Hospital Des Moines-West Des Moines, IA

Dallas County Hospital

Dallas County Hospital in Perry, IA publishes cash prices for 319 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Iowa median for 165 of 319 procedures and below it for 148. By typical cash price it ranks #43 of 78 Iowa hospitals and #3 of 8 hospitals in the Des Moines, IA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

610 10th St, Perry, IA, 50220 Collected Sep 27, 2026 Source price file (515) 465-3547

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161322 · 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 2 actions for a hospital named Dallas County Hospital in Perry, IA:

Jul 10, 2025 Met requirements
Jul 24, 2026 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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 Iowa	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US VAS ANKLE-ARM INDEX/LTD ARTERIAL (DUP	$398.00	$613.00	$74.40–$521.05	27% above	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 RESTING ANKLE BRACHIAL INDEX	$398.00	$613.00	$74.40–$521.05	27% above	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 RESTING ANKLE BRACHIAL INDEX	$398.00	$613.00	$74.40–$521.05	—	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS-XRAY PER PROTOCOL	$324.00	$499.00	$85.43–$424.15	10% below	35%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS-XRAY PER PROTOCOL	$324.00	$499.00	$85.43–$424.15	—	35%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN W/B WHOLE PER PROTOCOL	$3,238.00	$4,982.00	$233.40–$4,234.70	169% above	35%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN W/B WHOLE PER PROTOCOL	$3,238.00	$4,982.00	$233.40–$4,234.70	—	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED PER PROROCOL	$646.00	$994.00	$75.86–$844.90	81% above	35%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED PER PROROCOL	$646.00	$994.00	$75.86–$844.90	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$2,672.00	$4,110.00	$254.13–$3,493.50	26% above	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST	$2,672.00	$4,110.00	$254.13–$3,493.50	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST -PER PROTOCOL	$1,418.00	$2,181.00	$166.99–$1,853.85	47% below	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST -PER PROTOCOL	$1,418.00	$2,181.00	$166.99–$1,853.85	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS WITH CONTRAST -PER PROTOCO	$2,971.00	$4,571.00	$271.98–$3,885.35	8% below	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS WITH CONTRAST -PER PROTOCO	$2,971.00	$4,571.00	$271.98–$3,885.35	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL WO/W BY CONTR FOLLWD 1-2 BD R	$3,374.00	$5,191.00	$306.00–$4,412.35	3% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL WO/W BY CONTR FOLLWD 1-2 BD R	$3,374.00	$5,191.00	$306.00–$4,412.35	—	35%
CT scan of the abdomen with contrast CPT 74160 CT ABD WITH CONTRAST- PER PROTOCOL	$2,314.00	$3,560.00	$208.28–$3,026.00	39% above	35%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD WITH CONTRAST- PER PROTOCOL	$2,314.00	$3,560.00	$208.28–$3,026.00	—	35%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTRAST	$1,065.00	$1,638.00	$124.07–$1,392.30	20% below	35%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTRAST	$1,065.00	$1,638.00	$124.07–$1,392.30	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST -PER PROT	$1,214.00	$1,868.00	$116.31–$1,587.80	6% below	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST -PER PROT	$1,214.00	$1,868.00	$116.31–$1,587.80	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST -PER PROTOCOL	$835.00	$1,285.00	$96.83–$1,092.25	38% below	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST -PER PROTOCOL	$835.00	$1,285.00	$96.83–$1,092.25	—	35%
CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAST- PER PROTOCOL	$1,344.00	$2,068.00	$134.51–$1,757.80	11% below	35%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH CONTRAST- PER PROTOCOL	$1,344.00	$2,068.00	$134.51–$1,757.80	—	35%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO/W BY CONTR FOLLWD- PER PROTOC	$1,519.00	$2,337.00	$157.06–$1,986.45	16% below	35%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO/W BY CONTR FOLLWD- PER PROTOC	$1,519.00	$2,337.00	$157.06–$1,986.45	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTR -PER PROTOCOL	$1,321.00	$2,032.00	$118.05–$1,727.20	13% below	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTR -PER PROTOCOL	$1,321.00	$2,032.00	$118.05–$1,727.20	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTR -PER PROTOCOL	$1,327.00	$2,042.00	$118.65–$1,735.70	12% below	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTR -PER PROTOCOL	$1,327.00	$2,042.00	$118.65–$1,735.70	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST- PER PROTOCOL	$2,320.00	$3,569.00	$204.08–$3,033.65	33% above	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST- PER PROTOCOL	$2,320.00	$3,569.00	$204.08–$3,033.65	—	35%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US (MOB) CAROTID DUP COM/BIL- PER PROTOC	$788.00	$1,213.00	$169.99–$1,031.05	10% below	35%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX COMPLETE- PER PROTOCOL	$907.00	$1,395.00	$169.99–$1,185.75	3% above	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US (MOB) CAROTID DUP COM/BIL- PER PROTOC	$788.00	$1,213.00	$169.99–$1,031.05	—	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX COMPLETE- PER PROTOCOL	$907.00	$1,395.00	$169.99–$1,185.75	—	35%
Chest X-ray, 2 views CPT 71046 PANORA-XRAY EXAM, CHEST 2 VIEWS	$247.00	$380.00	$29.90–$323.00	21% above	35%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEW FRONT & LAT PER PROTOCOL	$266.00	$409.00	$29.90–$347.65	31% above	35%
Chest X-ray, 2 views inpatient CPT 71046 PANORA-XRAY EXAM, CHEST 2 VIEWS	$247.00	$380.00	$29.90–$323.00	—	35%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEW FRONT & LAT PER PROTOCOL	$266.00	$409.00	$29.90–$347.65	—	35%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW FRONTAL -PER PROTOCOL	$181.00	$278.00	$22.92–$236.30	8% above	35%
Chest X-ray, single view CPT 71045 PANORA-XRAY EXAM, CHEST 1 VIEW	$184.00	$283.00	$22.92–$240.55	10% above	35%
Chest X-ray, single view CPT 71045 XR CHEST PORTABLE FRONTAL 1 VIEW	$199.00	$306.00	$22.92–$260.10	19% above	35%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW FRONTAL -PER PROTOCOL	$181.00	$278.00	$22.92–$236.30	—	35%
Chest X-ray, single view inpatient CPT 71045 PANORA-XRAY EXAM, CHEST 1 VIEW	$184.00	$283.00	$22.92–$240.55	—	35%
Chest X-ray, single view inpatient CPT 71045 XR CHEST PORTABLE FRONTAL 1 VIEW	$199.00	$306.00	$22.92–$260.10	—	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US KIDNEY COMPL RETROPERITONEAL	$918.00	$1,413.00	$96.40–$1,201.05	51% above	35%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US KIDNEY COMPL RETROPERITONEAL	$918.00	$1,413.00	$96.40–$1,201.05	—	35%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DXA BONE DENSITY AXIAL >=1 SITES	$363.00	$558.00	$35.55–$474.30	7% below	35%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DXA BONE DENSITY AXIAL >=1 SITES	$363.00	$558.00	$35.55–$474.30	—	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL	$295.00	$454.00	$28.67–$385.90	18% above	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY/PERIPHERAL	$295.00	$454.00	$28.67–$385.90	—	35%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB DETAILED ANATOMIC EVALUATION	$941.00	$1,448.00	$166.51–$1,230.80	53% above	35%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB DETAILED ANATOMIC EVALUATION	$941.00	$1,448.00	$166.51–$1,230.80	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST -PER PROTOCOL	$1,265.00	$1,946.00	$120.64–$1,654.10	8% below	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST -PER PROTOCOL	$1,265.00	$1,946.00	$120.64–$1,654.10	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST -PER PROTOCOL	$1,684.00	$2,591.00	$151.07–$2,202.35	6% below	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST -PER PROTOCOL	$1,684.00	$2,591.00	$151.07–$2,202.35	—	35%
Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO BILAT DIAG DIG DIR PER PROTOCOL	$303.00	$466.00	$142.14–$396.10	—	35%
Diagnostic mammogram, both breasts CPT 77066 MM DIGITAL DIAG MAMMO ADD COMP/PROTOCOL	$1,401.00	$2,156.00	$142.14–$1,832.60	313% above	35%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO BILAT DIAG DIG DIR PER PROTOCOL	$303.00	$466.00	$142.14–$396.10	—	35%
Diagnostic mammogram, both breasts inpatient CPT 77066 MM DIGITAL DIAG MAMMO ADD COMP/PROTOCOL	$1,401.00	$2,156.00	$142.14–$1,832.60	—	35%
Diagnostic mammogram, one breast CPT 77065 MAMMO CAD CHARGE	$47.00	$73.00	$32.91–$71.54	84% below	36%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO CAD CHARGE	$47.00	$73.00	$32.91–$71.54	—	36%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US (MOB) ART DUP/LOW EXTRE BILAT- PER PR	$712.00	$1,095.00	$213.26–$930.75	—	35%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US PERIPH ARTERIL EVAL	$712.00	$1,095.00	$213.26–$930.75	2% below	35%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US ART LOW EXT DUPLEX COMPLET PER PROTOC	$939.00	$1,444.00	$213.26–$1,227.40	29% above	35%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US (MOB) ART DUP/LOW EXTRE BILAT- PER PR	$712.00	$1,095.00	$213.26–$930.75	—	35%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US PERIPH ARTERIL EVAL	$712.00	$1,095.00	$213.26–$930.75	—	35%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ART LOW EXT DUPLEX COMPLET PER PROTOC	$939.00	$1,444.00	$213.26–$1,227.40	—	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 US (MOB) BIL VENOUS DOPPLER- PER PROTOCO	$793.00	$1,220.00	$165.39–$1,037.00	11% below	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS DUPLEX EXT COMPLETE- PER PROTO	$912.00	$1,403.00	$165.39–$1,192.55	2% above	35%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US (MOB) BIL VENOUS DOPPLER- PER PROTOCO	$793.00	$1,220.00	$165.39–$1,037.00	—	35%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS DUPLEX EXT COMPLETE- PER PROTO	$912.00	$1,403.00	$165.39–$1,192.55	—	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US 2D ECHOCARDIOGRAM PER PROTOCOL	$1,684.00	$2,590.00	$179.01–$2,201.50	11% above	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US 2D ECHOCARDIOGRAM PER PROTOCOL	$1,684.00	$2,590.00	$179.01–$2,201.50	—	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY W/O PHARM	$3,370.00	$5,184.00	$255.96–$4,406.40	190% above	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY W/O PHARM	$3,370.00	$5,184.00	$255.96–$4,406.40	—	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT	$432.00	$664.00	$94.06–$564.40	22% below	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG-SPLIT STDY; PSS W 4/> P W CPAP/BIPAP	$4,116.00	$6,333.00	$636.97–$5,383.05	31% above	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSS W 4/> P W CPAP/BIPAP	$4,365.00	$6,715.00	$636.97–$5,707.75	39% above	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG-SPLIT STDY; PSS W 4/> P W CPAP/BIPAP	$4,116.00	$6,333.00	$636.97–$5,383.05	—	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSS W 4/> P W CPAP/BIPAP	$4,365.00	$6,715.00	$636.97–$5,707.75	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER ABD LIMITED- PER PROTOCOL	$701.00	$1,078.00	$78.20–$916.30	43% above	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD PER PROTOCOL	$743.00	$1,143.00	$78.20–$971.55	51% above	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER ABD LIMITED- PER PROTOCOL	$701.00	$1,078.00	$78.20–$916.30	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD PER PROTOCOL	$743.00	$1,143.00	$78.20–$971.55	—	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST W/O CONTRAST -PER PROTOCOL	$1,193.00	$1,835.00	$123.76–$1,559.75	180% above	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG SCREENING -PER PROTOCOL	$1,265.00	$1,946.00	$123.76–$1,654.10	197% above	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST W/O CONTRAST -PER PROTOCOL	$1,193.00	$1,835.00	$123.76–$1,559.75	—	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG SCREENING -PER PROTOCOL	$1,265.00	$1,946.00	$123.76–$1,654.10	—	35%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LWR EXT JT W/O CONTRAST RT -PER PROT	$2,739.00	$4,214.00	$185.45–$3,581.90	22% above	35%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LWR EXT JT W/O CONTRAST LT-PER PROTO	$2,739.00	$4,214.00	$185.45–$3,581.90	22% above	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LWR EXT JT W/O CONTRAST RT -PER PROT	$2,739.00	$4,214.00	$185.45–$3,581.90	—	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LWR EXT JT W/O CONTRAST LT-PER PROTO	$2,739.00	$4,214.00	$185.45–$3,581.90	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO/W BY CONTR FOLLOWED	$5,847.00	$8,996.00	$345.33–$7,646.60	86% above	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT WO/W BY CONTR FOLLOWED	$5,847.00	$8,996.00	$345.33–$7,646.60	—	35%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST- PER PROTOCOL	$2,581.00	$3,971.00	$176.14–$3,375.35	25% above	35%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST- PER PROTOCOL	$2,581.00	$3,971.00	$176.14–$3,375.35	—	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/W FOLLOWED BY CONTRAST	$4,787.00	$7,364.00	$304.57–$6,259.40	43% above	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO/W FOLLOWED BY CONTRAST	$4,787.00	$7,364.00	$304.57–$6,259.40	—	35%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST -PER PROTOCOL	$2,524.00	$3,883.00	$177.52–$3,300.55	16% above	35%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST -PER PROTOCOL	$2,524.00	$3,883.00	$177.52–$3,300.55	—	35%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W BY CONTR FOLLOWED -PROTOC	$4,248.00	$6,536.00	$287.72–$5,555.60	20% above	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W BY CONTR FOLLOWED -PROTOC	$4,248.00	$6,536.00	$287.72–$5,555.60	—	35%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMB SPINE WO CONTR -PER PROTOCOL	$2,428.00	$3,735.00	$174.22–$3,174.75	2% above	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMB SPINE WO CONTR -PER PROTOCOL	$2,428.00	$3,735.00	$174.22–$3,174.75	—	35%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMB SPINE W&WO BY CONTR FOLLOWED	$4,044.00	$6,222.00	$288.92–$5,288.70	17% above	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMB SPINE W&WO BY CONTR FOLLOWED	$4,044.00	$6,222.00	$288.92–$5,288.70	—	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THOR SPINE W/O CONTRAST -PER PROTOCO	$2,422.00	$3,726.00	$173.03–$3,167.10	4% above	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THOR SPINE W/O CONTRAST -PER PROTOCO	$2,422.00	$3,726.00	$173.03–$3,167.10	—	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE WO/W BY, FOLLOWED- PER PROTO	$4,055.00	$6,238.00	$288.62–$5,302.30	20% above	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE WO/W BY, FOLLOWED- PER PROTO	$4,055.00	$6,238.00	$288.62–$5,302.30	—	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVIC SPINE WO CONTRAST -PER PROTOC	$2,422.00	$3,726.00	$173.33–$3,167.10	7% above	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVIC SPINE WO CONTRAST -PER PROTOC	$2,422.00	$3,726.00	$173.33–$3,167.10	—	35%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W BY CONTRAST FOLLOWED	$4,776.00	$7,347.00	$303.07–$6,244.95	48% above	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W BY CONTRAST FOLLOWED	$4,776.00	$7,347.00	$303.07–$6,244.95	—	35%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST- PER PROTOCOL	$3,278.00	$5,043.00	$206.39–$4,286.55	59% above	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST- PER PROTOCOL	$3,278.00	$5,043.00	$206.39–$4,286.55	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXT JOINT WO CONTRAST -PER PROTOC	$2,739.00	$4,214.00	$186.04–$3,581.90	23% above	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UP EXT JOINT WO CONTRAST -PER PROTOC	$2,739.00	$4,214.00	$186.04–$3,581.90	—	35%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM HT MUSCLE IMAGE SPECT MULT	$1,099.00	$1,691.00	$385.86–$1,437.35	61% below	35%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM HT MUSCLE IMAGE SPECT MULT	$1,099.00	$1,691.00	$385.86–$1,437.35	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US LIMITED PELVIS- PER PROTOCOL	$272.00	$419.00	$46.51–$356.15	23% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US LIMITED PELVIS- PER PROTOCOL	$272.00	$419.00	$46.51–$356.15	—	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMPLETE (NON OB) PER PROTOCOL	$907.00	$1,395.00	$95.36–$1,185.75	72% above	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMPLETE (NON OB) PER PROTOCOL	$907.00	$1,395.00	$95.36–$1,185.75	—	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 DONT USE OB COMPLETE	$287.00	$442.00	$123.41–$375.70	48% below	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >=14 WKS GESTATION SGL	$1,089.00	$1,676.00	$123.41–$1,424.60	98% above	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 DONT USE OB COMPLETE	$287.00	$442.00	$123.41–$375.70	—	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >=14 WKS GESTATION SGL	$1,089.00	$1,676.00	$123.41–$1,424.60	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14 WEEKS SGL GESTATION	$874.00	$1,344.00	$106.51–$1,142.40	96% above	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14 WEEKS SGL GESTATION	$874.00	$1,344.00	$106.51–$1,142.40	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 DONT USE OB LTD	$142.00	$219.00	$73.98–$186.15	58% below	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD 1 OR > FETUSES	$583.00	$897.00	$73.98–$762.45	74% above	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 DONT USE OB LTD	$142.00	$219.00	$73.98–$186.15	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LTD 1 OR > FETUSES	$583.00	$897.00	$73.98–$762.45	—	35%
Screening mammogram, both breasts both sides CPT 77067 MM MAMMO BILAT SCREEN DIG DIR- PER PROTO	$382.00	$588.00	$81.59–$499.80	—	35%
Screening mammogram, both breasts CPT 77067 MAMMO CAD	$47.00	$73.00	$37.23–$83.26	85% below	36%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM MAMMO BILAT SCREEN DIG DIR- PER PROTO	$382.00	$588.00	$81.59–$499.80	—	35%
Screening mammogram, both breasts inpatient CPT 77067 MAMMO CAD	$47.00	$73.00	$37.23–$83.26	—	36%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY; PSS W 4/> PARAM W TECH	$3,599.00	$5,537.00	$606.48–$4,706.45	25% above	35%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY; PSS W 4/> PARAM W TECH	$3,599.00	$5,537.00	$606.48–$4,706.45	—	35%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR VIDEO SWALLOW FCN W CINE/VIDEO	$312.00	$480.00	$108.59–$408.00	22% below	35%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR VIDEO SWALLOW FCN W CINE/VIDEO	$312.00	$480.00	$108.59–$408.00	—	35%
Transvaginal pelvic ultrasound CPT 76830 US PELVIS TRANSVAGINAL (NON OB) PER PROT	$1,066.00	$1,640.00	$106.27–$1,394.00	104% above	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIS TRANSVAGINAL (NON OB) PER PROT	$1,066.00	$1,640.00	$106.27–$1,394.00	—	35%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE PER PROTOCOL	$987.00	$1,518.00	$103.62–$1,290.30	42% above	35%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE PER PROTOCOL	$987.00	$1,518.00	$103.62–$1,290.30	—	35%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM PER PROTOCOL	$885.00	$1,361.00	$89.23–$1,156.85	63% above	35%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM PER PROTOCOL	$885.00	$1,361.00	$89.23–$1,156.85	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HD/&NEC PER PROTOCOL	$1,056.00	$1,624.00	$98.20–$1,380.40	129% above	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HD/&NEC PER PROTOCOL	$1,056.00	$1,624.00	$98.20–$1,380.40	—	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SINGLE CONTRAST	$787.00	$1,211.00	$110.64–$1,029.35	89% above	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI SINGLE CONTRAST	$787.00	$1,211.00	$110.64–$1,029.35	—	35%
X-ray of the abdomen, 1 view CPT 74018 PANORA-XRAY EXAM ABD 1 VIEW	$226.00	$348.00	$26.82–$295.80	28% above	35%
X-ray of the abdomen, 1 view CPT 74018 XR ABD 1 VIEW- PER PROTOCOL	$244.00	$376.00	$26.82–$319.60	38% above	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 PANORA-XRAY EXAM ABD 1 VIEW	$226.00	$348.00	$26.82–$295.80	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD 1 VIEW- PER PROTOCOL	$244.00	$376.00	$26.82–$319.60	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2-3 VIEWS	$204.00	$314.00	$36.49–$266.90	29% below	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 PANORA-XRAY SPINE, LUM/SACR 2 OR 3 VIEWS	$305.00	$469.00	$36.49–$398.65	7% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE-LUMBAR 2-3 VIEWS PER PROTOCOL	$329.00	$506.00	$36.49–$430.10	15% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE 2-3 VIEWS	$204.00	$314.00	$36.49–$266.90	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 PANORA-XRAY SPINE, LUM/SACR 2 OR 3 VIEWS	$305.00	$469.00	$36.49–$398.65	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE-LUMBAR 2-3 VIEWS PER PROTOCOL	$329.00	$506.00	$36.49–$430.10	—	35%
