SelfPayRates
Hospital

Endless Mountains Health Systems

Endless Mountains Health Systems in Montrose, PA publishes cash prices for 240 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 179 of 238 procedures and above it for 57. By typical cash price it ranks #18 of 102 Pennsylvania hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

100 Hospital Drive, Montrose, PA 18801 Collected Sep 27, 2026 Source price file (570) 278-3801

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 1 of 5 CCN 391306 · CMS hospital register NPI 1215918560

Scans and imaging

ProcedureCash price List priceInsurers payvs PennsylvaniaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABD W AND W/O $1,267.70 $1,811.00 $1,104.71–$1,448.80 33% below 30%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W AND W/O $1,267.70 $1,811.00 $1,104.71–$1,448.80 — 30%
Abdominal X-ray, 2 views CPT 74019 AP/OBLIQUE AND COMP ABD $149.10 $213.00 $129.93–$170.40 54% below 30%
Abdominal X-ray, 2 views inpatient CPT 74019 AP/OBLIQUE AND COMP ABD $149.10 $213.00 $129.93–$170.40 — 30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ARTERIAL DOPPLER SGL LEVE $176.40 $252.00 $153.72–$201.60 62% below 30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ARTERIAL DOPPLER SGL LEVE $176.40 $252.00 $153.72–$201.60 — 30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXT W/O $758.10 $1,083.00 $660.63–$866.40 39% below 30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXT W/O $758.10 $1,083.00 $660.63–$866.40 — 30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS $158.20 $226.00 $137.86–$180.80 66% below 30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS $158.20 $226.00 $137.86–$180.80 — 30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRA BREAST LIMITED UNILAT $161.00 $230.00 $140.30–$184.00 65% below 30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRA BREAST LIMITED UNILAT $161.00 $230.00 $140.30–$184.00 — 30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN AND PELVIS $2,223.20 $3,176.00 $1,937.36–$2,540.80 10% below 30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN AND PELVIS $2,223.20 $3,176.00 $1,937.36–$2,540.80 — 30%
CT angiography (CTA) of the head CPT 70496 CT HEAD ANGIO $1,054.20 $1,506.00 $918.66–$1,204.80 35% below 30%
CT angiography (CTA) of the head inpatient CPT 70496 CT HEAD ANGIO $1,054.20 $1,506.00 $918.66–$1,204.80 — 30%
CT angiography (CTA) of the neck CPT 70498 CTA NECK ANGIO $891.10 $1,273.00 $776.53–$1,018.40 46% below 30%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK ANGIO $891.10 $1,273.00 $776.53–$1,018.40 — 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST $1,207.50 $1,725.00 $1,052.25–$1,380.00 36% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST $1,207.50 $1,725.00 $1,052.25–$1,380.00 — 30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O $1,558.90 $2,227.00 $1,358.47–$1,781.60 25% below 30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O $1,558.90 $2,227.00 $1,358.47–$1,781.60 — 30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W AND W/O $2,223.20 $3,176.00 $1,937.36–$2,540.80 26% below 30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W AND W/O $2,223.20 $3,176.00 $1,937.36–$2,540.80 — 30%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O $847.00 $1,210.00 $738.10–$968.00 28% below 30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O $847.00 $1,210.00 $738.10–$968.00 — 30%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O $996.10 $1,423.00 $868.03–$1,138.40 8% below 30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O $996.10 $1,423.00 $868.03–$1,138.40 — 30%
CT scan of the head with contrast CPT 70460 CT HEAD W $1,054.20 $1,506.00 $918.66–$1,204.80 21% below 30%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W $1,054.20 $1,506.00 $918.66–$1,204.80 — 30%
CT scan of the head without and with contrast CPT 70470 CT HEAD W AND W/O $1,157.10 $1,653.00 $1,008.33–$1,322.40 31% below 30%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W AND W/O $1,157.10 $1,653.00 $1,008.33–$1,322.40 — 30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C SPINE W/O $854.70 $1,221.00 $744.81–$976.80 32% below 30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C SPINE W/O $854.70 $1,221.00 $744.81–$976.80 — 30%
Chest CT scan without and with contrast CPT 71270 CT CHEST W AND W/O $1,207.50 $1,725.00 $1,052.25–$1,380.00 28% below 30%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W AND W/O $1,207.50 $1,725.00 $1,052.25–$1,380.00 — 30%
Chest X-ray, 2 views CPT 71046 CHEST TWO VIEWS $147.70 $211.00 $128.71–$168.80 54% below 30%
Chest X-ray, 2 views inpatient CPT 71046 CHEST TWO VIEWS $147.70 $211.00 $128.71–$168.80 — 30%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW $95.20 $136.00 $82.96–$108.80 49% below 30%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW $95.20 $136.00 $82.96–$108.80 — 30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITOMETRY-BODY $276.50 $395.00 $240.95–$316.00 at median 30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITOMETRY-BODY $276.50 $395.00 $240.95–$316.00 — 30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENISTOMETRY-EXTREMI $163.10 $233.00 $142.13–$186.40 2% below 30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENISTOMETRY-EXTREMI $163.10 $233.00 $142.13–$186.40 — 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O $854.70 $1,221.00 $744.81–$976.80 23% below 30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O $854.70 $1,221.00 $744.81–$976.80 — 30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LOWER EXTREM ARTER BILAT $775.60 $1,108.00 $675.88–$886.40 — 30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LOWER EXTREM ARTER BILAT $775.60 $1,108.00 $675.88–$886.40 — 30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX SCAN BILAT EXTREM VN $616.00 $880.00 $536.80–$704.00 — 30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX SCAN BILAT EXTREM VN $616.00 $880.00 $536.80–$704.00 — 30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY COMPLETE $769.30 $1,099.00 $670.39–$879.20 60% below 30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY COMPLETE $769.30 $1,099.00 $670.39–$879.20 — 30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT POST FOSSA SELA IAC/WO $781.20 $1,116.00 $680.76–$892.80 28% below 30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT W/O $781.20 $1,116.00 $680.76–$892.80 28% below 30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT POST FOSSA SELA IAC/WO $781.20 $1,116.00 $680.76–$892.80 — 30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT W/O $781.20 $1,116.00 $680.76–$892.80 — 30%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXT W/O $758.10 $1,083.00 $660.63–$866.40 27% below 30%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXT W/O $758.10 $1,083.00 $660.63–$866.40 — 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN LTD ULTRASOUND $541.80 $774.00 $472.14–$619.20 22% below 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN LTD ULTRASOUND $541.80 $774.00 $472.14–$619.20 — 30%
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN $1,246.70 $1,781.00 $1,086.41–$1,424.80 30% below 30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA BRAIN $1,246.70 $1,781.00 $1,086.41–$1,424.80 — 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI THIGH LOW LEG FOOT W/O CON $847.70 $1,211.00 $738.71–$968.80 52% below 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI HIP KNEE ANKLE W/O CONT $997.50 $1,425.00 $869.25–$1,140.00 43% below 30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI THIGH LOW LEG FOOT W/O CON $847.70 $1,211.00 $738.71–$968.80 — 30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI HIP KNEE ANKLE W/O CONT $997.50 $1,425.00 $869.25–$1,140.00 — 30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI HIP KNEE ANKLE W/& W/O CON $1,395.80 $1,994.00 $1,216.34–$1,595.20 63% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI HIP KNEE ANKLE W/& W/O CON $1,395.80 $1,994.00 $1,216.34–$1,595.20 — 30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/& W/OUT CONTRAST $1,395.80 $1,994.00 $1,216.34–$1,595.20 62% below 30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/& W/OUT CONTRAST $1,395.80 $1,994.00 $1,216.34–$1,595.20 — 30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/O & W/ CONTR $1,395.80 $1,994.00 $1,216.34–$1,595.20 51% below 30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/O & W/ CONTR $1,395.80 $1,994.00 $1,216.34–$1,595.20 — 30%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST $1,395.80 $1,994.00 $1,216.34–$1,595.20 22% below 30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST $1,395.80 $1,994.00 $1,216.34–$1,595.20 — 30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/ & W/OUT CO $1,845.20 $2,636.00 $1,607.96–$2,108.80 45% below 30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/ & W/OUT CO $1,845.20 $2,636.00 $1,607.96–$2,108.80 — 30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE W/O CONTR $1,296.40 $1,852.00 $1,129.72–$1,481.60 37% below 30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE W/O CONTR $1,296.40 $1,852.00 $1,129.72–$1,481.60 — 30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/AND W/O $1,645.70 $2,351.00 $1,434.11–$1,880.80 42% below 30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CHEST W/ AND W/O CONTR $1,645.70 $2,351.00 $1,434.11–$1,880.80 42% below 30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CHEST W/ AND W/O CONTR $1,645.70 $2,351.00 $1,434.11–$1,880.80 — 30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/AND W/O $1,645.70 $2,351.00 $1,434.11–$1,880.80 — 30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O