Diagnostic mammogram, both breasts both sides CPT 77066 HCHG RAD MAMMO BILAT ADDL VIEWS WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, both breasts both sides CPT 77066 (IA) RAD XR MAMMO BILAT DIAGNOSTIC 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, both breasts both sides CPT 77066 HCHG RAD MAMMO BILAT DIAGNOSTIC WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, both breasts both sides CPT 77066 HCHG RAD MAMMO BILAT DIAGNOSTIC 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, both breasts both sides CPT 77066 (IA) RAD XR MAMMO BILAT ADDL VIEWS WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, both breasts both sides CPT 77066 PR DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, both breasts both sides CPT 77066 (IA) RAD XR MAMMO BILAT DIAGNOSTIC WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Diagnostic mammogram, one breast CPT 77065 HCHG RAD MAMMO UNI DIAGNOSTIC ADDL VIEWS WWO CAD	$212.50	$625.00	$147.00–$356.00	32% below	66%
Diagnostic mammogram, one breast CPT 77065 HCHG RAD MAMMO UNI DIAGNOSTIC 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	32% below	66%
Diagnostic mammogram, one breast CPT 77065 (IA) RAD XR MAMMO UNI DIAGNOSTIC 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	32% below	66%
Diagnostic mammogram, one breast CPT 77065 PR DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$212.50	$625.00	$147.00–$356.00	32% below	66%
Diagnostic mammogram, one breast CPT 77065 (IA) RAD XR MAMMO UNI DIAGNOSTIC ADDL VIEWS WWO CAD	$212.50	$625.00	$147.00–$356.00	32% below	66%
Diagnostic mammogram, one breast CPT 77065 HCHG RAD MAMMO UNI DIAGNOSTIC WWO CAD	$212.50	$625.00	$147.00–$356.00	32% below	66%
Diagnostic mammogram, one breast CPT 77065 (IA) RAD XR MAMMO UNI DIAGNOSTIC WWO CAD	$212.50	$625.00	$147.00–$356.00	32% below	66%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 (IA) RAD US LOWER EXTREMITY BILATERAL COMPLETE	$566.44	$1,666.00	$376.52–$934.63	—	66%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HCHG RAD US LOWER EXTREMITY BILATERAL COMPLETE	$566.44	$1,666.00	$376.52–$934.63	—	66%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$566.44	$1,666.00	$376.52–$934.63	—	66%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 (IA) RAD US LOWER EXTREMITY BILATERAL COMPLETE PORTABLE	$566.44	$1,666.00	$376.52–$934.63	—	66%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HCHG RAD US LOWER EXTREMITY BILATERAL COMPLETE PORTABLE	$566.44	$1,666.00	$376.52–$934.63	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 (IA) RAD US VEIN MAPPING EXTREMITY BILATERAL	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 PR DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 (IA) RAD US VENOUS INSUFFICIENCY LOWER EXTREMITY BILATERAL	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 (IA) RAD US DUPLEX SCAN EXTREMITY BILAT COMPLETE PORTABLE	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 (IA) RAD US DUPLEX SCAN EXTREMITY BILATERAL COMPLETE	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HCHG RAD US VENOUS INSUFFICIENCY LOWER EXTREMITY BILATERAL	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HCHG RAD US VEIN MAPPING EXTREMITY BILATERAL	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HCHG RAD US DUPLEX SCAN EXTREMITY BILAT COMPLETE PORTABLE	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HCHG RAD US DUPLEX SCAN EXTREMITY BILATERAL COMPLETE	$937.72	$2,758.00	$623.31–$1,547.24	—	66%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG ECHO 2D COMP WO CONT W BUBBLE-SPECTRAL-COLOR	$918.68	$2,702.00	$610.65–$1,515.82	27% below	66%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG ECHO 2D COMP WO CONT W SPECTRAL-COLOR	$918.68	$2,702.00	$610.65–$1,515.82	27% below	66%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D	$918.68	$2,702.00	$610.65–$1,515.82	27% below	66%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG RAD ECHO 2D COMP WO CONT W SPECTRAL-COLOR	$918.68	$2,702.00	$610.65–$1,515.82	27% below	66%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 (IA) RAD NM HEPATOBILIARY	$457.30	$1,345.00	$303.97–$754.54	66% below	66%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HCHG RAD NM HEPATOBILIARY	$457.30	$1,345.00	$303.97–$754.54	66% below	66%
Knee X-ray, 3 views CPT 73562 (IA) RAD XR KNEE 3 VIEWS	$233.24	$686.00	$161.35–$415.00	at median	66%
Knee X-ray, 3 views CPT 73562 HCHG RAD XRAY KNEE 3 VIEWS	$233.24	$686.00	$161.35–$415.00	at median	66%
Knee X-ray, 3 views CPT 73562 PR RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$233.24	$686.00	$161.35–$415.00	at median	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PR US ABDOMEN LIMITED	$89.76	$264.00	$59.66–$148.10	79% below	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 (IA) RAD US ABDOMEN LIMITED	$560.66	$1,649.00	$324.00–$712.37	34% above	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HCHG RAD US ABDOMEN LIMITED	$560.66	$1,649.00	$324.00–$712.37	34% above	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HCHG RAD US ABDOMEN LIMITED PORTABLE	$560.66	$1,649.00	$324.00–$712.37	34% above	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 (IA) RAD US ABDOMEN LIMITED PORTABLE	$560.66	$1,649.00	$324.00–$712.37	34% above	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PR US ABDOMINAL REAL TIME W/IMAGE LIMITED	$560.66	$1,649.00	$324.00–$712.37	34% above	66%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PR US ABDOMEN LIMITED	$89.76	$264.00	$59.66–$148.10	—	66%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HCHG RAD CT THORAX LOW DOSE LUNG CANCER SCREEN WO	$405.96	$1,194.00	$237.00–$1,443.00	30% below	66%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 (IA) RAD CT THORAX LOW DOSE LUNG CANCER SCREEN	$405.96	$1,194.00	$237.00–$1,443.00	30% below	66%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HCHG RAD MRI JOINT LOWER EXTREMITY WO	$1,844.84	$5,426.00	$709.00–$2,344.03	4% above	66%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 PR MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	4% above	66%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 (IA) RAD MR JOINT LOWER EXTREMITY WO	$1,844.84	$5,426.00	$709.00–$2,344.03	4% above	66%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 (IA) RAD MR JOINT OF LOWER EXTREMITY WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	28% below	66%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HCHG RAD MRI JOINT OF LOWER EXTREMITY WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	28% below	66%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 PR MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	28% below	66%
MRI of the abdomen without contrast CPT 74181 PR MRI ABDOMEN W/O CONTRAST MATERIAL	$1,844.84	$5,426.00	$709.00–$2,344.03	15% below	66%
MRI of the abdomen without contrast CPT 74181 HCHG RAD MRI ABDOMEN WO	$1,844.84	$5,426.00	$709.00–$2,344.03	15% below	66%
MRI of the abdomen without contrast CPT 74181 (IA) RAD MR ABDOMEN WO	$1,844.84	$5,426.00	$709.00–$2,344.03	15% below	66%
MRI of the abdomen, without and then with contrast dye CPT 74183 (IA) RAD MR ABDOMEN WWO	$2,212.04	$6,506.00	$709.00–$2,810.59	25% below	66%
MRI of the abdomen, without and then with contrast dye CPT 74183 HCHG RAD MRI ABDOMEN WWO	$2,212.04	$6,506.00	$709.00–$2,810.59	25% below	66%
MRI of the abdomen, without and then with contrast dye CPT 74183 PR MRI ABDOMEN W/O & W/CONTRAST MATERIAL	$2,325.60	$6,840.00	$709.00–$2,954.88	21% below	66%
MRI of the brain, no contrast dye CPT 70551 (IA) RAD MR HEAD BRAIN WO	$1,844.84	$5,426.00	$709.00–$2,344.03	9% below	66%
MRI of the brain, no contrast dye CPT 70551 (IA) RAD MR HEAD BRAIN WO LTD	$1,844.84	$5,426.00	$709.00–$2,344.03	9% below	66%
MRI of the brain, no contrast dye CPT 70551 PR MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL	$1,844.84	$5,426.00	$709.00–$2,344.03	9% below	66%
MRI of the brain, no contrast dye CPT 70551 HCHG RAD MRI HEAD BRAIN WO LIMITED	$1,844.84	$5,426.00	$709.00–$2,344.03	9% below	66%
MRI of the brain, no contrast dye CPT 70551 HCHG RAD MRI HEAD BRAIN WO	$1,844.84	$5,426.00	$709.00–$2,344.03	9% below	66%
MRI of the brain, no contrast dye CPT 70551 HCHG MRI BRAIN WO CONTRAST	$1,846.54	$5,431.00	$709.00–$2,346.19	9% below	66%
MRI of the brain, with and without contrast dye CPT 70553 PR MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$1,844.84	$5,426.00	$709.00–$2,344.03	32% below	66%
MRI of the brain, with and without contrast dye CPT 70553 (IA) RAD MR HEAD BRAIN WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	32% below	66%
MRI of the brain, with and without contrast dye CPT 70553 HCHG RAD MRI HEAD BRAIN WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	32% below	66%
MRI of the lower back, no contrast dye CPT 72148 HCHG RAD MRI SPINE LUMBAR WO	$1,844.84	$5,426.00	$709.00–$2,344.03	12% below	66%
MRI of the lower back, no contrast dye CPT 72148 PR MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$1,844.84	$5,426.00	$709.00–$2,344.03	12% below	66%
MRI of the lower back, no contrast dye CPT 72148 (IA) RAD MR SPINE LUMBAR WO	$1,844.84	$5,426.00	$709.00–$2,344.03	12% below	66%
MRI of the lower back, without and then with contrast dye CPT 72158 HCHG RAD MRI SPINE LUMBAR WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	28% below	66%
MRI of the lower back, without and then with contrast dye CPT 72158 (IA) RAD MR SPINE LUMBAR WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	28% below	66%
MRI of the lower back, without and then with contrast dye CPT 72158 PR MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	28% below	66%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 (IA) RAD MR SPINE THORACIC WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HCHG RAD MRI SPINE THORACIC WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 PR MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HCHG RAD MRI SPINE CERVICAL WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	26% below	66%
MRI of the neck (cervical spine) without and with contrast CPT 72156 (IA) RAD MR SPINE CERVICAL WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	26% below	66%
MRI of the neck (cervical spine) without and with contrast CPT 72156 PR MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	26% below	66%
MRI of the neck (cervical spine), no contrast dye CPT 72141 (IA) RAD MR SPINE CERVICAL WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the neck (cervical spine), no contrast dye CPT 72141 PR MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HCHG RAD MRI SPINE CERVICAL WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the pelvis without and with contrast CPT 72197 (IA) RAD MR PELVIS WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	31% below	66%
MRI of the pelvis without and with contrast CPT 72197 HCHG RAD MRI PELVIS WWO	$1,844.84	$5,426.00	$709.00–$2,344.03	31% below	66%
MRI of the pelvis without and with contrast CPT 72197 PR MRI PELVIS W/O & W/CONTRAST MATERIAL	$1,844.84	$5,426.00	$709.00–$2,344.03	31% below	66%
MRI of the pelvis, no contrast dye CPT 72195 PR MRI PELVIS W/O CONTRAST MATERIAL	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the pelvis, no contrast dye CPT 72195 HCHG RAD MRI PELVIS WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the pelvis, no contrast dye CPT 72195 (IA) RAD MR PELVIS WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HCHG RAD MRI JOINT OF UPPER EXTREMITY WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 PR MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 (IA) RAD MR JOINT OF UPPER EXTREMITY WO	$1,844.84	$5,426.00	$709.00–$2,344.03	13% below	66%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HCHG RAD NM CARDIAC MYOCARD MULT SPECT WWO EF AND WM	$1,441.60	$4,240.00	$958.24–$2,378.64	49% below	66%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 (IA) RAD NM CARDIAC MYOCARD MULT SPECT W VIABILITY	$1,441.60	$4,240.00	$958.24–$2,378.64	49% below	66%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 (IA) RAD NM CARDIAC MYOCARD MULT SPECT WWO EF AND WM	$1,441.60	$4,240.00	$958.24–$2,378.64	49% below	66%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HCHG RAD PET CT SKULL BASE TO MID THIGH INITIAL TREAT	$2,555.44	$7,516.00	$1,698.62–$4,216.48	at median	66%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 (IA) RAD PET CT SKULL BASE TO MID THIGH SUBSEQUENT TREAT	$2,555.44	$7,516.00	$1,698.62–$4,216.48	at median	66%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HCHG RAD PET CT SKULL BASE TO MID THIGH SUBSEQUENT TREAT	$2,555.44	$7,516.00	$1,698.62–$4,216.48	at median	66%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PR PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH	$2,555.44	$7,516.00	$1,698.62–$4,216.48	at median	66%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 (IA) RAD PET CT SKULL BASE TO MID THIGH INITIAL TREAT	$2,555.44	$7,516.00	$1,698.62–$4,216.48	at median	66%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PR US NON OB LTD	$99.28	$292.00	$65.99–$163.81	68% below	66%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HCHG RAD US PELVIS LIMITED STUDY PORTABLE	$99.28	$292.00	$68.68–$679.00	68% below	66%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 (IA) RAD US PELVIS LIMITED STUDY	$99.28	$292.00	$68.68–$679.00	68% below	66%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HCHG RAD US PELVIS LIMITED STUDY	$99.28	$292.00	$68.68–$679.00	68% below	66%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 (IA) RAD US PELVIS LIMITED STUDY PORTABLE	$99.28	$292.00	$68.68–$679.00	68% below	66%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PR US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$99.28	$292.00	$68.68–$679.00	68% below	66%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PR US NON OB LTD	$99.28	$292.00	$65.99–$163.81	—	66%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 (IA) RAD US PELVIS COMPLETE NONOBSTETRIC	$583.10	$1,715.00	$324.00–$740.88	25% above	66%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HCHG RAD US PELVIS COMPLETE NONOBSTETRIC PORTABLE	$583.10	$1,715.00	$324.00–$740.88	25% above	66%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PR US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$583.10	$1,715.00	$324.00–$740.88	25% above	66%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HCHG RAD US PELVIS COMPLETE NONOBSTETRIC	$583.10	$1,715.00	$324.00–$740.88	25% above	66%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 (IA) RAD US PELVIS COMPLETE NONOBSTETRIC PORTABLE	$583.10	$1,715.00	$324.00–$740.88	25% above	66%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PR US PELVIC NON OB COMPLETE	$583.44	$1,716.00	$387.82–$962.68	25% above	66%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PR US PELVIC NON OB COMPLETE	$583.44	$1,716.00	$387.82–$962.68	—	66%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HCHG RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE GEST	$548.42	$1,613.00	$324.00–$696.82	15% above	66%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 (IA) RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE GEST	$548.42	$1,613.00	$324.00–$696.82	15% above	66%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 (IA) RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE GEST PORTABLE	$548.42	$1,613.00	$324.00–$696.82	15% above	66%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PR US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$548.42	$1,613.00	$324.00–$696.82	15% above	66%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PR OB EQUAL OR GREATER THAN 14 WKS SINGLE	$548.42	$1,613.00	$364.54–$904.89	15% above	66%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HCHG RAD US OB EQUAL OR GREATER THAN 14 WKS SNGL GEST PORTABLE	$548.42	$1,613.00	$324.00–$696.82	15% above	66%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PR OB EQUAL OR GREATER THAN 14 WKS SINGLE	$548.42	$1,613.00	$364.54–$904.89	—	66%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PR US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$548.42	$1,613.00	$324.00–$696.82	31% above	66%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PR OB LESS THAN 14 WKS SINGLE GEST	$548.42	$1,613.00	$364.54–$904.89	31% above	66%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HCHG RAD US OB 1ST TRI SINGLE TRANSABD	$548.42	$1,613.00	$324.00–$696.82	31% above	66%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 (IA) RAD US OB 1ST TRI SINGLE TRANSABD	$548.42	$1,613.00	$324.00–$696.82	31% above	66%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 PR OB LESS THAN 14 WKS SINGLE GEST	$548.42	$1,613.00	$364.54–$904.89	—	66%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PR OB LIMITED 1 OR MORE FETUSES	$66.64	$196.00	$44.30–$109.96	79% below	66%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PR US PREGNANT UTERUS LIMITED 1/> FETUSES	$115.26	$339.00	$79.73–$679.00	64% below	66%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HCHG RAD US OB LIMITED ANY TRI 1 OR MORE FETUSES	$115.26	$339.00	$79.73–$679.00	64% below	66%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 (IA) RAD US OB LIMITED ANY TRI 1 OR MORE FETUSES	$115.26	$339.00	$79.73–$679.00	64% below	66%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HCHG US OB LIMITED 1 OR MORE FETUSES	$118.66	$349.00	$82.08–$679.00	63% below	66%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 PR OB LIMITED 1 OR MORE FETUSES	$66.64	$196.00	$44.30–$109.96	—	66%
Screening mammogram, both breasts both sides CPT 77067 HCHG RAD MAMMO BILAT SCREENING 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 HCHG RAD MAMMO BILAT SCREENING WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 HCHG RAD MAMMO BILAT SCREENING LTD WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 HCHG RAD MAMMO BILAT SCREENING W IMPLANT WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 (IA) RAD XR MAMMO BILAT SCREENING WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 (IA) RAD XR MAMMO BILAT SCREENING 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 PR SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 (IA) RAD XR MAMMO BILAT SCREENING LTD WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts both sides CPT 77067 (IA) RAD XR MAMMO BILAT SCREENING W IMPLANT WWO CAD	$212.50	$625.00	$147.00–$356.00	—	66%
Screening mammogram, both breasts CPT 77067 HCHG RAD MAMMO UNI SCREENING 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	37% below	66%
Screening mammogram, both breasts CPT 77067 (IA) RAD XR MAMMO UNI SCREENING 3D WWO CAD	$212.50	$625.00	$147.00–$356.00	37% below	66%