X-ray of the lower back, 4 or more views CPT 72110 PANORA-XRAY SPINE, LUM/SACR MIN 4 VIEWS	$400.00	$615.00	$48.11–$522.75	14% above	35%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL >= 4 VIEWS-PROTOCOL	$431.00	$663.00	$48.11–$563.55	23% above	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 PANORA-XRAY SPINE, LUM/SACR MIN 4 VIEWS	$400.00	$615.00	$48.11–$522.75	—	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL >= 4 VIEWS-PROTOCOL	$431.00	$663.00	$48.11–$563.55	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2VIEWS	$261.00	$402.00	$29.87–$341.70	3% above	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2VIEWS	$261.00	$402.00	$29.87–$341.70	—	35%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3 VIEWS >=	$335.00	$515.00	$33.68–$437.75	69% above	35%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MIN 3 VIEWS >=	$335.00	$515.00	$33.68–$437.75	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 PANORA-XRAY SPINE, CERVICAL 2 OR 3 VIEWS	$305.00	$469.00	$35.89–$398.65	22% above	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERV 2-3 VIEWS PER PROTOCOL	$329.00	$506.00	$35.89–$430.10	31% above	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 PANORA-XRAY SPINE, CERVICAL 2 OR 3 VIEWS	$305.00	$469.00	$35.89–$398.65	—	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERV 2-3 VIEWS PER PROTOCOL	$329.00	$506.00	$35.89–$430.10	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 PANORA-PELVIS, 1 OR 2 VIEWS	$221.00	$340.00	$25.29–$289.00	12% above	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS ANTEROPOSTERIOR 1-2 VIEWS	$238.00	$366.00	$25.29–$311.10	21% above	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PANORA-PELVIS, 1 OR 2 VIEWS	$221.00	$340.00	$25.29–$289.00	—	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS ANTEROPOSTERIOR 1-2 VIEWS	$238.00	$366.00	$25.29–$311.10	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MIN 2 VIEWS	$277.00	$426.00	$28.89–$362.10	26% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MIN 2 VIEWS	$277.00	$426.00	$28.89–$362.10	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 PANORA-ALT (SGPT)	$47.00	$72.00	$5.19–$61.20	11% above	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT(SGPT)	$47.00	$72.00	$5.19–$61.20	11% above	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 PERRY-ALT (SGPT)	$47.00	$72.00	$5.19–$61.20	11% above	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 PANORA-ALT (SGPT)	$47.00	$72.00	$5.19–$61.20	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 PERRY-ALT (SGPT)	$47.00	$72.00	$5.19–$61.20	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT(SGPT)	$47.00	$72.00	$5.19–$61.20	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST(SGOT)	$47.00	$72.00	$5.08–$61.20	21% above	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 PANORA-AST (SGOT)	$47.00	$72.00	$5.08–$61.20	21% above	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 PERRY-ALT (SGOT)	$47.00	$72.00	$5.08–$61.20	21% above	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 PANORA-AST (SGOT)	$47.00	$72.00	$5.08–$61.20	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST(SGOT)	$47.00	$72.00	$5.08–$61.20	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 PERRY-ALT (SGOT)	$47.00	$72.00	$5.08–$61.20	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 PERRY-HEPATITUS, ACUTE PANEL	$260.00	$400.00	$46.68–$340.00	14% above	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 PANORA-HEPATITIS, ACUTE PANEL	$260.00	$400.00	$46.68–$340.00	14% above	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE ACUTE	$260.00	$400.00	$46.68–$340.00	14% above	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 PERRY-HEPATITUS, ACUTE PANEL	$260.00	$400.00	$46.68–$340.00	—	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE ACUTE	$260.00	$400.00	$46.68–$340.00	—	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 PANORA-HEPATITIS, ACUTE PANEL	$260.00	$400.00	$46.68–$340.00	—	35%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE-ALPHA-1,3-GALACTOSE IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 COD IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BANANA	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY ALLERGEN	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 STINGING INSECT ALLERGEN PROFILE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ALLERGEN	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGIN AB	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HONEYBEE VENOM, IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE FACED HORNET VENOM, IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SALMON IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW FACED HORNET VENOM, IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM CHRYSOGENUM IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET VENOM, IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 WASP VENOM, IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEEF IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BRAZIL NUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MACADAMIA NUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT IGE (DONT USE!)	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BANANA (DONT USE)	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RED DYE (DONT ORDER!)	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WALNUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HAZELNUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CASHEW IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALMOND IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PORK IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SESAME IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCONUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PISTACHIO NUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN NUT IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RED DYE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM IGE	$28.00	$43.00	$5.12–$36.55	28% below	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW FACED HORNET VENOM, IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BANANA	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RED DYE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE-ALPHA-1,3-GALACTOSE IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM CHRYSOGENUM IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STINGING INSECT ALLERGEN PROFILE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COD IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY ALLERGEN	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX ALLERGEN	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGIN AB	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEYBEE VENOM, IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE FACED HORNET VENOM, IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET VENOM, IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WASP VENOM, IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BRAZIL NUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MACADAMIA NUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN NUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PISTACHIO NUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCONUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SESAME IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PORK IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASHEW IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAZELNUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RED DYE (DONT ORDER!)	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BANANA (DONT USE)	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT IGE (DONT USE!)	$28.00	$43.00	$5.12–$36.55	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT IGE	$28.00	$43.00	$5.12–$36.55	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB	$88.00	$135.00	$12.69–$114.75	26% above	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 PERRY-CYCLIC CITRULLINATED PEPTIDE AB	$88.00	$135.00	$12.69–$114.75	26% above	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 PANORA-CYCLIC CITRULLINATED PEPTIDE AB	$88.00	$135.00	$12.69–$114.75	26% above	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 PERRY-CYCLIC CITRULLINATED PEPTIDE AB	$88.00	$135.00	$12.69–$114.75	—	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB	$88.00	$135.00	$12.69–$114.75	—	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 PANORA-CYCLIC CITRULLINATED PEPTIDE AB	$88.00	$135.00	$12.69–$114.75	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB SCREEN W/RFLX ENA AND IFA	$82.00	$126.00	$11.85–$107.10	13% above	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 PANORA-ANA	$82.00	$126.00	$11.85–$107.10	13% above	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 FANA	$82.00	$126.00	$11.85–$107.10	13% above	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN WITH DSDNA SCREEN	$82.00	$126.00	$11.85–$107.10	13% above	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 PERRY-ANA	$82.00	$126.00	$11.85–$107.10	13% above	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN WITH DSDNA SCREEN	$82.00	$126.00	$11.85–$107.10	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB SCREEN W/RFLX ENA AND IFA	$82.00	$126.00	$11.85–$107.10	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 PANORA-ANA	$82.00	$126.00	$11.85–$107.10	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 FANA	$82.00	$126.00	$11.85–$107.10	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 PERRY-ANA	$82.00	$126.00	$11.85–$107.10	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PERRY-BNP	$177.00	$273.00	$38.47–$232.05	13% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP - ATLAS	$177.00	$273.00	$38.47–$232.05	13% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$177.00	$273.00	$38.47–$232.05	13% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PANORA-BNP	$177.00	$273.00	$38.47–$232.05	13% above	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP - ATLAS	$177.00	$273.00	$38.47–$232.05	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PERRY-BNP	$177.00	$273.00	$38.47–$232.05	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PANORA-BNP	$177.00	$273.00	$38.47–$232.05	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$177.00	$273.00	$38.47–$232.05	—	35%
Basic metabolic panel (blood test) CPT 80048 PANORA-METABOLIC PANEL, BASIC	$91.00	$140.00	$8.29–$119.00	10% above	35%
Basic metabolic panel (blood test) CPT 80048 METABOLIC BASIC PANEL	$91.00	$140.00	$8.29–$119.00	10% above	35%
Basic metabolic panel (blood test) CPT 80048 PERRY-METABOLIC PANEL, BASIC	$91.00	$140.00	$8.29–$119.00	10% above	35%
Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC BASIC PANEL	$91.00	$140.00	$8.29–$119.00	—	35%
Basic metabolic panel (blood test) inpatient CPT 80048 PANORA-METABOLIC PANEL, BASIC	$91.00	$140.00	$8.29–$119.00	—	35%
Basic metabolic panel (blood test) inpatient CPT 80048 PERRY-METABOLIC PANEL, BASIC	$91.00	$140.00	$8.29–$119.00	—	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH/HISTOLOGY	$122.00	$188.00	$64.59–$159.80	31% below	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH/HISTOLOGY	$122.00	$188.00	$64.59–$159.80	—	35%
Blood culture for bacteria CPT 87040 CULT BLOOD W/ARD	$121.00	$186.00	$10.11–$158.10	40% above	35%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$121.00	$186.00	$10.11–$158.10	40% above	35%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD W/ARD	$121.00	$186.00	$10.11–$158.10	—	35%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$121.00	$186.00	$10.11–$158.10	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$22.00	$34.00	$9.15–$28.90	11% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PERRY-VENIPUNCTURE COLLECTION	$22.00	$34.00	$9.15–$28.90	11% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PERRY-CAPILLARY BLOOD DRAW	$22.00	$34.00	$9.15–$28.90	11% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PANORA-VENIPUNCTURE COLLECTION	$22.00	$34.00	$9.15–$28.90	11% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PANORA-CAPILLARY BLOOD DRAW	$22.00	$34.00	$9.15–$28.90	11% above	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PERRY-CAPILLARY BLOOD DRAW	$22.00	$34.00	$9.15–$28.90	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PERRY-VENIPUNCTURE COLLECTION	$22.00	$34.00	$9.15–$28.90	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PANORA-VENIPUNCTURE COLLECTION	$22.00	$34.00	$9.15–$28.90	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PANORA-CAPILLARY BLOOD DRAW	$22.00	$34.00	$9.15–$28.90	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$22.00	$34.00	$9.15–$28.90	—	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$40.00	$62.00	$3.85–$52.70	19% above	35%
Blood glucose (sugar) test CPT 82947 PERRY-GLUCOSE (BS) BLOOD	$40.00	$62.00	$3.85–$52.70	19% above	35%
Blood glucose (sugar) test CPT 82947 PANORA-GLUCOSE (BS) BLOOD	$40.00	$62.00	$3.85–$52.70	19% above	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$40.00	$62.00	$3.85–$52.70	—	35%
Blood glucose (sugar) test inpatient CPT 82947 PANORA-GLUCOSE (BS) BLOOD	$40.00	$62.00	$3.85–$52.70	—	35%
Blood glucose (sugar) test inpatient CPT 82947 PERRY-GLUCOSE (BS) BLOOD	$40.00	$62.00	$3.85–$52.70	—	35%
Blood lead test CPT 83655 PERRY-LEAD	$53.00	$82.00	$11.87–$69.70	1% above	35%
Blood lead test CPT 83655 PANORA-LEAD	$53.00	$82.00	$11.87–$69.70	1% above	35%
Blood lead test CPT 83655 LEAD LEVEL SCREEN	$53.00	$82.00	$11.87–$69.70	1% above	35%
Blood lead test CPT 83655 LEAD LEVEL VENOUS	$53.00	$82.00	$11.87–$69.70	1% above	35%
Blood lead test inpatient CPT 83655 LEAD LEVEL SCREEN	$53.00	$82.00	$11.87–$69.70	—	35%
Blood lead test inpatient CPT 83655 LEAD LEVEL VENOUS	$53.00	$82.00	$11.87–$69.70	—	35%
Blood lead test inpatient CPT 83655 PANORA-LEAD	$53.00	$82.00	$11.87–$69.70	—	35%
Blood lead test inpatient CPT 83655 PERRY-LEAD	$53.00	$82.00	$11.87–$69.70	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREG TEST SERUM QUALITATIVE	$76.00	$117.00	$7.37–$99.45	23% above	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PANORA-PREG TEST, SERUM(QUALITATIVE)	$76.00	$117.00	$7.37–$99.45	23% above	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PERRY-PREG TEST SERUM (QUALITATIVE)	$76.00	$117.00	$7.37–$99.45	23% above	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PERRY-PREG TEST SERUM (QUALITATIVE)	$76.00	$117.00	$7.37–$99.45	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREG TEST SERUM QUALITATIVE	$76.00	$117.00	$7.37–$99.45	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PANORA-PREG TEST, SERUM(QUALITATIVE)	$76.00	$117.00	$7.37–$99.45	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 PANORA-BB ABO BLOOD	$62.00	$96.00	$2.93–$81.60	9% above	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 PERRY-BB ABO BLOOD	$62.00	$96.00	$2.93–$81.60	9% above	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO BLOOD	$62.00	$96.00	$2.93–$81.60	9% above	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 PANORA-BB ABO BLOOD	$62.00	$96.00	$2.93–$81.60	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO BLOOD	$62.00	$96.00	$2.93–$81.60	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 PERRY-BB ABO BLOOD	$62.00	$96.00	$2.93–$81.60	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 PERRY-C REACTIVE PROTEIN (CRP)	$67.00	$103.00	$5.08–$87.55	16% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$67.00	$103.00	$5.08–$87.55	16% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP (C-REACTIVE PROTEIN)	$67.00	$103.00	$5.08–$87.55	16% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 PANORA-C REACTIVE PROTEIN (CRP)	$67.00	$103.00	$5.08–$87.55	16% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 PERRY-C REACTIVE PROTEIN (CRP)	$67.00	$103.00	$5.08–$87.55	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 PANORA-C REACTIVE PROTEIN (CRP)	$67.00	$103.00	$5.08–$87.55	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP (C-REACTIVE PROTEIN)	$67.00	$103.00	$5.08–$87.55	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$67.00	$103.00	$5.08–$87.55	—	35%
C. difficile toxin gene test (stool PCR) CPT 87493 PANORA-C DIFF APPLIFIED PROBE	$114.00	$176.00	$36.52–$149.60	6% above	35%
C. difficile toxin gene test (stool PCR) CPT 87493 PERRY - C DIFF APPLIFIED PROBE	$114.00	$176.00	$36.52–$149.60	6% above	35%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN PCR	$114.00	$176.00	$36.52–$149.60	6% above	35%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF PCR - ATLAS	$114.00	$176.00	$36.52–$149.60	6% above	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 PANORA-C DIFF APPLIFIED PROBE	$114.00	$176.00	$36.52–$149.60	—	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN PCR	$114.00	$176.00	$36.52–$149.60	—	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 PERRY - C DIFF APPLIFIED PROBE	$114.00	$176.00	$36.52–$149.60	—	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF PCR - ATLAS	$114.00	$176.00	$36.52–$149.60	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$132.00	$203.00	$20.39–$172.55	38% above	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$132.00	$203.00	$20.39–$172.55	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$122.00	$188.00	$20.39–$159.80	7% above	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$122.00	$188.00	$20.39–$159.80	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS PCR	$125.00	$193.00	$50.28–$164.05	9% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS PCR	$125.00	$193.00	$50.28–$164.05	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE	$116.00	$179.00	$34.39–$152.15	17% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 PANORA-CHLAMYDIA TRACHOMATIS AMPLIFIED P	$116.00	$179.00	$34.39–$152.15	17% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 PERRY-CHLAMYDIA TRACHOMATIS AMPLIFIED PR	$116.00	$179.00	$34.39–$152.15	17% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 PANORA-CHLAMYDIA TRACHOMATIS AMPLIFIED P	$116.00	$179.00	$34.39–$152.15	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 PERRY-CHLAMYDIA TRACHOMATIS AMPLIFIED PR	$116.00	$179.00	$34.39–$152.15	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE	$116.00	$179.00	$34.39–$152.15	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$91.00	$140.00	$13.12–$119.00	7% above	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL - ATLAS	$101.00	$156.00	$13.12–$132.60	19% above	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 PERRY-LIPID PANEL	$101.00	$156.00	$13.12–$132.60	19% above	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 PANORA-LIPID PANEL	$101.00	$156.00	$13.12–$132.60	19% above	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$91.00	$140.00	$13.12–$119.00	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 PANORA-LIPID PANEL	$101.00	$156.00	$13.12–$132.60	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 PERRY-LIPID PANEL	$101.00	$156.00	$13.12–$132.60	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL - ATLAS	$101.00	$156.00	$13.12–$132.60	—	35%
Complete blood count (CBC) with differential CPT 85025 CBC - AUTO DIFF	$73.00	$113.00	$7.61–$96.05	18% above	35%
Complete blood count (CBC) with differential CPT 85025 PERRY-CBC/DIFF, AUTOMATED	$73.00	$113.00	$7.61–$96.05	18% above	35%
Complete blood count (CBC) with differential CPT 85025 HEMOGRAM + DIFF	$73.00	$113.00	$7.61–$96.05	18% above	35%
Complete blood count (CBC) with differential CPT 85025 PANORA-CBC/DIFF, AUTOMATED	$73.00	$113.00	$7.61–$96.05	18% above	35%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC - AUTO DIFF	$73.00	$113.00	$7.61–$96.05	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 PANORA-CBC/DIFF, AUTOMATED	$73.00	$113.00	$7.61–$96.05	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 HEMOGRAM + DIFF	$73.00	$113.00	$7.61–$96.05	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 PERRY-CBC/DIFF, AUTOMATED	$73.00	$113.00	$7.61–$96.05	—	35%
Complete blood count (CBC), no differential CPT 85027 PANORA-CBC, AUTOMATED	$62.00	$95.00	$6.34–$80.75	38% above	35%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$62.00	$95.00	$6.34–$80.75	38% above	35%
Complete blood count (CBC), no differential CPT 85027 CBC HEMOGRAM	$62.00	$95.00	$6.34–$80.75	38% above	35%
Complete blood count (CBC), no differential CPT 85027 PERRY-CBC, AUTOMATED	$62.00	$95.00	$6.34–$80.75	38% above	35%
Complete blood count (CBC), no differential inpatient CPT 85027 PANORA-CBC, AUTOMATED	$62.00	$95.00	$6.34–$80.75	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 PERRY-CBC, AUTOMATED	$62.00	$95.00	$6.34–$80.75	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC HEMOGRAM	$62.00	$95.00	$6.34–$80.75	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$62.00	$95.00	$6.34–$80.75	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$145.00	$223.00	$10.35–$189.55	22% above	35%
Comprehensive metabolic panel (blood test) CPT 80053 PANORA-METABOLIC PANEL, COMP	$145.00	$223.00	$10.35–$189.55	22% above	35%
Comprehensive metabolic panel (blood test) CPT 80053 PERRY-METABOLIC PANEL, COMP	$145.00	$223.00	$10.35–$189.55	22% above	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 PANORA-METABOLIC PANEL, COMP	$145.00	$223.00	$10.35–$189.55	—	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 PERRY-METABOLIC PANEL, COMP	$145.00	$223.00	$10.35–$189.55	—	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$145.00	$223.00	$10.35–$189.55	—	35%
D-dimer blood test (blood clot marker) CPT 85379 PANORA-D DIMER	$101.00	$155.00	$9.98–$131.75	19% above	35%
