Edgerton Hospital and Health Services
Edgerton Hospital and Health Services in Edgerton, WI publishes cash prices for 389 common procedures listed here, from its own machine-readable price file updated Jul 19, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Wisconsin median for 322 of 385 procedures and below it for 63. By typical cash price it ranks #102 of 105 Wisconsin hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
11101 N SHERMAN RD, EDGERTON, WI, 53534 Collected Sep 27, 2026 Source price file Check a bill from this hospital (608) 884-3441
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 521319 · CMS hospital register NPI 1154350049
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Edgerton Hospital and Health Services is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Edgerton Hospital and Health Services in Edgerton, WI:
- Jul 15, 2026 Warning notice
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN WITH & WITHOUT IV CONTRAST | $3,057.24 | $4,188.00 | $55.00–$1,187.43 | 27% above | 27% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN WITH & WITHOUT IV CONTRAST | $3,057.24 | $4,188.00 | $55.00–$1,187.43 | — | 27% |
| Abdominal X-ray, 2 views CPT 74019 HC XRAY ABDOMEN 2 VIEWS | $475.23 | $651.00 | $55.00–$64.34 | 98% above | 27% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC XRAY ABDOMEN 2 VIEWS | $475.23 | $651.00 | $55.00–$64.34 | — | 27% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE 3+ VW | $489.10 | $670.00 | $55.00–$116.80 | 108% above | 27% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE 3+ VW | $489.10 | $670.00 | $55.00–$116.80 | — | 27% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC ARTERIAL STUDY EXTREM BILATERAL LIMITED | $475.96 | $652.00 | $55.00–$395.34 | — | 27% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC ANKLE BRACH INDEX/SGL DOPPLER | $475.96 | $652.00 | $55.00–$395.34 | 24% above | 27% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC ARTERIAL STUDY EXTREM BILATERAL LIMITED | $475.96 | $652.00 | $55.00–$395.34 | — | 27% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC ANKLE BRACH INDEX/SGL DOPPLER | $475.96 | $652.00 | $55.00–$395.34 | — | 27% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$771.29 | 63% above | 27% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$771.29 | — | 27% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XRAY ESOPHAGUS SNGL CONTRAST | $671.60 | $920.00 | $55.00–$195.85 | 27% above | 27% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XRAY ESOPHAGUS SNGL CONTRAST | $671.60 | $920.00 | $55.00–$195.85 | — | 27% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN WHOLE BODY | $2,112.62 | $2,894.00 | $55.00–$756.75 | 42% above | 27% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE SCAN WHOLE BODY | $2,112.62 | $2,894.00 | $55.00–$756.75 | — | 27% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE | $702.26 | $962.00 | $55.00–$209.46 | 32% above | 27% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE | $702.26 | $962.00 | $55.00–$209.46 | — | 27% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL LIMITED | $672.33 | $921.00 | $55.00–$172.49 | 71% above | 27% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED | $672.33 | $921.00 | $55.00–$172.49 | — | 27% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO ABDOMEN PELVIS W WO CON | $4,627.47 | $6,339.00 | $55.00–$918.60 | 52% above | 27% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIO ABDOMEN PELVIS W WO CON | $4,627.47 | $6,339.00 | $55.00–$918.60 | — | 27% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIO HEAD WITH AND WITHOUT CONTRAST | $3,553.64 | $4,868.00 | $55.00–$723.79 | 71% above | 27% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO HEAD WITH AND WITHOUT CONTRAST | $3,553.64 | $4,868.00 | $55.00–$723.79 | — | 27% |
| CT angiography (CTA) of the neck CPT 70498 HC CT ANGIO NECK | $3,097.39 | $4,243.00 | $55.00–$723.79 | 53% above | 27% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIO NECK | $3,097.39 | $4,243.00 | $55.00–$723.79 | — | 27% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO CHEST W CONTRAST | $3,553.64 | $4,868.00 | $55.00–$879.36 | 75% above | 27% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO CHEST W CONTRAST | $3,553.64 | $4,868.00 | $55.00–$879.36 | — | 27% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CARDIAC ANGIO W CORO EVAL | $954.84 | $1,308.00 | $55.00–$880.27 | 45% below | 27% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CARDIAC ANGIO W CORO EVAL | $954.84 | $1,308.00 | $55.00–$880.27 | — | 27% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT SCREEN CARDIAC SCORING | $73.00 | $100.00 | $55.00–$177.59 | 13% above | 27% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT SCREEN CARDIAC SCORING | $73.00 | $100.00 | $55.00–$177.59 | — | 27% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN PELVIS WO CONTRAST | $3,808.41 | $5,217.00 | $55.00–$326.74 | 52% above | 27% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABDOMEN PELVIS WO CONTRAST | $3,808.41 | $5,217.00 | $55.00–$326.74 | — | 27% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRAST | $4,420.88 | $6,056.00 | $55.00–$542.03 | 38% above | 27% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRAST | $4,420.88 | $6,056.00 | $55.00–$542.03 | — | 27% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN PELVIS WWO CONTRAST | $5,091.02 | $6,974.00 | $55.00–$669.44 | 36% above | 27% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN PELVIS WWO CONTRAST | $5,091.02 | $6,974.00 | $55.00–$669.44 | — | 27% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN WITH IV CONTRAST | $2,649.90 | $3,630.00 | $55.00–$1,104.11 | 62% above | 27% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN WITH IV CONTRAST | $2,649.90 | $3,630.00 | $55.00–$1,104.11 | — | 27% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN NON IV CONTRAST | $2,347.68 | $3,216.00 | $55.00–$806.12 | 86% above | 27% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN NON IV CONTRAST | $2,347.68 | $3,216.00 | $55.00–$806.12 | — | 27% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SINUS FACIAL BONES NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$725.40 | 69% above | 27% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SINUS FACIAL BONES NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$725.40 | — | 27% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD NON CONTRAST | $2,180.51 | $2,987.00 | $55.00–$810.12 | 69% above | 27% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD NON CONTRAST | $2,180.51 | $2,987.00 | $55.00–$810.12 | — | 27% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD WITH CONTRAST | $2,729.47 | $3,739.00 | $55.00–$1,045.74 | 77% above | 27% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD WITH CONTRAST | $2,729.47 | $3,739.00 | $55.00–$1,045.74 | — | 27% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD WITH & WITHOUT CONTRAST | $2,740.42 | $3,754.00 | $55.00–$1,166.02 | 49% above | 27% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD WITH & WITHOUT CONTRAST | $2,740.42 | $3,754.00 | $55.00–$1,166.02 | — | 27% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE NON CONTRAST | $2,409.00 | $3,300.00 | $55.00–$1,003.67 | 56% above | 27% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE NON CONTRAST | $2,409.00 | $3,300.00 | $55.00–$1,003.67 | — | 27% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE NON CONTRAST | $2,418.49 | $3,313.00 | $55.00–$1,003.67 | 57% above | 27% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE NON CONTRAST | $2,418.49 | $3,313.00 | $55.00–$1,003.67 | — | 27% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS WITH IV CONTRAST | $2,649.90 | $3,630.00 | $55.00–$1,116.43 | 62% above | 27% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS WITH IV CONTRAST | $2,649.90 | $3,630.00 | $55.00–$1,116.43 | — | 27% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX CAROTID BILAT | $1,522.78 | $2,086.00 | $55.00–$440.34 | — | 27% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX CAROTID BILAT | $1,522.78 | $2,086.00 | $55.00–$440.34 | — | 27% |
| Chest CT scan without and with contrast CPT 71270 HC CT CHEST WITH & WITHOUT CONTRAST | $2,740.42 | $3,754.00 | $55.00–$1,376.12 | 20% above | 27% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT CHEST WITH & WITHOUT CONTRAST | $2,740.42 | $3,754.00 | $55.00–$1,376.12 | — | 27% |
| Chest X-ray, 2 views CPT 71046 HC XRAY CHEST 2 VIEWS | $489.83 | $671.00 | $55.00–$58.87 | 128% above | 27% |
| Chest X-ray, 2 views inpatient CPT 71046 HC XRAY CHEST 2 VIEWS | $489.83 | $671.00 | $55.00–$58.87 | — | 27% |
| Chest X-ray, single view CPT 71045 HC XRAY CHEST 1 VIEW | $440.92 | $604.00 | $38.33–$55.00 | 172% above | 27% |
| Chest X-ray, single view inpatient CPT 71045 HC XRAY CHEST 1 VIEW | $440.92 | $604.00 | $38.33–$55.00 | — | 27% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC XRAY CLAVICLE COMPLETE | $395.66 | $542.00 | $55.00–$113.22 | 91% above | 27% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XRAY CLAVICLE COMPLETE | $395.66 | $542.00 | $55.00–$113.22 | — | 27% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE | $1,012.51 | $1,387.00 | $55.00–$402.08 | 84% above | 27% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE | $1,012.51 | $1,387.00 | $55.00–$402.08 | — | 27% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA BONE DENSITY AXIAL SKELETON | $824.17 | $1,129.00 | $55.00–$195.54 | 107% above | 27% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA BONE DENSITY AXIAL SKELETON | $824.17 | $1,129.00 | $55.00–$195.54 | — | 27% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DEXA BONE DENSITY PERIPHERAL | $210.97 | $289.00 | $54.84–$56.39 | 25% below | 27% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DEXA BONE DENSITY PERIPHERAL | $210.97 | $289.00 | $54.84–$56.39 | — | 27% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$960.34 | 64% above | 27% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$960.34 | — | 27% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST WITH CONTRAST | $2,649.90 | $3,630.00 | $55.00–$1,117.16 | 62% above | 27% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST WITH CONTRAST | $2,649.90 | $3,630.00 | $55.00–$1,117.16 | — | 27% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMM DX BILATERAL INCLUDES CAD/AI | $401.50 | $550.00 | $55.00–$326.51 | — | 27% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMM DX BILATERAL INCLUDES CAD/AI | $401.50 | $550.00 | $55.00–$326.51 | — | 27% |
| Diagnostic mammogram, one breast one side CPT 77065 HC MAMM DX UNILATERAL INCLUDES CAD/AI | $321.20 | $440.00 | $55.00–$257.37 | 4% above | 27% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMM DX UNILATERAL INCLUDES CAD/AI | $321.20 | $440.00 | $55.00–$257.37 | — | 27% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 HC ART DUPLEX LE OR BYPASS GRAFT/BIL | $1,255.60 | $1,720.00 | $55.00–$559.17 | 116% above | 27% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC ART DUPLEX LE OR BYPASS GRAFT/BIL | $1,255.60 | $1,720.00 | $55.00–$559.17 | — | 27% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC US VENOUS MAP LOWER EXT BILAT | $1,460.00 | $2,000.00 | $55.00–$323.63 | — | 27% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX SCAN EXTREMITY VEINS BILAT COMP | $1,460.00 | $2,000.00 | $55.00–$323.63 | — | 27% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC US VENOUS INSUFFICIENCY BILAT | $1,460.00 | $2,000.00 | $55.00–$323.63 | — | 27% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC US VENOUS INSUFFICIENCY BILAT | $1,460.00 | $2,000.00 | $55.00–$323.63 | — | 27% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX SCAN EXTREMITY VEINS BILAT COMP | $1,460.00 | $2,000.00 | $55.00–$323.63 | — | 27% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC US VENOUS MAP LOWER EXT BILAT | $1,460.00 | $2,000.00 | $55.00–$323.63 | — | 27% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE 2D CMPLT WO CON W DOPPLER AND COLOR | $2,722.90 | $3,730.00 | $55.00–$342.22 | 55% above | 27% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE 2D CMPLT WO CON W DOPPLER AND COLOR | $2,722.90 | $3,730.00 | $55.00–$342.22 | — | 27% |