Shoulder X-ray, complete, 2 or more views CPT 73030 HCHG RAD XRAY SHOULDER COMPLETE 2 VIEWS OR MORE PORTABLE	$358.70	$1,055.00	$243.00–$455.76	59% above	66%
Shoulder X-ray, complete, 2 or more views CPT 73030 (IA) RAD XR SHOULDER COMPLETE 2 VIEWS OR MORE PORTABLE	$358.70	$1,055.00	$243.00–$455.76	59% above	66%
Shoulder X-ray, complete, 2 or more views CPT 73030 (IA) RAD XR SHOULDER COMPLETE 2 VIEWS OR MORE	$358.70	$1,055.00	$243.00–$455.76	59% above	66%
Shoulder X-ray, complete, 2 or more views CPT 73030 PR RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$358.70	$1,055.00	$243.00–$455.76	59% above	66%
Shoulder X-ray, complete, 2 or more views CPT 73030 HCHG RAD XRAY SHOULDER COMPLETE 2 VIEWS OR MORE	$358.70	$1,055.00	$243.00–$455.76	59% above	66%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 (IA) HCHG STRESS ECHO 2D EXERCISE W STRESS TEST WO CONTRAST	$918.68	$2,702.00	$610.65–$1,515.82	48% below	66%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HCHG RAD ECHO STRESS EXER OR PHARM WO CONT W CONTIN MONITOR	$918.68	$2,702.00	$610.65–$1,515.82	48% below	66%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 (IA) HCHG STRESS ECHO 2D PHARMACOLOGIC W STRESS TEST WO	$918.68	$2,702.00	$610.65–$1,515.82	48% below	66%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HCHG RAD XRAY VIDEO SWALLOW STUDY	$477.02	$1,403.00	$243.00–$606.10	61% above	66%
Swallow study (modified barium swallow, video X-ray) CPT 74230 PR SWALLOWING FUNCJ W/CINERADIOGRAPY/VIDRADIOG	$477.02	$1,403.00	$243.00–$606.10	61% above	66%
Swallow study (modified barium swallow, video X-ray) CPT 74230 (IA) RAD XR VIDEO SWALLOW STUDY	$477.02	$1,403.00	$243.00–$606.10	61% above	66%
Transvaginal pelvic ultrasound CPT 76830 (IA) RAD US TRANSVAGINAL	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 HCHG RAD US TRANSVAGINAL FOLLICLE STUDY	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 HCHG RAD US PELVIS COMPLETE TV ADD ON	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 PR PELVIS TRANSVAGINAL NON OB	$178.84	$526.00	$118.88–$295.09	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 PR US TRANSVAGINAL	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 (IA) RAD US TRANSVAGINAL FOLLICLE STUDY	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 (IA) RAD US PELVIS COMPLETE TV ADD ON	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 HCHG RAD US TRANSVAGINAL	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound CPT 76830 HCHG US PELVIS TRANSVAGINAL NON OB	$178.84	$526.00	$123.72–$679.00	54% below	66%
Transvaginal pelvic ultrasound inpatient CPT 76830 PR PELVIS TRANSVAGINAL NON OB	$178.84	$526.00	$118.88–$295.09	—	66%
Transvaginal ultrasound during pregnancy CPT 76817 (IA) RAD US OB TRANSVAGINAL LTD	$178.84	$526.00	$123.72–$679.00	46% below	66%
Transvaginal ultrasound during pregnancy CPT 76817 HCHG RAD US OB TRANSVAGINAL LTD	$178.84	$526.00	$123.72–$679.00	46% below	66%
Transvaginal ultrasound during pregnancy CPT 76817 PR OB TRANSVAGINAL	$178.84	$526.00	$118.88–$295.09	46% below	66%
Transvaginal ultrasound during pregnancy CPT 76817 HCHG US OB TRANSVAGINAL	$178.84	$526.00	$123.72–$679.00	46% below	66%
Transvaginal ultrasound during pregnancy CPT 76817 HCHG RAD US OB TRANSVAGINAL	$214.88	$632.00	$148.65–$679.00	36% below	66%
Transvaginal ultrasound during pregnancy CPT 76817 (IA) RAD US OB TRANSVAGINAL	$214.88	$632.00	$148.65–$679.00	36% below	66%
Transvaginal ultrasound during pregnancy CPT 76817 PR US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$538.90	$1,585.00	$324.00–$684.72	61% above	66%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 PR OB TRANSVAGINAL	$178.84	$526.00	$118.88–$295.09	—	66%
Ultrasound of the abdomen, complete CPT 76700 PR US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$456.28	$1,342.00	$315.64–$679.00	22% below	66%
Ultrasound of the abdomen, complete CPT 76700 HCHG RAD US ABDOMEN COMPLETE	$456.28	$1,342.00	$315.64–$679.00	22% below	66%
Ultrasound of the abdomen, complete CPT 76700 HCHG RAD US ABDOMEN COMPLETE PORTABLE	$456.28	$1,342.00	$315.64–$679.00	22% below	66%
Ultrasound of the abdomen, complete CPT 76700 (IA) RAD US ABDOMEN COMPLETE PORTABLE	$456.28	$1,342.00	$315.64–$679.00	22% below	66%
Ultrasound of the abdomen, complete CPT 76700 (IA) RAD US ABDOMEN COMPLETE	$456.28	$1,342.00	$315.64–$679.00	22% below	66%
Ultrasound of the scrotum and testicles CPT 76870 (IA) RAD US SCROTUM	$516.12	$1,518.00	$324.00–$679.00	13% above	66%
Ultrasound of the scrotum and testicles CPT 76870 HCHG RAD US SCROTUM	$516.12	$1,518.00	$324.00–$679.00	13% above	66%
Ultrasound of the scrotum and testicles CPT 76870 PR US SCROTUM & CONTENTS	$516.12	$1,518.00	$324.00–$679.00	13% above	66%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 (IA) RAD US NECK OR HEAD SOFT TISSUE	$789.14	$2,321.00	$324.00–$1,002.67	73% above	66%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HCHG RAD US NECK OR HEAD SOFT TISSUE	$789.14	$2,321.00	$324.00–$1,002.67	73% above	66%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 PR US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$789.14	$2,321.00	$324.00–$1,002.67	73% above	66%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HCHG RAD XRAY UPPER GI	$564.40	$1,660.00	$243.00–$717.12	76% above	66%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 (IA) RAD XR UPPER GI	$564.40	$1,660.00	$243.00–$717.12	76% above	66%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 PR RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/O KUB	$564.40	$1,660.00	$243.00–$717.12	76% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 (IA) RAD US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HCHG RAD US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HCHG RAD US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY PORTABLE	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 (IA) RAD US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY PORTABLE	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 PR DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$118.66	$349.00	$78.87–$195.79	78% below	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HCHG RAD US VENOUS INSUFF OR VEIN MAPPING EXTREMITY UNILATERAL	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 (IA) RAD US VENOUS INSUFF OR VEIN MAPPING EXTREMITY UNILATERAL	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 PR DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$611.32	$1,798.00	$406.35–$1,008.68	11% above	66%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 PR DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$118.66	$349.00	$78.87–$195.79	—	66%
Wrist X-ray, complete, 3 or more views CPT 73110 HCHG RAD XRAY WRIST THREE VIEWS OR MORE	$301.58	$887.00	$208.62–$415.00	38% above	66%
Wrist X-ray, complete, 3 or more views CPT 73110 PR RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$301.58	$887.00	$208.62–$415.00	38% above	66%
Wrist X-ray, complete, 3 or more views CPT 73110 (IA) RAD XR WRIST THREE VIEWS OR MORE PORTABLE	$301.58	$887.00	$208.62–$415.00	38% above	66%
Wrist X-ray, complete, 3 or more views CPT 73110 (IA) RAD XR WRIST THREE VIEWS OR MORE	$301.58	$887.00	$208.62–$415.00	38% above	66%
Wrist X-ray, complete, 3 or more views CPT 73110 HCHG RAD XRAY WRIST THREE VIEWS OR MORE PORTABLE	$301.58	$887.00	$208.62–$415.00	38% above	66%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HCHG RAD XRAY HIP WWO PELVIS UNILATERAL 2 OR 3 VIEWS	$237.32	$698.00	$164.17–$415.00	14% below	66%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 (IA) RAD XR HIP WWO PELVIS UNILATERAL 2 OR 3 VIEWS	$237.32	$698.00	$164.17–$415.00	14% below	66%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 PR RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$237.32	$698.00	$164.17–$415.00	14% below	66%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HCHG RAD XRAY HIP WWO PELVIS UNILATERAL 2 OR 3 VIEWS PORTABLE	$237.32	$698.00	$164.17–$415.00	14% below	66%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 (IA) RAD XR HIP WWO PELVIS UNILATERAL 2 OR 3 VIEWS PORTABLE	$237.32	$698.00	$164.17–$415.00	14% below	66%
X-ray of the abdomen, 1 view CPT 74018 PR RADIOLOGIC EXAM ABDOMEN 1 VIEW	$229.50	$675.00	$158.76–$415.00	9% above	66%
X-ray of the abdomen, 1 view CPT 74018 (IA) RAD XR ABDOMEN SINGLE AP VIEW PORTABLE	$229.50	$675.00	$158.76–$415.00	9% above	66%
X-ray of the abdomen, 1 view CPT 74018 HCHG RAD XRAY ABDOMEN SINGLE AP VIEW	$229.50	$675.00	$158.76–$415.00	9% above	66%
X-ray of the abdomen, 1 view CPT 74018 HCHG RAD XRAY ABDOMEN SINGLE AP VIEW PORTABLE	$229.50	$675.00	$158.76–$415.00	9% above	66%
X-ray of the abdomen, 1 view CPT 74018 (IA) RAD XR ABDOMEN SINGLE AP VIEW	$229.50	$675.00	$158.76–$415.00	9% above	66%
X-ray of the ankle, 2 views CPT 73600 (IA) RAD XR ANKLE 2 VIEWS PORTABLE	$199.92	$588.00	$138.30–$415.00	23% above	66%
X-ray of the ankle, 2 views CPT 73600 (IA) RAD XR ANKLE 2 VIEWS	$199.92	$588.00	$138.30–$415.00	23% above	66%
X-ray of the ankle, 2 views CPT 73600 HCHG RAD XRAY ANKLE 2 VIEWS PORTABLE	$199.92	$588.00	$138.30–$415.00	23% above	66%
X-ray of the ankle, 2 views CPT 73600 PR RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$199.92	$588.00	$138.30–$415.00	23% above	66%
X-ray of the ankle, 2 views CPT 73600 HCHG RAD XRAY ANKLE 2 VIEWS	$199.92	$588.00	$138.30–$415.00	23% above	66%
X-ray of the finger(s), 2 or more views CPT 73140 (IA) RAD XR FINGER TWO VIEWS OR MORE	$233.24	$686.00	$161.35–$415.00	20% above	66%
X-ray of the finger(s), 2 or more views CPT 73140 HCHG RAD XRAY FINGER TWO VIEWS OR MORE	$233.24	$686.00	$161.35–$415.00	20% above	66%
X-ray of the finger(s), 2 or more views CPT 73140 HCHG RAD XRAY FINGER TWO VIEWS OR MORE PORTABLE	$233.24	$686.00	$161.35–$415.00	20% above	66%
X-ray of the finger(s), 2 or more views CPT 73140 (IA) RAD XR FINGER TWO VIEWS OR MORE PORTABLE	$233.24	$686.00	$161.35–$415.00	20% above	66%
X-ray of the finger(s), 2 or more views CPT 73140 PR RADEX FINGR MINIMUM 2 VIEWS	$233.24	$686.00	$161.35–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 (IA) RAD XR FOOT 2 VIEWS LTD	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 HCHG RAD XRAY FOOT 2 VIEWS LIMITED	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 (IA) RAD XR FOOT 2 VIEWS	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 (IA) RAD XR FOOT 2 VIEWS PORTABLE	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 (IA) RAD XR FOOT 2 VIEWS PORTABLE LIMITED	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 HCHG RAD XRAY FOOT 2 VIEWS	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 HCHG RAD XRAY FOOT 2 VIEWS PORTABLE	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 HCHG RAD XRAY FOOT 2 VIEWS PORTABLE LIMITED	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, 2 views CPT 73620 PR RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$199.92	$588.00	$138.30–$415.00	20% above	66%
X-ray of the foot, complete, 3 or more views CPT 73630 HCHG RAD XRAY FOOT COMPLETE MINIMUM OF 3 VIEWS	$317.56	$934.00	$219.68–$415.00	52% above	66%
X-ray of the foot, complete, 3 or more views CPT 73630 (IA) RAD XR FOOT COMPLETE MINIMUM OF 3 VIEWS PORTABLE	$317.56	$934.00	$219.68–$415.00	52% above	66%
X-ray of the foot, complete, 3 or more views CPT 73630 (IA) RAD XR FOOT COMPLETE MINIMUM OF 3 VIEWS	$317.56	$934.00	$219.68–$415.00	52% above	66%
X-ray of the foot, complete, 3 or more views CPT 73630 HCHG RAD XRAY FOOT COMPLETE MINIMUM OF 3 VIEWS PORTABLE	$317.56	$934.00	$219.68–$415.00	52% above	66%
X-ray of the foot, complete, 3 or more views CPT 73630 PR RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$317.56	$934.00	$219.68–$415.00	52% above	66%
X-ray of the hand, 3 or more views CPT 73130 (IA) RAD XR HAND 3 VIEWS OR MORE	$295.80	$870.00	$204.62–$415.00	38% above	66%
X-ray of the hand, 3 or more views CPT 73130 PR RADEX HAND MINIMUM 3 VIEWS	$295.80	$870.00	$204.62–$415.00	38% above	66%
X-ray of the hand, 3 or more views CPT 73130 HCHG RAD XRAY HAND 3 VIEWS OR MORE	$295.80	$870.00	$204.62–$415.00	38% above	66%
X-ray of the knee, 1 or 2 views CPT 73560 HCHG RAD XRAY KNEE 1 OR 2 VIEWS PORTABLE	$131.24	$386.00	$90.79–$415.00	30% below	66%
X-ray of the knee, 1 or 2 views CPT 73560 PR RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$131.24	$386.00	$90.79–$415.00	30% below	66%
X-ray of the knee, 1 or 2 views CPT 73560 (IA) RAD XR KNEE 1 OR 2 VIEWS PORTABLE	$131.24	$386.00	$90.79–$415.00	30% below	66%
X-ray of the knee, 1 or 2 views CPT 73560 (IA) RAD XR KNEE 1 OR 2 VIEWS	$131.24	$386.00	$90.79–$415.00	30% below	66%
X-ray of the knee, 1 or 2 views CPT 73560 HCHG RAD XRAY KNEE 1 OR 2 VIEWS	$131.24	$386.00	$90.79–$415.00	30% below	66%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 PR RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$396.44	$1,166.00	$243.00–$503.71	51% above	66%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 (IA) RAD XR LUMBOSACRAL SPINE 2 OR 3 VIEWS PORTABLE	$396.44	$1,166.00	$243.00–$503.71	51% above	66%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 (IA) RAD XR LUMBOSACRAL SPINE 2 OR 3 VIEWS	$396.44	$1,166.00	$243.00–$503.71	51% above	66%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HCHG RAD XRAY LUMBOSACRAL SPINE 2 OR 3 VIEWS PORTABLE	$396.44	$1,166.00	$243.00–$503.71	51% above	66%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HCHG RAD XRAY LUMBOSACRAL SPINE 2 OR 3 VIEWS	$396.44	$1,166.00	$243.00–$503.71	51% above	66%
X-ray of the lower back, 4 or more views CPT 72110 (IA) RAD XR LUMBOSACRAL MINIMUM OF 4 VIEWS	$633.08	$1,862.00	$243.00–$804.38	85% above	66%
X-ray of the lower back, 4 or more views CPT 72110 PR RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$633.08	$1,862.00	$243.00–$804.38	85% above	66%
X-ray of the lower back, 4 or more views CPT 72110 HCHG RAD XRAY LUMBOSACRAL MINIMUM OF 4 VIEWS	$633.08	$1,862.00	$243.00–$804.38	85% above	66%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 PR RADEX SPINE THORACIC 2 VIEWS	$396.44	$1,166.00	$243.00–$503.71	61% above	66%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 (IA) RAD XR SPINE THORACIC 2 VIEWS	$413.44	$1,216.00	$243.00–$525.31	68% above	66%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 (IA) RAD XR SPINE THORACIC 2 VIEWS PORTABLE	$413.44	$1,216.00	$243.00–$525.31	68% above	66%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HCHG RAD XRAY SPINE THORACIC 2 VIEWS	$413.44	$1,216.00	$243.00–$525.31	68% above	66%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HCHG RAD XRAY SPINE THORACIC 2 VIEWS PORTABLE	$413.44	$1,216.00	$243.00–$525.31	68% above	66%
X-ray of the nasal bones, 3 or more views CPT 70160 (IA) RAD XR NASAL BONES COMPLETE MINIMUM OF THREE VIEWS	$301.58	$887.00	$208.62–$415.00	38% above	66%
X-ray of the nasal bones, 3 or more views CPT 70160 HCHG RAD XRAY NASAL BONES COMPLETE MINIMUM OF THREE VIEWS	$301.58	$887.00	$208.62–$415.00	38% above	66%
X-ray of the nasal bones, 3 or more views CPT 70160 PR RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$301.58	$887.00	$208.62–$415.00	38% above	66%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 PR RADEX SPINE CERVICAL 2 OR 3 VIEWS	$279.82	$823.00	$193.57–$415.00	13% above	66%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HCHG RAD XRAY SPINE CERVICAL 2 OR 3 VIEWS PORTABLE	$279.82	$823.00	$193.57–$415.00	13% above	66%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 (IA) RAD XR SPINE CERVICAL 2 OR 3 VIEWS	$279.82	$823.00	$193.57–$415.00	13% above	66%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 (IA) RAD XR SPINE CERVICAL 2 OR 3 VIEWS PORTABLE	$279.82	$823.00	$193.57–$415.00	13% above	66%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HCHG RAD XRAY SPINE CERVICAL 2 OR 3 VIEWS	$279.82	$823.00	$193.57–$415.00	13% above	66%
X-ray of the pelvis, 1 or 2 views CPT 72170 PR RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$221.00	$650.00	$152.88–$415.00	11% above	66%
X-ray of the pelvis, 1 or 2 views CPT 72170 (IA) RAD XR PELVIS 1 OR 2 VIEWS PORTABLE	$221.00	$650.00	$152.88–$415.00	11% above	66%
X-ray of the pelvis, 1 or 2 views CPT 72170 (IA) RAD XR PELVIS 1 OR 2 VIEWS	$221.00	$650.00	$152.88–$415.00	11% above	66%
X-ray of the pelvis, 1 or 2 views CPT 72170 HCHG RAD XRAY PELVIS 1 OR 2 VIEWS PORTABLE	$221.00	$650.00	$152.88–$415.00	11% above	66%
X-ray of the pelvis, 1 or 2 views CPT 72170 HCHG RAD XRAY PELVIS 1 OR 2 VIEWS	$221.00	$650.00	$152.88–$415.00	11% above	66%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 PR RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$396.44	$1,166.00	$243.00–$503.71	75% above	66%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HCHG RAD XRAY SACRUM AND COCCYX TWO VIEWS OR MORE	$447.44	$1,316.00	$243.00–$568.51	97% above	66%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 (IA) RAD XR SACRUM AND COCCYX TWO VIEWS OR MORE	$447.44	$1,316.00	$243.00–$568.51	97% above	66%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HCHG ALT (SGPT)	$34.34	$101.00	$22.83–$56.66	24% below	66%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 PR TRANSFERASE ALANINE AMINO ALT SGPT	$42.50	$125.00	$28.25–$70.12	6% below	66%
AST (aspartate aminotransferase) enzyme test CPT 84450 HCHG AST (SGOT)	$42.16	$124.00	$28.02–$69.56	6% below	66%
AST (aspartate aminotransferase) enzyme test CPT 84450 PR TRANSFERASE ASPARTATE AMINO AST SGOT	$46.92	$138.00	$31.19–$77.42	5% above	66%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 PR GENERAL LAB 8007400	$264.52	$778.00	$175.83–$436.46	13% above	66%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HCHG GENERAL LAB 8007401 LCC	$264.52	$778.00	$175.83–$436.46	13% above	66%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HCHG GENERAL LAB 8007400	$264.52	$778.00	$175.83–$436.46	13% above	66%
Allergy blood test, specific IgE, per allergen CPT 86003 PR ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$29.58	$87.00	$19.66–$48.81	95% above	66%
Allergy blood test, specific IgE, per allergen CPT 86003 HCHG RAST IN-HOUSE	$29.58	$87.00	$19.66–$48.81	95% above	66%
Allergy blood test, specific IgE, per allergen CPT 86003 HCHG ALLERGEN LC	$29.58	$87.00	$19.66–$48.81	95% above	66%
Allergy blood test, specific IgE, per allergen CPT 86003 PB RAST IN-HOUSE	$29.58	$87.00	$19.66–$48.81	95% above	66%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 PR CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$144.16	$424.00	$95.82–$237.86	245% above	66%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HCHG CCP ANTIBODY IGG	$144.16	$424.00	$95.82–$237.86	245% above	66%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HCHG ANA	$80.58	$237.00	$53.56–$132.96	79% above	66%