D-dimer blood test (blood clot marker) CPT 85379 PERRY-D DIMER	$101.00	$155.00	$9.98–$131.75	19% above	35%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$109.00	$168.00	$9.98–$142.80	29% above	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 PERRY-D DIMER	$101.00	$155.00	$9.98–$131.75	—	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 PANORA-D DIMER	$101.00	$155.00	$9.98–$131.75	—	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$109.00	$168.00	$9.98–$142.80	—	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$122.00	$188.00	$21.79–$159.80	9% above	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$122.00	$188.00	$21.79–$159.80	—	35%
Estradiol blood test CPT 82670 ESTRADIOL	$142.00	$219.00	$27.38–$186.15	9% above	35%
Estradiol blood test CPT 82670 PERRY-ESTRADIOL	$142.00	$219.00	$27.38–$186.15	9% above	35%
Estradiol blood test CPT 82670 PANORA-ESTRADIOL	$142.00	$219.00	$27.38–$186.15	9% above	35%
Estradiol blood test inpatient CPT 82670 PERRY-ESTRADIOL	$142.00	$219.00	$27.38–$186.15	—	35%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$142.00	$219.00	$27.38–$186.15	—	35%
Estradiol blood test inpatient CPT 82670 PANORA-ESTRADIOL	$142.00	$219.00	$27.38–$186.15	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 PANORA-FSH	$117.00	$180.00	$18.21–$153.00	27% above	35%
FSH (follicle-stimulating hormone) test CPT 83001 PERRY-FSH	$117.00	$180.00	$18.21–$153.00	27% above	35%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$117.00	$180.00	$18.21–$153.00	27% above	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 PANORA-FSH	$117.00	$180.00	$18.21–$153.00	—	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$117.00	$180.00	$18.21–$153.00	—	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 PERRY-FSH	$117.00	$180.00	$18.21–$153.00	—	35%
Fecal calprotectin (stool inflammation test) CPT 83993 PANORA-CALPROTECTIN FECAL	$235.00	$362.00	$19.24–$307.70	46% above	35%
Fecal calprotectin (stool inflammation test) CPT 83993 PERRY-CALPROTECTIN FECAL	$235.00	$362.00	$19.24–$307.70	46% above	35%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$235.00	$362.00	$19.24–$307.70	46% above	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 PERRY-CALPROTECTIN FECAL	$235.00	$362.00	$19.24–$307.70	—	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$235.00	$362.00	$19.24–$307.70	—	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 PANORA-CALPROTECTIN FECAL	$235.00	$362.00	$19.24–$307.70	—	35%
Ferritin blood test (iron stores) CPT 82728 FERRITIN - ATLAS	$92.00	$142.00	$13.36–$120.70	8% above	35%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$92.00	$142.00	$13.36–$120.70	8% above	35%
Ferritin blood test (iron stores) CPT 82728 PANORA-FERRITIN	$92.00	$142.00	$13.36–$120.70	8% above	35%
Ferritin blood test (iron stores) CPT 82728 PERRY-FERRITIN	$92.00	$142.00	$13.36–$120.70	8% above	35%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN - ATLAS	$92.00	$142.00	$13.36–$120.70	—	35%
Ferritin blood test (iron stores) inpatient CPT 82728 PERRY-FERRITIN	$92.00	$142.00	$13.36–$120.70	—	35%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$92.00	$142.00	$13.36–$120.70	—	35%
Ferritin blood test (iron stores) inpatient CPT 82728 PANORA-FERRITIN	$92.00	$142.00	$13.36–$120.70	—	35%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$96.00	$147.00	$14.41–$124.95	8% above	35%
Folate (folic acid) blood test CPT 82746 PANORA-FOLIC ACID (FOLATE)	$96.00	$147.00	$14.41–$124.95	8% above	35%
Folate (folic acid) blood test CPT 82746 PERRY-FOLIC ACID (FOLATE)	$96.00	$147.00	$14.41–$124.95	8% above	35%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$96.00	$147.00	$14.41–$124.95	—	35%
Folate (folic acid) blood test inpatient CPT 82746 PANORA-FOLIC ACID (FOLATE)	$96.00	$147.00	$14.41–$124.95	—	35%
Folate (folic acid) blood test inpatient CPT 82746 PERRY-FOLIC ACID (FOLATE)	$96.00	$147.00	$14.41–$124.95	—	35%
Free T3 thyroid hormone test CPT 84481 PERRY-FREE ASSAY (FT-3)	$107.00	$164.00	$16.60–$139.40	6% above	35%
Free T3 thyroid hormone test CPT 84481 PANORA-FREE ASSAY (FT-3)	$107.00	$164.00	$16.60–$139.40	6% above	35%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$107.00	$164.00	$16.60–$139.40	6% above	35%
Free T3 thyroid hormone test inpatient CPT 84481 PERRY-FREE ASSAY (FT-3)	$107.00	$164.00	$16.60–$139.40	—	35%
Free T3 thyroid hormone test inpatient CPT 84481 PANORA-FREE ASSAY (FT-3)	$107.00	$164.00	$16.60–$139.40	—	35%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$107.00	$164.00	$16.60–$139.40	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 PERRY-T4, FREE	$73.00	$112.00	$8.84–$95.20	13% above	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 PANORA-T4, FREE	$77.00	$119.00	$8.84–$101.15	19% above	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE TO MCL	$103.00	$159.00	$8.84–$135.15	59% above	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE	$103.00	$159.00	$8.84–$135.15	59% above	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 PERRY-T4, FREE	$73.00	$112.00	$8.84–$95.20	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 PANORA-T4, FREE	$77.00	$119.00	$8.84–$101.15	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE TO MCL	$103.00	$159.00	$8.84–$135.15	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE	$103.00	$159.00	$8.84–$135.15	—	35%
Free testosterone test CPT 84402 PANORA-TESTOSTERONE FREE	$114.00	$175.00	$24.96–$148.75	8% above	35%
Free testosterone test CPT 84402 PERRY-TESTOSTERONE FREE	$114.00	$175.00	$24.96–$148.75	8% above	35%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$114.00	$175.00	$24.96–$148.75	8% above	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$114.00	$175.00	$24.96–$148.75	—	35%
Free testosterone test inpatient CPT 84402 PANORA-TESTOSTERONE FREE	$114.00	$175.00	$24.96–$148.75	—	35%
Free testosterone test inpatient CPT 84402 PERRY-TESTOSTERONE FREE	$114.00	$175.00	$24.96–$148.75	—	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 PERRY-GENERAL HEALTH(COMP,CBC,TSH)	$426.00	$655.00	$295.27–$556.75	165% above	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 PANORA-GEN HEALTH(COMP,CBC,TSH)	$426.00	$655.00	$295.27–$556.75	165% above	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$426.00	$655.00	$295.27–$556.75	165% above	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$426.00	$655.00	$295.27–$556.75	—	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 PANORA-GEN HEALTH(COMP,CBC,TSH)	$426.00	$655.00	$295.27–$556.75	—	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 PERRY-GENERAL HEALTH(COMP,CBC,TSH)	$426.00	$655.00	$295.27–$556.75	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 1HR	$52.00	$80.00	$4.66–$68.00	44% above	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 1HR NONFASTING	$52.00	$80.00	$4.66–$68.00	44% above	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT 1HR NONFASTING	$52.00	$80.00	$4.66–$68.00	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT 1HR	$52.00	$80.00	$4.66–$68.00	—	35%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 HR FASTING	$92.00	$142.00	$12.61–$120.70	9% above	35%
Glucose tolerance test, 3 samples CPT 82951 GTT 2 HR	$92.00	$142.00	$12.61–$120.70	9% above	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 HR	$92.00	$142.00	$12.61–$120.70	—	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 HR FASTING	$92.00	$142.00	$12.61–$120.70	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NG DNA PROBE (CHLAMYDIA AND NEISSERIA)	$112.00	$173.00	$34.39–$147.05	23% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 PANORA-NEISSERIA GONORRHOEAE AMPLIFIED P	$112.00	$173.00	$34.39–$147.05	23% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 PERRY-NEISSERIA GONORRHOEAE AMPLIFIED PR	$112.00	$173.00	$34.39–$147.05	23% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 PANORA-NEISSERIA GONORRHOEAE AMPLIFIED P	$112.00	$173.00	$34.39–$147.05	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NG DNA PROBE (CHLAMYDIA AND NEISSERIA)	$112.00	$173.00	$34.39–$147.05	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 PERRY-NEISSERIA GONORRHOEAE AMPLIFIED PR	$112.00	$173.00	$34.39–$147.05	—	35%
H. pylori antibody blood test CPT 86677 PERRY-H-PYLORI ANTIBODY	$92.00	$141.00	$16.51–$119.85	15% above	35%
H. pylori antibody blood test CPT 86677 PANORA-H-PYLORI ANTIBODY	$92.00	$141.00	$16.51–$119.85	15% above	35%
H. pylori antibody blood test inpatient CPT 86677 PERRY-H-PYLORI ANTIBODY	$92.00	$141.00	$16.51–$119.85	—	35%
H. pylori antibody blood test inpatient CPT 86677 PANORA-H-PYLORI ANTIBODY	$92.00	$141.00	$16.51–$119.85	—	35%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN - STOOL	$104.00	$160.00	$14.09–$136.00	7% below	35%
H. pylori stool antigen test CPT 87338 PERRY-H PYLORI ANTIGEN - STOOL	$104.00	$160.00	$14.09–$136.00	7% below	35%
H. pylori stool antigen test CPT 87338 PANORA-H PYLORI ANTIGEN - STOOL	$104.00	$160.00	$14.09–$136.00	7% below	35%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN - STOOL	$104.00	$160.00	$14.09–$136.00	—	35%
H. pylori stool antigen test inpatient CPT 87338 PANORA-H PYLORI ANTIGEN - STOOL	$104.00	$160.00	$14.09–$136.00	—	35%
H. pylori stool antigen test inpatient CPT 87338 PERRY-H PYLORI ANTIGEN - STOOL	$104.00	$160.00	$14.09–$136.00	—	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 ULTRA SENS VIRAL LOAD BY PCR	$432.00	$665.00	$83.40–$565.25	60% above	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 ULTRA SENS VIRAL LOAD BY PCR	$432.00	$665.00	$83.40–$565.25	—	35%
HIV-1 and HIV-2 antibody test CPT 86703 PANORA-HIV 1 & 2 ASSAY	$73.00	$113.00	$13.44–$96.05	50% above	35%
HIV-1 and HIV-2 antibody test CPT 86703 PERRY-HIV 1 & 2 ASSAY	$73.00	$113.00	$13.44–$96.05	50% above	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PANORA-HIV 1 & 2 ASSAY	$73.00	$113.00	$13.44–$96.05	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PERRY-HIV 1 & 2 ASSAY	$73.00	$113.00	$13.44–$96.05	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 and 2 AB	$105.00	$161.00	$23.60–$136.85	40% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 and 2 AB	$105.00	$161.00	$23.60–$136.85	—	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 WITH REFLEX	$43.00	$66.00	$29.75–$56.10	55% below	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 WITH REFLEX	$43.00	$66.00	$29.75–$56.10	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED A1C	$65.00	$100.00	$9.52–$85.00	7% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED A1C - ATLAS	$65.00	$100.00	$9.52–$85.00	7% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 PANORA-HEMOGLOBIN A1C	$65.00	$100.00	$9.52–$85.00	7% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 PERRY-HEMOGLOBIN A1C	$65.00	$100.00	$9.52–$85.00	7% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 PANORA-HEMOGLOBIN A1C	$65.00	$100.00	$9.52–$85.00	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED A1C	$65.00	$100.00	$9.52–$85.00	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 PERRY-HEMOGLOBIN A1C	$65.00	$100.00	$9.52–$85.00	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED A1C - ATLAS	$65.00	$100.00	$9.52–$85.00	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 PERRY-HEPATITIS B SURFACE AB QUAL AND Q	$83.00	$128.00	$10.53–$108.80	22% above	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB QUAL AND QUANT	$83.00	$128.00	$10.53–$108.80	22% above	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 PANORA-HEPATITIS B SURFACE AB QUAL AND Q	$83.00	$128.00	$10.53–$108.80	22% above	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB QUANT	$83.00	$128.00	$10.53–$108.80	22% above	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 PERRY-HEPATITIS B SURFACE AB QUAL AND Q	$83.00	$128.00	$10.53–$108.80	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 PANORA-HEPATITIS B SURFACE AB QUAL AND Q	$83.00	$128.00	$10.53–$108.80	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB QUAL AND QUANT	$83.00	$128.00	$10.53–$108.80	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB QUANT	$83.00	$128.00	$10.53–$108.80	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 PANORA-HEPATITIS B SURFACE AG	$81.00	$124.00	$10.12–$105.40	24% above	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$81.00	$124.00	$10.12–$105.40	24% above	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 PERRY-HEPATITIS B SURFACE AG	$81.00	$124.00	$10.12–$105.40	24% above	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 PANORA-HEPATITIS B SURFACE AG	$81.00	$124.00	$10.12–$105.40	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$81.00	$124.00	$10.12–$105.40	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 PERRY-HEPATITIS B SURFACE AG	$81.00	$124.00	$10.12–$105.40	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 PANORA-HEPATITIS C AB TEST	$88.00	$135.00	$13.98–$114.75	13% above	35%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$88.00	$135.00	$13.98–$114.75	13% above	35%
Hepatitis C antibody blood test (screening) CPT 86803 PERRY-HEPATITIS C AB TEST	$88.00	$135.00	$13.98–$114.75	13% above	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$88.00	$135.00	$13.98–$114.75	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 PERRY-HEPATITIS C AB TEST	$88.00	$135.00	$13.98–$114.75	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 PANORA-HEPATITIS C AB TEST	$88.00	$135.00	$13.98–$114.75	—	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS (HCV) RNA QUANT	$437.00	$673.00	$41.98–$572.05	69% above	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS (HCV) RNA QUANT	$437.00	$673.00	$41.98–$572.05	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX VIRUS TYPE 1 AB	$83.00	$127.00	$12.93–$107.95	24% above	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX VIRUS TYPE 1 AB	$83.00	$127.00	$12.93–$107.95	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS TYPE 2 AB	$55.00	$84.00	$18.96–$71.40	5% below	35%
Herpes blood test, HSV-2 antibody CPT 86696 PERRY-HERPES SIMPLEX VIRUS TYPE 2 AB	$55.00	$84.00	$18.96–$71.40	5% below	35%
Herpes blood test, HSV-2 antibody CPT 86696 PANORA-HERPES SIMPLEX VIRUS TYPE 2 AB	$55.00	$84.00	$18.96–$71.40	5% below	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 PANORA-HERPES SIMPLEX VIRUS TYPE 2 AB	$55.00	$84.00	$18.96–$71.40	—	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS TYPE 2 AB	$55.00	$84.00	$18.96–$71.40	—	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 PERRY-HERPES SIMPLEX VIRUS TYPE 2 AB	$55.00	$84.00	$18.96–$71.40	—	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP - HIGH SENSITIVITY	$80.00	$123.00	$12.69–$104.55	3% above	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP - HIGH SENSITIVITY	$80.00	$123.00	$12.69–$104.55	—	35%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$114.00	$175.00	$17.56–$148.75	20% above	35%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$114.00	$175.00	$17.56–$148.75	—	35%
Insulin blood test CPT 83525 PERRY-INSULIN TOTAL	$85.00	$130.00	$11.20–$110.50	11% above	35%
Insulin blood test CPT 83525 PANORA-INSULIN TOTAL	$85.00	$130.00	$11.20–$110.50	11% above	35%
Insulin blood test CPT 83525 INSULIN TOTAL	$85.00	$130.00	$11.20–$110.50	11% above	35%
Insulin blood test inpatient CPT 83525 PERRY-INSULIN TOTAL	$85.00	$130.00	$11.20–$110.50	—	35%
Insulin blood test inpatient CPT 83525 PANORA-INSULIN TOTAL	$85.00	$130.00	$11.20–$110.50	—	35%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$85.00	$130.00	$11.20–$110.50	—	35%
Iron blood test (serum iron) CPT 83540 IRON	$52.00	$80.00	$6.34–$68.00	30% above	35%
Iron blood test (serum iron) CPT 83540 PANORA-IRON	$52.00	$80.00	$6.34–$68.00	30% above	35%
Iron blood test (serum iron) CPT 83540 PERRY-IRON	$52.00	$80.00	$6.34–$68.00	30% above	35%
Iron blood test (serum iron) inpatient CPT 83540 PANORA-IRON	$52.00	$80.00	$6.34–$68.00	—	35%
Iron blood test (serum iron) inpatient CPT 83540 PERRY-IRON	$52.00	$80.00	$6.34–$68.00	—	35%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$52.00	$80.00	$6.34–$68.00	—	35%
Iron-binding capacity (TIBC) test CPT 83550 PERRY-TIBC	$57.00	$87.00	$8.57–$73.95	18% above	34%
Iron-binding capacity (TIBC) test CPT 83550 PANORA-TIBC	$57.00	$87.00	$8.57–$73.95	18% above	34%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$57.00	$87.00	$8.57–$73.95	18% above	34%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$57.00	$87.00	$8.57–$73.95	—	34%
Iron-binding capacity (TIBC) test inpatient CPT 83550 PERRY-TIBC	$57.00	$87.00	$8.57–$73.95	—	34%
Iron-binding capacity (TIBC) test inpatient CPT 83550 PANORA-TIBC	$57.00	$87.00	$8.57–$73.95	—	34%
Kidney function blood test panel CPT 80069 RENAL PANEL	$99.00	$153.00	$8.51–$130.05	13% above	35%
Kidney function blood test panel CPT 80069 PERRY-RENAL PANEL	$99.00	$153.00	$8.51–$130.05	13% above	35%
Kidney function blood test panel CPT 80069 PANORA-RENAL PANEL	$99.00	$153.00	$8.51–$130.05	13% above	35%
Kidney function blood test panel inpatient CPT 80069 PANORA-RENAL PANEL	$99.00	$153.00	$8.51–$130.05	—	35%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$99.00	$153.00	$8.51–$130.05	—	35%
Kidney function blood test panel inpatient CPT 80069 PERRY-RENAL PANEL	$99.00	$153.00	$8.51–$130.05	—	35%
LH (luteinizing hormone) test CPT 83002 PANORA-LH	$107.00	$165.00	$18.15–$140.25	15% above	35%
LH (luteinizing hormone) test CPT 83002 LH	$107.00	$165.00	$18.15–$140.25	15% above	35%
LH (luteinizing hormone) test CPT 83002 PERRY-LH	$107.00	$165.00	$18.15–$140.25	15% above	35%
LH (luteinizing hormone) test inpatient CPT 83002 PANORA-LH	$107.00	$165.00	$18.15–$140.25	—	35%
LH (luteinizing hormone) test inpatient CPT 83002 PERRY-LH	$107.00	$165.00	$18.15–$140.25	—	35%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$107.00	$165.00	$18.15–$140.25	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$118.00	$182.00	$6.75–$154.70	86% above	35%
Lipase blood test (pancreas enzyme) CPT 83690 PERRY-LIPASE	$118.00	$182.00	$6.75–$154.70	86% above	35%
Lipase blood test (pancreas enzyme) CPT 83690 PANORA-LIPASE	$118.00	$182.00	$6.75–$154.70	86% above	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 PANORA-LIPASE	$118.00	$182.00	$6.75–$154.70	—	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 PERRY-LIPASE	$118.00	$182.00	$6.75–$154.70	—	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$118.00	$182.00	$6.75–$154.70	—	35%
Liver function blood test panel CPT 80076 LIVER PROFILE	$101.00	$156.00	$8.01–$132.60	20% above	35%
Liver function blood test panel CPT 80076 PANORA-HEPATIC FUNCTION	$101.00	$156.00	$8.01–$132.60	20% above	35%
Liver function blood test panel CPT 80076 PERRY-HEPATIC FUNCTION	$101.00	$156.00	$8.01–$132.60	20% above	35%
Liver function blood test panel inpatient CPT 80076 PERRY-HEPATIC FUNCTION	$101.00	$156.00	$8.01–$132.60	—	35%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE	$101.00	$156.00	$8.01–$132.60	—	35%
Liver function blood test panel inpatient CPT 80076 PANORA-HEPATIC FUNCTION	$101.00	$156.00	$8.01–$132.60	—	35%
Lyme disease antibody test CPT 86618 LYMES AB IGM	$93.00	$143.00	$16.69–$121.55	5% above	35%
Lyme disease antibody test CPT 86618 PERRY-LYMES AB IGG	$93.00	$143.00	$16.69–$121.55	5% above	35%
Lyme disease antibody test CPT 86618 PANORA-LYMES AB IGG	$93.00	$143.00	$16.69–$121.55	5% above	35%
Lyme disease antibody test CPT 86618 LYMES AB IGG	$93.00	$143.00	$16.69–$121.55	5% above	35%
Lyme disease antibody test inpatient CPT 86618 LYMES AB IGG	$93.00	$143.00	$16.69–$121.55	—	35%
Lyme disease antibody test inpatient CPT 86618 LYMES AB IGM	$93.00	$143.00	$16.69–$121.55	—	35%
Lyme disease antibody test inpatient CPT 86618 PERRY-LYMES AB IGG	$93.00	$143.00	$16.69–$121.55	—	35%
Lyme disease antibody test inpatient CPT 86618 PANORA-LYMES AB IGG	$93.00	$143.00	$16.69–$121.55	—	35%
Magnesium blood test CPT 83735 PERRY-ASSAY OF MAGNESIUM	$66.00	$102.00	$6.57–$86.70	36% above	35%
Magnesium blood test CPT 83735 UR 24HR MAGNESIUM	$66.00	$102.00	$6.57–$86.70	36% above	35%
Magnesium blood test CPT 83735 PANORA-ASSAY OF MAGNESIUM	$66.00	$102.00	$6.57–$86.70	36% above	35%
Magnesium blood test CPT 83735 MAGNESIUM	$66.00	$102.00	$6.57–$86.70	36% above	35%
Magnesium blood test CPT 83735 UR RANDOM MAGNESIUM	$66.00	$102.00	$6.57–$86.70	36% above	35%
Magnesium blood test inpatient CPT 83735 UR RANDOM MAGNESIUM	$66.00	$102.00	$6.57–$86.70	—	35%
Magnesium blood test inpatient CPT 83735 PERRY-ASSAY OF MAGNESIUM	$66.00	$102.00	$6.57–$86.70	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$66.00	$102.00	$6.57–$86.70	—	35%
Magnesium blood test inpatient CPT 83735 PANORA-ASSAY OF MAGNESIUM	$66.00	$102.00	$6.57–$86.70	—	35%
Magnesium blood test inpatient CPT 83735 UR 24HR MAGNESIUM	$66.00	$102.00	$6.57–$86.70	—	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM	$73.00	$113.00	$12.62–$96.05	33% above	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY, IGM	$73.00	$113.00	$12.62–$96.05	33% above	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY, IGG	$73.00	$113.00	$12.62–$96.05	33% above	35%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY, IGG	$73.00	$113.00	$12.62–$96.05	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGM	$73.00	$113.00	$12.62–$96.05	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY, IGM	$73.00	$113.00	$12.62–$96.05	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$51.00	$79.00	$5.08–$67.15	5% above	35%
Mono test (heterophile antibody, Monospot) CPT 86308 PANORA-MONOSPOT	$51.00	$79.00	$5.08–$67.15	5% above	35%