| Elbow X-ray, 2 views CPT 73070 HC ELBOW 2 VW | $447.49 | $613.00 | $50.67–$93.90 | 137% above | 27% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW 2 VW | $447.49 | $613.00 | $50.67–$93.90 | — | 27% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW 3+ VW | $551.88 | $756.00 | $55.00–$120.08 | 133% above | 27% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW 3+ VW | $551.88 | $756.00 | $55.00–$120.08 | — | 27% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT POST FOSSA EAR NON CONTRAST | $543.12 | $744.00 | $55.00–$701.71 | 64% below | 27% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT POST FOSSA EAR NON CONTRAST | $543.12 | $744.00 | $55.00–$701.71 | — | 27% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES 3+ VW | $551.88 | $756.00 | $55.00–$211.73 | 84% above | 27% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES 3+ VW | $551.88 | $756.00 | $55.00–$211.73 | — | 27% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM 2 VW | $447.49 | $613.00 | $50.67–$114.13 | 126% above | 27% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM 2 VW | $447.49 | $613.00 | $50.67–$114.13 | — | 27% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING | $1,614.03 | $2,211.00 | $55.00–$590.04 | 10% above | 27% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING | $1,614.03 | $2,211.00 | $55.00–$590.04 | — | 27% |
| Hand X-ray, 2 views CPT 73120 HC HAND 2 VW | $448.22 | $614.00 | $54.73–$79.37 | 138% above | 27% |
| Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VW | $448.22 | $614.00 | $54.73–$79.37 | — | 27% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC CALCANEUS 2+ VW | $447.49 | $613.00 | $49.51–$115.08 | 125% above | 27% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC CALCANEUS 2+ VW | $447.49 | $613.00 | $49.51–$115.08 | — | 27% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY 4 CHNL HOME W CONTR | $292.00 | $400.00 | $55.00–$967.60 | 52% below | 27% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY 4 CHNL HOME W CONTR | $292.00 | $400.00 | $55.00–$967.60 | — | 27% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMN W/CPAP >=6YRS | $4,855.23 | $6,651.00 | $55.00–$1,510.35 | 32% above | 27% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMN W/CPAP >=6YRS | $4,855.23 | $6,651.00 | $55.00–$1,510.35 | — | 27% |
| Knee X-ray, 3 views CPT 73562 HC KNEE 3 VW | $451.14 | $618.00 | $55.00–$120.15 | 78% above | 27% |
| Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VW | $451.14 | $618.00 | $55.00–$120.15 | — | 27% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4+ VW | $569.40 | $780.00 | $55.00–$127.08 | 104% above | 27% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4+ VW | $569.40 | $780.00 | $55.00–$127.08 | — | 27% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$771.00 | 58% above | 27% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$771.00 | — | 27% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED | $936.59 | $1,283.00 | $55.00–$319.64 | 110% above | 27% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED | $936.59 | $1,283.00 | $55.00–$319.64 | — | 27% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US JOINT OR NONVASC EXT LIMITED | $542.39 | $743.00 | $40.39–$110.05 | 89% above | 27% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US JOINT OR NONVASC EXT LIMITED | $542.39 | $743.00 | $40.39–$110.05 | — | 27% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT CHEST LOW DOSE FOR LUNG CA SCREEN | $229.95 | $315.00 | $55.00–$295.70 | 48% below | 27% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT CHEST LOW DOSE FOR LUNG CA SCREEN | $229.95 | $315.00 | $55.00–$295.70 | — | 27% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC TIBIA AND FIBULA 2 VW | $447.49 | $613.00 | $54.73–$117.61 | 110% above | 27% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC TIBIA AND FIBULA 2 VW | $447.49 | $613.00 | $54.73–$117.61 | — | 27% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA ANGIO HEAD NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$1,122.87 | 81% above | 27% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA ANGIO HEAD NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$1,122.87 | — | 27% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXT ANY JOINT NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,083.82 | 81% above | 27% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXT ANY JOINT NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,083.82 | — | 27% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXT ANY JNT W AND WO CONTRAST | $3,832.50 | $5,250.00 | $55.00–$2,455.46 | 12% above | 27% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXT ANY JNT W AND WO CONTRAST | $3,832.50 | $5,250.00 | $55.00–$2,455.46 | — | 27% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,014.28 | 81% above | 27% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,014.28 | — | 27% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,461.24 | 67% above | 27% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,461.24 | — | 27% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,046.99 | 81% above | 27% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,046.99 | — | 27% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,870.23 | 67% above | 27% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,870.23 | — | 27% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,061.43 | 81% above | 27% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,061.43 | — | 27% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,608.80 | 67% above | 27% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,608.80 | — | 27% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,035.41 | 81% above | 27% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,035.41 | — | 27% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,581.91 | 68% above | 27% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL WITH & WITHOUT CONTRAST | $5,715.17 | $7,829.00 | $55.00–$2,581.91 | — | 27% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,051.16 | 81% above | 27% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,051.16 | — | 27% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WITH & WITHOUT CONTRAST | $4,380.00 | $6,000.00 | $55.00–$2,461.24 | 28% above | 27% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WITH & WITHOUT CONTRAST | $4,380.00 | $6,000.00 | $55.00–$2,461.24 | — | 27% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$1,111.27 | 81% above | 27% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$1,111.27 | — | 27% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXT ANY JOINT NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,083.82 | 81% above | 27% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXT ANY JOINT NON CONTRAST | $4,006.97 | $5,489.00 | $55.00–$2,083.82 | — | 27% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SPINE MIN 4+ VW | $579.62 | $794.00 | $55.00–$198.42 | 80% above | 27% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC CERVICAL SPINE MIN 4+ VW | $579.62 | $794.00 | $55.00–$198.42 | — | 27% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK WITH CONTRAST | $2,649.90 | $3,630.00 | $55.00–$955.63 | 62% above | 27% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK WITH CONTRAST | $2,649.90 | $3,630.00 | $55.00–$955.63 | — | 27% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$721.87 | 65% above | 27% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$721.87 | — | 27% |
| Neck soft tissue X-ray CPT 70360 HC NECK SOFT TISSUE | $395.66 | $542.00 | $54.20–$118.95 | 88% above | 27% |
| Neck soft tissue X-ray inpatient CPT 70360 HC NECK SOFT TISSUE | $395.66 | $542.00 | $54.20–$118.95 | — | 27% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYOCARD PERFUSION SPECT STRESS AND REST | $6,369.25 | $8,725.00 | $55.00–$752.55 | 106% above | 27% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYOCARD PERFUSION SPECT STRESS AND REST | $6,369.25 | $8,725.00 | $55.00–$752.55 | — | 27% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET/CT SKULL TO MID THIGH | $2,664.50 | $3,650.00 | $55.00–$1,564.64 | 37% below | 27% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET/CT SKULL TO MID THIGH | $2,664.50 | $3,650.00 | $55.00–$1,564.64 | — | 27% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST | $2,348.41 | $3,217.00 | $55.00–$856.07 | 84% above | 27% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST | $2,348.41 | $3,217.00 | $55.00–$856.07 | — | 27% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS LIMITED | $936.59 | $1,283.00 | $55.00–$209.22 | 134% above | 27% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS LIMITED | $936.59 | $1,283.00 | $55.00–$209.22 | — | 27% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS COMPLETE | $1,012.51 | $1,387.00 | $55.00–$355.03 | 92% above | 27% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS COMPLETE | $1,012.51 | $1,387.00 | $55.00–$355.03 | — | 27% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB 14+ WKS SINGLE GEST | $982.58 | $1,346.00 | $55.00–$303.92 | 67% above | 27% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB 14+ WKS SINGLE GEST | $982.58 | $1,346.00 | $55.00–$303.92 | — | 27% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB < 14 WKS SINGLE GEST | $689.85 | $945.00 | $55.00–$204.74 | 33% above | 27% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB < 14 WKS SINGLE GEST | $689.85 | $945.00 | $55.00–$204.74 | — | 27% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREGNANT UTERUS LIMITED 1+ FETUSES | $629.26 | $862.00 | $55.00–$193.78 | 71% above | 27% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US PREGNANT UTERUS LIMITED 1+ FETUSES | $629.26 | $862.00 | $55.00–$193.78 | — | 27% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS UNILATERAL 2 VW | $516.84 | $708.00 | $55.00–$176.68 | 130% above | 27% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RIBS UNILATERAL 2 VW | $516.84 | $708.00 | $55.00–$176.68 | — | 27% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC RIBS UNILATERAL W PA CHEST | $532.17 | $729.00 | $55.00–$163.46 | 91% above | 27% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC RIBS UNILATERAL W PA CHEST | $532.17 | $729.00 | $55.00–$163.46 | — | 27% |
| Screening mammogram, both breasts both sides CPT 77067 HC MAMM SCREEN BILAT INCLUDES CAD/AI | $365.00 | $500.00 | $55.00–$263.53 | — | 27% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMM SCREEN BILAT INCLUDES CAD/AI | $365.00 | $500.00 | $55.00–$263.53 | — | 27% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER 2+ VW | $447.49 | $613.00 | $55.00–$137.87 | 91% above | 27% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER 2+ VW | $447.49 | $613.00 | $55.00–$137.87 | — | 27% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUSES 3+ VW | $551.88 | $756.00 | $55.00–$163.88 | 109% above | 27% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC SINUSES 3+ VW | $551.88 | $756.00 | $55.00–$163.88 | — | 27% |