Antinuclear antibody (ANA) blood test, screen CPT 86038 PR ANTINUCLEAR ANTIBODIES ANA	$80.58	$237.00	$53.56–$132.96	79% above	66%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PR NATRIURETIC PEPTIDE	$169.66	$499.00	$112.77–$279.94	26% above	66%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HCHG BRAIN NATRIURETIC PEPTIDE	$246.16	$724.00	$163.62–$406.16	83% above	66%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HCHG PRO-BNP	$246.16	$724.00	$163.62–$406.16	83% above	66%
Basic metabolic panel (blood test) CPT 80048 HCHG BASIC METABOLIC PANEL	$65.28	$192.00	$43.39–$107.71	27% below	66%
Basic metabolic panel (blood test) CPT 80048 HCHG BASIC METABOLIC RTR	$65.28	$192.00	$43.39–$107.71	27% below	66%
Basic metabolic panel (blood test) CPT 80048 PR BASIC METABOLIC PANEL CALCIUM TOTAL	$82.96	$244.00	$55.14–$136.88	7% below	66%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HCHG CELL BLOCK	$149.26	$439.00	$99.21–$246.28	43% above	66%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PR LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$149.26	$439.00	$99.21–$246.28	43% above	66%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HCHG TISSUE LEVEL IV	$149.26	$439.00	$99.21–$246.28	43% above	66%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PB CELL BLOCK	$149.26	$439.00	$99.21–$246.28	43% above	66%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PB TISSUE LEVEL 4 TC ONLY	$149.26	$439.00	$99.21–$246.28	43% above	66%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HCHG TISSUE LEVEL 4 TECH ONLY	$149.26	$439.00	$99.21–$246.28	43% above	66%
Blood culture for bacteria CPT 87040 HCHG BLOOD CULTURE-BACTEC	$185.64	$546.00	$123.40–$306.31	68% above	66%
Blood culture for bacteria CPT 87040 PR CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES	$185.64	$546.00	$123.40–$306.31	68% above	66%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HCHG ROUTINE VENIPUNCTURE	$19.04	$56.00	$12.66–$31.42	8% below	66%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HCHG VENIPUNCTURE	$19.38	$57.00	$12.88–$31.98	7% below	66%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PR COLLECTION VENOUS BLOOD VENIPUNCTURE	$19.38	$57.00	$12.88–$31.98	7% below	66%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HCHG LEGAL BLOOD ALCOHOL DRAW	$19.38	$57.00	$12.88–$31.98	—	66%
Blood glucose (sugar) test CPT 82947 HCHG GLUCOSE	$54.40	$160.00	$36.16–$89.76	22% above	66%
Blood glucose (sugar) test CPT 82947 PR GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$54.40	$160.00	$36.16–$89.76	22% above	66%
Blood glucose (sugar) test CPT 82947 HCHG GLUCOSE TOLERANCE FASTING	$54.40	$160.00	$36.16–$89.76	22% above	66%
Blood glucose (sugar) test CPT 82947 HCHG FASTING GLUCOSE	$64.94	$191.00	$43.17–$107.15	46% above	66%
Blood lead test CPT 83655 HCHG LEAD, FILTER PAPER	$62.56	$184.00	$41.58–$103.22	101% above	66%
Blood lead test CPT 83655 PB LEAD, CAPILLARY, BLOOD LC	$62.56	$184.00	$41.58–$103.22	101% above	66%
Blood lead test CPT 83655 HCHG LEAD HEAVY METALS PROFILE II, URINE LC	$62.56	$184.00	$41.58–$103.22	101% above	66%
Blood lead test CPT 83655 HCHG LEAD, BLOOD LC	$62.56	$184.00	$41.58–$103.22	101% above	66%
Blood lead test CPT 83655 HCHG LEAD, CAPILLARY, BLOOD LC	$62.56	$184.00	$41.58–$103.22	101% above	66%
Blood lead test CPT 83655 PR ASSAY OF LEAD	$62.56	$184.00	$41.58–$103.22	101% above	66%
Blood lead test CPT 83655 (IA) HCHG LEAD TEST	$66.64	$196.00	$44.30–$109.96	114% above	66%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PB GENERAL LAB 8470300	$112.20	$330.00	$74.58–$185.13	62% above	66%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCHG GENERAL LAB 8470300	$112.20	$330.00	$74.58–$185.13	62% above	66%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PR GENERAL LAB 8470300	$112.20	$330.00	$74.58–$185.13	62% above	66%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HCHG FETAL ABO	$88.40	$260.00	$58.76–$145.86	67% above	66%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HCHG ABO GROUP	$88.40	$260.00	$58.76–$145.86	67% above	66%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HCHG CORD ABO GROUP	$88.40	$260.00	$58.76–$145.86	67% above	66%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HCHG ARC-ABO TYPE	$88.40	$260.00	$58.76–$145.86	67% above	66%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 PR BLOOD TYPING SEROLOGIC ABO	$88.40	$260.00	$58.76–$145.86	67% above	66%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 PR C-REACTIVE PROTEIN	$33.32	$98.00	$22.15–$54.98	39% below	66%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HCHG C-REACTIVE PROTEIN	$50.66	$149.00	$33.67–$83.59	7% below	66%
C. difficile toxin gene test (stool PCR) CPT 87493 PB CLOSTRIDIUM DIFF TOXIN PCR	$123.42	$363.00	$82.04–$203.64	7% below	66%
C. difficile toxin gene test (stool PCR) CPT 87493 PR INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$123.42	$363.00	$82.04–$203.64	7% below	66%
C. difficile toxin gene test (stool PCR) CPT 87493 HCHG CLOSTRIDIUM DIFF TOXIN PCR	$123.42	$363.00	$82.04–$203.64	7% below	66%
CA 19-9 blood test (tumor marker) CPT 86301 PR IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$226.44	$666.00	$150.52–$373.63	123% above	66%
CA 19-9 blood test (tumor marker) CPT 86301 HCHG CA 19-9	$226.44	$666.00	$150.52–$373.63	123% above	66%
CA-125 blood test (ovarian cancer marker) CPT 86304 PR IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125	$144.84	$426.00	$96.28–$238.99	43% above	66%
CA-125 blood test (ovarian cancer marker) CPT 86304 HCHG CA 125	$216.24	$636.00	$143.74–$356.80	113% above	66%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 PB COVID 19 MML	$38.08	$112.00	$25.31–$62.83	68% below	66%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 PB COVID 19 INHOUSE	$38.08	$112.00	$25.31–$62.83	68% below	66%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HCHG COVID 19 MML	$38.08	$112.00	$25.31–$62.83	68% below	66%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HCHG COVID 19 NAA LC	$38.08	$112.00	$25.31–$62.83	68% below	66%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 PB COVID 19 INHOUSE	$38.08	$112.00	$25.31–$62.83	—	66%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HCHG GENERAL LAB 8749101	$56.78	$167.00	$37.74–$93.69	40% below	66%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HCHG GENERAL LAB 8749100	$56.78	$167.00	$37.74–$93.69	40% below	66%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 PR GENERAL LAB 8749100	$56.78	$167.00	$37.74–$93.69	40% below	66%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 PR LIPID PANEL	$64.60	$190.00	$42.94–$106.59	30% below	66%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HCHG LIPID PANEL	$64.60	$190.00	$42.94–$106.59	30% below	66%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HCHG LIPID PANEL LCC	$64.60	$190.00	$42.94–$106.59	30% below	66%
Complete blood count (CBC) with differential CPT 85025 HCHG CBC W/DIFF	$44.20	$130.00	$29.38–$72.93	47% below	66%
Complete blood count (CBC) with differential CPT 85025 PR BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$50.66	$149.00	$33.67–$83.59	39% below	66%
Complete blood count (CBC), no differential CPT 85027 HCHG CBC	$41.82	$123.00	$27.80–$69.00	36% below	66%
Complete blood count (CBC), no differential CPT 85027 PR BLOOD COUNT COMPLETE AUTOMATED	$46.58	$137.00	$30.96–$76.86	29% below	66%
Comprehensive metabolic panel (blood test) CPT 80053 PR COMPREHENSIVE METABOLIC PANEL	$72.76	$214.00	$48.36–$120.05	23% below	66%
Comprehensive metabolic panel (blood test) CPT 80053 HCHG COMPREHENSIVE METABOLIC PANE	$72.76	$214.00	$48.36–$120.05	23% below	66%
D-dimer blood test (blood clot marker) CPT 85379 PR FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE	$139.06	$409.00	$92.43–$229.45	40% above	66%
D-dimer blood test (blood clot marker) CPT 85379 HCHG D-DIMER QUANT	$139.06	$409.00	$92.43–$229.45	40% above	66%
DHEA sulfate (DHEA-S) blood test CPT 82627 PR DEHYDROEPIANDROSTERONE-SULFATE	$42.16	$124.00	$28.02–$69.56	27% below	66%
DHEA sulfate (DHEA-S) blood test CPT 82627 HCHG DHEA-SULFATE (DHEA-S) LCC	$42.16	$124.00	$28.02–$69.56	27% below	66%
DHEA sulfate (DHEA-S) blood test CPT 82627 HCHG DHEA-SULFATE	$42.16	$124.00	$28.02–$69.56	27% below	66%
Estradiol blood test CPT 82670 PR ASSAY OF ESTRADIOL	$53.38	$157.00	$35.48–$88.08	19% below	66%
Estradiol blood test CPT 82670 HCHG ESTRADIOL LCC	$64.94	$191.00	$43.17–$107.15	2% below	66%
Estradiol blood test CPT 82670 HCHG ESTRADIOL, LC/MS (ENDOCRINE SCIENCES) LC	$64.94	$191.00	$43.17–$107.15	2% below	66%
Estradiol blood test CPT 82670 HCHG ESTRADIOL SERUM	$64.94	$191.00	$43.17–$107.15	2% below	66%
FSH (follicle-stimulating hormone) test CPT 83001 HCHG FSH-SERUM	$70.72	$208.00	$47.01–$116.69	at median	66%
FSH (follicle-stimulating hormone) test CPT 83001 HCHG FSH LCC	$70.72	$208.00	$47.01–$116.69	at median	66%
FSH (follicle-stimulating hormone) test CPT 83001 PB FSH-SERUM	$93.84	$276.00	$62.38–$154.84	33% above	66%
FSH (follicle-stimulating hormone) test CPT 83001 PR GONADOTROPIN FOLLICLE STIMULATING HORMONE	$93.84	$276.00	$62.38–$154.84	33% above	66%
Fecal calprotectin (stool inflammation test) CPT 83993 PR ASSAY OF CALPROTECTIN FECAL	$302.26	$889.00	$200.91–$498.73	259% above	66%
Fecal calprotectin (stool inflammation test) CPT 83993 HCHG CALPROTECTIN, FECAL LC	$302.26	$889.00	$200.91–$498.73	259% above	66%
Ferritin blood test (iron stores) CPT 82728 PR ASSAY OF FERRITIN	$71.40	$210.00	$47.46–$117.81	20% below	66%
Ferritin blood test (iron stores) CPT 82728 HCHG FERRITIN	$133.62	$393.00	$88.82–$220.47	49% above	66%
Folate (folic acid) blood test CPT 82746 HCHG FOLIC ACID	$46.24	$136.00	$30.74–$76.30	42% below	66%
Folate (folic acid) blood test CPT 82746 PR ASSAY OF FOLIC ACID SERUM	$46.24	$136.00	$30.74–$76.30	42% below	66%
Free T3 thyroid hormone test CPT 84481 PR ASSAY OF TRIIODOTHYRONINE T3 FREE	$70.72	$208.00	$47.01–$116.69	31% below	66%
Free T3 thyroid hormone test CPT 84481 HCHG T3, FREE	$70.72	$208.00	$47.01–$116.69	31% below	66%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HCHG T4,FREE LCC	$70.38	$207.00	$46.78–$116.13	3% above	66%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HCHG T4, FREE	$70.38	$207.00	$46.78–$116.13	3% above	66%
Free T4 (free thyroxine) thyroid blood test CPT 84439 PR ASSAY OF FREE THYROXINE	$70.38	$207.00	$46.78–$116.13	3% above	66%
Free testosterone test CPT 84402 PR ASSAY OF TESTOSTERONE FREE	$61.54	$181.00	$40.91–$101.54	1% below	66%
Free testosterone test CPT 84402 HCHG TESTOSTERONE, FREE, EQUILIBRIUM ULTRAFILTRATION LC	$123.76	$364.00	$82.26–$204.20	98% above	66%
Free testosterone test CPT 84402 HCHG TESTOSTERONE FREE LC	$123.76	$364.00	$82.26–$204.20	98% above	66%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HCHG GENERAL HEALTH PANEL AFFILIATE ONLY	$168.30	$495.00	$111.87–$277.70	32% below	66%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 PR GENERAL HEALTH PANEL	$168.30	$495.00	$111.87–$277.70	32% below	66%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HCHG GLUCOSE, GESTATIONAL	$54.40	$160.00	$36.16–$89.76	29% above	66%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 PR GLUCOSE POST GLUCOSE DOSE	$54.40	$160.00	$36.16–$89.76	29% above	66%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HCHG GLUCOSE 2 HOUR	$54.40	$160.00	$36.16–$89.76	29% above	66%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HCHG GLUCOSE 2HPP	$62.90	$185.00	$41.81–$103.78	49% above	66%
Glucose tolerance test, 3 samples CPT 82951 PR GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS	$360.74	$1,061.00	$239.79–$595.22	276% above	66%
Glucose tolerance test, 3 samples CPT 82951 HCHG GTT	$360.74	$1,061.00	$239.79–$595.22	276% above	66%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HCHG GENERAL LAB 8759102	$123.42	$363.00	$82.04–$203.64	46% above	66%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HCHG GENERAL LAB 8759100	$123.42	$363.00	$82.04–$203.64	46% above	66%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 PR GENERAL LAB 8759100	$123.42	$363.00	$82.04–$203.64	46% above	66%
H. pylori antibody blood test CPT 86677 HCHG HELICOBACTER PYLORI IGG AFFILIATE ONLY	$64.60	$190.00	$42.94–$106.59	45% below	66%
H. pylori antibody blood test CPT 86677 PR ANTIBODY HELICOBACTER PYLORI	$64.60	$190.00	$42.94–$106.59	45% below	66%
H. pylori stool antigen test CPT 87338 PR IAAD IA HPYLORI STOOL	$53.04	$156.00	$35.26–$87.52	51% below	66%
H. pylori stool antigen test CPT 87338 HCHG H. PYLORI ANTIGEN, STOOL	$53.04	$156.00	$35.26–$87.52	51% below	66%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 PR GENERAL LAB 8753601	$294.44	$866.00	$195.72–$485.83	156% above	66%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HCHG GENERAL LAB 8753600	$294.44	$866.00	$195.72–$485.83	156% above	66%
HIV-1 and HIV-2 antibody test CPT 86703 PB GENERAL LAB 8670300	$42.16	$124.00	$28.02–$69.56	37% below	66%
HIV-1 and HIV-2 antibody test CPT 86703 PR GENERAL LAB 8670300	$42.16	$124.00	$28.02–$69.56	37% below	66%
HIV-1 and HIV-2 antibody test CPT 86703 HCHG GENERAL LAB 8670301	$42.16	$124.00	$28.02–$69.56	37% below	66%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HCHG ANTI HIV 1/2 LCC	$59.50	$175.00	$39.55–$98.18	6% below	66%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 PR GENERAL LAB 8738900	$59.50	$175.00	$39.55–$98.18	6% below	66%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HCHG GENERAL LAB 8738900	$59.50	$175.00	$39.55–$98.18	6% below	66%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HCHG GENERAL LAB 8762400	$98.60	$290.00	$65.54–$162.69	24% below	66%
HPV test for high-risk types, one combined (pooled) result CPT 87624 PR GENERAL LAB 8762400	$98.60	$290.00	$65.54–$162.69	24% below	66%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HCHG HEMOGLOBIN A1C	$62.56	$184.00	$41.58–$103.22	8% above	66%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 PR HEMOGLOBIN GLYCOSYLATED A1C	$73.10	$215.00	$48.59–$120.62	27% above	66%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HCHG GENERAL LAB 8670600	$70.38	$207.00	$46.78–$116.13	7% above	66%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 PR GENERAL LAB 8670600	$70.38	$207.00	$46.78–$116.13	7% above	66%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HCHG HBSAG LCC	$50.66	$149.00	$33.67–$83.59	5% below	66%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HCHG GENERAL LAB 8734000	$50.66	$149.00	$33.67–$83.59	5% below	66%
Hepatitis B surface antigen (HBsAg) test CPT 87340 PR GENERAL LAB 8734000	$50.66	$149.00	$33.67–$83.59	5% below	66%
Hepatitis C antibody blood test (screening) CPT 86803 PB GENERAL LAB 8680300	$96.90	$285.00	$64.41–$159.88	21% above	66%
Hepatitis C antibody blood test (screening) CPT 86803 PR GENERAL LAB 8680300	$96.90	$285.00	$64.41–$159.88	21% above	66%
Hepatitis C antibody blood test (screening) CPT 86803 HCHG ANTI HCV LCC	$96.90	$285.00	$64.41–$159.88	21% above	66%
Hepatitis C antibody blood test (screening) CPT 86803 HCHG GENERAL LAB 8680300	$96.90	$285.00	$64.41–$159.88	21% above	66%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCHG GENERAL LAB 87522 LCC	$143.48	$422.00	$95.37–$236.74	16% above	66%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCHG GENERAL LAB 8752200	$143.48	$422.00	$95.37–$236.74	16% above	66%
Hepatitis C viral load (HCV RNA) test CPT 87522 PR GENERAL LAB 8752200	$143.48	$422.00	$95.37–$236.74	16% above	66%
Herpes blood test, HSV-1 antibody CPT 86695 PR GENERAL LAB 8669500	$26.18	$77.00	$17.40–$43.20	43% below	66%
Herpes blood test, HSV-1 antibody CPT 86695 HCHG GENERAL LAB 8669500	$26.86	$79.00	$17.85–$44.32	42% below	66%
Herpes blood test, HSV-2 antibody CPT 86696 HCHG GENERAL LAB 8669600	$42.84	$126.00	$28.48–$70.69	26% below	66%
Herpes blood test, HSV-2 antibody CPT 86696 PR GENERAL LAB 8669600	$42.84	$126.00	$28.48–$70.69	26% below	66%
High-sensitivity CRP (hs-CRP) test CPT 86141 PR C-REACTIVE PROTEIN HIGH SENSITIVITY	$77.18	$227.00	$51.30–$127.35	9% above	66%
High-sensitivity CRP (hs-CRP) test CPT 86141 HCHG HIGH SENS CRP	$77.18	$227.00	$51.30–$127.35	9% above	66%
Homocysteine blood test CPT 83090 PR ASSAY OF HOMOCYSTEINE	$174.08	$512.00	$115.71–$287.23	94% above	66%
Homocysteine blood test CPT 83090 HCHG HOMOCYSTEINE, CARDIAC	$174.08	$512.00	$115.71–$287.23	94% above	66%
Insulin blood test CPT 83525 HCHG INSULIN	$42.84	$126.00	$28.48–$70.69	22% below	66%
Insulin blood test CPT 83525 PR ASSAY OF INSULIN TOTAL	$42.84	$126.00	$28.48–$70.69	22% below	66%
Iron blood test (serum iron) CPT 83540 HCHG IRON	$71.40	$210.00	$47.46–$117.81	39% above	66%
Iron blood test (serum iron) CPT 83540 PR ASSAY OF IRON	$71.40	$210.00	$47.46–$117.81	39% above	66%
Iron-binding capacity (TIBC) test CPT 83550 PR IRON BINDING CAPACITY	$36.04	$106.00	$23.96–$59.47	44% below	66%
Iron-binding capacity (TIBC) test CPT 83550 HCHG IRON BINDING CAPACITY (IBC)	$36.04	$106.00	$23.96–$59.47	44% below	66%
Kidney function blood test panel CPT 80069 HCHG RENAL FUNCTION PANEL	$71.40	$210.00	$47.46–$117.81	32% below	66%
Kidney function blood test panel CPT 80069 PR RENAL FUNCTION PANEL	$71.40	$210.00	$47.46–$117.81	32% below	66%
LH (luteinizing hormone) test CPT 83002 HCHG LUTEINIZING HORMONE	$160.48	$472.00	$106.67–$264.79	97% above	66%
LH (luteinizing hormone) test CPT 83002 PR GONADOTROPIN LUTEINIZING HORMONE	$160.48	$472.00	$106.67–$264.79	97% above	66%
LH (luteinizing hormone) test CPT 83002 PB LUTEINIZING HORMONE	$160.48	$472.00	$106.67–$264.79	97% above	66%
LH (luteinizing hormone) test CPT 83002 HCHG LUTEINIZING HORMONE LCC	$160.48	$472.00	$106.67–$264.79	97% above	66%
Lipase blood test (pancreas enzyme) CPT 83690 HCHG LIPASE	$64.60	$190.00	$42.94–$106.59	9% above	66%
Lipase blood test (pancreas enzyme) CPT 83690 PR ASSAY OF LIPASE	$64.60	$190.00	$42.94–$106.59	9% above	66%
Liver function blood test panel CPT 80076 PR HEPATIC FUNCTION PANEL	$112.88	$332.00	$75.03–$186.25	11% above	66%
Liver function blood test panel CPT 80076 HCHG HEPATIC FUNCTION PANEL	$155.72	$458.00	$103.51–$256.94	53% above	66%
Lyme disease antibody test CPT 86618 HCHG LYME (FIA) POLYVALENT	$64.60	$190.00	$42.94–$106.59	at median	66%
Lyme disease antibody test CPT 86618 HCHG LYME NO REFLEX	$64.60	$190.00	$42.94–$106.59	at median	66%
Lyme disease antibody test CPT 86618 PR ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$64.60	$190.00	$42.94–$106.59	at median	66%
Magnesium blood test CPT 83735 HCHG MAGNESIUM BLOOD	$64.60	$190.00	$42.94–$106.59	107% above	66%
Magnesium blood test CPT 83735 HCHG MAGNESIUM URINE LC	$64.60	$190.00	$42.94–$106.59	107% above	66%