Mono test (heterophile antibody, Monospot) CPT 86308 PERRY-MONOSPOT	$51.00	$79.00	$5.08–$67.15	5% above	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 PERRY-MONOSPOT	$51.00	$79.00	$5.08–$67.15	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$51.00	$79.00	$5.08–$67.15	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 PANORA-MONOSPOT	$51.00	$79.00	$5.08–$67.15	—	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL AND FREE, SERUM	$106.00	$163.00	$18.02–$138.55	9% above	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PANORA-PSA FREE	$114.00	$175.00	$18.02–$148.75	17% above	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE, SCREEN	$114.00	$175.00	$18.02–$148.75	17% above	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PERRY-PSA FREE	$114.00	$175.00	$18.02–$148.75	17% above	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA TOTAL AND FREE, SERUM	$106.00	$163.00	$18.02–$138.55	—	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PERRY-PSA FREE	$114.00	$175.00	$18.02–$148.75	—	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE, SCREEN	$114.00	$175.00	$18.02–$148.75	—	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PANORA-PSA FREE	$114.00	$175.00	$18.02–$148.75	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PERRY-PSA TOTAL	$109.00	$168.00	$18.02–$142.80	13% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PANORA-PSA TOTAL	$109.00	$168.00	$18.02–$142.80	13% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 SERUM PSA TOTAL	$109.00	$168.00	$18.02–$142.80	13% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC TOTAL	$114.00	$175.00	$18.02–$148.75	18% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREEN NON-MEDICARE	$114.00	$175.00	$18.02–$148.75	18% above	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PERRY-PSA TOTAL	$109.00	$168.00	$18.02–$142.80	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PANORA-PSA TOTAL	$109.00	$168.00	$18.02–$142.80	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 SERUM PSA TOTAL	$109.00	$168.00	$18.02–$142.80	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC TOTAL	$114.00	$175.00	$18.02–$148.75	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREEN NON-MEDICARE	$114.00	$175.00	$18.02–$148.75	—	35%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTO THIN PREP	$72.00	$110.00	$26.08–$93.50	8% below	35%
Pap test (liquid-based, automated screening with review) CPT 88175 PANORA-PAP SMEAR	$72.00	$110.00	$26.08–$93.50	8% below	35%
Pap test (liquid-based, automated screening with review) CPT 88175 PERRY-PAP SMEAR	$80.00	$123.00	$26.08–$104.55	3% above	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO THIN PREP	$72.00	$110.00	$26.08–$93.50	—	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PANORA-PAP SMEAR	$72.00	$110.00	$26.08–$93.50	—	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PERRY-PAP SMEAR	$80.00	$123.00	$26.08–$104.55	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT	$177.00	$272.00	$40.45–$231.20	at median	35%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$177.00	$272.00	$40.45–$231.20	at median	35%
Parathyroid hormone (PTH) blood test CPT 83970 PERRY-PARATHYROID HORMONE INTACT	$177.00	$272.00	$40.45–$231.20	at median	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$177.00	$272.00	$40.45–$231.20	—	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PERRY-PARATHYROID HORMONE INTACT	$177.00	$272.00	$40.45–$231.20	—	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT	$177.00	$272.00	$40.45–$231.20	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS SENSITIVE PTT BLOOD	$53.00	$81.00	$5.89–$68.85	18% above	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PERRY-PTT	$53.00	$81.00	$5.89–$68.85	18% above	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PANORA-PTT	$53.00	$81.00	$5.89–$68.85	18% above	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$53.00	$81.00	$5.89–$68.85	18% above	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PANORA-PTT	$53.00	$81.00	$5.89–$68.85	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PERRY-PTT	$53.00	$81.00	$5.89–$68.85	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS SENSITIVE PTT BLOOD	$53.00	$81.00	$5.89–$68.85	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$53.00	$81.00	$5.89–$68.85	—	35%
Progesterone blood test CPT 84144 PANORA-ASSAY OF PROGESTERONE	$111.00	$171.00	$20.44–$145.35	14% above	35%
Progesterone blood test CPT 84144 PROGESTERONE	$111.00	$171.00	$20.44–$145.35	14% above	35%
Progesterone blood test CPT 84144 PERRY-ASSAY OF PROGESTERONE	$111.00	$171.00	$20.44–$145.35	14% above	35%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$111.00	$171.00	$20.44–$145.35	—	35%
Progesterone blood test inpatient CPT 84144 PANORA-ASSAY OF PROGESTERONE	$111.00	$171.00	$20.44–$145.35	—	35%
Progesterone blood test inpatient CPT 84144 PERRY-ASSAY OF PROGESTERONE	$111.00	$171.00	$20.44–$145.35	—	35%
Prolactin blood test CPT 84146 PERRY-PROLACTIN	$120.00	$184.00	$18.99–$156.40	20% above	35%
Prolactin blood test CPT 84146 PANORA-PROLACTIN	$120.00	$184.00	$18.99–$156.40	20% above	35%
Prolactin blood test CPT 84146 PROLACTIN	$120.00	$184.00	$18.99–$156.40	20% above	35%
Prolactin blood test inpatient CPT 84146 PANORA-PROLACTIN	$120.00	$184.00	$18.99–$156.40	—	35%
Prolactin blood test inpatient CPT 84146 PERRY-PROLACTIN	$120.00	$184.00	$18.99–$156.40	—	35%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$120.00	$184.00	$18.99–$156.40	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PERRY-PROTIME/INR	$38.00	$59.00	$4.20–$50.15	16% above	36%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR	$38.00	$59.00	$4.20–$50.15	16% above	36%
Prothrombin time (PT/INR) clotting test CPT 85610 PANORA-PROTIME/INR	$38.00	$59.00	$4.20–$50.15	16% above	36%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR - ATLAS	$38.00	$59.00	$4.20–$50.15	16% above	36%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PERRY-PROTIME/INR	$38.00	$59.00	$4.20–$50.15	—	36%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR - ATLAS	$38.00	$59.00	$4.20–$50.15	—	36%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR	$38.00	$59.00	$4.20–$50.15	—	36%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PANORA-PROTIME/INR	$38.00	$59.00	$4.20–$50.15	—	36%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 UR ETHYL GLUCORONIDE SCREEN W/REFLEX	$108.00	$166.00	$12.35–$141.10	50% above	35%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 UR ETHYL GLUCORONIDE SCREEN W/REFLEX	$108.00	$166.00	$12.35–$141.10	—	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A/B CONFIRMATION - SHL	$60.00	$92.00	$16.22–$78.20	29% above	35%
Rapid flu test (influenza antigen) CPT 87804 PERRY-INFLUENZA A/B	$60.00	$92.00	$16.22–$78.20	29% above	35%
Rapid flu test (influenza antigen) CPT 87804 PANORA-INFLUENZA A/B	$60.00	$92.00	$16.22–$78.20	29% above	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA SCREEN A/B	$60.00	$92.00	$16.22–$78.20	29% above	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A/B CONFIRMATION - SHL	$60.00	$92.00	$16.22–$78.20	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 PERRY-INFLUENZA A/B	$60.00	$92.00	$16.22–$78.20	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA SCREEN A/B	$60.00	$92.00	$16.22–$78.20	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 PANORA-INFLUENZA A/B	$60.00	$92.00	$16.22–$78.20	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN GROUP A	$55.00	$84.00	$16.20–$71.40	10% above	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 PERRY-STREP SCREEN GROUP A	$55.00	$84.00	$16.20–$71.40	10% above	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 PANORA-STREP SCREEN GROUP A	$55.00	$84.00	$16.20–$71.40	10% above	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 PERRY-STREP SCREEN GROUP A	$55.00	$84.00	$16.20–$71.40	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 PANORA-STREP SCREEN GROUP A	$55.00	$84.00	$16.20–$71.40	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN GROUP A	$55.00	$84.00	$16.20–$71.40	—	35%
Rheumatoid factor (RF) test CPT 86431 PERRY-RHEUMATOID FACTOR, QUANT	$49.00	$76.00	$5.56–$64.60	1% above	36%
Rheumatoid factor (RF) test CPT 86431 PANORA-RHEUMATOID FACTOR, QUANT	$49.00	$76.00	$5.56–$64.60	1% above	36%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$49.00	$76.00	$5.56–$64.60	1% above	36%
Rheumatoid factor (RF) test inpatient CPT 86431 PERRY-RHEUMATOID FACTOR, QUANT	$49.00	$76.00	$5.56–$64.60	—	36%
Rheumatoid factor (RF) test inpatient CPT 86431 PANORA-RHEUMATOID FACTOR, QUANT	$49.00	$76.00	$5.56–$64.60	—	36%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$49.00	$76.00	$5.56–$64.60	—	36%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$64.00	$98.00	$14.10–$83.30	9% above	35%
Rubella antibody test (immunity check) CPT 86762 PANORA-RUBELLA ANTIBODY	$64.00	$98.00	$14.10–$83.30	9% above	35%
Rubella antibody test (immunity check) CPT 86762 PERRY-RUBELLA ANTIBODY	$64.00	$98.00	$14.10–$83.30	9% above	35%
Rubella antibody test (immunity check) inpatient CPT 86762 PERRY-RUBELLA ANTIBODY	$64.00	$98.00	$14.10–$83.30	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 PANORA-RUBELLA ANTIBODY	$64.00	$98.00	$14.10–$83.30	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG	$64.00	$98.00	$14.10–$83.30	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE - AUTOMATED	$44.00	$68.00	$2.65–$57.80	31% above	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 PERRY-SED RATE AUTO (MCL)	$44.00	$68.00	$2.65–$57.80	31% above	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 PANORA-SED RATEAUTO (MCL)	$44.00	$68.00	$2.65–$57.80	31% above	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 PERRY-SED RATE AUTO (MCL)	$44.00	$68.00	$2.65–$57.80	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE - AUTOMATED	$44.00	$68.00	$2.65–$57.80	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 PANORA-SED RATEAUTO (MCL)	$44.00	$68.00	$2.65–$57.80	—	35%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS	$40.00	$62.00	$12.06–$52.70	29% below	35%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS	$40.00	$62.00	$12.06–$52.70	—	35%
Stool ova and parasites exam CPT 87177 PERRY-OVA & PARASITES- CONC AND SMEAR (O	$57.00	$87.00	$8.72–$73.95	22% above	34%
Stool ova and parasites exam CPT 87177 OVA & PARASITES- CONC AND SMEAR-TO SHL	$57.00	$87.00	$8.72–$73.95	22% above	34%
Stool ova and parasites exam CPT 87177 PANORA-OVA & PARASITES- CONC AND SMEAR	$57.00	$87.00	$8.72–$73.95	22% above	34%
Stool ova and parasites exam inpatient CPT 87177 PANORA-OVA & PARASITES- CONC AND SMEAR	$57.00	$87.00	$8.72–$73.95	—	34%
Stool ova and parasites exam inpatient CPT 87177 PERRY-OVA & PARASITES- CONC AND SMEAR (O	$57.00	$87.00	$8.72–$73.95	—	34%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES- CONC AND SMEAR-TO SHL	$57.00	$87.00	$8.72–$73.95	—	34%
Stool test for hidden blood (guaiac FOBT) CPT 82270 PANORA-OCCULT BLOOD GUIAC FECES	$31.00	$47.00	$4.29–$39.95	6% below	34%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD CARDS	$31.00	$47.00	$4.29–$39.95	6% below	34%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOQUANT	$31.00	$47.00	$4.29–$39.95	6% below	34%
Stool test for hidden blood (guaiac FOBT) CPT 82270 PERRY-OCCULT BLOOD GUIAC FECES	$31.00	$47.00	$4.29–$39.95	6% below	34%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 PANORA-OCCULT BLOOD GUIAC FECES	$31.00	$47.00	$4.29–$39.95	—	34%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD CARDS	$31.00	$47.00	$4.29–$39.95	—	34%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 PERRY-OCCULT BLOOD GUIAC FECES	$31.00	$47.00	$4.29–$39.95	—	34%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOQUANT	$31.00	$47.00	$4.29–$39.95	—	34%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 PERRY-OCCULT BLOOD IMMUNOASSAY	$83.00	$127.00	$15.60–$107.95	44% above	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECAL DIAGNOSTIC	$83.00	$127.00	$15.60–$107.95	44% above	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 PANORA-OCCULT BLOOD IMMUNOASSAY	$83.00	$127.00	$15.60–$107.95	44% above	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 PERRY-OCCULT BLOOD IMMUNOASSAY	$83.00	$127.00	$15.60–$107.95	—	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FECAL DIAGNOSTIC	$83.00	$127.00	$15.60–$107.95	—	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 PANORA-OCCULT BLOOD IMMUNOASSAY	$83.00	$127.00	$15.60–$107.95	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 FTA ANTIBODY	$40.00	$62.00	$4.18–$52.70	18% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PERRY-VDRL, RPR	$40.00	$62.00	$4.18–$52.70	18% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PANORA-VDRL, RPR	$40.00	$62.00	$4.18–$52.70	18% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 FTA ANTIBODY	$40.00	$62.00	$4.18–$52.70	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 PANORA-VDRL, RPR	$40.00	$62.00	$4.18–$52.70	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 PERRY-VDRL, RPR	$40.00	$62.00	$4.18–$52.70	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL FEMALE/CHILD	$121.00	$186.00	$25.29–$158.10	17% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 PERRY-TESTOSTERONE TOTAL	$121.00	$186.00	$25.29–$158.10	17% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$121.00	$186.00	$25.29–$158.10	17% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 PANORA-TESTOSTERONE TOTAL	$121.00	$186.00	$25.29–$158.10	17% above	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL FEMALE/CHILD	$121.00	$186.00	$25.29–$158.10	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$121.00	$186.00	$25.29–$158.10	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PERRY-TESTOSTERONE TOTAL	$121.00	$186.00	$25.29–$158.10	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PANORA-TESTOSTERONE TOTAL	$121.00	$186.00	$25.29–$158.10	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 PERRY-MICROSOMAL ANTIBODIES EACH	$94.00	$145.00	$14.26–$123.25	24% above	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID AB PANEL	$94.00	$145.00	$14.26–$123.25	24% above	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY (TPO) EA	$94.00	$145.00	$14.26–$123.25	24% above	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL AB	$94.00	$145.00	$14.26–$123.25	24% above	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 PANORA-MICROSOMAL ANTIBODIES EACH	$94.00	$145.00	$14.26–$123.25	24% above	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL ANTIBODY (LKM)	$94.00	$145.00	$14.26–$123.25	24% above	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOMAL ANTIBODY (LKM)	$94.00	$145.00	$14.26–$123.25	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI MICROSOMAL AB	$94.00	$145.00	$14.26–$123.25	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID AB PANEL	$94.00	$145.00	$14.26–$123.25	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 PERRY-MICROSOMAL ANTIBODIES EACH	$94.00	$145.00	$14.26–$123.25	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 PANORA-MICROSOMAL ANTIBODIES EACH	$94.00	$145.00	$14.26–$123.25	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY (TPO) EA	$94.00	$145.00	$14.26–$123.25	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 PERRY-TSH	$97.00	$149.00	$16.46–$126.65	at median	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$110.00	$169.00	$16.46–$143.65	13% above	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HYPOTHYROIDISM NP	$110.00	$169.00	$16.46–$143.65	13% above	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH, SENSITIVE	$110.00	$169.00	$16.46–$143.65	13% above	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 PANORA-TSH	$110.00	$169.00	$16.46–$143.65	13% above	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 PERRY-TSH	$97.00	$149.00	$16.46–$126.65	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 PANORA-TSH	$110.00	$169.00	$16.46–$143.65	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$110.00	$169.00	$16.46–$143.65	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH, SENSITIVE	$110.00	$169.00	$16.46–$143.65	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HYPOTHYROIDISM NP	$110.00	$169.00	$16.46–$143.65	—	35%
Uric acid blood test CPT 84550 PERRY-URIC ACID, BLOOD	$42.00	$65.00	$4.43–$55.25	20% above	35%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$42.00	$65.00	$4.43–$55.25	20% above	35%
Uric acid blood test CPT 84550 PANORA-URIC ACID, BLOOD	$42.00	$65.00	$4.43–$55.25	20% above	35%
Uric acid blood test inpatient CPT 84550 PANORA-URIC ACID, BLOOD	$42.00	$65.00	$4.43–$55.25	—	35%
Uric acid blood test inpatient CPT 84550 PERRY-URIC ACID, BLOOD	$42.00	$65.00	$4.43–$55.25	—	35%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$42.00	$65.00	$4.43–$55.25	—	35%
Urinalysis with microscope exam, automated CPT 81001 PANORA-UA DIP & MICRO	$39.00	$60.00	$3.11–$51.00	6% below	35%
Urinalysis with microscope exam, automated CPT 81001 UA WITH MICRO	$39.00	$60.00	$3.11–$51.00	6% below	35%
Urinalysis with microscope exam, automated CPT 81001 PERRY-UA DIP & MICRO	$39.00	$60.00	$3.11–$51.00	6% below	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 PANORA-UA DIP & MICRO	$39.00	$60.00	$3.11–$51.00	—	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA WITH MICRO	$39.00	$60.00	$3.11–$51.00	—	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 PERRY-UA DIP & MICRO	$39.00	$60.00	$3.11–$51.00	—	35%
Urinalysis with microscope exam, manual CPT 81000 PERRY-UA/MICRO NON-AUTOMATED	$39.00	$60.00	$3.94–$51.00	52% above	35%
Urinalysis with microscope exam, manual CPT 81000 PANORA-UA/MICRO NON-AUTOMATED	$39.00	$60.00	$3.94–$51.00	52% above	35%
Urinalysis with microscope exam, manual inpatient CPT 81000 PERRY-UA/MICRO NON-AUTOMATED	$39.00	$60.00	$3.94–$51.00	—	35%
Urinalysis with microscope exam, manual inpatient CPT 81000 PANORA-UA/MICRO NON-AUTOMATED	$39.00	$60.00	$3.94–$51.00	—	35%
Urinalysis without microscope exam, automated CPT 81003 UR RANDOM SPECIFIC GRAVITY	$10.00	$16.00	$2.20–$13.60	61% below	38%
Urinalysis without microscope exam, automated CPT 81003 PANORA-UA DIP AUTOMATED	$31.00	$47.00	$2.20–$39.95	21% above	34%
Urinalysis without microscope exam, automated CPT 81003 PERRY-UA DIP AUTOMATED	$31.00	$47.00	$2.20–$39.95	21% above	34%
Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPE	$31.00	$47.00	$2.20–$39.95	21% above	34%
Urinalysis without microscope exam, automated CPT 81003 UA DIP CLINIC	$31.00	$47.00	$2.20–$39.95	21% above	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 UR RANDOM SPECIFIC GRAVITY	$10.00	$16.00	$2.20–$13.60	—	38%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPE	$31.00	$47.00	$2.20–$39.95	—	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 PERRY-UA DIP AUTOMATED	$31.00	$47.00	$2.20–$39.95	—	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 PANORA-UA DIP AUTOMATED	$31.00	$47.00	$2.20–$39.95	—	34%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP CLINIC	$31.00	$47.00	$2.20–$39.95	—	34%
Urinalysis without microscope exam, manual CPT 81002 PERRY-UA DIP NON-AUTOMATED	$25.00	$38.00	$3.41–$32.30	8% above	34%
Urinalysis without microscope exam, manual CPT 81002 PANORA-UA DIP NON-AUTOMATED	$25.00	$38.00	$3.41–$32.30	8% above	34%
Urinalysis without microscope exam, manual inpatient CPT 81002 PANORA-UA DIP NON-AUTOMATED	$25.00	$38.00	$3.41–$32.30	—	34%
Urinalysis without microscope exam, manual inpatient CPT 81002 PERRY-UA DIP NON-AUTOMATED	$25.00	$38.00	$3.41–$32.30	—	34%
Urine culture for bacteria, with colony count CPT 87086 PANORA-UA	$69.00	$106.00	$7.91–$90.10	18% above	35%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$69.00	$106.00	$7.91–$90.10	18% above	35%
Urine culture for bacteria, with colony count CPT 87086 PERRY - UA	$69.00	$106.00	$7.91–$90.10	18% above	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 PERRY - UA	$69.00	$106.00	$7.91–$90.10	—	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 PANORA-UA	$69.00	$106.00	$7.91–$90.10	—	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$69.00	$106.00	$7.91–$90.10	—	35%
Urine pregnancy test, read by color change CPT 81025 PANORA-PREG TEST, URINE	$57.00	$88.00	$8.44–$74.80	36% above	35%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$57.00	$88.00	$8.44–$74.80	36% above	35%
Urine pregnancy test, read by color change CPT 81025 PERRY-PREG TEST, URINE	$57.00	$88.00	$8.44–$74.80	36% above	35%
Urine pregnancy test, read by color change inpatient CPT 81025 PERRY-PREG TEST, URINE	$57.00	$88.00	$8.44–$74.80	—	35%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$57.00	$88.00	$8.44–$74.80	—	35%
Urine pregnancy test, read by color change inpatient CPT 81025 PANORA-PREG TEST, URINE	$57.00	$88.00	$8.44–$74.80	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 PANORA-B12, VITAMIN	$94.00	$145.00	$14.78–$123.25	13% above	35%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$94.00	$145.00	$14.78–$123.25	13% above	35%