CONT $1,196.30 $1,709.00 $1,042.49–$1,367.20 32% below 30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O CONT $1,196.30 $1,709.00 $1,042.49–$1,367.20 — 30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/& W/O CONTRAST $1,346.80 $1,924.00 $1,173.64–$1,539.20 62% below 30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/& W/O CONTRAST $1,346.80 $1,924.00 $1,173.64–$1,539.20 — 30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST $997.50 $1,425.00 $869.25–$1,140.00 48% below 30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST $997.50 $1,425.00 $869.25–$1,140.00 — 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SHOULDER ELBOW WRIST W/O C $1,096.90 $1,567.00 $955.87–$1,253.60 48% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI SHOULDER ELBOW WRIST W/O C $1,096.90 $1,567.00 $955.87–$1,253.60 — 30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE-COMPLETE $203.70 $291.00 $177.51–$232.80 57% below 30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE-COMPLETE $203.70 $291.00 $177.51–$232.80 — 30%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE W $891.10 $1,273.00 $776.53–$1,018.40 33% below 30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE W $891.10 $1,273.00 $776.53–$1,018.40 — 30%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O $781.20 $1,116.00 $680.76–$892.80 28% below 30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O $781.20 $1,116.00 $680.76–$892.80 — 30%
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK $149.10 $213.00 $129.93–$170.40 43% below 30%
Neck soft tissue X-ray inpatient CPT 70360 SOFT TISSUE NECK $149.10 $213.00 $129.93–$170.40 — 30%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O $847.00 $1,210.00 $738.10–$968.00 23% below 30%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O $847.00 $1,210.00 $738.10–$968.00 — 30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC NON OB LTD/BLADDER $413.00 $590.00 $359.90–$472.00 8% below 30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC NON OB LTD/BLADDER $413.00 $590.00 $359.90–$472.00 — 30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC NON OB COMP US $658.00 $940.00 $573.40–$752.00 14% above 30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC NON OB COMP US $658.00 $940.00 $573.40–$752.00 — 30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB PELVIC COMP ULTRASOUND $770.00 $1,100.00 $671.00–$880.00 19% above 30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB PELVIC COMP ULTRASOUND $770.00 $1,100.00 $671.00–$880.00 — 30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB PELVIC <14WKS $708.40 $1,012.00 $617.32–$809.60 26% above 30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB PELVIC <14WKS $708.40 $1,012.00 $617.32–$809.60 — 30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB PELVIC LTD 13 WKS US $466.90 $667.00 $406.87–$533.60 9% below 30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB PELVIC LTD 13 WKS US $466.90 $667.00 $406.87–$533.60 — 30%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES $191.80 $274.00 $167.14–$219.20 55% below 30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES $191.80 $274.00 $167.14–$219.20 — 30%
Skull X-ray, fewer than 4 views CPT 70250 SKULL-LIMITED $150.50 $215.00 $131.15–$172.00 58% below 30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL-LIMITED $150.50 $215.00 $131.15–$172.00 — 30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T SPINE W/O $819.70 $1,171.00 $714.31–$936.80 33% below 30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T SPINE W/O $819.70 $1,171.00 $714.31–$936.80 — 30%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAG FOR OB $708.40 $1,012.00 $617.32–$809.60 29% above 30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAG FOR OB $708.40 $1,012.00 $617.32–$809.60 — 30%
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM/TESTICLES US $441.00 $630.00 $384.30–$504.00 29% below 30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM/TESTICLES US $441.00 $630.00 $384.30–$504.00 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID/PAROTID-ST US $441.00 $630.00 $384.30–$504.00 23% below 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 THYROID/PAROTID-ST US $441.00 $630.00 $384.30–$504.00 — 30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI $223.30 $319.00 $194.59–$255.20 63% below 30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI $223.30 $319.00 $194.59–$255.20 — 30%
X-ray of the abdomen, 1 view CPT 74018 AP SINGLE VIEW $130.20 $186.00 $113.46–$148.80 55% below 30%
X-ray of the abdomen, 1 view inpatient CPT 74018 AP SINGLE VIEW $130.20 $186.00 $113.46–$148.80 — 30%
X-ray of the lower back, 4 or more views CPT 72110 LUMBO-SAC SPINE-COMPLETE $237.30 $339.00 $206.79–$271.20 50% below 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBO-SAC SPINE-COMPLETE $237.30 $339.00 $206.79–$271.20 — 30%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES $139.30 $199.00 $121.39–$159.20 49% below 30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES $139.30 $199.00 $121.39–$159.20 — 30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE-LIMITED $175.70 $251.00 $153.11–$200.80 47% below 30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE-LIMITED $175.70 $251.00 $153.11–$200.80 — 30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM OR COCCYX $143.50 $205.00 $125.05–$164.00 56% below 30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM OR COCCYX $143.50 $205.00 $125.05–$164.00 — 30%

Lab tests

ProcedureCash price List priceInsurers payvs PennsylvaniaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT $47.60 $68.00 $41.48–$54.40 28% above 30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT $47.60 $68.00 $41.48–$54.40 — 30%
Albumin blood test CPT 82040 ALBUMIN $35.00 $50.00 $30.50–$40.00 10% above 30%
Albumin blood test inpatient CPT 82040 ALBUMIN $35.00 $50.00 $30.50–$40.00 — 30%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM OR PLAS $44.10 $63.00 $38.43–$50.40 79% below 30%
Aldosterone blood test CPT 82088 ALDOSTERONE 24 HR URINE $44.10 $63.00 $38.43–$50.40 79% below 30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM OR PLAS $44.10 $63.00 $38.43–$50.40 — 30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24 HR URINE $44.10 $63.00 $38.43–$50.40 — 30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE $47.60 $68.00 $41.48–$54.40 27% above 30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE $47.60 $68.00 $41.48–$54.40 — 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FIREBRUSH $11.90 $17.00 $10.37–$13.60 63% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AL-POLISTES WASP $11.90 $17.00 $10.37–$13.60 63% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AL-YELLOW JACKET $11.90 $17.00 $10.37–$13.60 63% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AL-YELLOW HORNET $11.90 $17.00 $10.37–$13.60 63% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AL-HONEY BEE $11.90 $17.00 $10.37–$13.60 63% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-DERMATOPHAGOIDES PTERO $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-LOCUST $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-AMERICAN COCKROACH $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-ALTERNARIS ALTERNATA $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-NETTLE $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 KENTUCKY BLUEGRASS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-PIGWEED ROUGH $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-ENGLISH PLANTAIN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-RAGWEED SHORT $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-DOG EPITHELIUM $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-RED CEDAR $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-RED MAPLE $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-CLADOSPORIUM HERBARUM $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-RED MULBERRY $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-MUCOR RACEMOSUS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-WHITE BIRCH $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-CAT DANDER $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-WHITE HICKORY $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-BERMUDA GRASS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-WHITE OAK $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET VERNAL GRASS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-BAHIA GRASS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RYE ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-AMERICAN ELM $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHOSPORIUM HALO ALL $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COWS MILK ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG HAIR/DANDER $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CULT WHEAT GRASS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MARSH ELDER, ROUGH $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED, TALL $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BROME GRASS $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DANDELION $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ACARUS MITE $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MANGO ALLERGEN $13.30 $19.00 $11.59–$15.20 59% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP - MOUSE URINE PROTEIN $25.90 $37.00 $22.57–$29.60 20% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT ALLERGEN $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY ALLERGEN $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP CANDIDA ALBICANS $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 