| Skull X-ray, fewer than 4 views CPT 70250 HC SKULL < 4 VW | $551.88 | $756.00 | $55.00–$121.17 | 126% above | 27% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC SKULL < 4 VW | $551.88 | $756.00 | $55.00–$121.17 | — | 27% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMN 4 OR MORE >=6YRS | $4,784.42 | $6,554.00 | $55.00–$1,082.65 | 40% above | 27% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMN 4 OR MORE >=6YRS | $4,784.42 | $6,554.00 | $55.00–$1,082.65 | — | 27% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC TTE W CMPLT STRESS W EKG NON FACILITY | $2,482.00 | $3,400.00 | $55.00–$525.70 | 21% above | 27% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC TTE W CMPLT STRESS W EKG NON FACILITY | $2,482.00 | $3,400.00 | $55.00–$525.70 | — | 27% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOW FUNCT W VIDEO W CONTRAST | $790.59 | $1,083.00 | $55.00–$226.07 | 73% above | 27% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOW FUNCT W VIDEO W CONTRAST | $790.59 | $1,083.00 | $55.00–$226.07 | — | 27% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XRAY FEMUR MINIMUM 2 VIEWS | $447.49 | $613.00 | $43.81–$61.74 | 82% above | 27% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XRAY FEMUR MINIMUM 2 VIEWS | $447.49 | $613.00 | $43.81–$61.74 | — | 27% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$943.82 | 52% above | 27% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE NON CONTRAST | $2,348.41 | $3,217.00 | $55.00–$943.82 | — | 27% |
| Toe X-ray, 2 or more views CPT 73660 HC TOES 2+ VW | $447.49 | $613.00 | $50.60–$107.80 | 122% above | 27% |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC TOES 2+ VW | $447.49 | $613.00 | $50.60–$107.80 | — | 27% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB | $982.58 | $1,346.00 | $55.00–$422.59 | 109% above | 27% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB | $982.58 | $1,346.00 | $55.00–$422.59 | — | 27% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US PREGNANT UTERUS TRANSVAGINAL | $542.39 | $743.00 | $55.00–$161.60 | 39% above | 27% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREGNANT UTERUS TRANSVAGINAL | $542.39 | $743.00 | $55.00–$161.60 | — | 27% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $1,012.51 | $1,387.00 | $55.00–$383.51 | 49% above | 27% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE | $1,012.51 | $1,387.00 | $55.00–$383.51 | — | 27% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM AND CONTENTS | $936.59 | $1,283.00 | $55.00–$399.71 | 85% above | 27% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM AND CONTENTS | $936.59 | $1,283.00 | $55.00–$399.71 | — | 27% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US HEAD NECK TISSUES REAL TIME | $1,012.51 | $1,387.00 | $55.00–$271.72 | 98% above | 27% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US HEAD NECK TISSUES REAL TIME | $1,012.51 | $1,387.00 | $55.00–$271.72 | — | 27% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XRAY UPPER GI SINGLE CONTRAST | $653.35 | $895.00 | $55.00–$239.70 | 5% below | 27% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XRAY UPPER GI SINGLE CONTRAST | $653.35 | $895.00 | $55.00–$239.70 | — | 27% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS 2+ VW | $447.49 | $613.00 | $55.00–$129.80 | 111% above | 27% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS 2+ VW | $447.49 | $613.00 | $55.00–$129.80 | — | 27% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX VEIN EXTREM UNILAT | $1,011.78 | $1,386.00 | $55.00–$257.59 | 42% above | 27% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX VEIN EXTREM UNILAT | $1,011.78 | $1,386.00 | $55.00–$257.59 | — | 27% |
| Wrist X-ray, 2 views CPT 73100 HC WRIST 2 VW | $447.49 | $613.00 | $55.00–$87.40 | 107% above | 27% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC WRIST 2 VW | $447.49 | $613.00 | $55.00–$87.40 | — | 27% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST 3+ VW | $451.14 | $618.00 | $55.00–$122.57 | 78% above | 27% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST 3+ VW | $451.14 | $618.00 | $55.00–$122.57 | — | 27% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XRAY HIP UNILAT 2-3 VIEWS | $516.84 | $708.00 | $55.00–$82.71 | 77% above | 27% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC XRAY HIP UNILAT 2-3 VIEWS | $516.84 | $708.00 | $55.00–$82.71 | — | 27% |
| X-ray of the abdomen, 1 view CPT 74018 HC XRAY ABDOMEN 1 VIEW | $427.78 | $586.00 | $52.46–$55.00 | 103% above | 27% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XRAY ABDOMEN 1 VIEW | $427.78 | $586.00 | $52.46–$55.00 | — | 27% |
| X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VW | $447.49 | $613.00 | $55.00–$90.50 | 125% above | 27% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VW | $447.49 | $613.00 | $55.00–$90.50 | — | 27% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC XRAY FINGER(S) MIN 2 VW | $427.78 | $586.00 | $55.00–$97.88 | 75% above | 27% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XRAY FINGER(S) MIN 2 VW | $427.78 | $586.00 | $55.00–$97.88 | — | 27% |
| X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VW | $447.49 | $613.00 | $49.51–$91.12 | 136% above | 27% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VW | $447.49 | $613.00 | $49.51–$91.12 | — | 27% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT 3+ VW | $507.35 | $695.00 | $55.00–$116.54 | 110% above | 27% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT 3+ VW | $507.35 | $695.00 | $55.00–$116.54 | — | 27% |
| X-ray of the hand, 3 or more views CPT 73130 HC HAND 3+ VW | $451.14 | $618.00 | $55.00–$124.65 | 92% above | 27% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND 3+ VW | $451.14 | $618.00 | $55.00–$124.65 | — | 27% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VW | $447.49 | $613.00 | $55.00–$111.79 | 111% above | 27% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VW | $447.49 | $613.00 | $55.00–$111.79 | — | 27% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBAR SPINE 2 OR 3 VW | $551.88 | $756.00 | $55.00–$198.89 | 90% above | 27% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBAR SPINE 2 OR 3 VW | $551.88 | $756.00 | $55.00–$198.89 | — | 27% |