Vitamin B12 (cobalamin) blood test CPT 82607 PERRY-B12, VITAMIN	$94.00	$145.00	$14.78–$123.25	13% above	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 PANORA-B12, VITAMIN	$94.00	$145.00	$14.78–$123.25	—	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$94.00	$145.00	$14.78–$123.25	—	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 PERRY-B12, VITAMIN	$94.00	$145.00	$14.78–$123.25	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 WELLNESS VITAMIN D 25-HYDROXY	$27.00	$42.00	$18.93–$35.70	78% below	36%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 PERRY-VITAMIN D	$131.00	$202.00	$29.01–$171.70	4% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY-ATLAS	$131.00	$202.00	$29.01–$171.70	4% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 PANORA-VITAMIN D	$131.00	$202.00	$29.01–$171.70	4% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$131.00	$202.00	$29.01–$171.70	4% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 WELLNESS VITAMIN D 25-HYDROXY	$27.00	$42.00	$18.93–$35.70	—	36%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 PANORA-VITAMIN D	$131.00	$202.00	$29.01–$171.70	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$131.00	$202.00	$29.01–$171.70	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 PERRY-VITAMIN D	$131.00	$202.00	$29.01–$171.70	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY-ATLAS	$131.00	$202.00	$29.01–$171.70	—	35%
Zinc blood test CPT 84630 ZINC-SERUM	$52.00	$80.00	$11.16–$68.00	1% below	35%
Zinc blood test CPT 84630 ZINC	$52.00	$80.00	$11.16–$68.00	1% below	35%
Zinc blood test CPT 84630 UR ZINC	$52.00	$80.00	$11.16–$68.00	1% below	35%
Zinc blood test inpatient CPT 84630 ZINC-SERUM	$52.00	$80.00	$11.16–$68.00	—	35%
Zinc blood test inpatient CPT 84630 UR ZINC	$52.00	$80.00	$11.16–$68.00	—	35%
Zinc blood test inpatient CPT 84630 ZINC	$52.00	$80.00	$11.16–$68.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PERRY-PREG TEST SERUM (QUANTITATIVE)	$103.00	$158.00	$14.75–$134.30	16% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER	$103.00	$158.00	$14.75–$134.30	16% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE	$103.00	$158.00	$14.75–$134.30	16% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PANORA-PREG TEST, SERUM(QUANTITATIVE)	$103.00	$158.00	$14.75–$134.30	16% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER	$103.00	$158.00	$14.75–$134.30	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PANORA-PREG TEST, SERUM(QUANTITATIVE)	$103.00	$158.00	$14.75–$134.30	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PERRY-PREG TEST SERUM (QUANTITATIVE)	$103.00	$158.00	$14.75–$134.30	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE	$103.00	$158.00	$14.75–$134.30	—	35%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 2ND SURG-REM ADENOIDS 1' <12 YRS	$1,948.00	$2,997.00	$175.95–$2,547.45	77% above	35%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 OR-REM OF ADENOIDS 1' <12 YEARS	$4,269.00	$6,568.00	$175.95–$5,582.80	289% above	35%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 2ND SURG-REM ADENOIDS 1' <12 YRS	$1,948.00	$2,997.00	$175.95–$2,547.45	—	35%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 OR-REM OF ADENOIDS 1' <12 YEARS	$4,269.00	$6,568.00	$175.95–$5,582.80	—	35%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 OR IA ORTH PHYS-ARTHRO ANT CRUC LIG REP	$2,441.00	$3,756.00	$789.91–$1,915.56	13% below	35%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 OR-ARTHROSC; ANT CRUCIATE LIG REP/AUGM	$8,622.00	$13,264.00	$789.91–$11,274.40	206% above	35%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 OR-ARTHROSC; ANT CRUCIATE LIG REP/AUGM	$8,622.00	$13,264.00	$789.91–$11,274.40	—	35%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 OR IA ORTH PHYS-ARTHRSCPY SHOULDER	$2,105.00	$3,238.00	$866.04–$1,651.38	29% below	35%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 OR-ARTHRSCPY SHOULDER	$5,423.00	$8,343.00	$866.04–$7,091.55	83% above	35%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 OR-ARTHRSCPY SHOULDER	$5,423.00	$8,343.00	$866.04–$7,091.55	—	35%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 IA ORTHO FAC SC-CLTX DSTL FIBULAR FX LAT	$209.00	$321.00	$144.71–$312.90	52% below	35%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 IA ORTHO-CLTX DSTL FIBULAR FX LAT MALL	$320.00	$493.00	$251.43–$312.90	26% below	35%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 OR-BUNION CORRECT W MTRSL BONE INC	$5,486.00	$8,440.00	$800.66–$7,174.00	202% above	35%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 OR-BUNION CORRECT W MTRSL BONE INC	$5,486.00	$8,440.00	$800.66–$7,174.00	—	35%
Bunion correction with removal of part of the big toe joint CPT 28292 OR IA ORTH PHYS-CORR HALLUX VALGUS	$1,270.00	$1,954.00	$482.27–$996.54	27% below	35%
Bunion correction with removal of part of the big toe joint CPT 28292 OR-KELLER/MCBRIDE/MAYO BUNION CORRECT	$5,816.00	$8,948.00	$637.40–$7,605.80	236% above	35%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 OR-KELLER/MCBRIDE/MAYO BUNION CORRECT	$5,816.00	$8,948.00	$637.40–$7,605.80	—	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ER PRO FEE-CARDIOVERSION ELECTRIC EXT	$289.00	$444.00	$101.14–$226.44	64% below	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$921.00	$1,417.00	$141.55–$1,204.45	15% above	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ER-CARDIOVERSION ELECTRIC EXT	$976.00	$1,502.00	$141.55–$1,276.70	22% above	35%
Carpal tunnel release, open surgery CPT 64721 OR-NEUROPLASTY MED NERVE CARP TUNNEL	$3,937.00	$6,057.00	$429.49–$5,148.45	134% above	35%
Carpal tunnel release, open surgery CPT 64721 OR IA ORTH PHYS-NEUROP; MED NERV CT	$4,345.00	$6,684.00	$429.49–$3,408.84	159% above	35%
Carpal tunnel release, open surgery inpatient CPT 64721 OR-NEUROPLASTY MED NERVE CARP TUNNEL	$3,937.00	$6,057.00	$429.49–$5,148.45	—	35%
Cataract surgery with lens implant CPT 66984 OR-CAT W/IOL 1 STAGES EXTRACAPSULAR REM	$5,714.00	$8,790.00	$425.60–$7,471.50	11% above	35%
Cataract surgery with lens implant inpatient CPT 66984 OR-CAT W/IOL 1 STAGES EXTRACAPSULAR REM	$5,714.00	$8,790.00	$425.60–$7,471.50	—	35%
Cervical biopsy CPT 57500 OR-BIOPSY OF CERVIX	$973.00	$1,497.00	$135.37–$1,272.45	169% above	35%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 OR GEN PHYS - CIRCUMCISION >28 DAYS	$434.00	$668.00	$164.23–$340.68	28% below	35%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 OR URO PHYS - CIRCUMCISION >28 DAYS	$461.00	$709.00	$164.23–$361.59	24% below	35%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 OR-CIRCUMCISION > 28 DAYS OF AGE EXC	$3,636.00	$5,594.00	$164.23–$4,754.90	502% above	35%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 OR-CIRCUMCISION > 28 DAYS OF AGE EXC	$3,636.00	$5,594.00	$164.23–$4,754.90	—	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 ER PRO FEE-CIRCUMCISION	$449.00	$690.00	$88.04–$351.90	41% below	35%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PHYS-FRACTURE RADIUS CLOSED TMT WO MANIP	$540.00	$831.00	$211.90–$706.35	27% above	35%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ER PRO FE-FRACT RADIUS CLOSED TMT WO MAN	$629.00	$968.00	$343.84–$493.68	48% above	35%
Colonoscopy with polyp removal CPT 45385 OR GEN PHYS -COLSC FLX W/RMVL OF TUMOR P	$983.00	$1,512.00	$234.76–$771.12	31% below	35%
Colonoscopy with polyp removal CPT 45385 2ND SURG-COLON FLEX W REM LES SNARE	$3,205.00	$4,931.00	$452.12–$4,191.35	125% above	35%
Colonoscopy with polyp removal CPT 45385 OR-COLONOSCOPY REM LES TUMORS FLEX SNARE	$3,273.00	$5,035.00	$452.12–$4,279.75	129% above	35%
Colonoscopy with polyp removal inpatient CPT 45385 2ND SURG-COLON FLEX W REM LES SNARE	$3,205.00	$4,931.00	$452.12–$4,191.35	—	35%
Colonoscopy with polyp removal inpatient CPT 45385 OR-COLONOSCOPY REM LES TUMORS FLEX SNARE	$3,273.00	$5,035.00	$452.12–$4,279.75	—	35%
Colonoscopy with tissue sample CPT 45380 OR GEN PHYS - COLONOSCOPY W/BIOPSY SINGL	$931.00	$1,433.00	$186.15–$730.83	33% below	35%
Colonoscopy with tissue sample CPT 45380 2ND SURG-COLON W FLEX SIN OR MLT BIOP	$2,766.00	$4,255.00	$432.92–$3,616.75	100% above	35%
Colonoscopy with tissue sample CPT 45380 OR-COLONOSCOPY W BIOPSY FLEX SIN OR MLT	$2,932.00	$4,511.00	$432.92–$3,834.35	112% above	35%
Colonoscopy with tissue sample inpatient CPT 45380 2ND SURG-COLON W FLEX SIN OR MLT BIOP	$2,766.00	$4,255.00	$432.92–$3,616.75	—	35%
Colonoscopy with tissue sample inpatient CPT 45380 OR-COLONOSCOPY W BIOPSY FLEX SIN OR MLT	$2,932.00	$4,511.00	$432.92–$3,834.35	—	35%
Colonoscopy, diagnostic CPT 45378 OR GEN PHYS - COLONOSCOPY FLX DX W/COLLJ	$788.00	$1,212.00	$171.98–$618.12	28% below	35%
Colonoscopy, diagnostic CPT 45378 2ND SURG-DIAGNOSTIC COLONOSCOPY FLEX	$1,873.00	$2,881.00	$340.93–$2,448.85	72% above	35%
Colonoscopy, diagnostic CPT 45378 PR-DIAGNOSTIC COLONOSCOPY FLEXIBLE	$2,609.00	$4,014.00	$340.93–$3,411.90	140% above	35%
Colonoscopy, diagnostic inpatient CPT 45378 2ND SURG-DIAGNOSTIC COLONOSCOPY FLEX	$1,873.00	$2,881.00	$340.93–$2,448.85	—	35%
Colonoscopy, diagnostic inpatient CPT 45378 PR-DIAGNOSTIC COLONOSCOPY FLEXIBLE	$2,609.00	$4,014.00	$340.93–$3,411.90	—	35%
Complex cataract surgery with lens implant CPT 66982 OR-CATARACT REMOVAL W/IOL COMPLEX	$5,714.00	$8,790.00	$579.87–$7,471.50	25% above	35%
Complex cataract surgery with lens implant inpatient CPT 66982 OR-CATARACT REMOVAL W/IOL COMPLEX	$5,714.00	$8,790.00	$579.87–$7,471.50	—	35%
Cystoscopy with ureteral stent placement CPT 52332 OR URO PHYS - CYST W/INS OF INDW URET ST	$1,058.00	$1,627.00	$145.76–$829.77	36% below	35%
Cystoscopy with ureteral stent placement CPT 52332 OR-CYST W INS OF INDWELLING URETER STENT	$4,064.00	$6,252.00	$335.80–$5,314.20	147% above	35%
Cystoscopy with ureteral stent placement inpatient CPT 52332 OR-CYST W INS OF INDWELLING URETER STENT	$4,064.00	$6,252.00	$335.80–$5,314.20	—	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 OR GEN PHYS-CYSTOURETHROSCOPY	$461.00	$709.00	$74.24–$361.59	42% below	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$488.00	$751.00	$74.24–$383.01	39% below	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 URO PRO SC -CYSTOURETHROSCOPY	$1,165.00	$1,793.00	$74.24–$914.43	45% above	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PR-CYSTOSCOPY	$2,745.00	$4,223.00	$194.24–$3,589.55	243% above	35%
D&C (dilation and curettage), not related to pregnancy CPT 58120 ER PRO FEE-DILATION/CURETTAGE	$436.00	$670.00	$214.83–$341.70	47% below	35%
D&C (dilation and curettage), not related to pregnancy CPT 58120 OR-D&C DIAGNOSTIC OR THERAP NOT OB	$3,392.00	$5,218.00	$266.18–$4,435.30	316% above	35%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 OR-D&C DIAGNOSTIC OR THERAP NOT OB	$3,392.00	$5,218.00	$266.18–$4,435.30	—	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PERRY-FAC DEST PRE-MALIG LESION EA	$28.00	$43.00	$19.38–$42.14	81% below	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PERRY-DEST PRE-MALIG LESION EA	$111.00	$170.00	$49.97–$86.70	25% below	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PANORA-DEST PRE-MALIG LESION EA	$138.00	$213.00	$60.22–$181.05	7% below	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 OR-DESTRUCT PREMALG 1 LESIONS	$503.00	$774.00	$60.22–$657.90	239% above	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 OR-DESTRUCT PREMALG 1 LESIONS	$503.00	$774.00	$60.22–$657.90	—	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 OR-TYMPANOSTOMY, GENERAL ANESTHESIA	$3,883.00	$5,974.00	$130.39–$5,077.90	447% above	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 OR-TYMPANOSTOMY, GENERAL ANESTHESIA	$3,883.00	$5,974.00	$130.39–$5,077.90	—	35%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ER PRO FE-REM IMP EAR WAX 1-2 EARS IRRI	$25.00	$39.00	$15.10–$19.89	63% below	36%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ER-REMOVE IMP EAR WAX 1-2 EARS BY IRRIGA	$46.00	$70.00	$15.10–$59.50	32% below	34%
Earwax removal by irrigation (rinsing), one ear CPT 69209 OR-REM IMP EAR WAX 1-2 EARS BY IRRIG	$51.00	$78.00	$15.10–$66.30	25% below	35%
Earwax removal by irrigation (rinsing), one ear CPT 69209 PANORA-REMOVAL IMPCTD CER/LAVAGE	$77.00	$118.00	$15.10–$100.30	14% above	35%
Earwax removal by irrigation (rinsing), one ear CPT 69209 PERRY-REMOVAL IMPCTED CER/LAVAGE	$77.00	$118.00	$15.10–$100.30	14% above	35%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 OR-REM IMP EAR WAX 1-2 EARS BY IRRIG	$51.00	$78.00	$15.10–$66.30	—	35%
Earwax removal with instruments, one ear CPT 69210 PERRY-FAC REMOVAL IMPCTED CER/INSTMNT	$17.00	$26.00	$11.72–$25.48	84% below	35%
Earwax removal with instruments, one ear CPT 69210 PERRY-REMOVAL IMPCTED CER/INSTMNT	$68.00	$104.00	$28.42–$53.04	34% below	35%
Earwax removal with instruments, one ear CPT 69210 ER PRO FE-REM IMPCT EAR WAX 1-2 EAR INST	$80.00	$123.00	$28.42–$62.73	23% below	35%
Earwax removal with instruments, one ear CPT 69210 PANORA-REMOVAL IMPCTD CER/INSTMNT	$85.00	$130.00	$43.29–$110.50	18% below	35%
Earwax removal with instruments, one ear CPT 69210 ER-REMOVE IMP EAR WAX 1-2 EARS BY INSTRU	$85.00	$131.00	$33.40–$111.35	18% below	35%
Earwax removal with instruments, one ear CPT 69210 OR-REM IMP EAR WAX 1-2 EARS BY INSTRUM	$520.00	$800.00	$43.29–$680.00	402% above	35%
Earwax removal with instruments, one ear inpatient CPT 69210 OR-REM IMP EAR WAX 1-2 EARS BY INSTRUM	$520.00	$800.00	$43.29–$680.00	—	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PERRY-FAC ENDOMETRIAL BIOPSY	$42.00	$64.00	$28.85–$62.72	84% below	34%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PERRY-ENDOMETRIAL BIOPSY	$166.00	$256.00	$56.51–$130.56	35% below	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PANORA-ENDOMETRIAL BIOPSY	$209.00	$321.00	$87.78–$272.85	18% below	35%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PR-INJECT, SINGLE-CERVICAL/THORA W/IMAGE	$855.00	$1,316.00	$250.22–$1,118.60	29% below	35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 OR-INJ PARAVERT F JNT L/S 1 LEVEL	$796.00	$1,225.00	$172.46–$1,041.25	37% below	35%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 OR-INJ PARAVERT F JNT L/S 1 LEVEL	$796.00	$1,225.00	$172.46–$1,041.25	—	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 OR GEN PHYS - RPR AA HRN 1st 3-10 RDC	$850.00	$1,308.00	$454.40–$667.08	62% below	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 OR-RPR AA HRN 1ST 3-10 RDC	$6,480.00	$9,969.00	$454.40–$8,473.65	188% above	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 OR-RPR AA HRN 1ST 3-10 RDC	$6,480.00	$9,969.00	$454.40–$8,473.65	—	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 OR GEN PHYS -RPR AA HRN 1ST < 3 CM RDC	$2,686.00	$4,132.00	$273.93–$2,107.32	28% above	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 OR-RPR AA HRN 1ST < 3 CM RDC	$5,843.00	$8,989.00	$273.93–$7,640.65	179% above	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 OR-RPR AA HRN 1ST < 3 CM RDC	$5,843.00	$8,989.00	$273.93–$7,640.65	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 ER PRO FEE-SIGMOIDOSCOPY	$168.00	$258.00	$55.74–$193.13	70% below	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PR-SIGMOIDOSCOPY FLEXIBLE, DIAGNOSTIC	$2,074.00	$3,191.00	$193.13–$2,712.35	272% above	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PR-SIGMOIDOSCOPY FLEXIBLE, DIAGNOSTIC	$2,074.00	$3,191.00	$193.13–$2,712.35	—	35%
Gallbladder removal, laparoscopic CPT 47562 OR GEN PHYS -LAPAROSCOPIC CHOLECYSTECTOM	$1,325.00	$2,039.00	$549.80–$1,039.89	33% below	35%
Gallbladder removal, laparoscopic CPT 47562 OR-LAPAROSCOPIC CHOLECYSTECTOMY	$9,141.00	$14,063.00	$549.80–$11,953.55	365% above	35%
Gallbladder removal, laparoscopic inpatient CPT 47562 OR-LAPAROSCOPIC CHOLECYSTECTOMY	$9,141.00	$14,063.00	$549.80–$11,953.55	—	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 OR GEN PHYS -LAPARO CHOLECYSTECTOMY/GRA	$1,524.00	$2,345.00	$594.95–$1,195.95	26% below	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 OR-LAP; CHOLE W CHOLANGIOGR	$11,427.00	$17,580.00	$594.95–$14,943.00	452% above	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 OR-LAP; CHOLE W CHOLANGIOGR	$11,427.00	$17,580.00	$594.95–$14,943.00	—	35%
Gallbladder removal, open surgery through a larger incision CPT 47600 EXCISION CHOLECYSTECTOMY	$5,122.00	$7,880.00	$879.66–$6,698.00	139% above	35%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 EXCISION CHOLECYSTECTOMY	$5,122.00	$7,880.00	$879.66–$6,698.00	—	35%
Hammertoe correction surgery CPT 28285 OR IA ORTH PHYS-REPAIR OF HAMMERTOE	$1,231.00	$1,894.00	$387.77–$965.94	32% below	35%
Hammertoe correction surgery CPT 28285 2ND SURG-REPAIR OF HAMMERTOE	$2,157.00	$3,318.00	$496.53–$2,820.30	20% above	35%
Hammertoe correction surgery CPT 28285 OR-REPAIR OF HAMMERTOE	$4,572.00	$7,034.00	$496.53–$5,978.90	154% above	35%
Hammertoe correction surgery inpatient CPT 28285 2ND SURG-REPAIR OF HAMMERTOE	$2,157.00	$3,318.00	$496.53–$2,820.30	—	35%
Hammertoe correction surgery inpatient CPT 28285 OR-REPAIR OF HAMMERTOE	$4,572.00	$7,034.00	$496.53–$5,978.90	—	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 GEN SURG FAC SC-HEMORRHOIDECTOMY INTERNA	$116.00	$178.00	$80.24–$174.44	82% below	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 GEN SURG PRO SC-HEMORRHOIDECTOMY INTERNA	$501.00	$771.00	$203.56–$393.21	23% below	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 OR GEN PHYS-HEMORRHOIDECTOMY INTERNA	$532.00	$818.00	$203.56–$417.18	18% below	35%
Hemorrhoidectomy (internal and external), one area CPT 46255 OR-HEMORRHOIDECTOMY INT/EXT SIMPLE	$3,572.00	$5,496.00	$518.88–$4,671.60	207% above	35%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 OR-HEMORRHOIDECTOMY INT/EXT SIMPLE	$3,572.00	$5,496.00	$518.88–$4,671.60	—	35%
Hysteroscopy with endometrial ablation CPT 58563 OR-HYSTEROSCOPY ENDOMETRIAL ABLATION	$3,876.00	$5,963.00	$1,800.44–$5,068.55	3% below	35%
Hysteroscopy with endometrial ablation inpatient CPT 58563 OR-HYSTEROSCOPY ENDOMETRIAL ABLATION	$3,876.00	$5,963.00	$1,800.44–$5,068.55	—	35%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 OR-HYSTEROSCOPY;W BX ENDOM OR POLYPECT	$3,372.00	$5,188.00	$1,137.84–$4,409.80	at median	35%
Incision and drainage of a simple or single skin abscess CPT 10060 PERRY-FAC I&D ABSCESS, SIMPLE/SINGLE	$33.00	$50.00	$22.54–$49.00	86% below	34%
Incision and drainage of a simple or single skin abscess CPT 10060 PERRY-I&D ABSCESS, SIMPLE/SINGLE	$127.00	$196.00	$88.36–$166.60	48% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 ER PRO FEE-PARONYCHIA-ONYCHIA	$155.00	$238.00	$104.95–$121.38	36% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 ER PRO FEE-SEBACEOUS CYST	$155.00	$238.00	$104.95–$121.38	36% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 ER PRO FEE-FURUNCLE	$155.00	$238.00	$104.95–$121.38	36% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 PANORA-I&D ABSCESS, SIMPLE/SINGLE	$160.00	$246.00	$110.90–$209.10	34% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 OR IA ORTH PHYS-I&D ABSC; SMPL OR SGL	$204.00	$314.00	$104.95–$160.14	16% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 ER PRO FEE--I&D ABSC; SMPL OR SGL	$232.00	$357.00	$104.95–$182.07	4% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 ER-I&D ABSC; SMPL OR SGL	$347.00	$534.00	$116.41–$453.90	43% above	35%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 OR GEN PHYS -RPR 1ST INGUN HRNA AGE 5 YR	$1,046.00	$1,609.00	$442.38–$820.59	31% below	35%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 OR-PRP I/HERN INIT REDUC >=5 YEARS	$5,816.00	$8,948.00	$442.38–$7,605.80	285% above	35%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 OR-PRP I/HERN INIT REDUC >=5 YEARS	$5,816.00	$8,948.00	$442.38–$7,605.80	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ER PRO FEE-INJ TRIGGER POINT	$106.00	$163.00	$35.03–$83.13	56% below	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 LIG/TENDON INJECTION	$193.00	$297.00	$54.71–$252.45	19% below	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 IA ORTHO-INJ SGL TENDON SHTH OR LIGAMENT	$213.00	$328.00	$35.03–$167.28	11% below	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 OR-INJ SGL TENDON SHTH OR LIGAMENT	$619.00	$952.00	$54.71–$809.20	158% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 OR-INJ SGL TENDON SHTH OR LIGAMENT	$619.00	$952.00	$54.71–$809.20	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 AMB INF-DRAIN/INJ MAJOR JNT/BURSA	$89.00	$137.00	$61.63–$116.45	74% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SCHED-DRAIN/INJ MAJOR JNT/BURSA	$89.00	$137.00	$34.94–$116.45	74% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PERRY- ASP/INJ JNT MAJOR	$112.00	$172.00	$40.92–$87.72	67% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER PRO FEE-DRAIN/INJ MAJ JNT/BUR WO US	$121.00	$186.00	$40.92–$94.86	65% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS-MAJOR JOINT/BURSA	$134.00	$206.00	$61.63–$175.10	61% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PANORA- ASP/INJ JNT MAJOR	$140.00	$215.00	$61.63–$182.75	59% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR CAP ASSI-DRAIN/INJ MAJ JNT/BURS WO US	$149.00	$229.00	$40.92–$116.79	57% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR-OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SE	$164.00	$252.00	$61.63–$214.20	52% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR IA ORTH -DRAIN/INJ MAJ JNT/BURS WO US	$215.00	$330.00	$40.92–$168.30	38% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER-DRAIN/INJ MAJOR JNT/BURSA WO US	$272.00	$419.00	$61.63–$356.15	21% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 IA ORTHO-DRAIN/INJ MAJOR JNT/BURSA WO US	$276.00	$425.00	$40.92–$216.75	20% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS-MAJOR JOINT/BURSA	$134.00	$206.00	$61.63–$175.10	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 OR-OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SE	$164.00	$252.00	$61.63–$214.20	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER PRO FE-FDRAIN/INJ INTER JNT/BUR WO US	$103.00	$158.00	$33.61–$80.58	64% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PERRY-ASP/INJ JNT INTERM(WRIST,ANK,ELB)	$119.00	$183.00	$33.61–$93.33	58% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PANORA-ASP/INJ JNT INTERM(WRIST,ANK,ELB)	$149.00	$229.00	$51.70–$194.65	48% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 OR IA ORTH -ARTHROCENTESIS ASPIR&/INJ IN	$195.00	$300.00	$33.61–$153.00	32% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA WO US	$209.00	$322.00	$51.70–$273.70	27% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IA ORTHO-DRAIN/INJ INTER JNT/BURSA WO US	$236.00	$363.00	$33.61–$185.13	18% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 OR-DRAIN/INJ INTERM JNT/BURSA WO US	$656.00	$1,009.00	$51.70–$857.65	129% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 OR-DRAIN/INJ INTERM JNT/BURSA WO US	$656.00	$1,009.00	$51.70–$857.65	—	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PERRY - ASPIR/INJ JOINT SMALL	$84.00	$129.00	$32.86–$65.79	69% below	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PANORA-ASPIR/INJ JOINT SMALL	$105.00	$161.00	$50.74–$136.85	61% below	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 IA ORTHO-DRAIN/INJ SM JNT/BURSA WO US	$190.00	$293.00	$32.86–$149.43	30% below	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 OR-DRAIN/INJ SM JNT/BURSA WO US	$549.00	$845.00	$50.74–$718.25	102% above	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 OR-DRAIN/INJ SM JNT/BURSA WO US	$549.00	$845.00	$50.74–$718.25	—	35%