Magnesium blood test CPT 83735 PR ASSAY OF MAGNESIUM	$64.60	$190.00	$42.94–$106.59	107% above	66%
Measles (rubeola) antibody test CPT 86765 HCHG RUBEOLA IMMUNITY	$12.92	$38.00	$8.59–$21.32	65% below	66%
Measles (rubeola) antibody test CPT 86765 PR ANTIBODY RUBEOLA	$12.92	$38.00	$8.59–$21.32	65% below	66%
Mono test (heterophile antibody, Monospot) CPT 86308 HCHG HETEROPHILE	$102.68	$302.00	$68.25–$169.42	100% above	66%
Mono test (heterophile antibody, Monospot) CPT 86308 PR HETEROPHILE ANTIBODIES SCREEN	$102.68	$302.00	$68.25–$169.42	100% above	66%
Obstetric blood test panel CPT 80055 PR OBSTETRIC PANEL	$73.44	$216.00	$48.82–$121.18	72% below	66%
PSA (prostate-specific antigen) blood test, free CPT 84154 HCHG PSA,FREE	$125.80	$370.00	$83.62–$207.57	250% above	66%
PSA (prostate-specific antigen) blood test, free CPT 84154 PR ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$125.80	$370.00	$83.62–$207.57	250% above	66%
PSA (prostate-specific antigen) blood test, free CPT 84154 HCHG PSA,FREE LCC	$125.80	$370.00	$83.62–$207.57	250% above	66%
PSA (prostate-specific antigen) blood test, total CPT 84153 HCHG PSA-DIAGNOSTIC	$97.58	$287.00	$64.86–$161.01	21% above	66%
PSA (prostate-specific antigen) blood test, total CPT 84153 HCHG PSA,TOTAL LCC	$97.58	$287.00	$64.86–$161.01	21% above	66%
PSA (prostate-specific antigen) blood test, total CPT 84153 PB PSA-DIAGNOSTIC	$97.58	$287.00	$64.86–$161.01	21% above	66%
PSA (prostate-specific antigen) blood test, total CPT 84153 PR ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$97.58	$287.00	$64.86–$161.01	21% above	66%
Pap test (liquid-based, automated screening with review) CPT 88175 PR CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$63.58	$187.00	$42.26–$104.91	25% below	66%
Pap test (liquid-based, automated screening with review) CPT 88175 HCHG IMAGED THIN PREP PAP DIAGNOSTIC	$63.58	$187.00	$42.26–$104.91	25% below	66%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PR CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN	$67.32	$198.00	$44.75–$111.08	13% below	66%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HCHG THIN PREP PAP DIAGNOSTIC	$67.32	$198.00	$44.75–$111.08	13% below	66%
Parathyroid hormone (PTH) blood test CPT 83970 HCHG PTH INTACT	$97.58	$287.00	$64.86–$161.01	17% below	66%
Parathyroid hormone (PTH) blood test CPT 83970 PR ASSAY OF PARATHORMONE	$97.58	$287.00	$64.86–$161.01	17% below	66%
Partial thromboplastin time (PTT) clotting test CPT 85730 PR THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$64.94	$191.00	$43.17–$107.15	10% above	66%
Partial thromboplastin time (PTT) clotting test CPT 85730 HCHG ACTIVATED PTT	$64.94	$191.00	$43.17–$107.15	10% above	66%
Partial thromboplastin time (PTT) clotting test CPT 85730 PB ACTIVATED PTT	$64.94	$191.00	$43.17–$107.15	10% above	66%
Partial thromboplastin time (PTT) clotting test CPT 85730 HCHG PTT-LA SCREEN	$64.94	$191.00	$43.17–$107.15	10% above	66%
Partial thromboplastin time (PTT) clotting test CPT 85730 PB PTT-LA SCREEN	$64.94	$191.00	$43.17–$107.15	10% above	66%
Progesterone blood test CPT 84144 HCHG PROGESTERONE BLOOD	$41.82	$123.00	$27.80–$69.00	48% below	66%
Progesterone blood test CPT 84144 PR ASSAY OF PROGESTERONE	$41.82	$123.00	$27.80–$69.00	48% below	66%
Progesterone blood test CPT 84144 HCHG PROGESTERONE LCC	$41.82	$123.00	$27.80–$69.00	48% below	66%
Prolactin blood test CPT 84146 PR ASSAY OF PROLACTIN	$47.94	$141.00	$31.87–$79.10	27% below	66%
Prolactin blood test CPT 84146 HCHG PROLACTIN	$47.94	$141.00	$31.87–$79.10	27% below	66%
Prolactin blood test CPT 84146 HCHG PROLACTIN LCC	$48.96	$144.00	$32.54–$80.78	25% below	66%
Prothrombin time (PT/INR) clotting test CPT 85610 HCHG PROTHOMBIN TIME	$39.10	$115.00	$25.99–$64.52	29% above	66%
Prothrombin time (PT/INR) clotting test CPT 85610 PR PROTHROMBIN TIME	$39.10	$115.00	$25.99–$64.52	29% above	66%
Prothrombin time (PT/INR) clotting test CPT 85610 HCHG INR POCT	$39.10	$115.00	$25.99–$64.52	29% above	66%
Rapid flu test (influenza antigen) CPT 87804 PR IAADIADOO INFLUENZA	$49.30	$145.00	$32.77–$81.34	12% below	66%
Rapid flu test (influenza antigen) CPT 87804 HCHG INFLUENZA A&B	$49.30	$145.00	$32.77–$81.34	12% below	66%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 PR IAADIADOO STREPTOCOCCUS GROUP A	$87.72	$258.00	$58.31–$144.74	64% above	66%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HCHG RAPID STREP A THROAT-SAT	$87.72	$258.00	$58.31–$144.74	64% above	66%
Rheumatoid factor (RF) test CPT 86431 PR RHEUMATOID FACTOR QUANTITATIVE	$77.18	$227.00	$51.30–$127.35	59% above	66%
Rheumatoid factor (RF) test CPT 86431 HCHG RA QUANT	$77.18	$227.00	$51.30–$127.35	59% above	66%
Rubella antibody test (immunity check) CPT 86762 HCHG RUBELLA IMMUNE STATUS	$31.96	$94.00	$21.24–$52.73	32% below	66%
Rubella antibody test (immunity check) CPT 86762 PR ANTIBODY RUBELLA	$31.96	$94.00	$21.24–$52.73	32% below	66%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 PR SEDIMENTATION RATE RBC AUTOMATED	$58.82	$173.00	$39.10–$97.05	55% above	66%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HCHG SED RATE	$70.38	$207.00	$46.78–$116.13	86% above	66%
Stool ova and parasites exam CPT 87177 PB O&P EXAM LC	$88.40	$260.00	$58.76–$145.86	151% above	66%
Stool ova and parasites exam CPT 87177 (IA) HCHG O&P CONCENTRATE	$88.40	$260.00	$58.76–$145.86	151% above	66%
Stool ova and parasites exam CPT 87177 HCHG O&P EXAM LC	$88.40	$260.00	$58.76–$145.86	151% above	66%
Stool ova and parasites exam CPT 87177 PR OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID	$88.40	$260.00	$58.76–$145.86	151% above	66%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HCHG OCCULT BLOOD, IFOBT	$46.24	$136.00	$30.74–$76.30	20% below	66%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HCHG GENERAL LAB 8659200	$42.16	$124.00	$28.02–$69.56	42% above	66%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HCHG GENERAL LAB 8659203	$42.16	$124.00	$28.02–$69.56	42% above	66%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PR GENERAL LAB 8659200	$42.16	$124.00	$28.02–$69.56	42% above	66%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HCHG GENERAL LAB 8659201	$42.16	$124.00	$28.02–$69.56	42% above	66%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HCHG QUANTIFERON TB GOLD PLUS	$94.18	$277.00	$62.60–$155.40	24% below	66%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 PR TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$94.18	$277.00	$62.60–$155.40	24% below	66%
Testosterone blood test, total (not free testosterone) CPT 84403 PB TESTOSTERONE,TOTAL	$61.54	$181.00	$40.91–$101.54	2% below	66%
Testosterone blood test, total (not free testosterone) CPT 84403 HCHG TESTOSTERONE	$61.54	$181.00	$40.91–$101.54	2% below	66%
Testosterone blood test, total (not free testosterone) CPT 84403 HCHG TOTAL TESTOSTERONE, LC	$61.54	$181.00	$40.91–$101.54	2% below	66%
Testosterone blood test, total (not free testosterone) CPT 84403 PR ASSAY OF TESTOSTERONE TOTAL	$61.54	$181.00	$40.91–$101.54	2% below	66%
Thyroid peroxidase (TPO) antibody test CPT 86376 PR MICROSOMAL ANTIBODIES EACH	$109.48	$322.00	$72.77–$180.64	107% above	66%
Thyroid peroxidase (TPO) antibody test CPT 86376 HCHG THY PEROXIDASE ABY	$109.48	$322.00	$72.77–$180.64	107% above	66%
Thyroid peroxidase (TPO) antibody test CPT 86376 HCHG LIVER-KIDNEY MICROSOMAL AB LC	$109.48	$322.00	$72.77–$180.64	107% above	66%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 PB TSH	$60.86	$179.00	$40.45–$100.42	35% below	66%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HCHG TSH	$60.86	$179.00	$40.45–$100.42	35% below	66%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 PR ASSAY OF THYROID STIMULATING HORMONE TSH	$60.86	$179.00	$40.45–$100.42	35% below	66%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HCHG TSH LCC	$60.86	$179.00	$40.45–$100.42	35% below	66%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HCHG CONGENITAL HYPOTHYROIDISM	$60.86	$179.00	$40.45–$100.42	35% below	66%
Trichomonas test (NAAT) CPT 87661 HCHG GENERAL LAB 87661 AFFILIATE ONLY	$68.34	$201.00	$45.43–$112.76	36% above	66%
Trichomonas test (NAAT) CPT 87661 HCHG GENERAL LAB 8766103	$68.34	$201.00	$45.43–$112.76	36% above	66%
Trichomonas test (NAAT) CPT 87661 PR GENERAL LAB 8766100	$68.34	$201.00	$45.43–$112.76	36% above	66%
Uric acid blood test CPT 84550 PR ASSAY OF BLOOD/URIC ACID	$129.54	$381.00	$86.11–$213.74	198% above	66%
Uric acid blood test CPT 84550 HCHG URIC ACID	$129.54	$381.00	$86.11–$213.74	198% above	66%
Urinalysis with microscope exam, automated CPT 81001 PR URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$41.82	$123.00	$27.80–$69.00	16% below	66%
Urinalysis with microscope exam, automated CPT 81001 HCHG URINALYSIS COMPLETE	$41.82	$123.00	$27.80–$69.00	16% below	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG URINALYSIS RTR	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG UA MULTI	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG KETONES URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG PROTEIN QUAL URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG URINALYSIS	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG SPECIFIC GRAVITY URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 PB PH URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG URINALYSIS WO MICRO	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG PH URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG BILIRUBIN URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 HCHG GLUCOSE QUAL URINE	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, automated CPT 81003 PR URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$39.44	$116.00	$26.22–$65.08	54% above	66%
Urinalysis without microscope exam, manual CPT 81002 PR URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$10.88	$32.00	$7.23–$17.95	51% below	66%
Urinalysis without microscope exam, manual inpatient CPT 81002 PR URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$10.88	$32.00	$7.23–$17.95	—	66%
Urine culture for bacteria, with colony count CPT 87086 HCHG URINE CULTURE	$24.14	$71.00	$16.05–$39.83	56% below	66%
Urine culture for bacteria, with colony count CPT 87086 PR CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE	$24.14	$71.00	$16.05–$39.83	56% below	66%
Urine pregnancy test, read by color change CPT 81025 HCHG GENERAL LAB 8102500	$39.44	$116.00	$26.22–$65.08	1% above	66%
Urine pregnancy test, read by color change CPT 81025 PR GENERAL LAB 8102500	$39.44	$116.00	$26.22–$65.08	1% above	66%
Vitamin B12 (cobalamin) blood test CPT 82607 HCHG VITAMIN B-12	$105.40	$310.00	$70.06–$173.91	19% above	66%
Vitamin B12 (cobalamin) blood test CPT 82607 PR CYANOCOBALAMIN VITAMIN B-12	$117.30	$345.00	$77.97–$193.54	32% above	66%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HCHG VITAMIN D D2D3 LCC	$79.22	$233.00	$52.66–$130.71	18% below	66%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 PR 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$79.22	$233.00	$52.66–$130.71	18% below	66%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HCHG 25-HYDROXY VITAMIN D (D2+D3 FRACTIONATED) LC	$79.22	$233.00	$52.66–$130.71	18% below	66%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HCHG VITAMIN D TOTAL	$104.72	$308.00	$69.61–$172.79	8% above	66%
Zinc blood test CPT 84630 HCHG ZINC, PLASMA OR SERUM LC	$29.58	$87.00	$19.66–$48.81	2% below	66%
Zinc blood test CPT 84630 PR ASSAY OF ZINC	$29.58	$87.00	$19.66–$48.81	2% below	66%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCHG GENERAL LAB 8470205	$112.20	$330.00	$74.58–$185.13	22% above	66%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PR GENERAL LAB 8470200	$112.20	$330.00	$74.58–$185.13	22% above	66%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCHG GENERAL LAB 8470201	$112.20	$330.00	$74.58–$185.13	22% above	66%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCHG GENERAL LAB 8470202	$112.20	$330.00	$74.58–$185.13	22% above	66%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCHG GENERAL LAB 8470208	$112.20	$330.00	$74.58–$185.13	22% above	66%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PR ADENOIDECTOMY PRIMARY <AGE 12	$466.82	$1,373.00	$310.30–$770.25	25% below	66%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 PR ADENOIDECTOMY PRIMARY <AGE 12	$466.82	$1,373.00	$310.30–$770.25	—	66%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2	$2,314.04	$6,806.00	$1,538.16–$3,818.17	68% below	66%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2	$2,314.04	$6,806.00	$1,538.16–$3,818.17	—	66%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 PR APPENDEC RPTD APPENDIX ABSC/PRITONITIS	$1,629.62	$4,793.00	$1,083.22–$2,688.87	at median	66%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 PR APPENDEC RPTD APPENDIX ABSC/PRITONITIS	$1,629.62	$4,793.00	$1,083.22–$2,688.87	—	66%
Appendectomy, open surgery CPT 44950 PR APPENDECTOMY	$1,112.48	$3,272.00	$739.47–$1,835.59	11% below	66%
Appendectomy, open surgery inpatient CPT 44950 PR APPENDECTOMY	$1,112.48	$3,272.00	$739.47–$1,835.59	—	66%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	$3,606.72	$10,608.00	$2,397.41–$5,951.09	6% above	66%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	$3,606.72	$10,608.00	$2,397.41–$5,951.09	—	66%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 PR ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR	$3,402.72	$10,008.00	$2,261.81–$5,614.49	33% above	66%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 PR ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR	$3,402.72	$10,008.00	$2,261.81–$5,614.49	—	66%
Botox injections for chronic migraine CPT 64615 PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$160.48	$472.00	$106.67–$264.79	74% below	66%
Botox injections for chronic migraine inpatient CPT 64615 PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$160.48	$472.00	$106.67–$264.79	—	66%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HCHG RAD BIOPSY BREAST INC MARKER 1ST LESION STEREO GUIDE	$4,162.96	$12,244.00	$2,732.00–$5,289.41	145% above	66%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$465.46	$1,369.00	$309.39–$768.01	at median	66%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$465.46	$1,369.00	$309.39–$768.01	at median	66%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$465.46	$1,369.00	$309.39–$768.01	—	66%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PR CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$326.40	$960.00	$216.96–$538.56	12% below	66%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PR CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$326.40	$960.00	$216.96–$538.56	12% below	66%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 PR CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$326.40	$960.00	$216.96–$538.56	—	66%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 PR CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT	$1,172.32	$3,448.00	$779.25–$1,934.33	28% below	66%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 PR CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT	$1,172.32	$3,448.00	$779.25–$1,934.33	—	66%
Bunion correction with removal of part of the big toe joint CPT 28292 PR CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL	$1,455.20	$4,280.00	$967.28–$2,401.08	at median	66%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 PR CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL	$1,455.20	$4,280.00	$967.28–$2,401.08	—	66%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$598.74	$1,761.00	$397.99–$987.92	42% below	66%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$598.74	$1,761.00	$397.99–$987.92	42% below	66%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$598.74	$1,761.00	$397.99–$987.92	—	66%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HCHG CARDIOVERSION ELECTIVE, EXTERNAL	$1,073.72	$3,158.00	$713.71–$1,771.64	—	66%
Carpal tunnel release, open surgery CPT 64721 PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$1,346.06	$3,959.00	$894.73–$2,221.00	8% below	66%
Carpal tunnel release, open surgery inpatient CPT 64721 PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$1,346.06	$3,959.00	$894.73–$2,221.00	—	66%
Cervical biopsy CPT 57500 PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$263.16	$774.00	$174.92–$434.21	39% below	66%
Cervical biopsy inpatient CPT 57500 PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$263.16	$774.00	$174.92–$434.21	—	66%
Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$3,068.84	$9,026.00	$2,039.88–$5,063.59	16% below	66%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$3,068.84	$9,026.00	$2,039.88–$5,063.59	—	66%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 PR CIRCUMCISION AGE >28 DAYS	$264.86	$779.00	$176.05–$437.02	81% below	66%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 PR CIRCUMCISION AGE >28 DAYS	$264.86	$779.00	$176.05–$437.02	—	66%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$213.86	$629.00	$142.15–$352.87	12% below	66%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HCHG CIRCUMCISION W REGIONAL BLOCK	$128.52	$378.00	$85.43–$212.06	—	66%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$213.86	$629.00	$142.15–$352.87	—	66%
Circumcision, surgical, older than a newborn CPT 54160 PR CIRCUMCISION NEONATE	$212.50	$625.00	$141.25–$350.62	59% below	66%
Circumcision, surgical, older than a newborn inpatient CPT 54160 PR CIRCUMCISION NEONATE	$212.50	$625.00	$141.25–$350.62	—	66%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$425.00	$1,250.00	$282.50–$701.25	14% below	66%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$425.34	$1,251.00	$282.73–$701.81	14% below	66%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$425.00	$1,250.00	$282.50–$701.25	—	66%
Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,126.08	$3,312.00	$748.51–$1,858.03	10% below	66%
Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,126.08	$3,312.00	$748.51–$1,858.03	—	66%
Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$846.26	$2,489.00	$562.51–$1,396.33	33% below	66%
Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$846.26	$2,489.00	$562.51–$1,396.33	—	66%
Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$722.16	$2,124.00	$480.02–$1,191.56	40% below	66%
Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$722.16	$2,124.00	$480.02–$1,191.56	—	66%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$837.08	$2,462.00	$556.41–$1,381.18	16% above	66%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$837.08	$2,462.00	$556.41–$1,381.18	—	66%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$321.98	$947.00	$214.02–$531.27	41% below	66%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$321.98	$947.00	$214.02–$531.27	—	66%