POTATO ALLERGY $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO ALLERGEN $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AP-CHICKEN MEAT $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT ALLERGEN $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA BETAE IgE $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITHELIA IgE $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA TENUIS $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MALT ALLERGY $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF ALLERGEN $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK ALLERGEN $26.60 $38.00 $23.18–$30.40 18% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY FEATHERS $28.00 $40.00 $24.40–$32.00 14% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR ALLERGEN $28.00 $40.00 $24.40–$32.00 14% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS ALLERGEN $28.00 $40.00 $24.40–$32.00 14% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM PURPURASCENS $28.70 $41.00 $25.01–$32.80 11% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DUSK FEATHERS $28.70 $41.00 $25.01–$32.80 11% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS $28.70 $41.00 $25.01–$32.80 11% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE $28.70 $41.00 $25.01–$32.80 11% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SALMON ALLERGY $29.40 $42.00 $25.62–$33.60 9% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM ALLERGEN $29.40 $42.00 $25.62–$33.60 9% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN $29.40 $42.00 $25.62–$33.60 9% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER ALLERGEN $29.40 $42.00 $25.62–$33.60 9% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA ALLERGEN $29.40 $42.00 $25.62–$33.60 9% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN $29.40 $42.00 $25.62–$33.60 9% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTON SEED ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FLAXSEED ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO ALLERGEN $30.80 $44.00 $26.84–$35.20 5% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE PINE TREE $31.50 $45.00 $27.45–$36.00 3% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE $31.50 $45.00 $27.45–$36.00 3% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZLENUT TREE $31.50 $45.00 $27.45–$36.00 3% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTERS $31.50 $45.00 $27.45–$36.00 3% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WILLOW TREE $31.50 $45.00 $27.45–$36.00 3% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS VERSICOLOR $48.30 $69.00 $42.09–$55.20 49% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS AMSTEL/GLAUCUS $48.30 $69.00 $42.09–$55.20 49% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS TERREUS $48.30 $69.00 $42.09–$55.20 49% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASH GREEN $60.90 $87.00 $53.07–$69.60 88% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 POPLAR WHITE $60.90 $87.00 $53.07–$69.60 88% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM CULMORUM ALLERGE $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL ALLERGEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD TREE ALLERGEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW DOCKWOOD ALLERGEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHOSPORIUM INT ALLE $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AM SYCAMORE ALLERGEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BEECH ALLERGEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM MONILIFORM ALL $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BAKERS YEAST ALLERGEN $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG, WHOLE $65.80 $94.00 $57.34–$75.20 103% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS $67.20 $96.00 $58.56–$76.80 108% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RED DYE $93.80 $134.00 $81.74–$107.20 190% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ZUCCHINI ALLERGEN $96.60 $138.00 $84.18–$110.40 198% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RED TOP GRASS $100.10 $143.00 $87.23–$114.40 209% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CULT RYE GRASS $420.00 $600.00 $366.00–$480.00 1197% above 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL-HONEY BEE $11.90 $17.00 $10.37–$13.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL-YELLOW JACKET $11.90 $17.00 $10.37–$13.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL-YELLOW HORNET $11.90 $17.00 $10.37–$13.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL-POLISTES WASP $11.90 $17.00 $10.37–$13.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIREBRUSH $11.90 $17.00 $10.37–$13.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KENTUCKY BLUEGRASS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-ENGLISH PLANTAIN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-DOG EPITHELIUM $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-DERMATOPHAGOIDES PTERO $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-CLADOSPORIUM HERBARUM $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-CAT DANDER $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-PIGWEED ROUGH $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-RED MULBERRY $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-RED MAPLE $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-WHITE BIRCH $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-RED CEDAR $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-WHITE HICKORY $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-RAGWEED SHORT $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-WHITE OAK $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-LOCUST $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ACARUS MITE $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DANDELION $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BROME GRASS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHOSPORIUM HALO ALL $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED, TALL $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-NETTLE $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MARSH ELDER, ROUGH $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-ALTERNARIS ALTERNATA $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CULT WHEAT GRASS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG HAIR/DANDER $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COWS MILK ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-MUCOR RACEMOSUS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-BERMUDA GRASS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-BAHIA GRASS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND ALLERGEN $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET VERNAL GRASS $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-AMERICAN ELM $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-AMERICAN COCKROACH $13.30 $19.00 $11.59–$15.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP - MOUSE URINE PROTEIN $25.90 $37.00 $22.57–$29.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF ALLERGEN $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHOMA BETAE IgE $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK ALLERGEN $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO ALLERGY $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA TENUIS $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP-CHICKEN MEAT $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO ALLERGEN $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITHELIA IgE $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AP CANDIDA ALBICANS $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY ALLERGEN $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT ALLERGEN $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT ALLERGEN $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MALT ALLERGY $26.60 $38.00 $23.18–$30.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY FEATHERS $28.00 $40.00 $24.40–$32.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS ALLERGEN $28.00 $40.00 $24.40–$32.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN CEDAR ALLERGEN $28.00 $40.00 $24.40–$32.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE $28.70 $41.00 $25.01–$32.80 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM PURPURASCENS $28.70 $41.00 $25.01–$32.80 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS $28.70 $41.00 $25.01–$32.80 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUSK FEATHERS $28.70 $41.00 $25.01–$32.80 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON ALLERGY $29.40 $42.00 $25.62–$33.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGEN $29.40 $42.00 $25.62–$33.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA ALLERGEN $29.40 $42.00 $25.62–$33.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER ALLERGEN $29.40 $42.00 $25.62–$33.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM ALLERGEN $29.40 $42.00 $25.62–$33.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER ALLERGEN $29.40 $42.00 $25.62–$33.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FLAXSEED ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTON SEED ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK ALLERGEN $30.80 $44.00 $26.84–$35.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZLENUT TREE $31.50 $45.00 $27.45–$36.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE PINE TREE $31.50 $45.00 $27.45–$36.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WILLOW TREE $31.50 $45.00 $27.45–$36.