Knee arthroscopy with meniscus trim CPT 29881 OR IA ORTH PH-ARTH KNEE W/MENISCTOMY MED	$1,417.00	$2,180.00	$457.76–$1,111.80	41% below	35%
Knee arthroscopy with meniscus trim CPT 29881 OR-ARTHROSCOPY KNEE W MENISCTOMY MED LAT	$5,714.00	$8,790.00	$457.76–$7,471.50	136% above	35%
Knee arthroscopy with meniscus trim inpatient CPT 29881 OR-ARTHROSCOPY KNEE W MENISCTOMY MED LAT	$5,714.00	$8,790.00	$457.76–$7,471.50	—	35%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 OR CAP ASSI-ARTHRO KNEE W/MENISCTOMY LAT	$1,388.00	$2,136.00	$473.14–$1,089.36	29% below	35%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 OR IA ORTH PH-ARTH KNEE W/MENISCTOMY LAT	$1,388.00	$2,136.00	$473.14–$1,089.36	29% below	35%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 OR-ARTHRSCPY KNEE W MENISCECTOMY LAT MED	$5,389.00	$8,291.00	$473.14–$7,047.35	174% above	35%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 OR-ARTHRSCPY KNEE W MENISCECTOMY LAT MED	$5,389.00	$8,291.00	$473.14–$7,047.35	—	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 OR IA ORTH PHYS-ARTHROS, KNEE DEBRID/SHV	$1,537.00	$2,364.00	$520.60–$1,205.64	10% below	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 OR-ARTHROSCOPY, KNEE DEBRID/SHV AC	$4,785.00	$7,362.00	$520.60–$6,257.70	180% above	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 OR-ARTHROSCOPY, KNEE DEBRID/SHV AC	$4,785.00	$7,362.00	$520.60–$6,257.70	—	35%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 OR GEN PHYS - LAPAROSCOPY, SURGICAL, APP	$1,152.00	$1,772.00	$503.72–$903.72	33% below	35%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY, SURGICAL, APPENDECTOMY	$8,622.00	$13,264.00	$503.72–$11,274.40	399% above	35%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY, SURGICAL, APPENDECTOMY	$8,622.00	$13,264.00	$503.72–$11,274.40	—	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 OR GEN PHYS -LAP ING HERNIA REPAIR INIT	$850.00	$1,308.00	$369.99–$667.08	31% below	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 2ND SURG-LAP ING HERNIA REPAIR INIT	$3,994.00	$6,145.00	$369.99–$5,223.25	225% above	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 OR-LAP ING HERNIA REPAIR INIT	$9,141.00	$14,063.00	$369.99–$11,953.55	645% above	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 2ND SURG-LAP ING HERNIA REPAIR INIT	$3,994.00	$6,145.00	$369.99–$5,223.25	—	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 OR-LAP ING HERNIA REPAIR INIT	$9,141.00	$14,063.00	$369.99–$11,953.55	—	35%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 OR GEN PHYS-LAP ING HERNIA REPAIR RECUR	$933.00	$1,435.00	$479.56–$731.85	38% below	35%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 2ND SURG-LAP ING HERNIA RPR RECUR	$4,313.00	$6,635.00	$479.56–$5,639.75	188% above	35%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 OR-LAP ING HERNIA REPAIR RECUR	$9,141.00	$14,063.00	$479.56–$11,953.55	511% above	35%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 2ND SURG-LAP ING HERNIA RPR RECUR	$4,313.00	$6,635.00	$479.56–$5,639.75	—	35%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 OR-LAP ING HERNIA REPAIR RECUR	$9,141.00	$14,063.00	$479.56–$11,953.55	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD WND REPAIR S/A/T/EXT <=2.50 CM	$250.00	$384.00	$97.92–$326.40	30% below	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ER PRO F -INTMD WND REP S/A/T/EXT<=2.5CM	$285.00	$439.00	$139.19–$234.54	20% below	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 OR GEN PHYS - INTMD RPR S/A/T/EXT 2.5 C	$497.00	$765.00	$139.19–$390.15	40% above	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 OR-INTMD WND REPAIR S/A/T/EXT <= 2.5 CM	$807.00	$1,242.00	$234.54–$1,055.70	127% above	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 OR-INTMD WND REPAIR S/A/T/EXT <= 2.5 CM	$807.00	$1,242.00	$234.54–$1,055.70	—	35%
Lower-back epidural injection, with imaging guidance CPT 62323 PR-INJECT, SINGLE-LUMBAR,SACRAL W/IMAGE	$593.00	$912.00	$247.01–$775.20	48% below	35%
Lower-back epidural injection, without imaging guidance CPT 62322 PR-INJECTION, SINGLE-LUMBAR,SACRAL	$307.00	$473.00	$132.24–$402.05	56% below	35%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 OR-INJ EPI 1 LEVEL AGNT/ANESTH LUM/S/STE	$647.00	$996.00	$239.78–$846.60	50% below	35%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 OR-INJ EPI 1 LEVEL AGNT/ANESTH LUM/S/STE	$647.00	$996.00	$239.78–$846.60	—	35%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 OR IA ORTH P-LAMNOTMY INCL W/DCMPRSN NRV	$2,262.00	$3,480.00	$772.82–$1,774.80	at median	35%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 OR-LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 IN	$8,734.00	$13,437.00	$772.82–$11,421.45	286% above	35%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 OR-LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 IN	$8,734.00	$13,437.00	$772.82–$11,421.45	—	35%
Lumbar laminectomy (spinal decompression), one level CPT 63047 OR IA ORTH PH-REMOVAL OF SPINAL LAMI SGL	$2,575.00	$3,962.00	$914.39–$2,020.62	10% below	35%
Lumbar laminectomy (spinal decompression), one level CPT 63047 OR-REMOVAL OF SPINAL LAMINA SGL LUMBAR	$8,734.00	$13,437.00	$914.39–$11,421.45	206% above	35%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 OR-REMOVAL OF SPINAL LAMINA SGL LUMBAR	$8,734.00	$13,437.00	$914.39–$11,421.45	—	35%
Lumbar spinal fusion (posterior), one level CPT 22612 OR IA ORTH PHYS-LUMBAR SPINE FUSION	$3,106.00	$4,779.00	$1,267.61–$2,437.29	25% below	35%
Lumbar spinal fusion (posterior), one level CPT 22612 OR-LUMBAR SPINE FUSION	$8,734.00	$13,437.00	$1,267.61–$11,421.45	109% above	35%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 OR-LUMBAR SPINE FUSION	$8,734.00	$13,437.00	$1,267.61–$11,421.45	—	35%
Lumpectomy (partial mastectomy) CPT 19301 OR-MASTECTOMY, PARTIAL (EG, LUMPECTOMY,	$4,851.00	$7,463.00	$551.68–$6,343.55	177% above	35%
Lumpectomy (partial mastectomy) inpatient CPT 19301 OR-MASTECTOMY, PARTIAL (EG, LUMPECTOMY,	$4,851.00	$7,463.00	$551.68–$6,343.55	—	35%
Mastectomy (total removal of the breast) CPT 19303 OR-RECONSTRUCTION WITH IMPLANTS	$3,378.00	$5,197.50	$798.37–$4,417.88	38% above	35%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$3,648.00	$5,613.00	$798.37–$4,771.05	49% above	35%
Mastectomy (total removal of the breast) CPT 19303 OR-MAST, SIMPLE, COMPLETE	$3,717.00	$5,718.00	$798.37–$4,860.30	52% above	35%
Mastectomy (total removal of the breast) inpatient CPT 19303 OR-RECONSTRUCTION WITH IMPLANTS	$3,378.00	$5,197.50	$798.37–$4,417.88	—	35%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$3,648.00	$5,613.00	$798.37–$4,771.05	—	35%
Mastectomy (total removal of the breast) inpatient CPT 19303 OR-MAST, SIMPLE, COMPLETE	$3,717.00	$5,718.00	$798.37–$4,860.30	—	35%
Miscarriage treatment with D&C, first trimester CPT 59820 ER PRO FEE-MISCARRIAGE TREATMT	$482.00	$741.00	$348.19–$377.91	56% below	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PERRY-FAC EXC TR-EXT B9+MARG 0.5CM/<	$54.00	$83.00	$37.42–$81.34	81% below	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PERRY-EXC TR-EXT B9+MARG 0.5CM/<	$216.00	$332.00	$79.55–$169.32	22% below	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PANORA-EXC TR-EXT B9+MARG 0.5CM/<	$270.00	$415.00	$115.30–$352.75	3% below	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 LEVEL 1 EXC/BIOPSY	$356.00	$548.00	$115.30–$465.80	28% above	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 OR-EXC TR-EXT B9+MARG 0.5 CM/<	$2,074.00	$3,191.00	$115.30–$2,712.35	648% above	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 OR-EXC TR-EXT B9+MARG 0.5 CM/<	$2,074.00	$3,191.00	$115.30–$2,712.35	—	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PERRY-FAC EXC FACE-MM B9+MARG 0.5CM/<	$79.00	$121.00	$54.55–$118.58	82% below	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PERRY-EXC FACE-MM B9+MARG 0.5CM/<	$313.00	$482.00	$102.04–$245.82	29% below	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PANORA-EXC FACE-MM B9+MARG 0.5CM/<	$392.00	$603.00	$128.26–$512.55	12% below	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 OR-EXC FACE-MM B9+MARG 0.5 CM/<	$2,074.00	$3,191.00	$128.26–$2,712.35	368% above	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 OR-EXC FACE-MM B9+MARG 0.5 CM/<	$2,074.00	$3,191.00	$128.26–$2,712.35	—	35%
Nail removal (partial or complete), one nail CPT 11730 PERRY-FAC NAIL PLATE,AVUL,PRTL/COMP SIN	$29.00	$44.00	$19.84–$43.12	86% below	34%
Nail removal (partial or complete), one nail CPT 11730 REMOVE NAIL PLATE SINGLE SIMPLE	$85.00	$131.00	$33.40–$111.35	60% below	35%
Nail removal (partial or complete), one nail CPT 11730 PERRY-NAIL PLATE,AVULSION,PRTL/COMP SIN	$115.00	$177.00	$51.99–$101.52	46% below	35%
Nail removal (partial or complete), one nail CPT 11730 ER PRO FEE--SPL AVULSE NP; SGL	$126.00	$194.00	$51.99–$101.52	41% below	35%
Nail removal (partial or complete), one nail CPT 11730 PANORA-NAIL PLATE,AVULSION,PRTL/COMP SIN	$144.00	$222.00	$100.08–$188.70	32% below	35%
Nail removal (partial or complete), one nail CPT 11730 IA ORTHO-REMOVE NAIL PLATE SINGLE SIMPLE	$155.00	$239.00	$51.99–$121.89	27% below	35%
Nail removal (partial or complete), one nail CPT 11730 OR-SPL AVULSE NP; SGL	$701.00	$1,078.00	$101.52–$916.30	229% above	35%
Nail removal (partial or complete), one nail inpatient CPT 11730 OR-SPL AVULSE NP; SGL	$701.00	$1,078.00	$101.52–$916.30	—	35%
Paracentesis with imaging guidance CPT 49083 US ABDOMINAL PARACENTESIS INIT- PER PROT	$448.00	$689.00	$256.74–$585.65	60% below	35%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING	$3,466.00	$5,332.00	$256.74–$4,532.20	212% above	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERRY-FAC NAIL/MATR, EXC (PERM) PRT/COMP	$73.00	$113.00	$50.94–$110.74	83% below	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ER PRO FEE--REMOVAL OF NAIL BED	$235.00	$362.00	$99.32–$184.62	45% below	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERRY-NAIL/MATRIX, EXC (PERM) PRT/COMP	$294.00	$453.00	$99.32–$231.03	31% below	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PANORA-NAIL/MATRX,EXC(PERM) PRT/COMP	$369.00	$568.00	$143.28–$482.80	14% below	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ER-REMOVAL OF NAIL BED	$398.00	$613.00	$143.28–$521.05	7% below	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 OR-REMOVAL OF NAIL BED	$2,074.00	$3,191.00	$143.28–$2,712.35	383% above	35%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 OR-REMOVAL OF NAIL BED	$2,074.00	$3,191.00	$143.28–$2,712.35	—	35%
Prostate biopsy CPT 55700 URO FAC SC-PROSTATE NEEDLE PUNCH BX	$214.00	$329.00	$148.31–$279.65	84% below	35%
Prostate biopsy CPT 55700 URO PRO SC-PROSTATE NEEDLE PUNCH BX	$1,490.00	$2,293.00	$131.57–$1,169.43	11% above	35%
Prostate biopsy CPT 55700 OR URO PHYS - PROSTATE NEEDLE BIOPSY ANY	$1,596.00	$2,455.00	$131.57–$1,252.05	18% above	35%
Prostate biopsy CPT 55700 OR-PROSTATE NEEDLE PUNCH BX	$2,114.00	$3,253.00	$211.38–$2,765.05	57% above	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 OR-DESTROY LUMB/SAC FACET JNT	$1,711.00	$2,632.00	$421.01–$2,237.20	17% below	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 OR-DESTROY LUMB/SAC FACET JNT	$1,711.00	$2,632.00	$421.01–$2,237.20	—	35%
Removal of a breast lump, open surgery CPT 19120 OR-REMOVAL BREAST LESION >= 1 LESIONS	$3,456.00	$5,317.00	$505.42–$4,519.45	146% above	35%
Removal of a breast lump, open surgery inpatient CPT 19120 OR-REMOVAL BREAST LESION >= 1 LESIONS	$3,456.00	$5,317.00	$505.42–$4,519.45	—	35%
Removal of a foreign object under the skin, simple CPT 10120 PERRY-FAC FB REM SQ TISSU-SIMPW/O LAMP	$51.00	$79.00	$35.61–$77.42	83% below	35%
Removal of a foreign object under the skin, simple CPT 10120 ER-INC & REM FB, SUBCUTANEOUS SIM	$201.00	$309.00	$78.80–$262.65	33% below	35%
Removal of a foreign object under the skin, simple CPT 10120 PERRY-FOR BOD REM SQ TISSU-SIMPW/O LAMP	$206.00	$317.00	$106.48–$161.67	31% below	35%
Removal of a foreign object under the skin, simple CPT 10120 PANORA-FOR BOD REM SQ TISSU-SIMPW/O LAMP	$257.00	$396.00	$142.00–$336.60	14% below	35%
Removal of a foreign object under the skin, simple CPT 10120 OR IA ORTH PHY-INCIS/REM FB-SUBQ TIS SIM	$257.00	$395.00	$106.48–$201.45	14% below	35%
Removal of a foreign object under the skin, simple CPT 10120 ER PRO FEE-INCISION & REM FB SUBCUT SMPL	$278.00	$427.00	$106.48–$217.77	7% below	35%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REM FB-SUBQ TISSUE SIMPLE	$1,337.00	$2,057.00	$142.00–$1,748.45	348% above	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REM FB-SUBQ TISSUE SIMPLE	$1,337.00	$2,057.00	$142.00–$1,748.45	—	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 OR GEN PHYS-SCRN COLONOSCOPY PT NOT HI	$798.00	$1,227.00	$172.14–$625.77	19% below	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 OR-SCRN COLONOSCOPY PT NOT HI RISK	$4,303.00	$6,620.00	$341.07–$5,627.00	338% above	35%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 OR-SCRN COLONOSCOPY PT NOT HI RISK	$4,303.00	$6,620.00	$341.07–$5,627.00	—	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 OR GEN PHYS-SCRN COLONOSCOPY HIGH RISK	$892.00	$1,372.00	$171.98–$699.72	18% below	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PR-SCREENING COLONOSCOPY,HIGH RISK INDIV	$3,667.00	$5,642.00	$340.93–$4,795.70	237% above	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PR-SCREENING COLONOSCOPY,HIGH RISK INDIV	$3,667.00	$5,642.00	$340.93–$4,795.70	—	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 OR URO PHYS - LITHOTRIPSY	$1,589.00	$2,444.00	$543.82–$1,246.44	30% below	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 OR GEN PHYS-LITHO EXTRACOR SHOCKWAVE	$1,639.00	$2,521.00	$543.82–$1,285.71	28% below	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 OR URO PHY-LITHO EXTRACOR SHOCKWAVE	$1,737.00	$2,673.00	$543.82–$1,363.23	24% below	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 OR-LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE	$13,713.00	$21,097.00	$687.33–$17,932.45	503% above	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 OR-LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE	$13,713.00	$21,097.00	$687.33–$17,932.45	—	35%
Short arm cast (elbow to hand) CPT 29075 ER PRO FEE-APPLY SHORT ARM CAST	$85.00	$131.00	$60.30–$87.17	63% below	35%
Short arm cast (elbow to hand) CPT 29075 ER-APPLY SHORT ARM CAST	$160.00	$246.00	$62.73–$209.10	29% below	35%
Short arm splint (forearm and hand) CPT 29125 IA ORTHO FAC SC- SHRT ARM STAT SPLNT APP	$29.00	$45.00	$20.29–$44.10	84% below	36%
Short arm splint (forearm and hand) CPT 29125 PERRY- FAC SHORT ARM STATIC SPLINT APPL	$31.00	$47.00	$21.19–$46.06	82% below	34%
Short arm splint (forearm and hand) CPT 29125 ER PRO FEE-APP SHRT ARM SPLT; STATIC	$120.00	$185.00	$42.18–$94.35	32% below	35%
Short arm splint (forearm and hand) CPT 29125 PERRY- SHORT ARM STATIC SPLINT APPL	$122.00	$188.00	$42.18–$95.88	31% below	35%
Short arm splint (forearm and hand) CPT 29125 PANORA- SHORT ARM STATIC SPLINT APPL	$153.00	$235.00	$70.82–$199.75	13% below	35%
Short arm splint (forearm and hand) CPT 29125 IA ORTHO- SHORT ARM STATIC SPLINT APPL	$164.00	$252.00	$42.18–$128.52	7% below	35%
Short arm splint (forearm and hand) CPT 29125 OR IA ORTH PHY-APPLY SHORT ARM SPT; STAT	$169.00	$260.00	$42.18–$132.60	4% below	35%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT; STATIC	$241.00	$371.00	$70.82–$315.35	37% above	35%
Short leg cast (below the knee) CPT 29405 ER PRO FEE-APPLY SHORT LEG CAST	$122.00	$188.00	$57.48–$95.88	49% below	35%
Short leg cast (below the knee) CPT 29405 ER-APPLY SH LEG CAST	$164.00	$253.00	$64.52–$215.05	32% below	35%
Short leg splint (calf to foot) CPT 29515 PERRY-FAC APPLY SHORT LEG SPLINT	$35.00	$54.00	$24.34–$52.92	79% below	35%
Short leg splint (calf to foot) CPT 29515 CAST APP-LOWER LEG	$77.00	$118.00	$53.19–$100.30	54% below	35%
Short leg splint (calf to foot) CPT 29515 ER PRO FEE-APPLY SHORT LEG SPLINT	$130.00	$200.00	$51.25–$102.00	22% below	35%
Short leg splint (calf to foot) CPT 29515 PERRY-APPLY SHORT LEG SPLINT	$141.00	$217.00	$51.25–$110.67	15% below	35%
Short leg splint (calf to foot) CPT 29515 OR IA ORTH PHYS-APPLY SHORT LEG SPLINT	$158.00	$243.00	$51.25–$123.93	5% below	35%
Short leg splint (calf to foot) CPT 29515 PANORA-APPLY SHORT LEG SPLINT	$176.00	$271.00	$73.92–$230.35	6% above	35%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$237.00	$364.00	$73.92–$309.40	43% above	35%
Short leg splint (calf to foot) inpatient CPT 29515 CAST APP-LOWER LEG	$77.00	$118.00	$53.19–$100.30	—	35%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 OR IA ORTH PHYS-SHOULDER MUMFORD PROC	$1,656.00	$2,547.00	$567.49–$1,298.97	16% below	35%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 2ND SURG-SHOULDER MUMFORD PROC	$2,315.00	$3,561.00	$567.49–$3,026.85	17% above	35%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 OR-SHOULDER MUMFORD PROC	$4,630.00	$7,123.00	$567.49–$6,054.55	134% above	35%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 2ND SURG-SHOULDER MUMFORD PROC	$2,315.00	$3,561.00	$567.49–$3,026.85	—	35%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 OR-SHOULDER MUMFORD PROC	$4,630.00	$7,123.00	$567.49–$6,054.55	—	35%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 OR IA ORTH PHYS-ARTHRS SHOULDER DECOMPR	$1,253.00	$1,927.00	$130.70–$982.77	57% above	35%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 2ND SURG-ARTHRSCPY SHOULDER DECOMPR	$2,204.00	$3,391.00	$130.70–$2,882.35	177% above	35%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 OR-ARTHRSCPY SHOULDER DECOMPR	$4,408.00	$6,782.00	$130.70–$5,764.70	454% above	35%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 2ND SURG-ARTHRSCPY SHOULDER DECOMPR	$2,204.00	$3,391.00	$130.70–$2,882.35	—	35%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 OR-ARTHRSCPY SHOULDER DECOMPR	$4,408.00	$6,782.00	$130.70–$5,764.70	—	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PERRY-FAC SREP S/N/A/G/TR/E; <=2.5 CM	$55.00	$85.00	$38.32–$83.30	75% below	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PERRY-FAC SREP S/N/A/G/TR/E; 2.6-7.5CM	$60.00	$93.00	$41.92–$91.14	73% below	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PERRY-SREP S/N/A/G/TR/E; <=2.5 CM	$221.00	$340.00	$44.58–$173.40	1% below	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER PRO FEE--SREP S/N/A/G/TR/E; <=2.50 CM	$259.00	$398.00	$44.58–$202.98	16% above	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E; <=2.5 CM	$276.00	$425.00	$101.36–$361.25	24% above	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PANORA-SREP S/N/A/G/TR/E; <=2.5 CM	$276.00	$425.00	$101.36–$361.25	24% above	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PERRY-EXC TR-EXT MAL+MARG 0.5< CM	$183.00	$282.00	$112.94–$178.77	55% below	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PANORA-EXC TR-EXT MAL+MARG 0.5< CM	$229.00	$353.00	$159.13–$300.05	43% below	35%
Skin tag removal, up to 15 tags CPT 11200 PERRY-FAC SKIN TAGS, EXC (1-15) ANY ARE	$28.00	$43.00	$19.38–$42.14	84% below	35%
Skin tag removal, up to 15 tags CPT 11200 PERRY-SKIN TAGS, EXCISION (1-15) ANY ARE	$111.00	$170.00	$72.29–$86.70	35% below	35%
Skin tag removal, up to 15 tags CPT 11200 ER PRO FEE--REM SKIN TAGS; <= 15 LES	$122.00	$188.00	$72.29–$95.88	29% below	35%
Skin tag removal, up to 15 tags CPT 11200 PANORA-SKIN TAGS,EXCISION (1-15) ANY ARE	$138.00	$213.00	$83.54–$181.05	20% below	35%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS; <=15 LESIONS	$164.00	$253.00	$64.52–$215.05	4% below	35%