Cystoscopy with ureteral stent placement CPT 52332 PR CYSTO W/INSERT URETERAL STENT	$542.64	$1,596.00	$360.70–$895.36	84% below	66%
Cystoscopy with ureteral stent placement inpatient CPT 52332 PR CYSTO W/INSERT URETERAL STENT	$542.64	$1,596.00	$360.70–$895.36	—	66%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PR CYSTOURETHROSCOPY	$628.32	$1,848.00	$417.65–$1,036.73	16% below	66%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 PR CYSTOURETHROSCOPY	$628.32	$1,848.00	$417.65–$1,036.73	—	66%
D&C (dilation and curettage), not related to pregnancy CPT 58120 PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$589.90	$1,735.00	$392.11–$973.34	59% below	66%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$589.90	$1,735.00	$392.11–$973.34	—	66%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PR DESTRUCTION PREMALIGNANT LESION 1ST	$111.86	$329.00	$74.35–$184.57	38% below	66%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PR DESTRUCTION PREMALIGNANT LESION 1ST	$111.86	$329.00	$74.35–$184.57	—	66%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 PR TYMPANOSTOMY GENERAL ANESTHESIA	$350.20	$1,030.00	$232.78–$577.83	60% below	66%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 PR TYMPANOSTOMY GENERAL ANESTHESIA	$350.20	$1,030.00	$232.78–$577.83	—	66%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 PR TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$350.20	$1,030.00	$232.78–$577.83	18% below	66%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 PR TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$350.20	$1,030.00	$232.78–$577.83	—	66%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$11.90	$35.00	$7.91–$19.64	85% below	66%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$11.90	$35.00	$7.91–$19.64	85% below	66%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$11.90	$35.00	$7.91–$19.64	—	66%
Earwax removal with instruments, one ear one side CPT 69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$73.44	$216.00	$48.82–$121.18	40% below	66%
Earwax removal with instruments, one ear one side CPT 69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$112.54	$331.00	$74.81–$185.69	9% below	66%
Earwax removal with instruments, one ear inpatient one side CPT 69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$73.44	$216.00	$48.82–$121.18	—	66%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$222.70	$655.00	$148.03–$367.46	10% below	66%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$222.70	$655.00	$148.03–$367.46	—	66%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY	$636.48	$1,872.00	$423.07–$1,050.19	76% below	66%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY	$636.48	$1,872.00	$423.07–$1,050.19	—	66%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS	$4,094.62	$12,043.00	$2,721.72–$6,756.12	11% below	66%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS	$4,094.62	$12,043.00	$2,721.72–$6,756.12	—	66%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY	$221.00	$650.00	$146.90–$364.65	66% below	66%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY	$221.00	$650.00	$146.90–$364.65	—	66%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS	$583.44	$1,716.00	$387.82–$962.68	64% below	66%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS	$583.44	$1,716.00	$387.82–$962.68	—	66%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PR NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$228.14	$671.00	$151.65–$376.43	77% below	66%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HCHG RAD INJ EPIDURAL CERVICAL OR THORACIC W GUIDE	$1,320.90	$3,885.00	$913.75–$1,947.00	33% above	66%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HCHG XR INJ EPIDURAL CERVICAL OR THORACIC SPINE W GUIDE	$1,320.90	$3,885.00	$913.75–$1,947.00	33% above	66%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PR NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$228.14	$671.00	$151.65–$376.43	—	66%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$168.30	$495.00	$111.87–$277.70	88% below	66%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HCHG XR INJ FACET LUMBAR OR SACRAL SINGLE LEV	$1,320.90	$3,885.00	$913.75–$1,947.00	5% below	66%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HCHG RAD INJ FACET JOINT LUMBAR/SACRAL ONE LEVEL W GUIDE	$1,320.90	$3,885.00	$913.75–$1,947.00	5% below	66%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HCHG CT FACET JOINT INJ LUMBAR/SACRAL SNGL LEVEL W CT GUIDE	$1,320.90	$3,885.00	$913.75–$1,947.00	5% below	66%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$168.30	$495.00	$111.87–$277.70	—	66%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$830.62	$2,443.00	$552.12–$1,370.52	47% below	66%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$830.62	$2,443.00	$552.12–$1,370.52	—	66%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$1,116.56	$3,284.00	$742.18–$1,842.32	35% below	66%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$1,116.56	$3,284.00	$742.18–$1,842.32	—	66%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$496.06	$1,459.00	$329.73–$818.50	68% below	66%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$496.06	$1,459.00	$329.73–$818.50	—	66%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$236.30	$695.00	$157.07–$389.90	72% below	66%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$236.30	$695.00	$157.07–$389.90	—	66%
Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$2,346.68	$6,902.00	$1,559.85–$3,872.02	42% above	66%
Gallbladder removal, laparoscopic inpatient CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$2,346.68	$6,902.00	$1,559.85–$3,872.02	—	66%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$2,216.12	$6,518.00	$1,473.07–$3,656.60	11% above	66%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$2,216.12	$6,518.00	$1,473.07–$3,656.60	—	66%
Gallbladder removal, open surgery through a larger incision CPT 47600 PR CHOLECYSTECTOMY	$1,718.70	$5,055.00	$1,142.43–$2,835.86	at median	66%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 PR CHOLECYSTECTOMY	$1,718.70	$5,055.00	$1,142.43–$2,835.86	—	66%
Hammertoe correction surgery CPT 28285 PR CORRECTION HAMMERTOE	$763.64	$2,246.00	$507.60–$1,260.01	67% below	66%
Hammertoe correction surgery inpatient CPT 28285 PR CORRECTION HAMMERTOE	$763.64	$2,246.00	$507.60–$1,260.01	—	66%
Hemorrhoid banding (rubber band ligation) CPT 46221 PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$353.60	$1,040.00	$235.04–$583.44	56% below	66%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$353.60	$1,040.00	$235.04–$583.44	—	66%
Hemorrhoidectomy (internal and external), one area CPT 46255 PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$878.90	$2,585.00	$584.21–$1,450.18	53% below	66%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$878.90	$2,585.00	$584.21–$1,450.18	—	66%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$4,655.62	$13,693.00	$3,094.62–$7,681.77	at median	66%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$4,655.62	$13,693.00	$3,094.62–$7,681.77	—	66%
Hysterectomy through an abdominal incision (total) CPT 58150 PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$1,508.92	$4,438.00	$1,002.99–$2,489.72	31% below	66%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$1,508.92	$4,438.00	$1,002.99–$2,489.72	—	66%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HCHG RAD INJ HYSTEROSALPINGOGRAM W CATHETERIZATION	$133.28	$392.00	$92.20–$982.00	56% below	66%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HCHG XR INJ HYSTEROSALPINGOGRAM	$133.28	$392.00	$92.20–$982.00	56% below	66%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 PR CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$480.76	$1,414.00	$319.56–$793.25	59% above	66%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 PR CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$480.76	$1,414.00	$319.56–$793.25	—	66%
Hysteroscopy with endometrial ablation CPT 58563 PR HYSTEROSCOPY ENDOMETRIAL ABLATION	$3,074.96	$9,044.00	$2,043.94–$5,073.68	8% below	66%
Hysteroscopy with endometrial ablation inpatient CPT 58563 PR HYSTEROSCOPY ENDOMETRIAL ABLATION	$3,074.96	$9,044.00	$2,043.94–$5,073.68	—	66%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$485.52	$1,428.00	$322.73–$801.11	78% below	66%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$485.52	$1,428.00	$322.73–$801.11	—	66%
IUD insertion (the device itself billed separately) CPT 58300 PR INSERTION INTRAUTERINE DEVICE IUD	$292.40	$860.00	$194.36–$482.46	15% above	66%
IUD insertion (the device itself billed separately) inpatient CPT 58300 PR INSERTION INTRAUTERINE DEVICE IUD	$292.40	$860.00	$194.36–$482.46	—	66%
Incision and drainage of a simple or single skin abscess CPT 10060 HCHG US DRAIN SUBCUTANEOUS ABSCESS	$162.18	$477.00	$112.19–$982.00	44% below	66%
Incision and drainage of a simple or single skin abscess CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$162.18	$477.00	$107.80–$267.60	44% below	66%
Incision and drainage of a simple or single skin abscess CPT 10060 HCHG RAD DRAIN SUBCUTANEOUS ABSCESS	$162.18	$477.00	$112.19–$982.00	44% below	66%
Incision and drainage of a simple or single skin abscess CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$162.52	$478.00	$108.03–$268.16	44% below	66%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HCHG I&D ABSCESS/CARB/CYST SINGLE SIMPLE	$162.18	$477.00	$107.80–$267.60	—	66%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$162.52	$478.00	$108.03–$268.16	—	66%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,050.94	$3,091.00	$698.57–$1,734.05	40% below	66%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,050.94	$3,091.00	$698.57–$1,734.05	—	66%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$113.90	$335.00	$75.71–$187.94	69% below	66%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$114.24	$336.00	$75.94–$188.50	69% below	66%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HCHG US INJ SINGLE TENDON SHEATH LIGAMENT	$170.68	$502.00	$118.07–$982.00	54% below	66%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HCHG RAD INJECTION SINGLE TENDON SHEATH LIGAMENT	$170.68	$502.00	$118.07–$982.00	54% below	66%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$113.90	$335.00	$75.71–$187.94	—	66%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HCHG XR INJECTION SINGLE TENDON SHEATH LIGAMENT	$223.72	$658.00	$154.76–$982.00	—	66%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HCHG RAD INJECTION SINGLE TENDON SHEATH LIGAMENT	$223.72	$658.00	$154.76–$982.00	—	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$230.86	$679.00	$153.45–$380.92	37% below	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$231.88	$682.00	$154.13–$382.60	36% below	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG RAD ARTHROCENTESIS ASPIRATION INJECTION MAJOR JOINT BURSA	$440.98	$1,297.00	$305.05–$982.00	21% above	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG CT INJECTION MAJOR JOINT BURSA	$440.98	$1,297.00	$305.05–$982.00	21% above	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG XR ARTHROCENTESIS MAJOR JOINT OR BURSA	$440.98	$1,297.00	$305.05–$982.00	21% above	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG CT ARTHROCENTESIS MAJOR JOINT OR BURSA	$440.98	$1,297.00	$305.05–$982.00	21% above	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HCHG ARTHROCENT/ASPIR/INJ MAJOR JOINT/BURSA WO US GUIDE UNILAT	$440.98	$1,297.00	$305.05–$982.00	21% above	66%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$231.88	$682.00	$154.13–$382.60	—	66%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PR INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT	$391.34	$1,151.00	$260.13–$645.71	42% above	66%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 PR INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT	$391.34	$1,151.00	$260.13–$645.71	—	66%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$117.64	$346.00	$78.20–$194.11	61% below	66%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$117.64	$346.00	$78.20–$194.11	61% below	66%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HCHG IR INJ OR ASP INTERMED JT OR BURSA	$170.68	$502.00	$118.07–$982.00	44% below	66%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HCHG XR ARTHROCENTESIS INTERMEDIATE JOINT OR BURSA	$170.68	$502.00	$118.07–$982.00	44% below	66%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HCHG RAD ARTHROCENTESIS ASPIRATION INJECTION INTERM JOINT BURSA	$170.68	$502.00	$118.07–$982.00	44% below	66%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$117.64	$346.00	$78.20–$194.11	—	66%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$107.78	$317.00	$71.64–$177.84	67% below	66%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$107.78	$317.00	$71.64–$177.84	67% below	66%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HCHG RAD ARTHROCENTESIS ASPIRATION SMALL JOINT OR BURSA	$185.64	$546.00	$128.42–$982.00	43% below	66%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$107.78	$317.00	$71.64–$177.84	—	66%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL	$2,721.02	$8,003.00	$1,808.68–$4,489.68	12% above	66%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL	$2,721.02	$8,003.00	$1,808.68–$4,489.68	—	66%
Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$2,015.18	$5,927.00	$1,339.50–$3,325.05	4% above	66%
Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$2,015.18	$5,927.00	$1,339.50–$3,325.05	—	66%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	$2,378.64	$6,996.00	$1,581.10–$3,924.76	at median	66%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	$2,378.64	$6,996.00	$1,581.10–$3,924.76	—	66%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$1,787.38	$5,257.00	$1,188.08–$2,949.18	at median	66%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$1,787.38	$5,257.00	$1,188.08–$2,949.18	—	66%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM	$2,524.50	$7,425.00	$1,678.05–$4,165.42	—	66%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM	$2,524.50	$7,425.00	$1,678.05–$4,165.42	—	66%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PR LAPAROSCOPIC APPENDECTOMY	$1,412.02	$4,153.00	$938.58–$2,329.83	8% above	66%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 PR LAPAROSCOPIC APPENDECTOMY	$1,412.02	$4,153.00	$938.58–$2,329.83	—	66%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 PR LAPS SURG ESOPG/GSTR FUNDOPLASTY	$2,762.16	$8,124.00	$1,836.02–$4,557.56	1% above	66%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 PR LAPS SURG ESOPG/GSTR FUNDOPLASTY	$2,762.16	$8,124.00	$1,836.02–$4,557.56	—	66%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<	$1,388.90	$4,085.00	$923.21–$2,291.68	1% below	66%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<	$1,388.90	$4,085.00	$923.21–$2,291.68	—	66%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY	$1,517.42	$4,463.00	$1,008.64–$2,503.74	24% below	66%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY	$1,517.42	$4,463.00	$1,008.64–$2,503.74	—	66%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	$1,441.60	$4,240.00	$958.24–$2,378.64	21% above	66%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	$1,441.60	$4,240.00	$958.24–$2,378.64	—	66%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 PR LAPS SURG RPR RECURRENT INGUINAL HERNIA	$1,544.28	$4,542.00	$1,026.49–$2,548.06	9% above	66%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 PR LAPS SURG RPR RECURRENT INGUINAL HERNIA	$1,544.28	$4,542.00	$1,026.49–$2,548.06	—	66%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	$1,900.60	$5,590.00	$1,263.34–$3,135.99	11% above	66%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	$1,900.60	$5,590.00	$1,263.34–$3,135.99	—	66%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 PR LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY	$2,103.58	$6,187.00	$1,398.26–$3,470.91	2% above	66%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 PR LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY	$2,103.58	$6,187.00	$1,398.26–$3,470.91	—	66%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM	$253.64	$746.00	$168.60–$418.51	44% below	66%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM	$410.72	$1,208.00	$273.01–$677.69	9% below	66%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM	$410.72	$1,208.00	$273.01–$677.69	—	66%
Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$228.14	$671.00	$151.65–$376.43	76% below	66%
Lower-back epidural injection, with imaging guidance CPT 62323 HCHG RAD INJ EPIDURAL LUMBAR OR SACRAL W GUIDE	$1,586.44	$4,666.00	$1,019.00–$2,015.71	67% above	66%
Lower-back epidural injection, with imaging guidance CPT 62323 HCHG XR INJ EPIDURAL LUMBAR OR SACRAL W GUIDE	$1,586.44	$4,666.00	$1,019.00–$2,015.71	67% above	66%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$228.14	$671.00	$151.65–$376.43	—	66%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$123.08	$362.00	$81.81–$203.08	—	66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$213.52	$628.00	$141.93–$352.31	83% below	66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HCHG CT TRANSFORAMINAL LUMB OR SACRAL SNGL W CT GUIDE	$2,289.56	$6,734.00	$1,019.00–$2,909.09	79% above	66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HCHG RAD INJ TRANS EPIDURAL LUMBAR/SACRAL ONE LEVEL W GUIDE	$2,289.56	$6,734.00	$1,019.00–$2,909.09	79% above	66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HCHG XR INJ TRANSFORAMINAL LUMBAR OR SACRAL SINGLE LEV	$2,289.56	$6,734.00	$1,019.00–$2,909.09	79% above	66%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$213.52	$628.00	$141.93–$352.31	—	66%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR	$1,304.24	$3,836.00	$866.94–$2,152.00	73% below	66%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR	$1,304.24	$3,836.00	$866.94–$2,152.00	—	66%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PR LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR	$1,490.90	$4,385.00	$991.01–$2,459.98	73% below	66%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 PR LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR	$1,490.90	$4,385.00	$991.01–$2,459.98	—	66%
Lumbar spinal fusion (posterior), one level CPT 22612 PR ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR	$2,187.22	$6,433.00	$1,453.86–$3,608.91	—	66%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 PR ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR	$2,187.22	$6,433.00	$1,453.86–$3,608.91	—	66%