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT TREE $31.50 $45.00 $27.45–$36.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTERS $31.50 $45.00 $27.45–$36.00 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS VERSICOLOR $48.30 $69.00 $42.09–$55.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS TERREUS $48.30 $69.00 $42.09–$55.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS AMSTEL/GLAUCUS $48.30 $69.00 $42.09–$55.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASH GREEN $60.90 $87.00 $53.07–$69.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POPLAR WHITE $60.90 $87.00 $53.07–$69.60 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAKERS YEAST ALLERGEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM MONILIFORM ALL $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEECH ALLERGEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AM SYCAMORE ALLERGEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM CULMORUM ALLERGE $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHOSPORIUM INT ALLE $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW DOCKWOOD ALLERGEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD TREE ALLERGEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL ALLERGEN $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG, WHOLE $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST $65.80 $94.00 $57.34–$75.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS $67.20 $96.00 $58.56–$76.80 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED DYE $93.80 $134.00 $81.74–$107.20 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ZUCCHINI ALLERGEN $96.60 $138.00 $84.18–$110.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED TOP GRASS $100.10 $143.00 $87.23–$114.40 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CULT RYE GRASS $420.00 $600.00 $366.00–$480.00 — 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETO PROTEIN PREG $43.40 $62.00 $37.82–$49.60 59% below 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL AFP $48.30 $69.00 $42.09–$55.20 54% below 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 TRIPLE SCREEN AFP $63.70 $91.00 $55.51–$72.80 40% below 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP-TUMOR MARKER $110.60 $158.00 $96.38–$126.40 4% above 30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETO PROTEIN PREG $43.40 $62.00 $37.82–$49.60 — 30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL AFP $48.30 $69.00 $42.09–$55.20 — 30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 TRIPLE SCREEN AFP $63.70 $91.00 $55.51–$72.80 — 30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP-TUMOR MARKER $110.60 $158.00 $96.38–$126.40 — 30%
Amylase blood test CPT 82150 AMYLASE,BODY FLUID $21.70 $31.00 $18.91–$24.80 52% below 30%
Amylase blood test CPT 82150 AMYLASE BODY FLUID $22.40 $32.00 $19.52–$25.60 51% below 30%
Amylase blood test CPT 82150 AMYLASE, URINE $47.60 $68.00 $41.48–$54.40 5% above 30%
Amylase blood test inpatient CPT 82150 AMYLASE,BODY FLUID $21.70 $31.00 $18.91–$24.80 — 30%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID $22.40 $32.00 $19.52–$25.60 — 30%
Amylase blood test inpatient CPT 82150 AMYLASE, URINE $47.60 $68.00 $41.48–$54.40 — 30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI CCP $43.40 $62.00 $37.82–$49.60 51% below 30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI CCP $43.40 $62.00 $37.82–$49.60 — 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA DIRECT $24.50 $35.00 $21.35–$28.00 67% below 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA DIRECT $24.50 $35.00 $21.35–$28.00 — 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 STAT BNP $100.80 $144.00 $87.84–$115.20 49% below 30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 STAT BNP $100.80 $144.00 $87.84–$115.20 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NASOPHARYNGEAL PERTUSSIS $31.50 $45.00 $27.45–$36.00 49% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 AEROBIC 2 $32.90 $47.00 $28.67–$37.60 46% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, WOUND $32.90 $47.00 $28.67–$37.60 46% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 AEROBIC CULTURE $32.90 $47.00 $28.67–$37.60 46% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, SPUTUM $33.60 $48.00 $29.28–$38.40 45% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT $33.60 $48.00 $29.28–$38.40 45% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID $36.40 $52.00 $31.72–$41.60 41% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, SPINAL FLUID $36.40 $52.00 $31.72–$41.60 41% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NASOPHARYNGEAL PERTUSSIS $31.50 $45.00 $27.45–$36.00 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 AEROBIC CULTURE $32.90 $47.00 $28.67–$37.60 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 AEROBIC 2 $32.90 $47.00 $28.67–$37.60 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, WOUND $32.90 $47.00 $28.67–$37.60 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT $33.60 $48.00 $29.28–$38.40 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, SPUTUM $33.60 $48.00 $29.28–$38.40 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, SPINAL FLUID $36.40 $52.00 $31.72–$41.60 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID $36.40 $52.00 $31.72–$41.60 — 30%
Bilirubin blood test, total CPT 82247 BILIRUBIN-TOTAL-VANDENBUR $47.60 $68.00 $41.48–$54.40 49% above 30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN-TOTAL-VANDENBUR $47.60 $68.00 $41.48–$54.40 — 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE-GROSS LV IV/CELL B $136.50 $195.00 $118.95–$156.00 31% below 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE-GRS EXM LV IV REDU $214.20 $306.00 $186.66–$244.80 9% above 30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE-GROSS LV IV/CELL B $136.50 $195.00 $118.95–$156.00 — 30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE-GRS EXM LV IV REDU $214.20 $306.00 $186.66–$244.80 — 30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $10.50 $15.00 $9.15–$12.00 30% below 30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE $10.50 $15.00 $9.15–$12.00 — 30%
Blood glucose (sugar) test CPT 82947 GLUCOSE $47.60 $68.00 $41.48–$54.40 76% above 30%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR POST PRANDIAL $47.60 $68.00 $41.48–$54.40 76% above 30%
Blood glucose (sugar) test CPT 82947 GLUCOSE PRENATAL $58.80 $84.00 $51.24–$67.20 118% above 30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE $47.60 $68.00 $41.48–$54.40 — 30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR POST PRANDIAL $47.60 $68.00 $41.48–$54.40 — 30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE PRENATAL $58.80 $84.00 $51.24–$67.20 — 30%
Blood lead test CPT 83655 LEAD, BLOOD $40.60 $58.00 $35.38–$46.40 48% below 30%
Blood lead test CPT 83655 LEAD, 24 HOUR URINE $63.00 $90.00 $54.90–$72.00 19% below 30%
Blood lead test CPT 83655 LEAD,URINE $209.30 $299.00 $182.39–$239.20 168% above 30%
Blood lead test inpatient CPT 83655 LEAD, BLOOD $40.60 $58.00 $35.38–$46.40 — 30%
Blood lead test inpatient CPT 83655 LEAD, 24 HOUR URINE $63.00 $90.00 $54.90–$72.00 — 30%
Blood lead test inpatient CPT 83655 LEAD,URINE $209.30 $299.00 $182.39–$239.20 — 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST-QUALITY SR $47.60 $68.00 $41.48–$54.40 16% below 30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST-QUALITY SR $47.60 $68.00 $41.48–$54.40 — 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE $77.00 $110.00 $67.10–$88.00 40% below 30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE $77.00 $110.00 $67.10–$88.00 — 30%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN-BUN $40.60 $58.00 $35.38–$46.40 41% above 30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN-BUN $40.60 $58.00 $35.38–$46.40 — 30%
C-peptide blood test CPT 84681 C-PEPTIDE INSULIN BLOOD $40.60 $58.00 $35.38–$46.40 61% below 30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE INSULIN BLOOD $40.60 $58.00 $35.38–$46.40 — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $40.60 $58.00 $35.38–$46.40 5% above 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $40.60 $58.00 $35.38–$46.40 — 30%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9 $133.00 $190.00 $115.90–$152.00 3% below 30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9 $133.00 $190.00 $115.90–$152.00 — 30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 $79.80 $114.00 $69.54–$91.20 39% below 30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125 $79.80 $114.00 $69.54–$91.20 — 30%
Calcium blood test, total CPT 82310 CALCIUM-SERUM $40.60 $58.00 $35.38–$46.40 21% above 30%
Calcium blood test, total inpatient CPT 82310 CALCIUM-SERUM $40.60 $58.00 $35.38–$46.40 — 30%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA $63.70 $91.00 $55.51–$72.80 39% below 30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA $63.70 $91.00 $55.51–$72.80 — 30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IgG $69.30 $99.00 $60.39–$79.20 24% below 30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA IgG $69.30 $99.00 $60.39–$79.20 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA UR2 $137.20 $196.00 $119.56–$156.80 30% below 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA,URINE 1 $142.10 $203.00 $123.83–$162.40 28% below 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA,URINE $151.90 $217.00 $132.37–$173.60 23% below 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NAAT $173.60 $248.00 $151.28–$198.40 12% below 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 URINE GC/CHLAMYDIA NAAT $297.50 $425.00 $259.25–$340.00 51% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA UR2 $137.20 $196.00 $119.56–$156.80 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA,URINE 1 $142.10 $203.00 $123.83–$162.40 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA,URINE $151.90 $217.00 $132.37–$173.60 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NAAT $173.60 $248.00 $151.28–$198.40 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 URINE GC/CHLAMYDIA NAAT $297.50 $425.00 $259.25–$340.00 — 30%