Skin tag removal, up to 15 tags CPT 11200 PR-REMOVE SKIN TAGS <=15 LESIONS	$573.00	$881.00	$83.54–$748.85	234% above	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$196.00	$301.00	$135.69–$255.85	60% below	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ER-SPINAL TAP	$540.00	$831.00	$146.35–$706.35	11% above	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ER PRO FEE-LUMBAR TAP	$896.00	$1,379.00	$58.77–$703.29	84% above	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$196.00	$301.00	$135.69–$255.85	—	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC REPAIR 2.6-7.5	$134.00	$206.00	$92.86–$175.10	45% below	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PERRY-SREP S/N/A/G/TR/E; 2.6-7.5 CM	$244.00	$375.00	$58.12–$191.25	at median	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER PRO FEE-SREP S/N/A/G/TR/E; 2.6-7.5 CM	$271.00	$417.00	$58.12–$212.67	11% above	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PANORA-SREP S/N/A/G/TR/E; 2.6-7.5 CM	$304.00	$468.00	$123.91–$397.80	25% above	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SREP S/N/A/G/TR/E; 2.6-7.5 CM	$320.00	$492.00	$123.91–$418.20	32% above	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC REPAIR 2.6-7.5	$134.00	$206.00	$92.86–$175.10	—	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER PRO FEE--SREP F/E/N/L/MM; <=2.5 CM	$267.00	$410.00	$54.99–$209.10	8% above	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SREP F/E/N/L/MM; <=2.5CM	$289.00	$444.00	$113.22–$377.40	17% above	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER-SREP F/E/N/L/MM; > 30CM	$498.00	$766.00	$124.19–$651.10	101% above	35%
TURP (transurethral resection of the prostate) CPT 52601 OR URO PHYS - TRURL ELECTROSURG RESCJ PR	$1,650.00	$2,538.00	$477.49–$1,294.38	34% below	35%
TURP (transurethral resection of the prostate) CPT 52601 OR-TRANSUR ELECTR RESECTION OF PROSTATE	$7,775.00	$11,961.00	$477.49–$10,166.85	209% above	35%
TURP (transurethral resection of the prostate) inpatient CPT 52601 OR-TRANSUR ELECTR RESECTION OF PROSTATE	$7,775.00	$11,961.00	$477.49–$10,166.85	—	35%
Tonsil and adenoid removal, age 12 or older CPT 42821 OR-T&A >=12.00 YEARS	$4,027.00	$6,195.00	$245.58–$5,265.75	321% above	35%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 OR-T&A >=12.00 YEARS	$4,027.00	$6,195.00	$245.58–$5,265.75	—	35%
Tonsil and adenoid removal, child under 12 CPT 42820 OR-REM T & A < 12.00 YRS	$4,269.00	$6,568.00	$235.35–$5,582.80	118% above	35%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 OR-REM T & A < 12.00 YRS	$4,269.00	$6,568.00	$235.35–$5,582.80	—	35%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 OR-T >=12 YEARS	$4,027.00	$6,195.00	$208.77–$5,265.75	162% above	35%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 OR-T >=12 YEARS	$4,027.00	$6,195.00	$208.77–$5,265.75	—	35%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 OR-T < 12.00 YEARS	$4,027.00	$6,195.00	$219.72–$5,265.75	279% above	35%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 OR-T < 12.00 YEARS	$4,027.00	$6,195.00	$219.72–$5,265.75	—	35%
Total knee replacement CPT 27447 OR IA ORTH -TOTAL KNEE ARTHROPLASTY	$984.00	$1,514.00	$772.14–$1,202.33	76% below	35%
Total knee replacement CPT 27447 OR-TOTAL KNEE ARTHROPLASTY	$7,847.00	$12,072.00	$1,024.59–$10,261.20	91% above	35%
Total knee replacement inpatient CPT 27447 OR-TOTAL KNEE ARTHROPLASTY	$7,847.00	$12,072.00	$1,024.59–$10,261.20	—	35%
Trigger finger release surgery CPT 26055 OR IA ORTH PHYS-INCISION TENDON SHEATH	$1,334.00	$2,053.00	$294.94–$1,047.03	17% below	35%
Trigger finger release surgery CPT 26055 2ND SURG-INCISION TENDON SHEATH	$1,890.00	$2,907.00	$563.17–$2,470.95	18% above	35%
Trigger finger release surgery CPT 26055 OR-INCISION TENDON SHEATH	$3,773.00	$5,805.00	$563.17–$4,934.25	136% above	35%
Trigger finger release surgery inpatient CPT 26055 2ND SURG-INCISION TENDON SHEATH	$1,890.00	$2,907.00	$563.17–$2,470.95	—	35%
Trigger finger release surgery inpatient CPT 26055 OR-INCISION TENDON SHEATH	$3,773.00	$5,805.00	$563.17–$4,934.25	—	35%
Trigger point injections, 1 or 2 muscles CPT 20552 PERRY-FAC TRIGGER PT INJ 1-2 MUSCLE(S)	$77.00	$119.00	$47.02–$101.15	69% below	35%
Trigger point injections, 1 or 2 muscles CPT 20552 ER PRO FEE-INJ TRIGGER POINT 1-2 MUSCLES	$112.00	$172.00	$37.54–$87.72	54% below	35%
Trigger point injections, 1 or 2 muscles CPT 20552 OR-INJ TRIGGER POINT, 1-2 MUSCLES	$145.00	$223.00	$47.02–$189.55	41% below	35%
Trigger point injections, 1 or 2 muscles CPT 20552 PERRY-TRIGGER PT INJ 1-2 MUSCLE(S)	$161.00	$248.00	$37.54–$126.48	34% below	35%
Trigger point injections, 1 or 2 muscles CPT 20552 PANORA-TRIGGER PT INJ 1-2 MUSCLE(S)	$161.00	$248.00	$47.02–$210.80	34% below	35%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1.0-2.0 MUSCLES	$622.00	$957.00	$47.02–$813.45	154% above	35%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 OR-INJ TRIGGER POINT, 1-2 MUSCLES	$145.00	$223.00	$47.02–$189.55	—	35%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 OR-LAPAROSCOPY FULGURATION OVIDUCTS	$870.00	$1,338.00	$297.34–$1,137.30	17% below	35%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 OR-LAPAROSCOPY FULGURATION OVIDUCTS	$870.00	$1,338.00	$297.34–$1,137.30	—	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PERRY-EGD DILATION <30 MM	$281.00	$433.00	$142.99–$424.34	87% below	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 OR GEN SURG SC-EGD BAL DIL ESOP <30 MM	$1,482.00	$2,280.00	$142.99–$1,162.80	30% below	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 OR-ESOPH EGD DILATION <30 MM BALLOON	$2,438.00	$3,751.00	$1,060.60–$3,188.35	15% above	35%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 OR-ESOPH EGD DILATION <30 MM BALLOON	$2,438.00	$3,751.00	$1,060.60–$3,188.35	—	35%
Upper endoscopy (EGD) with biopsy CPT 43239 PERRY-EGD BIOPSY SINGLE/MULTIPLE	$361.00	$556.00	$129.62–$377.49	71% below	35%
Upper endoscopy (EGD) with biopsy CPT 43239 OR GEN PHYS -EGD BIOPSY SINGLE/MULTI	$776.00	$1,194.00	$129.62–$608.94	39% below	35%
Upper endoscopy (EGD) with biopsy CPT 43239 2ND SURG-EGD BIOPSY SINGLE/MULTIPLE	$3,162.00	$4,865.00	$377.49–$4,135.25	151% above	35%
Upper endoscopy (EGD) with biopsy CPT 43239 OR-EGD BIOPSY SINGLE/MULTIPLE	$3,352.00	$5,157.00	$377.49–$4,383.45	166% above	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 2ND SURG-EGD BIOPSY SINGLE/MULTIPLE	$3,162.00	$4,865.00	$377.49–$4,135.25	—	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 OR-EGD BIOPSY SINGLE/MULTIPLE	$3,352.00	$5,157.00	$377.49–$4,383.45	—	35%
Upper endoscopy (EGD) with injection into the lining CPT 43236 OR-UPPER GI SCOPE W/SUBMUC INJ	$2,621.00	$4,033.00	$402.04–$3,428.05	182% above	35%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 OR-UPPER GI SCOPE W/SUBMUC INJ	$2,621.00	$4,033.00	$402.04–$3,428.05	—	35%
Upper endoscopy (EGD), diagnostic CPT 43235 OR GEN PHYS -EGD DIAGNOSTIC BRUSH WASH	$543.00	$836.00	$115.86–$426.36	44% below	35%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI PROCEDURE	$621.00	$955.00	$243.52–$811.75	36% below	35%
Upper endoscopy (EGD), diagnostic CPT 43235 OR-EGD DIAGNOSTIC BRUSH WASH	$2,692.00	$4,142.00	$290.93–$3,520.70	176% above	35%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 OR-EGD DIAGNOSTIC BRUSH WASH	$2,692.00	$4,142.00	$290.93–$3,520.70	—	35%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 OR URO PHYS - CYSTOURETERO W/LITHOTRIPSY	$1,782.00	$2,741.00	$312.76–$1,397.91	40% above	35%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 OR-CYSTOURETERO W/LITHOTRIPSY	$6,112.00	$9,403.00	$312.76–$7,992.55	380% above	35%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 OR-CYSTOURETERO W/LITHOTRIPSY	$6,112.00	$9,403.00	$312.76–$7,992.55	—	35%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 OR URO PHYS - CYSTO/URETERO W/LITHOTRIPS	$912.00	$1,403.00	$331.77–$715.53	82% below	35%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 OR-CYSTO/URETERO W/LITHOTRIPSY	$8,790.00	$13,523.00	$331.77–$11,494.55	70% above	35%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 OR-CYSTO/URETERO W/LITHOTRIPSY	$8,790.00	$13,523.00	$331.77–$11,494.55	—	35%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 URO PRO SC-VASECTOMY, UNI OR BI SEP PROC	$934.00	$1,437.00	$227.25–$732.87	—	35%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 OR URO PHYS - VASECTOMY, UNI OR BI	$970.00	$1,492.00	$227.25–$760.92	—	35%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY, UNI OR BILATERAL (SEP PROC) I	$3,392.00	$5,218.00	$312.92–$4,435.30	—	35%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 URO FAC SC-VASECTOMY, UNI OR BIL SEP PRO	$202.00	$310.00	$139.75–$303.80	77% below	35%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNI OR BILATERAL (SEP PROC) I	$3,392.00	$5,218.00	$312.92–$4,435.30	—	35%
Wart removal, up to 14 warts CPT 17110 PERRY-FAC DEST OF BENIGN LESION 1-4	$27.00	$42.00	$18.93–$41.16	87% below	36%
Wart removal, up to 14 warts CPT 17110 ER PRO FEE-RMV PLANTER WARTS	$106.00	$163.00	$65.22–$100.44	48% below	35%
Wart removal, up to 14 warts CPT 17110 PERRY-DEST OF BENIGN LESION 1-4	$108.00	$166.00	$65.22–$100.44	47% below	35%
Wart removal, up to 14 warts CPT 17110 PANORA-DEST OF BENIGN LESION 1-4	$136.00	$209.00	$94.22–$177.65	33% below	35%
Wart removal, up to 14 warts CPT 17110 OR-DESTRUCT B9 <=14 LESIONS	$573.00	$881.00	$100.44–$748.85	182% above	35%
Wart removal, up to 14 warts inpatient CPT 17110 OR-DESTRUCT B9 <=14 LESIONS	$573.00	$881.00	$100.44–$748.85	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER PRO FEE--DEB SUBQ TISSUE <= 20 SQ CM	$180.00	$277.00	$58.12–$141.27	57% below	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER-DEB SUB Q TISSUE <=20 SQ CM	$478.00	$736.00	$119.42–$625.60	14% above	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 OR-DEB SUBQ TISSUE 20 SQ CM/<	$573.00	$881.00	$119.42–$748.85	37% above	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 OR-DEB SUBQ TISSUE 20 SQ CM/<	$573.00	$881.00	$119.42–$748.85	—	35%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OR IA ORTH -OPTX DST RD XARTC FX/EPI SEP	$580.00	$892.00	$454.92–$726.87	73% below	35%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OR-TREAT FX DISTAL RAD EXTRA ARTICULAR	$7,870.00	$12,108.00	$619.42–$10,291.80	265% above	35%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OR-TREAT FX DISTAL RAD EXTRA ARTICULAR	$7,870.00	$12,108.00	$619.42–$10,291.80	—	35%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Blood transfusion (giving blood or blood components) CPT 36430 OR-BLOOD ADMINISTRATION	$230.00	$354.00	$42.02–$300.90	58% below	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATIO	$239.00	$367.00	$42.02–$311.95	56% below	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN OBSERV	$269.00	$414.00	$42.02–$351.90	51% below	35%
Blood transfusion (giving blood or blood components) CPT 36430 SCHED-BLOOD ADMIN 2-4 HRS	$540.00	$831.00	$42.02–$706.35	1% below	35%
Blood transfusion (giving blood or blood components) CPT 36430 SCHED-BLOOD ADMIN 4-6 HRS	$540.00	$831.00	$42.02–$706.35	1% below	35%
Blood transfusion (giving blood or blood components) CPT 36430 SCHED-BLOOD ADMIN 0-2 HRS	$540.00	$831.00	$42.02–$706.35	1% below	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-1 HOUR TRANSFUSION	$734.00	$1,129.00	$42.02–$959.65	34% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-1 HOUR TRANSFUSION	$735.00	$1,130.00	$42.02–$960.50	34% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD OR-1 HOUR TRANSFUSION	$735.00	$1,130.00	$42.02–$960.50	34% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-1 HOUR TRANSFUSION	$778.00	$1,197.00	$42.02–$1,017.45	42% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-2 HOURS TRANSFUSION	$1,061.00	$1,632.00	$42.02–$1,387.20	94% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-2 HOURS TRANSFUSION	$1,063.00	$1,635.00	$42.02–$1,389.75	94% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD OR-2 HOURS TRANSFUSION	$1,063.00	$1,635.00	$42.02–$1,389.75	94% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-2 HOURS TRANSFUSION	$1,125.00	$1,731.00	$42.02–$1,471.35	106% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-3 HOURS TRANSFUSION	$1,303.00	$2,004.00	$42.02–$1,703.40	138% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-3 HOURS TRANSFUSION	$1,303.00	$2,005.00	$42.02–$1,704.25	138% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-3 HOURS TRANSFUSION	$1,381.00	$2,125.00	$42.02–$1,806.25	152% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-4 HOURS TRANSFUSION	$1,491.00	$2,294.00	$42.02–$1,949.90	172% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-4 HOURS TRANSFUSION	$1,492.00	$2,296.00	$42.02–$1,951.60	173% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-4 HOURS TRANSFUSION	$1,581.00	$2,432.00	$42.02–$2,067.20	189% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-5 HOURS TRANSFUSION	$1,625.00	$2,500.00	$42.02–$2,125.00	197% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-5 HOURS TRANSFUSION	$1,625.00	$2,500.00	$42.02–$2,125.00	197% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-5 HOURS TRANSFUSION	$1,627.00	$2,503.00	$42.02–$2,127.55	197% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-6 HOURS TRANSFUSION	$1,674.00	$2,576.00	$42.02–$2,189.60	206% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD MEDSURG-7 HOURS TRANSFUSION	$1,725.00	$2,654.00	$42.02–$2,255.90	215% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-6 HOURS TRANSFUSION	$1,763.00	$2,712.00	$42.02–$2,305.20	222% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-6 HOURS TRANSFUSION	$1,869.00	$2,875.00	$42.02–$2,443.75	242% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-7 HOURS TRANSFUSION	$1,898.00	$2,920.00	$42.02–$2,482.00	247% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 AMB INF-7 HOURS TRANSFUSION	$1,898.00	$2,920.00	$42.02–$2,482.00	247% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ER-8 HOURS TRANSFUSION	$2,032.00	$3,126.00	$42.02–$2,657.10	271% above	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OR-BLOOD ADMINISTRATION	$230.00	$354.00	$42.02–$300.90	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATIO	$239.00	$367.00	$42.02–$311.95	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN OBSERV	$269.00	$414.00	$42.02–$351.90	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SCHED-BLOOD ADMIN 2-4 HRS	$540.00	$831.00	$42.02–$706.35	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SCHED-BLOOD ADMIN 4-6 HRS	$540.00	$831.00	$42.02–$706.35	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SCHED-BLOOD ADMIN 0-2 HRS	$540.00	$831.00	$42.02–$706.35	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-1 HOUR TRANSFUSION	$734.00	$1,129.00	$42.02–$959.65	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-1 HOUR TRANSFUSION	$735.00	$1,130.00	$42.02–$960.50	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD OR-1 HOUR TRANSFUSION	$735.00	$1,130.00	$42.02–$960.50	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-1 HOUR TRANSFUSION	$778.00	$1,197.00	$42.02–$1,017.45	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-2 HOURS TRANSFUSION	$1,061.00	$1,632.00	$42.02–$1,387.20	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-2 HOURS TRANSFUSION	$1,063.00	$1,635.00	$42.02–$1,389.75	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD OR-2 HOURS TRANSFUSION	$1,063.00	$1,635.00	$42.02–$1,389.75	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-2 HOURS TRANSFUSION	$1,125.00	$1,731.00	$42.02–$1,471.35	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-3 HOURS TRANSFUSION	$1,303.00	$2,005.00	$42.02–$1,704.25	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-3 HOURS TRANSFUSION	$1,303.00	$2,004.00	$42.02–$1,703.40	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-3 HOURS TRANSFUSION	$1,381.00	$2,125.00	$42.02–$1,806.25	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-4 HOURS TRANSFUSION	$1,491.00	$2,294.00	$42.02–$1,949.90	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-4 HOURS TRANSFUSION	$1,492.00	$2,296.00	$42.02–$1,951.60	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-4 HOURS TRANSFUSION	$1,581.00	$2,432.00	$42.02–$2,067.20	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-5 HOURS TRANSFUSION	$1,625.00	$2,500.00	$42.02–$2,125.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-5 HOURS TRANSFUSION	$1,625.00	$2,500.00	$42.02–$2,125.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-5 HOURS TRANSFUSION	$1,627.00	$2,503.00	$42.02–$2,127.55	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-6 HOURS TRANSFUSION	$1,674.00	$2,576.00	$42.02–$2,189.60	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD MEDSURG-7 HOURS TRANSFUSION	$1,725.00	$2,654.00	$42.02–$2,255.90	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-6 HOURS TRANSFUSION	$1,763.00	$2,712.00	$42.02–$2,305.20	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-6 HOURS TRANSFUSION	$1,869.00	$2,875.00	$42.02–$2,443.75	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 AMB INF-7 HOURS TRANSFUSION	$1,898.00	$2,920.00	$42.02–$2,482.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-7 HOURS TRANSFUSION	$1,898.00	$2,920.00	$42.02–$2,482.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ER-8 HOURS TRANSFUSION	$2,032.00	$3,126.00	$42.02–$2,657.10	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AER/VAP INHAL	$49.00	$76.00	$7.61–$64.60	56% below	36%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INCENT SPIROMET INT	$71.00	$109.00	$7.61–$92.65	36% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PANORA-NEBULIZER TX W/MEDS(UNITS)	$102.00	$157.00	$7.61–$133.45	8% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PERRY-NEBULIZER TX W/MEDS (UNITS)	$102.00	$157.00	$7.61–$80.07	8% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY NEB RN MEDSURG INITIAL	$108.00	$166.00	$7.61–$141.10	2% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY NEB RN ER NEB INIT	$114.00	$176.00	$7.61–$149.60	3% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 METERED DOSE INHALER TRMT RT INITIAL	$114.00	$176.00	$7.61–$149.60	3% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 AIRWAY NEB RT INITIAL	$114.00	$176.00	$7.61–$149.60	3% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AER/VAP INHAL	$49.00	$76.00	$7.61–$64.60	—	36%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INCENT SPIROMET INT	$71.00	$109.00	$7.61–$92.65	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY NEB RN MEDSURG INITIAL	$108.00	$166.00	$7.61–$141.10	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY NEB RN ER NEB INIT	$114.00	$176.00	$7.61–$149.60	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 AIRWAY NEB RT INITIAL	$114.00	$176.00	$7.61–$149.60	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 METERED DOSE INHALER TRMT RT INITIAL	$114.00	$176.00	$7.61–$149.60	—	35%
Chemotherapy IV infusion, first hour CPT 96413 SCHED-CHEMO DRUG IV INFUSION <=1HR INIT	$378.00	$582.00	$119.10–$494.70	30% below	35%
Chemotherapy IV infusion, first hour CPT 96413 AMB IN-CHEMO DRUG IV INFUSION <=1HR INIT	$378.00	$582.00	$119.10–$494.70	30% below	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 AMB IN-CHEMO DRUG IV INFUSION <=1HR INIT	$378.00	$582.00	$119.10–$494.70	—	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 SCHED-CHEMO DRUG IV INFUSION <=1HR INIT	$378.00	$582.00	$119.10–$494.70	—	35%
Critical care, first 30 to 74 minutes CPT 99291 ER PRO FEE-CRITICAL CARE 30-74 MIN	$311.00	$479.00	$210.72–$281.76	64% below	35%
Critical care, first 30 to 74 minutes CPT 99291 ER PRO F- CRTCL CARE EVAL & MGMT 30-74 M	$525.00	$807.00	$210.72–$411.57	40% below	35%