| X-ray of the lower back, 4 or more views CPT 72110 HC LUMBAR SPINE 4+ VW | $666.49 | $913.00 | $55.00–$230.21 | 76% above | 27% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBAR SPINE 4+ VW | $666.49 | $913.00 | $55.00–$230.21 | — | 27% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VW | $483.26 | $662.00 | $55.00–$206.73 | 103% above | 27% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VW | $483.26 | $662.00 | $55.00–$206.73 | — | 27% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES | $395.66 | $542.00 | $55.00–$136.43 | 63% above | 27% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES | $395.66 | $542.00 | $55.00–$136.43 | — | 27% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2 OR 3 VW | $551.88 | $756.00 | $55.00–$197.66 | 130% above | 27% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2 OR 3 VW | $551.88 | $756.00 | $55.00–$197.66 | — | 27% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS 1 OR 2 VW | $447.49 | $613.00 | $48.38–$132.52 | 102% above | 27% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS 1 OR 2 VW | $447.49 | $613.00 | $48.38–$132.52 | — | 27% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM AND COCCYX | $447.49 | $613.00 | $55.00–$121.03 | 105% above | 27% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM AND COCCYX | $447.49 | $613.00 | $55.00–$121.03 | — | 27% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 LCHG ACTH | $295.65 | $405.00 | $55.00–$213.68 | 34% above | 27% |
| ACTH blood test inpatient CPT 82024 LCHG ACTH | $295.65 | $405.00 | $55.00–$213.68 | — | 27% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LCHG ALT | $67.89 | $93.00 | $9.28–$74.00 | 94% above | 27% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 LCHG ALT | $67.89 | $93.00 | $9.28–$74.00 | — | 27% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LCHG AST BLOOD | $69.35 | $95.00 | $9.28–$74.00 | 46% above | 27% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 LCHG AST BLOOD | $69.35 | $95.00 | $9.28–$74.00 | — | 27% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 LCHG HEPATITIS SCREEN ACUTE | $642.40 | $880.00 | $55.00–$183.67 | 121% above | 27% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 LCHG HEPATITIS SCREEN ACUTE | $642.40 | $880.00 | $55.00–$183.67 | — | 27% |
| Albumin blood test CPT 82040 LCHG ALBUMIN BLOOD | $67.16 | $92.00 | $8.70–$74.00 | 79% above | 27% |
| Albumin blood test inpatient CPT 82040 LCHG ALBUMIN BLOOD | $67.16 | $92.00 | $8.70–$74.00 | — | 27% |
| Aldosterone blood test CPT 82088 LCHG ALDOSTERONE | $317.55 | $435.00 | $55.00–$318.68 | 66% above | 27% |
| Aldosterone blood test inpatient CPT 82088 LCHG ALDOSTERONE | $317.55 | $435.00 | $55.00–$318.68 | — | 27% |
| Alkaline phosphatase (ALP) blood test CPT 84075 LCHG ALKALINE PHOSPHATASE BONE SPECIFIC | $81.03 | $111.00 | $9.28–$74.00 | 66% above | 27% |
| Alkaline phosphatase (ALP) blood test CPT 84075 LCHG ALKALINE PHOSPHATASE BLOOD | $81.03 | $111.00 | $9.28–$74.00 | 66% above | 27% |
| Alkaline phosphatase (ALP) blood test CPT 84075 LCHG ALKALINE PHOSPHATASE I | $81.03 | $111.00 | $9.28–$74.00 | 66% above | 27% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 LCHG ALKALINE PHOSPHATASE BONE SPECIFIC | $81.03 | $111.00 | $9.28–$74.00 | — | 27% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 LCHG ALKALINE PHOSPHATASE BLOOD | $81.03 | $111.00 | $9.28–$74.00 | — | 27% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 LCHG ALKALINE PHOSPHATASE I | $81.03 | $111.00 | $9.28–$74.00 | — | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN BIRCH IGE | $37.96 | $52.00 | $9.28–$256.96 | 52% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN RAGWEED IGE | $37.96 | $52.00 | $9.28–$256.96 | 52% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN DERM FARINAE IGE | $37.96 | $52.00 | $9.28–$256.96 | 52% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN DERM PTERONYSSINUS IGE | $37.96 | $52.00 | $9.28–$256.96 | 52% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN PEANUT IGE | $44.53 | $61.00 | $9.28–$256.96 | 78% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN SPEC IGE QUANT EACH | $44.53 | $61.00 | $9.28–$256.96 | 78% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN MILK IGE | $44.53 | $61.00 | $9.28–$256.96 | 78% above | 27% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN INDIVIDUAL | $44.53 | $61.00 | $9.28–$256.96 | 78% above | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN DERM FARINAE IGE | $37.96 | $52.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN DERM PTERONYSSINUS IGE | $37.96 | $52.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN RAGWEED IGE | $37.96 | $52.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN BIRCH IGE | $37.96 | $52.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN PEANUT IGE | $44.53 | $61.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN MILK IGE | $44.53 | $61.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN SPEC IGE QUANT EACH | $44.53 | $61.00 | $9.28–$256.96 | — | 27% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN INDIVIDUAL | $44.53 | $61.00 | $9.28–$256.96 | — | 27% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 LCHG ALPHA FETOPROTEIN BLOOD TUMOR | $226.30 | $310.00 | $29.57–$87.20 | 169% above | 27% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 LCHG ALPHA FETOPROTEIN BLOOD TUMOR | $226.30 | $310.00 | $29.57–$87.20 | — | 27% |
| Ammonia blood test CPT 82140 LCHG AMMONIA | $183.23 | $251.00 | $25.51–$118.58 | 104% above | 27% |
| Ammonia blood test inpatient CPT 82140 LCHG AMMONIA | $183.23 | $251.00 | $25.51–$118.58 | — | 27% |