Lumpectomy (partial mastectomy) CPT 19301 PR MASTECTOMY PARTIAL	$937.04	$2,756.00	$622.86–$1,546.12	36% below	66%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PR MASTECTOMY PARTIAL	$937.04	$2,756.00	$622.86–$1,546.12	—	66%
Mastectomy (total removal of the breast) CPT 19303 PR MASTECTOMY SIMPLE COMPLETE	$1,441.60	$4,240.00	$958.24–$2,378.64	46% below	66%
Mastectomy (total removal of the breast) inpatient CPT 19303 PR MASTECTOMY SIMPLE COMPLETE	$1,441.60	$4,240.00	$958.24–$2,378.64	—	66%
Miscarriage treatment with D&C, first trimester CPT 59820 PR TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$590.92	$1,738.00	$392.79–$975.02	26% below	66%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 PR TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$590.92	$1,738.00	$392.79–$975.02	—	66%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$163.88	$482.00	$108.93–$270.40	60% below	66%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$163.88	$482.00	$108.93–$270.40	60% below	66%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$163.88	$482.00	$108.93–$270.40	—	66%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$183.94	$541.00	$122.27–$303.50	65% below	66%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$183.94	$541.00	$122.27–$303.50	—	66%
Nail removal (partial or complete), one nail CPT 11730 PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$187.68	$552.00	$124.75–$309.67	33% below	66%
Nail removal (partial or complete), one nail CPT 11730 PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$188.02	$553.00	$124.98–$310.23	33% below	66%
Nail removal (partial or complete), one nail inpatient CPT 11730 PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$187.68	$552.00	$124.75–$309.67	—	66%
Occipital nerve block (injection for headaches) CPT 64405 PR INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$141.44	$416.00	$94.02–$233.38	77% below	66%
Occipital nerve block (injection for headaches) CPT 64405 PR INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$141.44	$416.00	$94.02–$233.38	77% below	66%
Occipital nerve block (injection for headaches) CPT 64405 HCHG XR INJ NERVE BLOCK OCCIPITAL NERVE	$915.62	$2,693.00	$522.00–$1,163.38	51% above	66%
Occipital nerve block (injection for headaches) CPT 64405 HCHG RAD INJ ANES AGENT STEROID OCCIPITAL NERVE	$915.62	$2,693.00	$522.00–$1,163.38	51% above	66%
Occipital nerve block (injection for headaches) inpatient CPT 64405 PR INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$141.44	$416.00	$94.02–$233.38	—	66%
Pacemaker implant (dual chamber) CPT 33208 PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT	$2,252.84	$6,626.00	$1,497.48–$3,717.19	83% below	66%
Pacemaker implant (dual chamber) inpatient CPT 33208 PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT	$2,252.84	$6,626.00	$1,497.48–$3,717.19	—	66%
Paracentesis with imaging guidance CPT 49083 PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$875.84	$2,576.00	$582.18–$1,445.14	at median	66%
Paracentesis with imaging guidance CPT 49083 PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$892.84	$2,626.00	$593.48–$1,473.19	2% above	66%
Paracentesis with imaging guidance CPT 49083 HCHG RAD PARACENTESIS ABDOMEN WITH IMAGING PORTABLE	$1,314.44	$3,866.00	$909.28–$2,757.00	51% above	66%
Paracentesis with imaging guidance CPT 49083 HCHG CT PARACENTESIS ABDOMEN PELVIS ASPIRATION	$1,314.44	$3,866.00	$909.28–$2,757.00	51% above	66%
Paracentesis with imaging guidance CPT 49083 HCHG US PARACENTESIS ABDOMEN WITH IMAGING	$1,314.44	$3,866.00	$909.28–$2,757.00	51% above	66%
Paracentesis with imaging guidance CPT 49083 HCHG RAD PARACENTESIS ABDOMEN WITH IMAGING	$1,314.44	$3,866.00	$909.28–$2,757.00	51% above	66%
Paracentesis with imaging guidance CPT 49083 HCHG US PARACENTESIS ABDOMEN W IMAGING PORTABLE	$1,314.44	$3,866.00	$909.28–$2,757.00	51% above	66%
Paracentesis with imaging guidance inpatient CPT 49083 PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$875.84	$2,576.00	$582.18–$1,445.14	—	66%
Partial knee replacement (one compartment) CPT 27446 PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT	$3,462.90	$10,185.00	$2,301.81–$5,713.78	1% above	66%
Partial knee replacement (one compartment) inpatient CPT 27446 PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT	$3,462.90	$10,185.00	$2,301.81–$5,713.78	—	66%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PR EXCISION NAIL MATRIX PERMANENT REMOVAL	$396.78	$1,167.00	$263.74–$654.69	21% below	66%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PR EXCISION NAIL MATRIX PERMANENT REMOVAL	$396.78	$1,167.00	$263.74–$654.69	21% below	66%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PR EXCISION NAIL MATRIX PERMANENT REMOVAL	$396.78	$1,167.00	$263.74–$654.69	—	66%
Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$294.44	$866.00	$195.72–$485.83	80% below	66%
Prostate biopsy inpatient CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$294.44	$866.00	$195.72–$485.83	—	66%
Prostate removal (prostatectomy), laparoscopic CPT 55866 PR LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT	$1,935.28	$5,692.00	$1,286.39–$3,193.21	—	66%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PR LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT	$1,935.28	$5,692.00	$1,286.39–$3,193.21	—	66%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$407.32	$1,198.00	$270.75–$672.08	81% below	66%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HCHG RAD DSTR NROLYTC AGNT PARVERTEB FACET SNGL LMBR/SACRAL	$1,702.38	$5,007.00	$1,177.65–$3,749.00	19% below	66%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$407.32	$1,198.00	$270.75–$672.08	—	66%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 HCHG DSTR PARAVERT FACET JT NRV W FLUORO LMBR/SAC SGL UNILAT	$1,702.38	$5,007.00	$1,177.65–$3,749.00	—	66%
Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$742.90	$2,185.00	$493.81–$1,225.78	50% below	66%
Removal of a breast lump, open surgery inpatient CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$742.90	$2,185.00	$493.81–$1,225.78	—	66%
Removal of a foreign object under the skin, simple CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$300.56	$884.00	$199.78–$495.92	25% below	66%
Removal of a foreign object under the skin, simple CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$300.90	$885.00	$200.01–$496.48	25% below	66%
Removal of a foreign object under the skin, simple inpatient CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$300.90	$885.00	$200.01–$496.48	—	66%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY	$1,712.58	$5,037.00	$1,138.36–$2,825.76	26% above	66%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY	$1,712.58	$5,037.00	$1,138.36–$2,825.76	—	66%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PR COLON CA SCRN NOT HI RSK IND	$601.46	$1,769.00	$399.79–$992.41	45% below	66%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PR COLON CA SCRN NOT HI RSK IND	$601.46	$1,769.00	$399.79–$992.41	—	66%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PR COLORECTAL SCRN; HI RISK IND	$722.16	$2,124.00	$480.02–$1,191.56	39% below	66%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PR COLORECTAL SCRN; HI RISK IND	$722.16	$2,124.00	$480.02–$1,191.56	—	66%
Septoplasty to straighten the nasal septum CPT 30520 PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	$1,380.74	$4,061.00	$917.79–$2,278.22	at median	66%
Septoplasty to straighten the nasal septum inpatient CPT 30520 PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	$1,380.74	$4,061.00	$917.79–$2,278.22	—	66%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 PR LITHOTRIPSY XTRCORP SHOCK WAVE	$767.72	$2,258.00	$510.31–$1,266.74	82% below	66%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 PR LITHOTRIPSY XTRCORP SHOCK WAVE	$767.72	$2,258.00	$510.31–$1,266.74	—	66%
Short arm cast (elbow to hand) CPT 29075 PR APPLICATION CAST ELBOW FINGER SHORT ARM	$149.26	$439.00	$99.21–$246.28	37% below	66%
Short arm cast (elbow to hand) CPT 29075 PR APPLICATION CAST ELBOW FINGER SHORT ARM	$150.62	$443.00	$100.12–$248.52	36% below	66%
Short arm cast (elbow to hand) inpatient CPT 29075 PR APPLICATION CAST ELBOW FINGER SHORT ARM	$149.26	$439.00	$99.21–$246.28	—	66%
Short arm splint (forearm and hand) CPT 29125 PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$121.72	$358.00	$80.91–$200.84	39% below	66%
Short arm splint (forearm and hand) CPT 29125 PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$121.72	$358.00	$80.91–$200.84	39% below	66%
Short arm splint (forearm and hand) inpatient CPT 29125 HCHG OT APPLICATION SHORTARM SPLINT STATIC	$109.14	$321.00	$72.55–$151.00	—	66%
Short arm splint (forearm and hand) inpatient CPT 29125 PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$121.72	$358.00	$80.91–$200.84	—	66%
Short leg cast (below the knee) CPT 29405 PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$199.92	$588.00	$132.89–$329.87	27% below	66%
Short leg cast (below the knee) CPT 29405 PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$199.92	$588.00	$132.89–$329.87	27% below	66%
Short leg cast (below the knee) inpatient CPT 29405 PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$199.92	$588.00	$132.89–$329.87	—	66%
Short leg splint (calf to foot) CPT 29515 PR APPLICATION SHORT LEG SPLINT CALF FOOT	$127.16	$374.00	$84.52–$209.81	43% below	66%
Short leg splint (calf to foot) CPT 29515 PR APPLICATION SHORT LEG SPLINT CALF FOOT	$127.84	$376.00	$84.98–$210.94	43% below	66%
Short leg splint (calf to foot) inpatient CPT 29515 PR APPLICATION SHORT LEG SPLINT CALF FOOT	$127.16	$374.00	$84.52–$209.81	—	66%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PR ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY	$1,845.18	$5,427.00	$1,226.50–$3,044.55	13% below	66%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 PR ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY	$1,845.18	$5,427.00	$1,226.50–$3,044.55	—	66%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE	$2,049.86	$6,029.00	$1,362.55–$3,382.27	87% above	66%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE	$2,049.86	$6,029.00	$1,362.55–$3,382.27	—	66%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$212.84	$626.00	$141.48–$351.19	21% below	66%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 (IA) PR REPAIR SUPERF WOUND BODY < OR = 2.5 CM	$212.84	$626.00	$141.48–$351.19	21% below	66%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$212.84	$626.00	$141.48–$351.19	21% below	66%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$212.84	$626.00	$141.48–$351.19	—	66%
Skin biopsy, punch, one lesion CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION	$120.02	$353.00	$79.78–$198.03	58% below	66%
Skin biopsy, punch, one lesion CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION	$120.02	$353.00	$79.78–$198.03	58% below	66%
Skin biopsy, punch, one lesion inpatient CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION	$120.02	$353.00	$79.78–$198.03	—	66%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$249.56	$734.00	$165.88–$411.77	49% below	66%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$249.56	$734.00	$165.88–$411.77	—	66%
Skin tag removal, up to 15 tags CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$146.20	$430.00	$97.18–$241.23	25% below	66%
Skin tag removal, up to 15 tags CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$147.22	$433.00	$97.86–$242.91	25% below	66%
Skin tag removal, up to 15 tags inpatient CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$147.22	$433.00	$97.86–$242.91	—	66%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PR SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$257.04	$756.00	$170.86–$424.12	65% below	66%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PR SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$316.54	$931.00	$210.41–$522.29	56% below	66%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PR SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$171.02	$503.00	$113.68–$282.18	—	66%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PR SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$316.54	$931.00	$210.41–$522.29	—	66%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HCHG SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$353.60	$1,040.00	$235.04–$583.44	—	66%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$268.26	$789.00	$178.31–$442.63	13% below	66%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$268.60	$790.00	$178.54–$443.19	13% below	66%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 (IA) PR REPAIR SUPERF WOUND BODY 2.6-7.5 CM	$268.60	$790.00	$178.54–$443.19	13% below	66%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$268.26	$789.00	$178.31–$442.63	—	66%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PR REPAIR SUPERF WOUND FACE EARS EYELIDS NOSE LIPS <= 2.5 CM	$228.82	$673.00	$152.10–$377.55	16% below	66%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PR REPAIR SUPERF WOUND FACE EARS EYELIDS NOSE LIPS <= 2.5 CM	$228.82	$673.00	$152.10–$377.55	16% below	66%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PR REPAIR SUPERF WOUND FACE EARS EYELIDS NOSE LIPS <= 2.5 CM	$228.82	$673.00	$152.10–$377.55	—	66%
TURP (transurethral resection of the prostate) CPT 52601 PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	$1,009.80	$2,970.00	$671.22–$1,666.17	69% below	66%
TURP (transurethral resection of the prostate) inpatient CPT 52601 PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	$1,009.80	$2,970.00	$671.22–$1,666.17	—	66%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PR TANGENTIAL BIOPSY SKIN SINGLE LESION	$73.10	$215.00	$48.59–$120.62	70% below	66%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 PR TANGENTIAL BIOPSY SKIN SINGLE LESION	$73.10	$215.00	$48.59–$120.62	—	66%
Thoracentesis with imaging guidance CPT 32555 PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$484.84	$1,426.00	$322.28–$799.99	46% below	66%
Thoracentesis with imaging guidance CPT 32555 PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$502.52	$1,478.00	$334.03–$829.16	44% below	66%
Thoracentesis with imaging guidance CPT 32555 HCHG CT THORACENTESIS PLEURAL ASPIRATION	$1,111.46	$3,269.00	$768.87–$1,947.00	24% above	66%
Thoracentesis with imaging guidance CPT 32555 HCHG US THORACENTESIS PLEURAL SPACE	$1,111.46	$3,269.00	$768.87–$1,947.00	24% above	66%
Thoracentesis with imaging guidance CPT 32555 HCHG US THORACENTESIS PLEURAL SPACE PORTABLE	$1,111.46	$3,269.00	$768.87–$1,947.00	24% above	66%
Thoracentesis with imaging guidance CPT 32555 HCHG RAD THORACENTESIS PLEURAL SPACE NEEDLE OR CATHETER	$1,111.46	$3,269.00	$768.87–$1,947.00	24% above	66%
Thoracentesis with imaging guidance inpatient CPT 32555 PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$484.84	$1,426.00	$322.28–$799.99	—	66%
Tonsil and adenoid removal, age 12 or older CPT 42821 PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>	$583.44	$1,716.00	$387.82–$962.68	33% below	66%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>	$583.44	$1,716.00	$387.82–$962.68	—	66%
Tonsil and adenoid removal, child under 12 CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$661.30	$1,945.00	$439.57–$1,091.14	10% below	66%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$661.30	$1,945.00	$439.57–$1,091.14	—	66%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>	$583.44	$1,716.00	$387.82–$962.68	20% below	66%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>	$583.44	$1,716.00	$387.82–$962.68	—	66%
Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$3,901.84	$11,476.00	$2,593.58–$6,438.04	at median	66%
Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$3,901.84	$11,476.00	$2,593.58–$6,438.04	—	66%
Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$4,181.32	$12,298.00	$2,779.35–$6,899.18	12% above	66%
Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$4,181.32	$12,298.00	$2,779.35–$6,899.18	—	66%
Total shoulder replacement CPT 23472 PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$3,744.08	$11,012.00	$2,488.71–$6,177.73	8% below	66%
Total shoulder replacement inpatient CPT 23472 PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$3,744.08	$11,012.00	$2,488.71–$6,177.73	—	66%
Total thyroid removal (thyroidectomy) CPT 60240 PR THYROIDECTOMY TOTAL/COMPLETE	$2,131.80	$6,270.00	$1,417.02–$3,517.47	3% below	66%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 PR THYROIDECTOMY TOTAL/COMPLETE	$2,131.80	$6,270.00	$1,417.02–$3,517.47	—	66%
Trigger finger release surgery CPT 26055 PR TENDON SHEATH INCISION	$630.70	$1,855.00	$419.23–$1,040.66	51% below	66%
Trigger finger release surgery inpatient CPT 26055 PR TENDON SHEATH INCISION	$630.70	$1,855.00	$419.23–$1,040.66	—	66%
Trigger point injections, 1 or 2 muscles CPT 20552 PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$241.74	$711.00	$160.69–$398.87	22% below	66%
Trigger point injections, 1 or 2 muscles CPT 20552 PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$241.74	$711.00	$160.69–$398.87	22% below	66%
Trigger point injections, 1 or 2 muscles CPT 20552 HCHG RAD INJECTION(S) SGL/MULI TRIGGER POINT(S) 1 OR 2 MUSCLE	$789.14	$2,321.00	$522.00–$1,002.67	155% above	66%
Trigger point injections, 1 or 2 muscles CPT 20552 HCHG INJ(S) SGL/MUL TRIG PT(S) 1 OR 2 MUSC	$789.14	$2,321.00	$524.55–$1,302.08	155% above	66%
Trigger point injections, 1 or 2 muscles CPT 20552 HCHG XR INJ TRIGGER POINT EQUAL OR LESS 2	$789.14	$2,321.00	$522.00–$1,002.67	155% above	66%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$241.74	$711.00	$160.69–$398.87	—	66%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 PR LAPAROSCOPY FULGURATION OVIDUCTS	$1,298.46	$3,819.00	$863.09–$2,142.46	67% above	66%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 PR LAPAROSCOPY FULGURATION OVIDUCTS	$1,298.46	$3,819.00	$863.09–$2,142.46	—	66%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$275.40	$810.00	$183.06–$454.41	83% below	66%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HCHG RAD BIOPSY BREAST INC MARKER 1ST LESION W US GUIDE	$4,580.14	$13,471.00	$2,732.00–$5,819.47	180% above	66%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$275.40	$810.00	$183.06–$454.41	—	66%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$1,097.86	$3,229.00	$729.75–$1,811.47	39% below	66%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$1,097.86	$3,229.00	$729.75–$1,811.47	—	66%
Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$539.92	$1,588.00	$358.89–$890.87	49% below	66%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$539.92	$1,588.00	$358.89–$890.87	—	66%