Critical care, first 30 to 74 minutes CPT 99291 ED-CRITICAL CARE 30-74 MINS	$1,603.00	$2,466.00	$281.76–$2,096.10	83% above	35%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ER PRO FEE-EKG-INTERPRETATION	$38.00	$59.00	$13.92–$50.15	62% below	36%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PERRY-FAC EKG, INTERP & REPORT (12 LEAD)	$72.00	$110.00	$13.92–$93.50	28% below	35%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PANORA-EKG, INTERP & REPORT (12 LEAD)	$72.00	$110.00	$13.92–$93.50	28% below	35%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PERRY-EKG, INTERP & REPORT (12 LEAD)	$75.00	$116.00	$13.92–$59.16	25% below	35%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ER PRO FEE-EKG-INTERPRETATION	$38.00	$59.00	$13.92–$50.15	—	36%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PERRY-EKG, TRACING ONLY	$170.00	$261.00	$6.12–$221.85	7% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PANORA-EKG, TRACING ONLY	$170.00	$261.00	$6.12–$221.85	7% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 OPS-EKG	$172.00	$264.00	$6.12–$224.40	8% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG-12 LEAD, TRACING ONLY	$176.00	$270.00	$6.12–$229.50	11% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 EKG RT-12 LEAD, TRACING ONLY	$176.00	$270.00	$6.12–$229.50	11% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PANORA-EKG, TRACING ONLY	$170.00	$261.00	$6.12–$221.85	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PERRY-EKG, TRACING ONLY	$170.00	$261.00	$6.12–$221.85	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 OPS-EKG	$172.00	$264.00	$6.12–$224.40	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG-12 LEAD, TRACING ONLY	$176.00	$270.00	$6.12–$229.50	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient one side CPT 93005 EKG RT-12 LEAD, TRACING ONLY	$176.00	$270.00	$6.12–$229.50	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PRO FEE-ER PRO LEVEL 1	$94.00	$145.00	$10.07–$73.95	39% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL I-XIX	$101.00	$156.00	$10.07–$132.60	50% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 AMB INF-EMER DEPT VISIT LVL 1	$106.00	$163.00	$10.07–$138.55	57% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SCHED-EMER DEPT VISIT LVL 1	$106.00	$163.00	$10.07–$138.55	57% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL I	$147.00	$226.00	$10.07–$192.10	118% above	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER PRO FEE-ER PRO LEVEL 2	$139.00	$214.00	$36.97–$109.14	3% below	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL II-XIX	$190.00	$292.00	$36.97–$248.20	33% above	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL II	$218.00	$336.00	$36.97–$285.60	52% above	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER PRO FEE-ER PRO LEVEL 3	$209.00	$322.00	$63.36–$164.22	25% below	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL III-XIX	$371.00	$570.00	$63.36–$484.50	33% above	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL III	$437.00	$672.00	$63.36–$571.20	57% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER PRO FEE-ER PRO LEVEL 4	$316.00	$486.00	$107.71–$247.86	39% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL IV-XIX	$700.00	$1,077.00	$107.71–$915.45	34% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL IV	$759.00	$1,168.00	$107.71–$992.80	45% above	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER PRO FEE-ER PRO LEVEL 5	$462.00	$711.00	$156.63–$362.61	40% below	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL V-XIX	$1,139.00	$1,753.00	$156.63–$1,490.05	49% above	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL V	$1,230.00	$1,892.00	$156.63–$1,608.20	61% above	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST CVSLR TRACING ONLY	$988.00	$1,520.00	$34.70–$1,292.00	47% above	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST CVSLR TRACING ONLY	$988.00	$1,520.00	$34.70–$1,292.00	—	35%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT	$570.00	$877.00	$105.86–$447.27	144% above	35%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT	$543.00	$835.00	$102.06–$425.85	140% above	35%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY 45 MIN	$525.00	$808.00	$28.95–$412.08	135% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PERRY-IV ADMIN HYDRATION UP TO 1 HR	$282.00	$434.00	$30.25–$221.34	1% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PANORA-IV ADMIN HYDRA UP TO 1 HR	$282.00	$434.00	$30.25–$368.90	1% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OBS-HYDRATION IV INF INIT 31-60 MIN	$385.00	$592.00	$30.25–$503.20	38% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 SCHED-INF HYDRATION INIT 31-60 MINS	$409.00	$629.00	$30.25–$534.65	46% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER-HYDRATION IV INFUSION INIT 31-60 MINS	$409.00	$629.00	$30.25–$534.65	46% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 AMB INF-INF HYDRATION INIT 31-60 MINS	$409.00	$629.00	$30.25–$534.65	46% above	35%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY 1ST HOUR -SCHEDULED	$385.00	$593.00	$60.10–$504.05	22% above	35%
IV infusion of a medicine, first hour CPT 96365 OBS-THER/PROPH/DIAG IV INF INIT <=1 HR	$385.00	$593.00	$60.10–$504.05	22% above	35%
IV infusion of a medicine, first hour CPT 96365 PERRY-IV ADMIN THERAPY UP TO 1 HR	$385.00	$593.00	$60.10–$302.43	22% above	35%
IV infusion of a medicine, first hour CPT 96365 PANORA-IV ADMIN THERAPY UP TO 1 HR	$385.00	$593.00	$60.10–$504.05	22% above	35%
IV infusion of a medicine, first hour CPT 96365 SCHED-THER/PROPH/DIAG IV INF INIT <=1 HR	$409.00	$629.00	$60.10–$534.65	30% above	35%
IV infusion of a medicine, first hour CPT 96365 ER-THER/PROPH/DIAG IV INF INIT <=1 HR	$409.00	$629.00	$60.10–$534.65	30% above	35%
IV infusion of a medicine, first hour CPT 96365 AMB I-THER/PROPH/DIAG IV INF INIT <=1 HR	$409.00	$629.00	$60.10–$534.65	30% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PANORA-THERAPEUTIC/DIAGNOSTIC INJECTION	$46.00	$70.00	$14.08–$59.50	46% below	34%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION-IM/SQ	$46.00	$70.00	$14.08–$59.50	46% below	34%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PERRY-THERAPEUTIC/DIAGNOSTIC INJECTION	$46.00	$70.00	$14.08–$59.50	46% below	34%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ-IM ANTIBIOTICIC	$101.00	$156.00	$14.08–$132.60	18% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 AMB INF-SCHEDULED INJECTION-IM/SQ	$107.00	$165.00	$14.08–$140.25	25% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SCHEDULED INJECTION-IM/SQ	$107.00	$165.00	$14.08–$140.25	25% above	35%
New patient office visit, about 30 minutes CPT 99203 PERRY -FAC-NEW LEVEL 3	$32.00	$49.00	$22.09–$48.02	80% below	35%
New patient office visit, about 30 minutes CPT 99203 IA ORTHO FAC SC -OFFICE NEW/LIMITED	$62.00	$95.00	$42.83–$93.10	62% below	35%
New patient office visit, about 30 minutes CPT 99203 GEN SURG FAC SC-OFFICE NEW/LIMITED	$66.00	$101.00	$45.53–$98.98	60% below	35%
New patient office visit, about 30 minutes CPT 99203 URO FAC SC - OFFICE NEW/LIMITED	$113.00	$174.00	$78.44–$147.90	31% below	35%
New patient office visit, about 30 minutes CPT 99203 PERRY - PRO-NEW LEVEL 3	$125.00	$193.00	$75.71–$107.16	24% below	35%
New patient office visit, about 30 minutes CPT 99203 GEN SURG PRO SC-OFFICE NEW/LIMITED	$138.00	$212.00	$75.71–$108.12	16% below	35%
New patient office visit, about 30 minutes CPT 99203 IA ORTHO-OFFICE NEW/LIMITED	$151.00	$233.00	$75.71–$118.83	8% below	35%
New patient office visit, about 30 minutes CPT 99203 URO PRO SC-OFFICE NEW/LIMITED	$151.00	$233.00	$75.71–$118.83	8% below	35%
New patient office visit, about 30 minutes CPT 99203 PANORA - NEW LEVEL 3	$156.00	$240.00	$107.16–$204.00	5% below	35%
New patient office visit, about 45 minutes CPT 99204 PERRY -FAC-NEW LEVEL 4	$47.00	$72.00	$32.46–$70.56	81% below	35%
New patient office visit, about 45 minutes CPT 99204 GEN SURG FAC SC-OFFICE NEW/MODERATE	$109.00	$167.00	$75.28–$162.20	56% below	35%
New patient office visit, about 45 minutes CPT 99204 URO FAC SC-OFFICE NEW/MODERATE	$115.00	$177.00	$79.79–$162.20	53% below	35%
New patient office visit, about 45 minutes CPT 99204 IA ORTHO FAC SC-OFFICE NEW/MODERATE	$115.00	$177.00	$79.79–$162.20	53% below	35%
New patient office visit, about 45 minutes CPT 99204 PERRY - PRO-NEW LEVEL 4	$186.00	$286.00	$124.20–$162.20	24% below	35%
New patient office visit, about 45 minutes CPT 99204 GEN SURG PRO SC-OFFICE NEW/MODERATE	$195.00	$300.00	$124.20–$162.20	21% below	35%
New patient office visit, about 45 minutes CPT 99204 URO PRO SC-OFFICE NEW/MODERATE	$206.00	$317.00	$124.20–$162.20	16% below	35%
New patient office visit, about 45 minutes CPT 99204 IA ORTHO-OFFICE NEW/MODERATE	$219.00	$337.00	$124.20–$171.87	11% below	35%
New patient office visit, about 45 minutes CPT 99204 PANORA - NEW LEVEL 4	$232.00	$357.00	$160.94–$303.45	6% below	35%
New patient office visit, about 60 minutes CPT 99205 PERRY -FAC-NEW LEVEL 5	$61.00	$94.00	$42.38–$92.12	81% below	35%
New patient office visit, about 60 minutes CPT 99205 URO FAC SC -OFFICE NEW/HIGH	$142.00	$219.00	$98.73–$214.62	56% below	35%
New patient office visit, about 60 minutes CPT 99205 IA ORTHO FAC SC-OFFICE OUTPAT NW 60 MINU	$142.00	$219.00	$98.73–$214.62	56% below	35%
New patient office visit, about 60 minutes CPT 99205 GEN SURG FAC SC-OFFICE NEW/HIGH	$142.00	$219.00	$98.73–$214.62	56% below	35%
New patient office visit, about 60 minutes CPT 99205 URO PRO SC-OFFICE NEW/HIGH	$211.00	$325.00	$165.75–$215.98	34% below	35%
New patient office visit, about 60 minutes CPT 99205 GEN SURG PRO SC-OFFICE NEW/HIGH	$211.00	$325.00	$165.75–$215.98	34% below	35%
New patient office visit, about 60 minutes CPT 99205 PERRY - PRO-NEW LEVEL 5	$247.00	$380.00	$169.50–$215.98	23% below	35%
New patient office visit, about 60 minutes CPT 99205 IA ORTHO-OFFICE OUTPATIENT NEW 60 M	$291.00	$447.00	$169.50–$227.97	9% below	35%
New patient office visit, about 60 minutes CPT 99205 PANORA - NEW LEVEL 5	$309.00	$475.00	$214.13–$403.75	4% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PERRY - FAC-NEW LEVEL 2	$21.00	$33.00	$14.88–$32.34	79% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 IA ORTHO FAC SC-OFFICE NW/EXP PROB FCUSD	$34.00	$53.00	$23.89–$51.94	66% below	36%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 GEN SURG FAC SC-OFFICE NEW/EXPANDED PROB	$38.00	$58.63	$26.43–$57.46	62% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PERRY - PRO-NEW LEVEL 2	$86.00	$133.00	$43.97–$68.79	15% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 IA ORTHO-OFFICE NEW/EXP PROB FOCUS	$108.00	$166.00	$43.97–$84.66	7% above	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PANORA - NEW LEVEL 2	$108.00	$166.00	$68.79–$141.10	7% above	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 GEN SURG PRO SC-OFFICE NEW/EXPANDED PROB	$109.00	$168.00	$43.97–$85.68	8% above	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 URO FAC SC-OFFICE NEW/EXP PROBLEM FOCUS	$109.00	$168.00	$68.79–$142.80	8% above	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 URO PRO SC-OFFICE NEW/EXP PROBLEM FOCUS	$109.00	$168.00	$43.97–$85.68	8% above	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CARDIAC INTERVIEW; OFF/OP VS NEW LVL 1	$335.00	$516.00	$68.79–$438.60	232% above	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT NUTRITION THER; EA 15M INDIV	$51.00	$79.00	$34.25–$67.15	19% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT DRY NEEDLING SINGLE	$33.00	$50.00	$22.54–$42.50	66% below	34%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT-PTA-DRY NEEDLING SINGLE	$33.00	$50.00	$22.54–$42.50	66% below	34%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT-PTA-DRY NEEDLING PACKAGE	$130.00	$200.00	$25.88–$170.00	34% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT DRY NEEDLING PACKAGE	$130.00	$200.00	$25.88–$170.00	34% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT-PTA-DRY NEEDLING SINGLE	$33.00	$50.00	$22.54–$42.50	—	34%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT DRY NEEDLING SINGLE	$33.00	$50.00	$22.54–$42.50	—	34%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT DRY NEEDLING PACKAGE	$130.00	$200.00	$25.88–$170.00	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT-PTA-DRY NEEDLING PACKAGE	$130.00	$200.00	$25.88–$170.00	—	35%
Preventive checkup, new patient aged 18–39 CPT 99385 PERRY -NEW-WELL ADOL 18 - 39 YR	$183.00	$282.00	$143.82	7% below	35%
Preventive checkup, new patient aged 18–39 CPT 99385 PANORA-NEW-18-39 YR	$183.00	$282.00	$127.13–$239.70	7% below	35%
Preventive checkup, new patient aged 40–64 CPT 99386 PERRY -NEW-WELL ADOL 40 - 64 YR	$220.00	$338.00	$172.38	6% above	35%
Preventive checkup, new patient aged 40–64 CPT 99386 PANORA-NEW-40-64 YR	$220.00	$338.00	$152.37–$287.30	6% above	35%
Preventive checkup, new patient aged 65 or older CPT 99387 PANORA-NEW-65+ YR	$224.00	$344.00	$155.08–$292.40	9% below	35%
Preventive checkup, new patient aged 65 or older CPT 99387 PERRY -NEW-WELL ADOL 65+ YR	$224.00	$344.00	$175.44	9% below	35%
Preventive checkup, returning patient aged 18–39 CPT 99395 PANORA-ESTAB-18-39 YR	$165.00	$254.00	$114.50–$215.90	at median	35%
Preventive checkup, returning patient aged 18–39 CPT 99395 PERRY -PRO-EST-WELL ADOL 18 - 39 YR	$165.00	$254.00	$129.54	at median	35%
Preventive checkup, returning patient aged 40–64 CPT 99396 PANORA-ESTAB-40-64 YR	$190.00	$293.00	$132.08–$249.05	2% above	35%
Preventive checkup, returning patient aged 40–64 CPT 99396 PERRY -ESTAB-WELL ADOL 40 - 64 YR	$190.00	$293.00	$149.43	2% above	35%
Preventive checkup, returning patient aged 65 or older CPT 99397 PERRY -ESTAB-WELL ADOL 65+ YR	$193.00	$297.00	$151.47	9% below	35%
Preventive checkup, returning patient aged 65 or older CPT 99397 PANORA-ESTAB-65+ YR	$193.00	$297.00	$133.89–$252.45	9% below	35%
Psychotherapy session, 30 minutes CPT 90832 16-37 MINS INDIVIDUAL PSYCHOTHERAPY	$436.00	$671.00	$82.20–$342.21	156% above	35%
Psychotherapy session, 45 minutes CPT 90834 38-52 MINS INDIVIDUAL PSYCHOTHERAPY	$540.00	$830.00	$108.92–$423.30	141% above	35%
Psychotherapy session, 60 minutes CPT 90837 53-67 MINS INDIVIDUAL PSYCHOTHERAPY	$551.00	$847.00	$159.93–$431.97	93% above	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PERRY -FAC-ESTAB LEVEL 5	$42.00	$64.00	$28.85–$62.72	82% below	34%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 IA ORTHO FAC SC -OFFICE ESTABLISHED-HIGH	$94.00	$145.00	$65.37–$142.10	60% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 URO FAC SC -OFFICE ESTABLISHED-HIGH	$94.00	$145.00	$65.37–$142.10	60% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 GEN SURG FAC SC-OFFICE ESTABLISHED-HIGH	$116.00	$178.00	$80.24–$174.44	51% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PERRY -PRO-ESTAB LEVEL 5	$165.00	$254.00	$129.54–$176.74	30% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 UROLOGY PRO FEE-OFFICE ESTABLISHED-HIGH	$195.00	$300.00	$134.37–$176.74	17% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 GEN SURG PRO SC-OFFICE ESTABLISHED-HIGH	$195.00	$300.00	$134.37–$176.74	17% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 IA ORTHO PRO FEE-OFFICE ESTABLISHED-HIGH	$195.00	$300.00	$134.37–$176.74	17% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PANORA - ESTAB LEVEL 5	$207.00	$319.00	$143.81–$271.15	12% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PERRY -FAC-ESTAB LEVEL 3	$21.00	$32.00	$14.43–$31.36	82% below	34%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 URO FAC SC -OFFICE ESTABLISHED-LIMITED	$47.00	$72.00	$32.46–$70.56	60% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IA ORTHO FAC SC-OFFICE ESTABL-LIMITED	$50.00	$77.00	$34.71–$75.46	58% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 GEN SURG FAC SC-OFFICE ESTABLISHED-LIMIT	$53.00	$82.00	$36.97–$80.36	55% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PERRY -PRO-ESTAB LEVEL 3	$83.00	$127.00	$61.65–$87.45	30% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IA ORTHO-OFFICE ESTABLISHED-LIMIT	$88.00	$135.00	$61.65–$87.45	26% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PANORA - ESTAB LEVEL 3	$103.00	$159.00	$71.68–$135.15	13% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 GEN SURG PRO SC-OFFICE ESTABLISHED-LIMIT	$105.00	$162.00	$61.65–$87.45	11% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 UROLOGY PRO SC-OFFICE ESTABL-MINOR	$105.00	$162.00	$61.65–$87.45	11% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PERRY -FAC-ESTAB LEVEL 4	$31.00	$47.00	$21.19–$46.06	81% below	34%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 IA ORTHO FAC SC-OFFICE ESTABL-MODERATE	$70.00	$108.00	$48.69–$105.84	58% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 URO FAC SC -OFFICE ESTABLISHED-MODERATE	$71.00	$109.00	$49.14–$106.82	57% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GEN SURG FAC SC-OFFICE ESTABLISHED-MOD	$79.00	$121.00	$54.55–$118.58	52% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GEN SURG PRO SC-OFFICE ESTABLISHED-MOD	$112.00	$172.00	$87.72–$124.57	33% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 IA ORTHO-OFFICE ESTABLISHED-MOD	$114.00	$175.00	$89.25–$124.57	31% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PERRY -PRO-ESTAB LEVEL 4	$122.00	$187.00	$90.55–$124.57	27% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PANORA - ESTAB LEVEL 4	$151.00	$233.00	$105.04–$198.05	9% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 URO PRO SC-OFFICE ESTABLISHED-MODERATE	$151.00	$233.00	$90.55–$124.57	9% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PERRY -FAC-ESTAB LEVEL 2	$13.00	$20.00	$9.02–$19.60	84% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 URO FAC SC -OFFICE ESTABLISHED-MINOR	$23.00	$35.00	$15.78–$34.30	71% below	34%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 IA ORTHO FAC SC-OFFICE ESTABLISHED-MINOR	$25.00	$39.00	$17.58–$38.22	69% below	36%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GEN SURG FAC SC-OFFICE ESTABLISHED-MINOR	$29.00	$44.00	$19.84–$43.12	64% below	34%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PERRY -PRO-ESTAB LEVEL 2	$51.00	$78.00	$33.10–$54.24	36% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PANORA - ESTAB LEVEL 2	$62.00	$96.00	$43.28–$81.60	22% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 IA ORTHO-OFFICE ESTABLISHED-MINOR	$66.00	$102.00	$33.10–$54.24	17% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GEN SURG PRO SC-OFFICE ESTABLISHED-MINOR	$70.00	$108.00	$33.10–$55.08	12% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 URO PRO SC-OFFICE ESTABLISHED-MINOR	$70.00	$108.00	$33.10–$55.08	12% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SCHED-OP VISIT EST LVL 2	$134.00	$206.00	$52.53–$175.10	68% above	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 AMB INF-OP VISIT EST LVL 2	$142.00	$219.00	$54.24–$186.15	78% above	35%
Specialist consultation, low complexity or 30+ minutes CPT 99243 ER PRO FEE-COUNSELING	$190.00	$292.00	$148.92	6% below	35%
Specialist consultation, low complexity or 30+ minutes CPT 99243 GEN SURG PRO SC-OFFICE CONSULT-LIMITED	$195.00	$300.00	$153.00	3% below	35%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PANORA-CONSULTATION-LEVEL 3	$229.00	$353.00	$159.13–$300.05	13% above	35%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PERRY -CONSULTATION-LEVEL 3	$229.00	$353.00	$180.03	13% above	35%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 GEN SURG PRO SC-OFFICE CONSULT-MODERATE	$285.00	$439.00	$223.89	at median	35%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PERRY -CONSULTATION-LEVEL 4	$322.00	$495.00	$252.45	13% above	35%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PANORA-CONSULTATION-LEVEL 4	$322.00	$495.00	$223.15–$420.75	13% above	35%
Spirometry (breathing test) CPT 94010 PERRY-FAC SPIROMETRY (PFT)	$33.00	$51.00	$22.99–$43.35	82% below	35%
Spirometry (breathing test) CPT 94010 PERRY-SPIROMETRY (PFT)	$133.00	$204.00	$8.96–$104.04	28% below	35%
Spirometry (breathing test) CPT 94010 SPIROMETRY-SIMP PFT	$154.00	$237.00	$26.79–$201.45	17% below	35%
Spirometry (breathing test) CPT 94010 PANORA-SPIROMETRY (PFT)	$166.00	$255.00	$26.79–$216.75	10% below	35%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$218.00	$336.00	$26.79–$285.60	18% above	35%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-SIMP PFT	$154.00	$237.00	$26.79–$201.45	—	35%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$218.00	$336.00	$26.79–$285.60	—	35%
Spirometry before and after a bronchodilator CPT 94060 PERRY-FAC SPIROMETRY PRE & POST (PFT)	$66.00	$101.00	$39.18–$85.85	83% below	35%
Spirometry before and after a bronchodilator CPT 94060 PERRY-SPIROMETRY PRE & POST (PFT)	$259.00	$399.00	$11.16–$203.49	33% below	35%
Spirometry before and after a bronchodilator CPT 94060 PANORA-SPIROMETRY PRE/POST(PFT)	$325.00	$500.00	$39.18–$425.00	16% below	35%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATOR-PRE & POST BD, SPIROMETRY	$419.00	$644.00	$39.18–$547.40	8% above	35%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATOR-PRE & POST BD, SPIROMETRY	$419.00	$644.00	$39.18–$547.40	—	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$86.00	$133.00	$59.96–$113.05	56% below	35%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 ER PRO FEE-TREADMILL INTERP	$151.00	$232.00	$67.25–$118.32	63% below	35%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 PERRY-CV STRS TST XERS&/OR RX CONT ECG W	$286.00	$440.00	$67.25–$224.40	30% below	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PERRY-HZV ZOSTER VACC RECOM IM	$195.00	$300.00	$153.00	18% below	35%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PANORA-HZV ZOSTER VACC RECOM IM	$195.00	$300.00	$135.24–$255.00	18% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PANORA-VFC ADMIN PNEUM VACC SQ/IM, SING	$15.00	$23.00	$10.37–$20.07	57% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PERRY-VFC ADMIN PNEUM VACC SQ/IM, SING	$15.00	$23.00	$10.37–$20.07	57% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PANORA-ADMIN INFLU VACCINE SQ/IM, SINGLE	$35.00	$54.00	$20.07–$27.54	at median	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PANORA-ADMIN PNEUM VACCINE SQ/IM, SINGLE	$35.00	$54.00	$20.07–$27.54	at median	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PERRY-ADMIN INFLU VACCINE SQ/IM, SINGLE	$35.00	$54.00	$20.07–$27.54	at median	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PERRY-ADMIN PNEUM VACCINE SQ/IM, SINGLE	$37.00	$57.00	$20.07–$29.07	6% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$38.00	$59.00	$20.07–$30.09	9% above	36%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PANORA-VFC IMMUNIZ ADM; EA ADDL VACCINE	$15.00	$23.00	$10.37–$14.62	48% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PERRY-VFC IMMUNIZ ADM; EA ADDL VACCINE	$15.00	$23.00	$10.37–$14.62	48% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADDT'L	$21.00	$33.00	$14.62–$16.83	27% below	36%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ER-IMMUNIZATION ADM; EA ADDL VACCINE	$21.00	$33.00	$14.62–$16.83	27% below	36%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PANORA-IMMUNIZATION ADM; EA ADDL VACCINE	$21.00	$33.00	$14.62–$16.83	27% below	36%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PERRY-IMMUNIZATION ADM; EA ADDL VACCINE	$21.00	$33.00	$14.62–$16.83	27% below	36%

Source file: https://www.dallascohospital.org/sites/default/files/426037739_dallas-county-hospital_standardcharges.csv