Complete blood count (CBC) with differential CPT 85025 CBC $56.70 $81.00 $49.41–$64.80 14% above 30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC $56.70 $81.00 $49.41–$64.80 — 30%
Cortisol blood test, total CPT 82533 DEXAMETHASONE SUPPRESSSION TES $46.20 $66.00 $40.26–$52.80 55% below 30%
Cortisol blood test, total CPT 82533 CORTISOL, SALIVA $66.50 $95.00 $57.95–$76.00 35% below 30%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL X4 $585.20 $836.00 $509.96–$668.80 468% above 30%
Cortisol blood test, total inpatient CPT 82533 DEXAMETHASONE SUPPRESSSION TES $46.20 $66.00 $40.26–$52.80 — 30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SALIVA $66.50 $95.00 $57.95–$76.00 — 30%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL X4 $585.20 $836.00 $509.96–$668.80 — 30%
Creatine kinase (CK) blood test, total CPT 82550 CPK $47.60 $68.00 $41.48–$54.40 1% above 30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK $47.60 $68.00 $41.48–$54.40 — 30%
Creatinine blood test CPT 82565 CREATININE SERUM $40.60 $58.00 $35.38–$46.40 22% above 30%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM $40.60 $58.00 $35.38–$46.40 — 30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER $64.40 $92.00 $56.12–$73.60 16% below 30%
D-dimer blood test (blood clot marker) CPT 85379 STAT DDIMER $64.40 $92.00 $56.12–$73.60 16% below 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER $64.40 $92.00 $56.12–$73.60 — 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 STAT DDIMER $64.40 $92.00 $56.12–$73.60 — 30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE $86.80 $124.00 $75.64–$99.20 29% below 30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE $86.80 $124.00 $75.64–$99.20 — 30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES PANEL $47.60 $68.00 $41.48–$54.40 28% below 30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES PANEL $47.60 $68.00 $41.48–$54.40 — 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA-IGGM $70.70 $101.00 $61.61–$80.80 30% below 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGM $70.70 $101.00 $61.61–$80.80 30% below 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA,IGG $70.70 $101.00 $61.61–$80.80 30% below 30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA,IGG $70.70 $101.00 $61.61–$80.80 — 30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IGM $70.70 $101.00 $61.61–$80.80 — 30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA-IGGM $70.70 $101.00 $61.61–$80.80 — 30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $62.30 $89.00 $54.29–$71.20 44% below 30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $62.30 $89.00 $54.29–$71.20 — 30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN,FECAL $465.50 $665.00 $405.65–$532.00 238% above 30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN,FECAL $465.50 $665.00 $405.65–$532.00 — 30%
Fibrinogen blood test CPT 85384 FIBRINOGEN $243.60 $348.00 $212.28–$278.40 256% above 30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN $243.60 $348.00 $212.28–$278.40 — 30%
Folate (folic acid) blood test CPT 82746 FOLIC ACID, SERUM $29.40 $42.00 $25.62–$33.60 66% below 30%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID, SERUM $29.40 $42.00 $25.62–$33.60 — 30%
Free T3 thyroid hormone test CPT 84481 FREE T3 $21.00 $30.00 $18.30–$24.00 80% below 30%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 $21.00 $30.00 $18.30–$24.00 — 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 (FREE THYROXINE) $47.60 $68.00 $41.48–$54.40 23% below 30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 (FREE THYROXINE) $47.60 $68.00 $41.48–$54.40 — 30%
Free testosterone test CPT 84402 TESTOSTERONE WEAKLY BOUND $589.40 $842.00 $513.62–$673.60 348% above 30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE WEAKLY BOUND $589.40 $842.00 $513.62–$673.60 — 30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP-GAMMA GLUTAMYLASE $47.60 $68.00 $41.48–$54.40 1% above 30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP-GAMMA GLUTAMYLASE $47.60 $68.00 $41.48–$54.40 — 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HOUR $58.80 $84.00 $51.24–$67.20 56% above 30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HOUR $58.80 $84.00 $51.24–$67.20 — 30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE, PRENATAL 1 HR $95.20 $136.00 $82.96–$108.80 18% above 30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 3 SPECIMANS $95.20 $136.00 $82.96–$108.80 18% above 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 3 SPECIMANS $95.20 $136.00 $82.96–$108.80 — 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE, PRENATAL 1 HR $95.20 $136.00 $82.96–$108.80 — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC,CHLAMYDIA, URINE 2 $142.10 $203.00 $123.83–$162.40 23% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONOCOCCUS NAAT $173.60 $248.00 $151.28–$198.40 6% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC,CHLAMYDIA, URINE 2 $142.10 $203.00 $123.83–$162.40 — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONOCOCCUS NAAT $173.60 $248.00 $151.28–$198.40 — 30%
H. pylori antibody blood test CPT 86677 H PYLORI AB, IGG $35.00 $50.00 $30.50–$40.00 72% below 30%
H. pylori antibody blood test CPT 86677 H PYLORI ABS,LGM $179.90 $257.00 $156.77–$205.60 46% above 30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB, IGG $35.00 $50.00 $30.50–$40.00 — 30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ABS,LGM $179.90 $257.00 $156.77–$205.60 — 30%
H. pylori stool antigen test CPT 87338 H PYLORI,STOOL $170.80 $244.00 $148.84–$195.20 68% above 30%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI,STOOL $170.80 $244.00 $148.84–$195.20 — 30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 AB $172.20 $246.00 $150.06–$196.80 72% above 30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 AB $172.20 $246.00 $150.06–$196.80 — 30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV REFLEX $277.20 $396.00 $241.56–$316.80 32% above 30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV REFLEX $277.20 $396.00 $241.56–$316.80 — 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN $56.70 $81.00 $49.41–$64.80 6% above 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN $56.70 $81.00 $49.41–$64.80 — 30%
Hemoglobin blood test CPT 85018 HEMOGLOBIN $14.00 $20.00 $12.20–$16.00 27% below 30%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN $14.00 $20.00 $12.20–$16.00 — 30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY $40.60 $58.00 $35.38–$46.40 58% below 30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY $40.60 $58.00 $35.38–$46.40 — 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB $32.20 $46.00 $28.06–$36.80 60% below 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB $32.20 $46.00 $28.06–$36.80 — 30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG $32.20 $46.00 $28.06–$36.80 54% below 30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG $32.20 $46.00 $28.06–$36.80 — 30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY $35.70 $51.00 $31.11–$40.80 67% below 30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY $35.70 $51.00 $31.11–$40.80 — 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C-RNA VIRAL LOA $249.90 $357.00 $217.77–$285.60 8% below 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C-RNA VIRAL LOA $249.90 $357.00 $217.77–$285.60 — 30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES II ANTIBODIES IGG $23.80 $34.00 $20.74–$27.20 75% below 30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES II ANTIBODIES IGG $23.80 $34.00 $20.74–$27.20 — 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP, HIGH SENSITIVITY $29.40 $42.00 $25.62–$33.60 60% below 30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP, HIGH SENSITIVITY $29.40 $42.00 $25.62–$33.60 — 30%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL $50.40 $72.00 $43.92–$57.60 58% below 30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL $50.40 $72.00 $43.92–$57.60 — 30%
Insulin blood test CPT 83525 INSULIN $36.40 $52.00 $31.72–$41.60 45% below 30%
Insulin blood test CPT 83525 ISLET-INSULIN $122.50 $175.00 $106.75–$140.00 84% above 30%
Insulin blood test inpatient CPT 83525 INSULIN $36.40 $52.00 $31.72–$41.60 — 30%
Insulin blood test inpatient CPT 83525 ISLET-INSULIN $122.50 $175.00 $106.75–$140.00 — 30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPAC.-TIBC $40.60 $58.00 $35.38–$46.40 35% below 30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPAC.-TIBC $40.60 $58.00 $35.38–$46.40 — 30%
LH (luteinizing hormone) test CPT 83002 LH-LEUTINIZING HORMONE $62.30 $89.00 $54.29–$71.20 44% below 30%
LH (luteinizing hormone) test inpatient CPT 83002 LH-LEUTINIZING HORMONE $62.30 $89.00 $54.29–$71.20 — 30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH $47.60 $68.00 $41.48–$54.40 38% above 30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH $47.60 $68.00 $41.48–$54.40 — 30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $63.70 $91.00 $55.51–$72.80 29% above 30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $63.70 $91.00 $55.51–$72.80 — 30%