Upper endoscopy (EGD) with injection into the lining CPT 43236 PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$374.68	$1,102.00	$249.05–$618.22	71% below	66%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$374.68	$1,102.00	$249.05–$618.22	—	66%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$787.10	$2,315.00	$523.19–$1,298.72	55% below	66%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$787.10	$2,315.00	$523.19–$1,298.72	—	66%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$537.20	$1,580.00	$357.08–$886.38	62% below	66%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$537.20	$1,580.00	$357.08–$886.38	—	66%
Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$478.04	$1,406.00	$317.76–$788.77	50% below	66%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$478.04	$1,406.00	$317.76–$788.77	—	66%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 PR CYSTO W/URETEROSCOPY W/LITHOTRIPSY	$662.66	$1,949.00	$440.47–$1,093.39	63% below	66%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 PR CYSTO W/URETEROSCOPY W/LITHOTRIPSY	$662.66	$1,949.00	$440.47–$1,093.39	—	66%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$566.44	$1,666.00	$376.52–$934.63	74% below	66%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$567.80	$1,670.00	$377.42–$936.87	74% below	66%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$567.80	$1,670.00	$377.42–$936.87	—	66%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$2,555.44	$7,516.00	$1,698.62–$4,216.48	24% below	66%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$2,555.44	$7,516.00	$1,698.62–$4,216.48	—	66%
Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$3,098.76	$9,114.00	$2,059.76–$5,112.95	at median	66%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$3,098.76	$9,114.00	$2,059.76–$5,112.95	—	66%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$758.54	$2,231.00	$504.21–$1,251.59	—	66%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$758.54	$2,231.00	$504.21–$1,251.59	—	66%
Wart removal, up to 14 warts CPT 17110 PR DESTRUCTION BENIGN LESIONS UP TO 14	$159.80	$470.00	$106.22–$263.67	19% below	66%
Wart removal, up to 14 warts inpatient CPT 17110 PR DESTRUCTION BENIGN LESIONS UP TO 14	$159.80	$470.00	$106.22–$263.67	—	66%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$264.52	$778.00	$175.83–$436.46	41% below	66%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$264.52	$778.00	$175.83–$436.46	41% below	66%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$264.52	$778.00	$175.83–$436.46	—	66%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 PR OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	$1,562.98	$4,597.00	$1,038.92–$2,578.92	34% below	66%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 PR OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	$1,562.98	$4,597.00	$1,038.92–$2,578.92	—	66%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 PR TRANSFUSION BLOOD/BLOOD COMPONENTS	$79.90	$235.00	$53.11–$131.84	89% below	66%
Blood transfusion (giving blood or blood components) CPT 36430 PR TRANSFUSION BLOOD/BLOOD COMPONENTS	$79.90	$235.00	$53.11–$131.84	89% below	66%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PR TRANSFUSION BLOOD/BLOOD COMPONENTS	$79.90	$235.00	$53.11–$131.84	—	66%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG BLOOD/BLOOD PRODUCT ADMIN PER UNIT	$268.60	$790.00	$178.54–$443.19	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$31.28	$92.00	$20.79–$51.61	73% below	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$31.28	$92.00	$20.79–$51.61	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC AIRWAY INHALATION TX EZPAP W NEB	$31.28	$92.00	$20.79–$51.61	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC SPUTUM INDUCTION	$31.28	$92.00	$20.79–$51.61	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC AIRWAY INHALATION TX MDI/DPI	$42.84	$126.00	$28.48–$70.69	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC AIRWAY INHALATION TX IPPB	$42.84	$126.00	$28.48–$70.69	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 (IA) PR INHALATION TREATMENT AIRWAY OBST	$42.84	$126.00	$28.48–$70.69	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC AIRWAY INHALATION TX	$42.84	$126.00	$28.48–$70.69	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC AIRWAY INHALATION TX MDI VENT	$42.84	$126.00	$28.48–$70.69	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG RC AIRWAY INHALATION TX HELIUM	$42.84	$126.00	$28.48–$70.69	—	66%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$42.84	$126.00	$28.48–$70.69	—	66%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HCHG CHEMO IV ADMIN INITIAL HOUR	$283.22	$833.00	$188.26–$467.31	—	66%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ	$79.22	$233.00	$52.66–$130.71	49% below	66%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ	$79.22	$233.00	$52.66–$130.71	—	66%
Critical care, first 30 to 74 minutes CPT 99291 PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$451.18	$1,327.00	$299.90–$744.45	71% below	66%
Critical care, first 30 to 74 minutes CPT 99291 PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$542.98	$1,597.00	$360.92–$895.92	65% below	66%
Critical care, first 30 to 74 minutes CPT 99291 HCHG ED CRITICAL CARE LEVEL VI	$1,899.24	$5,586.00	$615.00–$3,430.00	23% above	66%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$267.24	$786.00	$177.64–$440.95	—	66%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$451.18	$1,327.00	$299.90–$744.45	—	66%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HCHG EEG AWAKE/DROWSY	$407.66	$1,199.00	$270.97–$672.64	—	66%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$86.36	$254.00	$57.40–$142.49	34% below	66%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$86.36	$254.00	$57.40–$142.49	—	66%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PR ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R	$82.96	$244.00	$55.14–$136.88	52% below	66%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PR ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R	$92.14	$271.00	$61.25–$152.03	47% below	66%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PR ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R	$82.96	$244.00	$55.14–$136.88	—	66%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HCHG EKG 12LEAD TRACING ONLY WO REPORT/INTERP	$92.14	$271.00	$61.25–$152.03	—	66%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$36.04	$106.00	$23.96–$59.47	81% below	66%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$67.66	$199.00	$44.97–$111.64	65% below	66%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LVL 1 HCHG	$425.34	$1,251.00	$275.00–$754.00	120% above	66%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$36.04	$106.00	$23.96–$59.47	—	66%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HCHG ED TRIAGE AFFILIATE ONLY	$49.30	$145.00	$34.10–$754.00	—	66%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HCHG ED LEVEL 1 CONV CARE AFFILIATE ONLY	$49.30	$145.00	$34.10–$754.00	—	66%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$70.72	$208.00	$47.01–$116.69	71% below	66%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 (IA) PR EMERGENCY DEPT VISIT LEVEL 2	$175.78	$517.00	$116.84–$290.04	29% below	66%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$175.78	$517.00	$116.84–$290.04	29% below	66%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LVL 2 HCHG	$525.64	$1,546.00	$344.00–$894.00	112% above	66%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$70.72	$208.00	$47.01–$116.69	—	66%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PR EMERGENCY DEPARTMENT VISIT LOW MDM	$120.02	$353.00	$79.78–$198.03	70% below	66%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PR EMERGENCY DEPARTMENT VISIT LOW MDM	$228.48	$672.00	$151.87–$376.99	42% below	66%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 (IA) PR EMERGENCY DEPT VISIT LEVEL 3	$228.48	$672.00	$151.87–$376.99	42% below	66%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LVL 3 HCHG	$818.38	$2,407.00	$450.00–$1,507.00	107% above	66%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PR EMERGENCY DEPARTMENT VISIT LOW MDM	$120.02	$353.00	$79.78–$198.03	—	66%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$189.72	$558.00	$126.11–$313.04	70% below	66%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$343.74	$1,011.00	$228.49–$567.17	46% below	66%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 (IA) PR EMERGENCY DEPT VISIT LEVEL 4	$343.74	$1,011.00	$228.49–$567.17	46% below	66%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LVL 4 HCHG	$1,165.86	$3,429.00	$520.00–$2,355.00	83% above	66%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$189.72	$558.00	$126.11–$313.04	—	66%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$409.02	$1,203.00	$271.88–$674.88	57% below	66%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$409.02	$1,203.00	$271.88–$674.88	57% below	66%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 (IA) PR EMERGENCY DEPT VISIT LEVEL 5	$409.02	$1,203.00	$271.88–$674.88	57% below	66%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LVL 5 HCHG	$1,694.56	$4,984.00	$615.00–$3,430.00	79% above	66%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$409.02	$1,203.00	$271.88–$674.88	—	66%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HCHG RAD CV STRESS TEST EXERCISE OR PHARM TRACE ONLY	$249.90	$735.00	$166.11–$412.34	—	66%
Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$225.08	$662.00	$149.61–$371.38	16% above	66%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$225.08	$662.00	$149.61–$371.38	—	66%
Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$178.16	$524.00	$118.42–$293.96	3% below	66%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$178.16	$524.00	$118.42–$293.96	—	66%
Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY	$105.06	$309.00	$69.83–$173.35	35% above	66%
Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY	$105.06	$309.00	$69.83–$173.35	—	66%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 PR XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I	$228.14	$671.00	$151.65–$376.43	at median	66%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 HCHG HOLTER COMPLETE UP TO 48 HR AFFILIATE ONLY	$94.18	$277.00	$62.60–$155.40	—	66%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 PR XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I	$228.14	$671.00	$151.65–$376.43	—	66%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$88.74	$261.00	$58.99–$146.42	67% below	66%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$88.74	$261.00	$58.99–$146.42	—	66%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HCHG ED IV INFUSION HYDRATION INITIAL 31-60 MIN	$199.24	$586.00	$132.44–$328.75	—	66%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HCHG IV INFUSION HYDRATION INITIAL 31-60 MIN	$199.24	$586.00	$132.44–$328.75	—	66%
IV infusion of a medicine, first hour CPT 96365 PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR	$208.42	$613.00	$138.54–$343.89	36% below	66%
IV infusion of a medicine, first hour inpatient CPT 96365 PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR	$208.42	$613.00	$138.54–$343.89	—	66%
IV infusion of a medicine, first hour inpatient CPT 96365 HCHG ED IV INF THERAPY/DX/PROPH INITIAL HR	$210.12	$618.00	$139.67–$346.70	—	66%
IV infusion of a medicine, first hour inpatient CPT 96365 HCHG IV INF THERAPY/DX/PROPH INITIAL HR	$210.12	$618.00	$139.67–$346.70	—	66%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$36.38	$107.00	$24.18–$60.03	53% below	66%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PR INJ SQ IM BCBS	$42.50	$125.00	$28.25–$70.12	45% below	66%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PR INJ SQ IM BCBS	$42.50	$125.00	$28.25–$70.12	45% below	66%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HCHG ED INJECTION SQ/IM	$17.00	$50.00	$11.30–$28.05	—	66%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$36.38	$107.00	$24.18–$60.03	—	66%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PR INJ SQ IM BCBS	$42.50	$125.00	$28.25–$70.12	—	66%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$97.92	$288.00	$65.09–$161.57	—	66%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HCHG INJECTION SQ/IM	$102.00	$300.00	$67.80–$168.30	—	66%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION	$329.46	$969.00	$218.99–$543.61	28% above	66%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION	$329.46	$969.00	$218.99–$543.61	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG OT NEUROMUSCULAR RE-ED XU	$43.86	$129.00	$29.15–$151.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG OT NEUROMUSCULAR RE-ED 15MIN	$43.86	$129.00	$29.15–$151.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG OT NEUROMUSCULAR RE-ED XP	$43.86	$129.00	$29.15–$151.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG PT NEUROMUSCULAR RE-ED 15MIN	$43.86	$129.00	$29.15–$147.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG OT NEUROMUSCULAR RE-ED XS	$43.86	$129.00	$29.15–$151.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG OT NEUROMUSCULAR RE-ED XE	$43.86	$129.00	$29.15–$151.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG PT NEUROMUSCULAR RE-ED XU	$43.86	$129.00	$29.15–$147.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG PT NEUROMUSCULAR RE-ED XP	$43.86	$129.00	$29.15–$147.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG PT NEUROMUSCULAR RE-ED XS	$43.86	$129.00	$29.15–$147.00	—	66%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG PT NEUROMUSCULAR RE-ED XE	$43.86	$129.00	$29.15–$147.00	—	66%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$240.72	$708.00	$160.01–$397.19	106% above	66%
New patient office visit, about 30 minutes CPT 99203 PR FIRST OB VISIT -LEVEL 3 NEW PT LOW MDM 30 MINUTES	$241.06	$709.00	$160.23–$397.75	106% above	66%
New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$240.72	$708.00	$160.01–$397.19	—	66%
New patient office visit, about 30 minutes inpatient CPT 99203 PR FIRST OB VISIT -LEVEL 3 NEW PT LOW MDM 30 MINUTES	$241.06	$709.00	$160.23–$397.75	—	66%
New patient office visit, about 45 minutes CPT 99204 PR FIRST OB VISIT -LEVEL 4 NEW PT MODERATE MDM 45 MINUTES	$297.84	$876.00	$197.98–$491.44	74% above	66%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$297.84	$876.00	$197.98–$491.44	74% above	66%
New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$297.84	$876.00	$197.98–$491.44	—	66%
New patient office visit, about 45 minutes inpatient CPT 99204 PR FIRST OB VISIT -LEVEL 4 NEW PT MODERATE MDM 45 MINUTES	$297.84	$876.00	$197.98–$491.44	—	66%
New patient office visit, about 60 minutes CPT 99205 PR FIRST OB VISIT-LEVEL 5 NEW PT HIGH MDM 60 MINUTES	$373.66	$1,099.00	$248.37–$616.54	59% above	66%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$451.52	$1,328.00	$300.13–$745.01	92% above	66%
New patient office visit, about 60 minutes inpatient CPT 99205 PR FIRST OB VISIT-LEVEL 5 NEW PT HIGH MDM 60 MINUTES	$373.66	$1,099.00	$248.37–$616.54	—	66%
New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$451.52	$1,328.00	$300.13–$745.01	—	66%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR FIRST OB VISIT-LEVEL 2 NEW PT SF MDM 15 MINUTES	$166.60	$490.00	$110.74–$274.89	119% above	66%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$183.94	$541.00	$122.27–$303.50	142% above	66%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PR FIRST OB VISIT-LEVEL 2 NEW PT SF MDM 15 MINUTES	$166.60	$490.00	$110.74–$274.89	—	66%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$183.94	$541.00	$122.27–$303.50	—	66%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$36.38	$107.00	$24.18–$60.03	42% below	66%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$36.38	$107.00	$24.18–$60.03	—	66%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HCHG MNT INDIV INITIAL EA 15MIN	$40.12	$118.00	$27.75–$91.00	—	66%
Occupational therapy evaluation, low complexity CPT 97165 PR OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS	$80.58	$237.00	$53.56–$132.96	52% below	66%