| Amylase blood test CPT 82150 LCHG AMYLASE FLUID | $36.50 | $50.00 | $11.59–$74.00 | 41% below | 27% |
| Amylase blood test CPT 82150 LCHG AMYLASE URINE TIMED | $111.69 | $153.00 | $11.59–$74.00 | 81% above | 27% |
| Amylase blood test CPT 82150 LCHG AMYLASE BLOOD | $111.69 | $153.00 | $11.59–$74.00 | 81% above | 27% |
| Amylase blood test inpatient CPT 82150 LCHG AMYLASE FLUID | $36.50 | $50.00 | $11.59–$74.00 | — | 27% |
| Amylase blood test inpatient CPT 82150 LCHG AMYLASE BLOOD | $111.69 | $153.00 | $11.59–$74.00 | — | 27% |
| Amylase blood test inpatient CPT 82150 LCHG AMYLASE URINE TIMED | $111.69 | $153.00 | $11.59–$74.00 | — | 27% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 LCHG CYCLIC CITRUL PEPTIDE AB IGG (CCP) I | $113.15 | $155.00 | $23.19–$74.00 | 37% above | 27% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 LCHG CYCLIC CITRUL PEPTIDE AB IGG (CCP) | $176.66 | $242.00 | $23.19–$74.00 | 114% above | 27% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 LCHG CYCLIC CITRUL PEPTIDE AB IGG (CCP) I | $113.15 | $155.00 | $23.19–$74.00 | — | 27% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 LCHG CYCLIC CITRUL PEPTIDE AB IGG (CCP) | $176.66 | $242.00 | $23.19–$74.00 | — | 27% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LCHG ANA BLOOD SCREEN I | $105.85 | $145.00 | $21.45–$116.18 | 55% above | 27% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LCHG ANA I | $105.85 | $145.00 | $21.45–$116.18 | 55% above | 27% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LCHG ANA II | $105.85 | $145.00 | $21.45–$116.18 | 55% above | 27% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LCHG ANA BLOOD SCREEN | $169.36 | $232.00 | $21.45–$116.18 | 148% above | 27% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LCHG ANA BLOOD SCREEN I | $105.85 | $145.00 | $21.45–$116.18 | — | 27% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LCHG ANA I | $105.85 | $145.00 | $21.45–$116.18 | — | 27% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LCHG ANA II | $105.85 | $145.00 | $21.45–$116.18 | — | 27% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LCHG ANA BLOOD SCREEN | $169.36 | $232.00 | $21.45–$116.18 | — | 27% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 LCHG PRO BRAIN NATRIURETIC PEPTIDE | $385.44 | $528.00 | $55.00–$113.82 | 170% above | 27% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 LCHG B-TYPE NATRIURETIC PEPTIDE | $409.53 | $561.00 | $55.00–$113.82 | 187% above | 27% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 LCHG PRO BRAIN NATRIURETIC PEPTIDE | $385.44 | $528.00 | $55.00–$113.82 | — | 27% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 LCHG B-TYPE NATRIURETIC PEPTIDE | $409.53 | $561.00 | $55.00–$113.82 | — | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCHG CULTURE SPUTUM | $104.39 | $143.00 | $15.07–$90.06 | 99% above | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCHG CULTURE RESPIRATORY | $137.24 | $188.00 | $15.07–$90.06 | 161% above | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCHG CULTURE ROUTINE | $137.24 | $188.00 | $15.07–$90.06 | 161% above | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCHG CULTURE THROAT | $137.24 | $188.00 | $15.07–$90.06 | 161% above | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCHG CULTURE CSF | $137.24 | $188.00 | $15.07–$90.06 | 161% above | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCHG CULTURE SPUTUM | $104.39 | $143.00 | $15.07–$90.06 | — | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCHG CULTURE THROAT | $137.24 | $188.00 | $15.07–$90.06 | — | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCHG CULTURE CSF | $137.24 | $188.00 | $15.07–$90.06 | — | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCHG CULTURE ROUTINE | $137.24 | $188.00 | $15.07–$90.06 | — | 27% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCHG CULTURE RESPIRATORY | $137.24 | $188.00 | $15.07–$90.06 | — | 27% |
| Basic metabolic panel (blood test) CPT 80048 LCHG BASIC METABOLIC PANEL (CA TOTAL) | $221.19 | $303.00 | $15.07–$74.00 | 150% above | 27% |
| Basic metabolic panel (blood test) CPT 80048 LCHG BASIC METABOLIC PANEL FASTING | $221.19 | $303.00 | $15.07–$74.00 | 150% above | 27% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LCHG BASIC METABOLIC PANEL FASTING | $221.19 | $303.00 | $15.07–$74.00 | — | 27% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LCHG BASIC METABOLIC PANEL (CA TOTAL) | $221.19 | $303.00 | $15.07–$74.00 | — | 27% |
| Bilirubin blood test, total CPT 82247 LCHG BILIRUBIN TOTAL BLOOD | $83.22 | $114.00 | $8.70–$74.00 | 78% above | 27% |
| Bilirubin blood test, total inpatient CPT 82247 LCHG BILIRUBIN TOTAL BLOOD | $83.22 | $114.00 | $8.70–$74.00 | — | 27% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LCHG CELL BLOCK | $164.25 | $225.00 | $55.00–$296.47 | 24% below | 27% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LCHG SP G+M LEVEL IV TC | $443.11 | $607.00 | $55.00–$296.47 | 105% above | 27% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LCHG SP G+M LEVEL IV | $443.11 | $607.00 | $55.00–$296.47 | 105% above | 27% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LCHG SP G+M LEVEL IV TC NL II | $614.66 | $842.00 | $55.00–$296.47 | 185% above | 27% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LCHG CELL BLOCK | $164.25 | $225.00 | $55.00–$296.47 | — | 27% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LCHG SP G+M LEVEL IV TC | $443.11 | $607.00 | $55.00–$296.47 | — | 27% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LCHG SP G+M LEVEL IV | $443.11 | $607.00 | $55.00–$296.47 | — | 27% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LCHG SP G+M LEVEL IV TC NL II | $614.66 | $842.00 | $55.00–$296.47 | — | 27% |
| Blood culture for bacteria CPT 87040 LCHG CULTURE BLOOD QUANT | $193.45 | $265.00 | $18.55–$81.28 | 125% above | 27% |