Liver function blood test panel CPT 80076 LIVER PROFILE-HEPATIC PRF $91.00 $130.00 $79.30–$104.00 1% below 30%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE-HEPATIC PRF $91.00 $130.00 $79.30–$104.00 — 30%
Lyme disease antibody test CPT 86618 LYME DISEASE $21.00 $30.00 $18.30–$24.00 78% below 30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE $21.00 $30.00 $18.30–$24.00 — 30%
Magnesium blood test CPT 83735 URORISK,MG $21.00 $30.00 $18.30–$24.00 49% below 30%
Magnesium blood test inpatient CPT 83735 URORISK,MG $21.00 $30.00 $18.30–$24.00 — 30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG $40.60 $58.00 $35.38–$46.40 50% below 30%
Measles (rubeola) antibody test CPT 86765 MEASLES IgM $79.80 $114.00 $69.54–$91.20 2% below 30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG $40.60 $58.00 $35.38–$46.40 — 30%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IgM $79.80 $114.00 $69.54–$91.20 — 30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT $47.60 $68.00 $41.48–$54.40 23% above 30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT $47.60 $68.00 $41.48–$54.40 — 30%
Mumps immunity blood test CPT 86735 MUMPS IgM $204.40 $292.00 $178.12–$233.60 154% above 30%
Mumps immunity blood test inpatient CPT 86735 MUMPS IgM $204.40 $292.00 $178.12–$233.60 — 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE TOTAL PSA $88.20 $126.00 $76.86–$100.80 6% below 30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE TOTAL PSA $88.20 $126.00 $76.86–$100.80 — 30%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUIDED $76.30 $109.00 $66.49–$87.20 16% below 30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IMAGE GUIDED $76.30 $109.00 $66.49–$87.20 — 30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THIN GC $67.20 $96.00 $58.56–$76.80 10% above 30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP THIN GC $67.20 $96.00 $58.56–$76.80 — 30%
Parathyroid hormone (PTH) blood test CPT 83970 PTH C-TERMINAL $221.90 $317.00 $193.37–$253.60 6% above 30%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT $221.90 $317.00 $193.37–$253.60 6% above 30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH C-TERMINAL $221.90 $317.00 $193.37–$253.60 — 30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT $221.90 $317.00 $193.37–$253.60 — 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT $56.70 $81.00 $49.41–$64.80 24% above 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 TP # 15 LUPUS PTT $150.50 $215.00 $131.15–$172.00 230% above 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTCG PTT $150.50 $215.00 $131.15–$172.00 230% above 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT $56.70 $81.00 $49.41–$64.80 — 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTCG PTT $150.50 $215.00 $131.15–$172.00 — 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 TP # 15 LUPUS PTT $150.50 $215.00 $131.15–$172.00 — 30%
Potassium blood test CPT 84132 POTASSIUM $35.00 $50.00 $30.50–$40.00 7% above 30%
Potassium blood test CPT 84132 POTASSIUM RBC $151.90 $217.00 $132.37–$173.60 365% above 30%
Potassium blood test inpatient CPT 84132 POTASSIUM $35.00 $50.00 $30.50–$40.00 — 30%
Potassium blood test inpatient CPT 84132 POTASSIUM RBC $151.90 $217.00 $132.37–$173.60 — 30%
Progesterone blood test CPT 84144 PROGESTERONE $33.60 $48.00 $29.28–$38.40 75% below 30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE $33.60 $48.00 $29.28–$38.40 — 30%
Prolactin blood test CPT 84146 PROLACTIN, SERUM $77.00 $110.00 $67.10–$88.00 37% below 30%
Prolactin blood test CPT 84146 PROLACTIN, MOMOMERIC $114.80 $164.00 $100.04–$131.20 6% below 30%
Prolactin blood test inpatient CPT 84146 PROLACTIN, SERUM $77.00 $110.00 $67.10–$88.00 — 30%
Prolactin blood test inpatient CPT 84146 PROLACTIN, MOMOMERIC $114.80 $164.00 $100.04–$131.20 — 30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $40.60 $58.00 $35.38–$46.40 39% above 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $40.60 $58.00 $35.38–$46.40 — 30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN,URINE $317.10 $453.00 $276.33–$362.40 472% above 30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN,URINE $317.10 $453.00 $276.33–$362.40 — 30%
Renin blood test CPT 84244 RENIN 2 $489.30 $699.00 $426.39–$559.20 220% above 30%
Renin blood test CPT 84244 RENIN, PLASMA $501.20 $716.00 $436.76–$572.80 227% above 30%
Renin blood test inpatient CPT 84244 RENIN 2 $489.30 $699.00 $426.39–$559.20 — 30%
Renin blood test inpatient CPT 84244 RENIN, PLASMA $501.20 $716.00 $436.76–$572.80 — 30%
Rh blood typing CPT 86901 HIV GENOTYPE $560.00 $800.00 $488.00–$640.00 948% above 30%
Rh blood typing inpatient CPT 86901 HIV GENOTYPE $560.00 $800.00 $488.00–$640.00 — 30%
Rheumatoid factor (RF) test CPT 86431 RA IGG $47.60 $68.00 $41.48–$54.40 21% above 30%
Rheumatoid factor (RF) test inpatient CPT 86431 RA IGG $47.60 $68.00 $41.48–$54.40 — 30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN $33.60 $48.00 $29.28–$38.40 60% below 30%
Rubella antibody test (immunity check) CPT 86762 MMR #3 RUBELLA $33.60 $48.00 $29.28–$38.40 60% below 30%
Rubella antibody test (immunity check) inpatient CPT 86762 MMR #3 RUBELLA $33.60 $48.00 $29.28–$38.40 — 30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN $33.60 $48.00 $29.28–$38.40 — 30%
Sodium blood test CPT 84295 SODIUM $40.60 $58.00 $35.38–$46.40 21% above 30%
Sodium blood test inpatient CPT 84295 SODIUM $40.60 $58.00 $35.38–$46.40 — 30%
Stool ova and parasites exam CPT 87177 OVA & PARASITES,STOOL $46.90 $67.00 $40.87–$53.60 24% below 30%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES,STOOL $46.90 $67.00 $40.87–$53.60 — 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD $14.00 $20.00 $12.20–$16.00 31% below 30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD $14.00 $20.00 $12.20–$16.00 — 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 T PALLIDIUM ANTIBODIES $14.00 $20.00 $12.20–$16.00 81% below 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS $30.80 $44.00 $26.84–$35.20 59% below 30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T PALLIDIUM ANTIBODIES $14.00 $20.00 $12.20–$16.00 — 30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS $30.80 $44.00 $26.84–$35.20 — 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR $24.50 $35.00 $21.35–$28.00 13% below 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL $35.70 $51.00 $31.11–$40.80 27% above 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR $24.50 $35.00 $21.35–$28.00 — 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL $35.70 $51.00 $31.11–$40.80 — 30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB $231.00 $330.00 $201.30–$264.00 20% below 30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON $448.70 $641.00 $391.01–$512.80 55% above 30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB $231.00 $330.00 $201.30–$264.00 — 30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON $448.70 $641.00 $391.01–$512.80 — 30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE $45.50 $65.00 $39.65–$52.00 72% below 30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE $45.50 $65.00 $39.65–$52.00 — 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB $40.60 $58.00 $35.38–$46.40 46% below 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL A $44.10 $63.00 $38.43–$50.40 41% below 30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB $40.60 $58.00 $35.38–$46.40 — 30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL A $44.10 $63.00 $38.43–$50.40 — 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH THYROID STIMULATING $47.60 $68.00 $41.48–$54.40 51% below 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH THYROID STIMULATING $47.60 $68.00 $41.48–$54.40 — 30%
Total cholesterol blood test CPT 82465 CHOLESTEROL $32.20 $46.00 $28.06–$36.80 3% above 30%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL $32.20 $46.00 $28.06–$36.80 — 30%
Total thyroxine (T4) blood test CPT 84436 T4 $47.60 $68.00 $41.48–$54.40 7% above 30%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 $47.60 $68.00 $41.48–$54.40 — 30%
Total triiodothyronine (T3) blood test CPT 84480 T3 $47.60 $68.00 $41.48–$54.40 52% below 30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 $47.60 $68.00 $41.48–$54.40 — 30%
Transferrin blood test CPT 84466 TRANSFERRIN $47.60 $68.00 $41.48–$54.40 47% below 30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN $47.60 $68.00 $41.48–$54.40 — 30%
Trichomonas test (NAAT) CPT 87661 PAP TRICH $95.20 $136.00 $82.96–$108.80 48% below 30%
Trichomonas test (NAAT) inpatient CPT 87661 PAP TRICH $95.20 $136.00 $82.96–$108.80 — 30%
Troponin test, quantitative CPT 84484 TROPONIN I $63.70 $91.00 $55.51–$72.80 24% below 30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I $63.70 $91.00 $55.51–$72.80 — 30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS-ROUTINE-COMPLE $40.60 $58.00 $35.38–$46.40 15% above 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS-ROUTINE-COMPLE $40.60 $58.00 $35.38–$46.40 — 30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED DIP $21.00 $30.00 $18.30–$24.00 9% above 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED DIP $21.00 $30.00 $18.30–$24.00 — 30%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE,COMPHRENSIV $42.70 $61.00 $37.21–$48.80 29% below 30%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE $79.80 $114.00 $69.54–$91.20 33% above 30%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE,COMPHRENSIV $42.70 $61.00 $37.21–$48.80 — 30%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE $79.80 $114.00 $69.54–$91.20 — 30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RATIO $19.60 $28.00 $17.08–$22.40 53% below 30%