Occupational therapy evaluation, low complexity inpatient CPT 97165 PR OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS	$80.58	$237.00	$53.56–$132.96	—	66%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG OT EVAL LOW COMPLEXITY XU	$80.58	$237.00	$53.56–$147.00	—	66%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG OT EVAL LOW COMPLEXITY XP	$80.58	$237.00	$53.56–$147.00	—	66%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG OT EVAL LOW COMPLEXITY XE	$80.58	$237.00	$53.56–$147.00	—	66%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG OT EVAL LOW COMPLEXITY	$80.58	$237.00	$53.56–$147.00	—	66%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG OT EVAL LOW COMPLEXITY XS	$80.58	$237.00	$53.56–$147.00	—	66%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG PT EVAL HIGH COMPLEXITY	$128.52	$378.00	$85.43–$163.30	—	66%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG PT EVAL HIGH COMPLEXITY XU	$128.52	$378.00	$85.43–$163.30	—	66%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG PT EVAL HIGH COMPLEXITY XS	$128.52	$378.00	$85.43–$163.30	—	66%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG PT EVAL HIGH COMPLEXITY XP	$128.52	$378.00	$85.43–$163.30	—	66%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG PT EVAL HIGH COMPLEXITY XE	$128.52	$378.00	$85.43–$163.30	—	66%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG PT EVAL LOW COMPLEXITY XE	$80.58	$237.00	$53.56–$147.00	—	66%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG PT EVAL LOW COMPLEXITY	$80.58	$237.00	$53.56–$147.00	—	66%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG PT EVAL LOW COMPLEXITY XS	$80.58	$237.00	$53.56–$147.00	—	66%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG PT EVAL LOW COMPLEXITY XP	$80.58	$237.00	$53.56–$147.00	—	66%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG PT EVAL LOW COMPLEXITY XU	$80.92	$238.00	$53.79–$147.00	—	66%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG PT EVAL MOD COMPLEXITY	$104.38	$307.00	$69.38–$147.00	—	66%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG PT EVAL MOD COMPLEXITY XU	$104.38	$307.00	$69.38–$147.00	—	66%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG PT EVAL MOD COMPLEXITY XS	$104.38	$307.00	$69.38–$147.00	—	66%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG PT EVAL MOD COMPLEXITY XP	$104.38	$307.00	$69.38–$147.00	—	66%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG PT EVAL MOD COMPLEXITY XE	$104.38	$307.00	$69.38–$147.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PR MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES	$38.76	$114.00	$25.76–$63.95	53% below	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 (IA) PR MANUAL THER TECH 1+ REGIONS EA 15 MIN	$18.02	$53.00	$11.98–$29.73	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG OT MANUAL THERAPY XP	$38.76	$114.00	$25.76–$151.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG PT MANUAL THERAPY XP	$38.76	$114.00	$25.76–$147.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG PT MANUAL THERAPY XS	$38.76	$114.00	$25.76–$147.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG PT MANUAL THERAPY XE	$38.76	$114.00	$25.76–$147.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG OT MANUAL THERAPY 15MIN	$38.76	$114.00	$25.76–$151.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG OT MANUAL THERAPY XU	$38.76	$114.00	$25.76–$151.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG PT MANUAL THERAPY 15MIN	$38.76	$114.00	$25.76–$147.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PR MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES	$38.76	$114.00	$25.76–$63.95	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG OT MANUAL THERAPY XS	$38.76	$114.00	$25.76–$151.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG OT MANUAL THERAPY XE	$38.76	$114.00	$25.76–$151.00	—	66%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG PT MANUAL THERAPY XU	$38.76	$114.00	$25.76–$147.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$42.50	$125.00	$28.25–$70.12	53% below	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG PT THERAPEUTIC EXERCISE XP	$42.50	$125.00	$28.25–$147.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG OT THERAPEUTIC EXERCISE 15MIN	$42.50	$125.00	$28.25–$151.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$42.50	$125.00	$28.25–$70.12	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG PT THERAPEUTIC EXERCISE 15MIN	$42.50	$125.00	$28.25–$147.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG PT THERAPEUTIC EXERCISE XU	$42.50	$125.00	$28.25–$147.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG PT THERAPEUTIC EXERCISE XS	$42.50	$125.00	$28.25–$147.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG PT THERAPEUTIC EXERCISE XE	$42.50	$125.00	$28.25–$147.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG OT THERAPEUTIC EXERCISE XU	$42.50	$125.00	$28.25–$151.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG OT THERAPEUTIC EXERCISE XP	$42.50	$125.00	$28.25–$151.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG OT THERAPEUTIC EXERCISE XS	$42.50	$125.00	$28.25–$151.00	—	66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG OT THERAPEUTIC EXERCISE XE	$42.50	$125.00	$28.25–$151.00	—	66%
Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$182.24	$536.00	$121.14–$300.70	12% above	66%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$182.24	$536.00	$121.14–$300.70	—	66%
Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$197.54	$581.00	$131.31–$325.94	10% below	66%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$197.54	$581.00	$131.31–$325.94	—	66%
Preventive checkup, new patient aged 65 or older CPT 99387 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$215.90	$635.00	$143.51–$356.24	18% below	66%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$215.90	$635.00	$143.51–$356.24	—	66%
Preventive checkup, returning patient aged 18–39 CPT 99395 PR OCH PREVENTIVE VISIT EST 18-39	$48.62	$143.00	$32.32–$143.00	63% below	66%
Preventive checkup, returning patient aged 18–39 CPT 99395 PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$182.24	$536.00	$121.14–$300.70	40% above	66%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PR OCH PREVENTIVE VISIT EST 18-39	$48.62	$143.00	$32.32–$143.00	—	66%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$182.24	$536.00	$121.14–$300.70	—	66%
Preventive checkup, returning patient aged 40–64 CPT 99396 PR OCH PREVENTIVE VISIT EST 40-64	$15.64	$46.00	$10.40–$46.00	89% below	66%
Preventive checkup, returning patient aged 40–64 CPT 99396 PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$171.36	$504.00	$113.90–$282.74	18% above	66%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PR OCH PREVENTIVE VISIT EST 40-64	$15.64	$46.00	$10.40–$46.00	—	66%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$171.36	$504.00	$113.90–$282.74	—	66%
Preventive checkup, returning patient aged 65 or older CPT 99397 PR OCH PREVENTIVE VISIT EST 65 AND OVER	$44.20	$130.00	$29.38–$130.00	79% below	66%
Preventive checkup, returning patient aged 65 or older CPT 99397 PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$201.62	$593.00	$134.02–$332.67	6% below	66%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PR OCH PREVENTIVE VISIT EST 65 AND OVER	$44.20	$130.00	$29.38–$130.00	—	66%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$201.62	$593.00	$134.02–$332.67	—	66%
Psychiatric evaluation with medical services CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$141.44	$416.00	$94.02–$233.38	29% below	66%
Psychiatric evaluation with medical services inpatient CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$141.44	$416.00	$94.02–$233.38	—	66%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$117.64	$346.00	$78.20–$194.11	29% below	66%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$117.64	$346.00	$78.20–$194.11	—	66%
Psychotherapy for crisis, first 60 minutes CPT 90839 PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$186.32	$548.00	$123.85–$307.43	21% below	66%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$186.32	$548.00	$123.85–$307.43	—	66%
Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$137.70	$405.00	$91.53–$227.20	21% above	66%
Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$137.70	$405.00	$91.53–$227.20	—	66%
Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$179.86	$529.00	$119.55–$296.77	20% above	66%
Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$179.86	$529.00	$119.55–$296.77	—	66%
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$263.50	$775.00	$175.15–$434.78	46% above	66%
Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$263.50	$775.00	$175.15–$434.78	—	66%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 PR TOBACCO USE CESSATION INTERMEDIATE >3-10 MINUTES	$13.94	$41.00	$9.27–$23.00	58% below	66%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 PR TOBACCO USE CESSATION INTERMEDIATE >3-10 MINUTES	$13.94	$41.00	$9.27–$23.00	—	66%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HCHG SMOKING & TOBACCO CESSATION >3-10 MIN VISIT	$13.94	$41.00	$9.64–$91.00	—	66%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MINUTES	$262.48	$772.00	$174.47–$433.09	55% above	66%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR FIRST OB VISIT LEVEL 5 EST PT HIGH MDM 40 MINUTES	$262.82	$773.00	$174.70–$433.65	55% above	66%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MINUTES	$262.48	$772.00	$174.47–$433.09	—	66%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PR FIRST OB VISIT LEVEL 5 EST PT HIGH MDM 40 MINUTES	$262.82	$773.00	$174.70–$433.65	—	66%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MINUTES	$190.06	$559.00	$126.33–$313.60	102% above	66%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MINUTES	$190.06	$559.00	$126.33–$313.60	102% above	66%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR FIRST OB VISIT-LEVEL 3 EST PT LOW MDM 20 MINUTES	$190.06	$559.00	$126.33–$313.60	102% above	66%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PR FIRST OB VISIT-LEVEL 3 EST PT LOW MDM 20 MINUTES	$190.06	$559.00	$126.33–$313.60	—	66%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MINUTES	$190.06	$559.00	$126.33–$313.60	—	66%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MINUTES	$231.54	$681.00	$153.91–$382.04	93% above	66%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR FIRST OB VISIT -LEVEL 4 EST PT MOD MDM 30 MINUTES	$231.54	$681.00	$153.91–$382.04	93% above	66%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MINUTES	$231.54	$681.00	$153.91–$382.04	—	66%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PR FIRST OB VISIT -LEVEL 4 EST PT MOD MDM 30 MINUTES	$231.54	$681.00	$153.91–$382.04	—	66%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MINUTES	$231.54	$681.00	$153.91–$382.04	—	66%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PR FIRST OB VISIT LEVEL 2 EST PT SF MDM 10 MINUTES	$78.54	$231.00	$52.21–$129.59	4% below	66%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MINUTES	$79.22	$233.00	$52.66–$130.71	3% below	66%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MINUTES	$140.42	$413.00	$93.34–$231.69	72% above	66%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PR FIRST OB VISIT LEVEL 2 EST PT SF MDM 10 MINUTES	$78.54	$231.00	$52.21–$129.59	—	66%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MINUTES	$140.42	$413.00	$93.34–$231.69	—	66%
Speech and language evaluation inpatient CPT 92523 HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XU	$216.24	$636.00	$143.74–$274.75	—	66%
Speech and language evaluation inpatient CPT 92523 HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XE	$216.24	$636.00	$143.74–$274.75	—	66%
Speech and language evaluation inpatient CPT 92523 HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP 52	$216.24	$636.00	$143.74–$274.75	—	66%
Speech and language evaluation inpatient CPT 92523 HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP	$216.24	$636.00	$143.74–$274.75	—	66%
Speech and language evaluation inpatient CPT 92523 HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XS	$216.24	$636.00	$143.74–$274.75	—	66%
Speech and language evaluation inpatient CPT 92523 HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XP	$216.24	$636.00	$143.74–$274.75	—	66%
Speech therapy session, individual inpatient CPT 92507 HCHG SLP INDIV TX COMMUNICATION	$81.60	$240.00	$54.24–$147.00	—	66%
Speech therapy session, individual inpatient CPT 92507 HCHG SLP INDIV TX COMMUNICATION XU	$81.60	$240.00	$54.24–$147.00	—	66%
Speech therapy session, individual inpatient CPT 92507 HCHG SLP INDIV TX COMMUNICATION XP	$81.60	$240.00	$54.24–$147.00	—	66%
Speech therapy session, individual inpatient CPT 92507 HCHG SLP INDIV TX COMMUNICATION XS	$81.60	$240.00	$54.24–$147.00	—	66%
Speech therapy session, individual inpatient CPT 92507 HCHG SLP INDIV TX COMMUNICATION XE	$81.60	$240.00	$54.24–$147.00	—	66%
Spirometry (breathing test) CPT 94010 PR SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$70.04	$206.00	$46.56–$115.57	56% below	66%
Spirometry (breathing test) inpatient CPT 94010 PR SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$70.04	$206.00	$46.56–$115.57	—	66%
Spirometry (breathing test) inpatient CPT 94010 HCHG PFT SPIROMETRY-LAB	$125.80	$370.00	$83.62–$207.57	—	66%
Spirometry (breathing test) inpatient CPT 94010 HCHG SPIROMETRY INCOMPLETE	$136.00	$400.00	$90.40–$224.40	—	66%
Spirometry (breathing test) inpatient CPT 94010 HCHG SPIROMETRY BEDSIDE	$183.60	$540.00	$122.04–$302.94	—	66%
Spirometry before and after a bronchodilator CPT 94060 PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$87.04	$256.00	$57.86–$143.62	70% below	66%
Spirometry before and after a bronchodilator inpatient CPT 94060 PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$87.04	$256.00	$57.86–$143.62	—	66%
Spirometry before and after a bronchodilator inpatient CPT 94060 HCHG BRONCHOSPASM EVAL-BEDSIDE	$147.22	$433.00	$97.86–$242.91	—	66%
Spirometry before and after a bronchodilator inpatient CPT 94060 HCHG PFT BRONCHOSPASM EVAL-LAB	$153.00	$450.00	$101.70–$252.45	—	66%
Therapeutic activities (functional training), 15 minutes CPT 97530 PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$109.48	$322.00	$72.77–$180.64	41% above	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$109.48	$322.00	$72.77–$180.64	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG PT THERAPEUTIC ACTIVITIES XP	$109.48	$322.00	$72.77–$147.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG PT THERAPEUTIC ACTIVITIES XS	$109.48	$322.00	$72.77–$147.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG PT THERAPEUTIC ACTIVITIES XU	$109.48	$322.00	$72.77–$147.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG OT THERAPEUTIC ACTIVITIES XU	$109.48	$322.00	$72.77–$151.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG OT THERAPEUTIC ACTIVITIES XP	$109.48	$322.00	$72.77–$151.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG OT THERAPEUTIC ACTIVITIES XE	$109.48	$322.00	$72.77–$151.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG OT THERAPEUTIC ACTIVITY 15MIN	$109.48	$322.00	$72.77–$151.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG OT THERAPEUTIC ACTIVITIES XS	$109.48	$322.00	$72.77–$151.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG PT THERAPEUTIC ACTIVITY 15MIN	$109.48	$322.00	$72.77–$147.00	—	66%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG PT THERAPEUTIC ACTIVITIES XE	$109.48	$322.00	$72.77–$147.00	—	66%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HCHG PHLEBOTOMY THERAPEUTIC	$153.00	$450.00	$101.70–$252.45	28% below	66%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PR PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$153.00	$450.00	$101.70–$252.45	28% below	66%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HCHG PHLEBOTOMY THERAPEUTIC	$153.00	$450.00	$101.70–$252.45	—	66%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE (MODERNA)	$190.06	$559.00	$126.33–$313.60	4% above	66%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE (MODERNA)	$190.06	$559.00	$126.33–$313.60	—	66%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$174.08	$512.00	$115.71–$287.23	27% below	66%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$174.08	$512.00	$115.71–$287.23	—	66%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$18.02	$53.00	$11.98–$29.73	19% below	66%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$18.02	$53.00	$11.98–$29.73	—	66%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE	$201.96	$594.00	$134.24–$333.23	47% below	66%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE	$201.96	$594.00	$134.24–$333.23	—	66%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM	$85.68	$252.00	$56.95–$141.37	41% below	66%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM	$85.68	$252.00	$56.95–$141.37	—	66%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$104.38	$307.00	$69.38–$172.23	at median	66%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$104.38	$307.00	$69.38–$172.23	—	66%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$34.68	$102.00	$23.05–$57.22	69% below	66%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$34.68	$102.00	$23.05–$57.22	—	66%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$54.40	$160.00	$36.16–$89.76	27% below	66%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$54.40	$160.00	$36.16–$89.76	—	66%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ	$67.66	$199.00	$44.97–$111.64	46% below	66%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ	$67.66	$199.00	$44.97–$111.64	—	66%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MCV4/MENACWY CONJ VACC GRPS ACYW-135 IM USE	$201.62	$593.00	$134.02–$332.67	3% above	66%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MCV4/MENACWY CONJ VACC GRPS ACYW-135 IM USE	$201.62	$593.00	$134.02–$332.67	—	66%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$204.68	$602.00	$136.05–$337.72	32% below	66%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$204.68	$602.00	$136.05–$337.72	—	66%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$419.22	$1,233.00	$278.66–$691.71	4% above	66%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$419.22	$1,233.00	$278.66–$691.71	—	66%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$118.66	$349.00	$78.87–$195.79	10% below	66%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$118.66	$349.00	$78.87–$195.79	—	66%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$706.86	$2,079.00	$469.85–$1,166.32	35% above	66%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$706.86	$2,079.00	$469.85–$1,166.32	—	66%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$706.86	$2,079.00	$469.85–$1,166.32	—	66%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$421.26	$1,239.00	$280.01–$695.08	91% above	66%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$421.26	$1,239.00	$280.01–$695.08	—	66%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$421.26	$1,239.00	$280.01–$695.08	—	66%
Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE INTRAMUSCULAR	$504.90	$1,485.00	$335.61–$833.08	8% below	66%
Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE INTRAMUSCULAR	$504.90	$1,485.00	$335.61–$833.08	—	66%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX	$216.92	$638.00	$144.19–$357.92	5% below	66%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX	$216.92	$638.00	$144.19–$357.92	—	66%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$51.34	$151.00	$34.13–$84.71	18% below	66%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$51.34	$151.00	$34.13–$84.71	—	66%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$50.66	$149.00	$33.67–$83.59	35% below	66%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$51.00	$150.00	$33.90–$84.15	35% below	66%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$51.00	$150.00	$33.90–$84.15	—	66%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PR TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM	$61.88	$182.00	$41.13–$102.10	58% below	66%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PR TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM	$61.88	$182.00	$41.13–$102.10	—	66%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$33.66	$99.00	$22.37–$55.54	18% below	66%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$33.66	$99.00	$22.37–$55.54	—	66%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$33.66	$99.00	$22.37–$55.54	—	66%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG IMMUN ADMIN IM/SQ ONE VACCINE (SGL/COMBO)	$33.66	$99.00	$22.37–$55.54	—	66%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$33.66	$99.00	$22.37–$55.54	34% above	66%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$33.66	$99.00	$22.37–$55.54	—	66%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG IMMUN ADMIN IM/SQ EA ADDL (SGL/COMBO)	$33.66	$99.00	$22.37–$55.54	—	66%

Source file: https://www.cuyunamed.org/411724637_cuyuna-regional-medical-center_standardcharges.csv