Urine microalbumin (albumin) test CPT 82043 MICRO ALBUMIN $40.60 $58.00 $35.38–$46.40 2% below 30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RATIO $19.60 $28.00 $17.08–$22.40 — 30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICRO ALBUMIN $40.60 $58.00 $35.38–$46.40 — 30%
Vitamin B12 (cobalamin) blood test CPT 82607 VIT B12 $10.50 $15.00 $9.15–$12.00 88% below 30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VIT B12 $10.50 $15.00 $9.15–$12.00 — 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D 25 $30.10 $43.00 $26.23–$34.40 80% below 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D 25 $30.10 $43.00 $26.23–$34.40 — 30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D1, 25 $264.60 $378.00 $230.58–$302.40 29% above 30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D1, 25 $264.60 $378.00 $230.58–$302.40 — 30%
Zinc blood test CPT 84630 ZINC PLASMA $31.50 $45.00 $27.45–$36.00 55% below 30%
Zinc blood test CPT 84630 ZINC URINE $42.70 $61.00 $37.21–$48.80 39% below 30%
Zinc blood test CPT 84630 ZINC RBC $92.40 $132.00 $80.52–$105.60 32% above 30%
Zinc blood test CPT 84630 ZINC TRANSPORTER 8 ANTIBODY $117.60 $168.00 $102.48–$134.40 68% above 30%
Zinc blood test inpatient CPT 84630 ZINC PLASMA $31.50 $45.00 $27.45–$36.00 — 30%
Zinc blood test inpatient CPT 84630 ZINC URINE $42.70 $61.00 $37.21–$48.80 — 30%
Zinc blood test inpatient CPT 84630 ZINC RBC $92.40 $132.00 $80.52–$105.60 — 30%
Zinc blood test inpatient CPT 84630 ZINC TRANSPORTER 8 ANTIBODY $117.60 $168.00 $102.48–$134.40 — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BET HCG,TUMOR $66.50 $95.00 $57.95–$76.00 20% below 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREG TEST QUANT BHCG $77.00 $110.00 $67.10–$88.00 8% below 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER $86.10 $123.00 $75.03–$98.40 3% above 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BET HCG,TUMOR $66.50 $95.00 $57.95–$76.00 — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREG TEST QUANT BHCG $77.00 $110.00 $67.10–$88.00 — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER $86.10 $123.00 $75.03–$98.40 — 30%

Surgery and procedures

ProcedureCash price List priceInsurers payvs PennsylvaniaOff list
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREATMENT METARARSAL FX $208.60 $298.00 $181.78–$238.40 60% below 30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREATMENT METARARSAL FX $208.60 $298.00 $181.78–$238.40 — 30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECT EXTER $539.70 $771.00 $470.31–$616.80 63% below 30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HEART ELECTROCONVERSION $689.50 $985.00 $600.85–$788.00 53% below 30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECT EXTER $539.70 $771.00 $470.31–$616.80 — 30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HEART ELECTROCONVERSION $689.50 $985.00 $600.85–$788.00 — 30%
Cervical biopsy CPT 57500 CERVICAL BX $233.10 $333.00 $203.13–$266.40 86% below 30%
Cervical biopsy inpatient CPT 57500 CERVICAL BX $233.10 $333.00 $203.13–$266.40 — 30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISTAL RADIAL INC $765.10 $1,093.00 $666.73–$874.40 31% above 30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DISTAL RADIAL INC $765.10 $1,093.00 $666.73–$874.40 — 30%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY WITH BIOPSY $233.10 $333.00 $203.13–$266.40 48% below 30%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY WITH BIOPSY $233.10 $333.00 $203.13–$266.40 — 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION ALL BENIGN LE $62.30 $89.00 $54.29–$71.20 80% below 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION ALL BENIGN LE $62.30 $89.00 $54.29–$71.20 — 30%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN $78.40 $112.00 $68.32–$89.60 41% below 30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN $78.40 $112.00 $68.32–$89.60 — 30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY UTERUS LINING $70.70 $101.00 $61.61–$80.80 81% below 30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY UTERUS LINING $70.70 $101.00 $61.61–$80.80 — 30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEX SIGMOIDSCOPY $225.40 $322.00 $196.42–$257.60 70% below 30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEX SIGMOIDSCOPY $225.40 $322.00 $196.42–$257.60 — 30%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS $247.80 $354.00 $215.94–$283.20 50% below 30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS $247.80 $354.00 $215.94–$283.20 — 30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION OF LIGAMENT $187.60 $268.00 $163.48–$214.40 65% below 30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION OF LIGAMENT $187.60 $268.00 $163.48–$214.40 — 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOIN $208.60 $298.00 $181.78–$238.40 55% below 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJ JOINT $259.70 $371.00 $226.31–$296.80 45% below 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JOIN $208.60 $298.00 $181.78–$238.40 — 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJ JOINT $259.70 $371.00 $226.31–$296.80 — 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTER JOIN $232.40 $332.00 $202.52–$265.60 31% below 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTER JOIN $232.40 $332.00 $202.52–$265.60 — 30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ $208.60 $298.00 $181.78–$238.40 49% below 30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ $208.60 $298.00 $181.78–$238.40 — 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS WOUNDS SCALP A $212.10 $303.00 $184.83–$242.40 66% below 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTER REPAIR $263.20 $376.00 $229.36–$300.80 57% below 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS WOUNDS SCALP A $212.10 $303.00 $184.83–$242.40 — 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTER REPAIR $263.20 $376.00 $229.36–$300.80 — 30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC OTHER BENIGN LESION F $388.50 $555.00 $338.55–$444.00 74% below 30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC OTHER BENIGN LESION F $388.50 $555.00 $338.55–$444.00 — 30%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL NAIL PLATE $116.90 $167.00 $101.87–$133.60 77% below 30%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL NAIL PLATE $116.90 $167.00 $101.87–$133.60 — 30%
Removal of a foreign object under the skin, simple CPT 10120 INC AND REMOVAL FB SUBC T $200.90 $287.00 $175.07–$229.60 61% below 30%
Removal of a foreign object under the skin, simple CPT 10120 INCISION REMOVAL FOR BODY $249.20 $356.00 $217.16–$284.80 52% below 30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC AND REMOVAL FB SUBC T $200.90 $287.00 $175.07–$229.60 — 30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION REMOVAL FOR BODY $249.20 $356.00 $217.16–$284.80 — 30%
Short arm cast (elbow to hand) CPT 29075 APPICATION SHORT ARM $116.90 $167.00 $101.87–$133.60 72% below 30%
Short arm cast (elbow to hand) inpatient CPT 29075 APPICATION SHORT ARM $116.90 $167.00 $101.87–$133.60 — 30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPL $116.90 $167.00 $101.87–$133.60 64% below 30%
Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT $144.20 $206.00 $125.66–$164.80 56% below 30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPL $116.90 $167.00 $101.87–$133.60 — 30%
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT $144.20 $206.00 $125.66–$164.80 — 30%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAS $116.90 $167.00 $101.87–$133.60 78% below 30%
Short leg cast (below the knee) CPT 29405 APPLICATION LEG CAST $144.20 $206.00 $125.66–$164.80 73% below 30%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAS $116.90 $167.00 $101.87–$133.60 — 30%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION LEG CAST $144.20 $206.00 $125.66–$164.80 — 30%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG $199.50 $285.00 $173.85–$228.00 57% below 30%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHRT LEG SPLN $246.40 $352.00 $214.72–$281.60 47% below 30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG $199.50 $285.00 $173.85–$228.00 — 30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHRT LEG SPLN $246.40 $352.00 $214.72–$281.60 — 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SUPRF WOUND $212.10 $303.00 $184.83–$242.40 59% below 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR,SCALP,NECK $263.20 $376.00 $229.36–$300.80 49% below 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SUPRF WOUND $212.10 $303.00 $184.83–$242.40 — 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR,SCALP,NECK $263.20 $376.00 $229.36–$300.80 — 30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MALIGNANT LESION TRUN $388.50 $555.00 $338.55–$444.00 62% below 30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MALIGNANT LESION TRUN $388.50 $555.00 $338.55–$444.00 — 30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS ANY $129.50 $185.00 $112.85–$148.00 78% below 30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS ANY $129.50 $185.00 $112.85–$148.00 — 30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6CM 7.5CM $263.20 $376.00 $229.36–$300.80 55% below 30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR 2.6CM 7.5CM $263.20 $376.00 $229.36–$300.80 — 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR-LACERATION $263.20 $376.00 $229.36–$300.80 49% below 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR-LACERATION $263.20 $376.00 $229.36–$300.80 — 30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINTS ONE OR $119.00 $170.00 $103.70–$136.00 76% below 30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULT TRIGGER P $232.40 $332.00 $202.52–$265.60 53% below 30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINTS ONE OR $119.00 $170.00 $103.70–$136.00 — 30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULT TRIGGER P $232.40 $332.00 $202.52–$265.60 — 30%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD $685.30 $979.00 $597.19–$783.20 63% below 30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD $685.30 $979.00 $597.19–$783.20 — 30%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY $1,733.20 $2,476.00 $1,510.36–$1,980.80 37% below 30%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY $1,733.20 $2,476.00 $1,510.36–$1,980.80 — 30%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BY ANY METHOD $62.30 $89.00 $54.29–$71.20 89% below 30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BY ANY METHOD $62.30 $89.00 $54.29–$71.20 — 30%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs PennsylvaniaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOO $546.00 $780.00 $475.80–$624.00 50% below 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOO $546.00 $780.00 $475.80–$624.00 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RX-IS $26.60 $38.00 $23.18–$30.40 87% below 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER RX-SUBSEQUENT $38.50 $55.00 $33.55–$44.00 81% below 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RX-IS $26.60 $38.00 $23.18–$30.40 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER RX-SUBSEQUENT $38.50 $55.00 $33.55–$44.00 — 30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG $129.50 $185.00 $112.85–$148.00 99% above 30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG $129.50 $185.00 $112.85–$148.00 — 30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER-E&M LEVEL I $142.80 $204.00 $124.44–$163.20 45% below 30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER-E&M LEVEL I $142.80 $204.00 $124.44–$163.20 — 30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER - E&M LEVEL III $247.80 $354.00 $215.94–$283.20 66% below 30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER - E&M LEVEL III $247.80 $354.00 $215.94–$283.20 — 30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER - E&M LEVEL IV $396.90 $567.00 $345.87–$453.60 68% below 30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER - E&M LEVEL IV $396.90 $567.00 $345.87–$453.60 — 30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER - E&M LEVEL V $396.90 $567.00 $345.87–$453.60 75% below 30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER - E&M LEVEL V $396.90 $567.00 $345.87–$453.60 — 30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INI $81.20 $116.00 $70.76–$92.80 81% below 30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INI $81.20 $116.00 $70.76–$92.80 — 30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION UP TO 1HR $266.70 $381.00 $232.41–$304.80 41% below 30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION UP TO 1 HR $326.90 $467.00 $284.87–$373.60 28% below 30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION UP TO 1HR $266.70 $381.00 $232.41–$304.80 — 30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION UP TO 1 HR $326.90 $467.00 $284.87–$373.60 — 30%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE INJ $25.20 $36.00 $21.96–$28.80 92% below 30%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE OR INIT SU $32.20 $46.00 $28.06–$36.80 90% below 30%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE INJ $25.20 $36.00 $21.96–$28.80 — 30%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE OR INIT SU $32.20 $46.00 $28.06–$36.80 — 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SC IM $32.90 $47.00 $28.67–$37.60 74% below 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SC IM $32.90 $47.00 $28.67–$37.60 — 30%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 STUDIES $381.50 $545.00 $332.45–$436.00 74% below 30%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 STUDIES $381.50 $545.00 $332.45–$436.00 — 30%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATIO $41.30 $59.00 $35.99–$47.20 67% below 30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATIO $41.30 $59.00 $35.99–$47.20 — 30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY $47.60 $68.00 $41.48–$54.40 64% below 30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY $47.60 $68.00 $41.48–$54.40 — 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERC 1/4 HR $44.10 $63.00 $38.43–$50.40 65% below 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERC 1/4 HR $44.10 $63.00 $38.43–$50.40 — 30%
Spirometry (breathing test) CPT 94010 PFT SPIROMETRY $72.80 $104.00 $63.44–$83.20 77% below 30%
Spirometry (breathing test) inpatient CPT 94010 PFT SPIROMETRY $72.80 $104.00 $63.44–$83.20 — 30%
Spirometry before and after a bronchodilator CPT 94060 PFT - SPIROMETRY PRE/POST $109.20 $156.00 $95.16–$124.80 83% below 30%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT - SPIROMETRY PRE/POST $109.20 $156.00 $95.16–$124.80 — 30%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 STRESS TEST GLOBAL $756.00 $1,080.00 $658.80–$864.00 83% above 30%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 STRESS TEST GLOBAL $756.00 $1,080.00 $658.80–$864.00 — 30%

Vaccines

ProcedureCash price List priceInsurers payvs PennsylvaniaOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX $242.20 $346.00 $211.06–$276.80 18% above 30%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX $242.20 $346.00 $211.06–$276.80 — 30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP UNDER 7 YEARS $51.80 $74.00 $45.14–$59.20 33% above 30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP UNDER 7 YEARS $51.80 $74.00 $45.14–$59.20 — 30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX $140.70 $201.00 $122.61–$160.80 70% above 30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX $140.70 $201.00 $122.61–$160.80 — 30%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACCEL VACCINE $208.60 $298.00 $181.78–$238.40 141% above 30%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACCEL VACCINE $208.60 $298.00 $181.78–$238.40 — 30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A 1.0ML $80.50 $115.00 $70.15–$92.00 2% below 30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A 1.0ML $80.50 $115.00 $70.15–$92.00 — 30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B ADULT 20YRS O $143.50 $205.00 $125.05–$164.00 83% above 30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B ADULT 20YRS O $143.50 $205.00 $125.05–$164.00 — 30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS .25ML NEWBORNS $65.10 $93.00 $56.73–$74.40 29% above 30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS .25ML NEWBORNS $65.10 $93.00 $56.73–$74.40 — 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB ADM FEE $9.10 $13.00 $7.93–$10.40 72% below 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB ADM FEE $9.10 $13.00 $7.93–$10.40 — 30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE HIGH DOSE $49.00 $70.00 $42.70–$56.00 46% below 30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE HIGH DOSE $49.00 $70.00 $42.70–$56.00 — 30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR 0.5ML $163.10 $233.00 $142.13–$186.40 156% above 30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR 0.5ML $163.10 $233.00 $142.13–$186.40 — 30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA $243.60 $348.00 $212.28–$278.40 160% above 30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACTRA $243.60 $348.00 $212.28–$278.40 — 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC 0.5CC IM $137.90 $197.00 $120.17–$157.60 53% above 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC 0.5CC IM $137.90 $197.00 $120.17–$157.60 — 30%
Polio vaccine, inactivated (IPV) CPT 90713 EIPV INJ $70.00 $100.00 $61.00–$80.00 at median 30%
Polio vaccine, inactivated (IPV) CPT 90713 IPV $70.70 $101.00 $61.61–$80.80 1% above 30%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 EIPV INJ $70.00 $100.00 $61.00–$80.00 — 30%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV $70.70 $101.00 $61.61–$80.80 — 30%
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE $293.30 $419.00 $255.59–$335.20 51% below 30%
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE $293.30 $419.00 $255.59–$335.20 — 30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX VACCINE $259.70 $371.00 $226.31–$296.80 4% below 30%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX VACCINE $259.70 $371.00 $226.31–$296.80 — 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP 7 YEARS + $68.60 $98.00 $59.78–$78.40 22% above 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP 7 YEARS + $68.60 $98.00 $59.78–$78.40 — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN.SINGLE/COMB VACINE $14.00 $20.00 $12.20–$16.00 78% below 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM $23.10 $33.00 $20.13–$26.40 64% below 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN.SINGLE/COMB VACINE $14.00 $20.00 $12.20–$16.00 — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM $23.10 $33.00 $20.13–$26.40 — 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EA ADDTL VACCINE $16.80 $24.00 $14.64–$19.20 38% below 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADDTL VACCINE $17.50 $25.00 $15.25–$20.00 35% below 30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EA ADDTL VACCINE $16.80 $24.00 $14.64–$19.20 — 30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EACH ADDTL VACCINE $17.50 $25.00 $15.25–$20.00 — 30%

Source file: https://www.endlesscare.org/s/232720289_endless-mountains-health-systems-inc_standardcharges.csv