| Blood culture for bacteria CPT 87040 LCHG CULTURE BLOOD | $236.52 | $324.00 | $18.55–$81.28 | 176% above | 27% |
| Blood culture for bacteria inpatient CPT 87040 LCHG CULTURE BLOOD QUANT | $193.45 | $265.00 | $18.55–$81.28 | — | 27% |
| Blood culture for bacteria inpatient CPT 87040 LCHG CULTURE BLOOD | $236.52 | $324.00 | $18.55–$81.28 | — | 27% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION BLOOD VENIPUNCTURE | $40.15 | $55.00 | $22.41–$74.00 | 174% above | 27% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 LCHG BLOOD DRAW | $43.80 | $60.00 | $22.41–$74.00 | 198% above | 27% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 LCHG ALCOHOL LEGAL COLLECTION | $64.24 | $88.00 | $22.41–$74.00 | 338% above | 27% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HCHG ALCOHOL LEGAL COLLECTION | $65.70 | $90.00 | $22.41–$74.00 | 348% above | 27% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION BLOOD VENIPUNCTURE | $40.15 | $55.00 | $22.41–$74.00 | — | 27% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LCHG BLOOD DRAW | $43.80 | $60.00 | $22.41–$74.00 | — | 27% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LCHG ALCOHOL LEGAL COLLECTION | $64.24 | $88.00 | $22.41–$74.00 | — | 27% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HCHG ALCOHOL LEGAL COLLECTION | $65.70 | $90.00 | $22.41–$74.00 | — | 27% |
| Blood glucose (sugar) test CPT 82947 LCHG GLUCOSE POCT | $46.72 | $64.00 | $6.96–$74.00 | 91% above | 27% |
| Blood glucose (sugar) test CPT 82947 LCHG GLUCOSE | $52.56 | $72.00 | $6.96–$74.00 | 115% above | 27% |
| Blood glucose (sugar) test CPT 82947 LCHG GLUCOSE FASTING | $52.56 | $72.00 | $6.96–$74.00 | 115% above | 27% |
| Blood glucose (sugar) test inpatient CPT 82947 LCHG GLUCOSE POCT | $46.72 | $64.00 | $6.96–$74.00 | — | 27% |
| Blood glucose (sugar) test inpatient CPT 82947 LCHG GLUCOSE | $52.56 | $72.00 | $6.96–$74.00 | — | 27% |
| Blood glucose (sugar) test inpatient CPT 82947 LCHG GLUCOSE FASTING | $52.56 | $72.00 | $6.96–$74.00 | — | 27% |
| Blood lead test CPT 83655 LCHG LEAD CAPILLARY | $137.24 | $188.00 | $21.45–$87.89 | 150% above | 27% |
| Blood lead test CPT 83655 HC LAB LEAD BLOOD | $144.54 | $198.00 | $21.45–$87.89 | 163% above | 27% |
| Blood lead test CPT 83655 LCHG LEAD URINE | $164.25 | $225.00 | $21.45–$87.89 | 199% above | 27% |
| Blood lead test CPT 83655 LCHG LEAD BLOOD | $164.25 | $225.00 | $21.45–$87.89 | 199% above | 27% |
| Blood lead test inpatient CPT 83655 LCHG LEAD CAPILLARY | $137.24 | $188.00 | $21.45–$87.89 | — | 27% |
| Blood lead test inpatient CPT 83655 LCHG LEAD BLOOD | $164.25 | $225.00 | $21.45–$87.89 | — | 27% |
| Blood lead test inpatient CPT 83655 LCHG LEAD URINE | $164.25 | $225.00 | $21.45–$87.89 | — | 27% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 LCHG HCG BLOOD QUALITATIVE | $101.47 | $139.00 | $13.33–$74.00 | 64% above | 27% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 LCHG HCG BLOOD QUALITATIVE | $101.47 | $139.00 | $13.33–$74.00 | — | 27% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LCHG BLOOD TYPE ABO | $77.38 | $106.00 | $5.22–$74.00 | 82% above | 27% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 LCHG BLOOD TYPE ABO | $77.38 | $106.00 | $5.22–$74.00 | — | 27% |
| Blood urea nitrogen (BUN) test CPT 84520 LCHG BUN | $69.35 | $95.00 | $6.96–$74.00 | 171% above | 27% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 LCHG BUN | $69.35 | $95.00 | $6.96–$74.00 | — | 27% |
| C-peptide blood test CPT 84681 LCHG C-PEPTIDE | $86.87 | $119.00 | $36.22–$74.00 | 1% below | 27% |
| C-peptide blood test inpatient CPT 84681 LCHG C-PEPTIDE | $86.87 | $119.00 | $36.22–$74.00 | — | 27% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LCHG C-REACTIVE PROTEIN I | $29.20 | $40.00 | $9.28–$74.00 | 47% below | 27% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LCHG C-REACTIVE PROTEIN | $101.47 | $139.00 | $9.28–$74.00 | 86% above | 27% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LCHG C-REACTIVE PROTEIN I | $29.20 | $40.00 | $9.28–$74.00 | — | 27% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LCHG C-REACTIVE PROTEIN | $101.47 | $139.00 | $9.28–$74.00 | — | 27% |
| C. difficile toxin gene test (stool PCR) CPT 87493 LCHG CLOSTRIDIUM DIFFICILE AMPLIFIDE PROBE | $404.42 | $554.00 | $55.00–$104.04 | 166% above | 27% |
| C. difficile toxin gene test (stool PCR) CPT 87493 LCHG CLOSTRIDIUM DIFF PCR | $404.42 | $554.00 | $55.00–$104.04 | 166% above | 27% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 LCHG CLOSTRIDIUM DIFFICILE AMPLIFIDE PROBE | $404.42 | $554.00 | $55.00–$104.04 | — | 27% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 LCHG CLOSTRIDIUM DIFF PCR | $404.42 | $554.00 | $55.00–$104.04 | — | 27% |
| CA 19-9 blood test (tumor marker) CPT 86301 LCHG CA 19-9 | $301.49 | $413.00 | $37.10–$74.00 | 168% above | 27% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 LCHG CA 19-9 | $301.49 | $413.00 | $37.10–$74.00 | — | 27% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 LCHG CA 125 BLOOD | $281.05 | $385.00 | $37.10–$74.00 | 134% above | 27% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 LCHG CA 125 BLOOD | $281.05 | $385.00 | $37.10–$74.00 | — | 27% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 LCHG SARS-COV-2 (COVID-19) | $124.10 | $170.00 | $55.00–$97.20 | 8% below | 27% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 LCHG SARS-COV-2 (COVID-19) IIII | $178.85 | $245.00 | $55.00–$97.20 | 32% above | 27% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 LCHG SARS-COV-2 (COVID-19) | $124.10 | $170.00 | $55.00–$97.20 | — | 27% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 LCHG SARS-COV-2 (COVID-19) IIII | $178.85 | $245.00 | $55.00–$97.20 | — | 27% |
| Calcium blood test, total CPT 82310 LCHG CALCIUM BLOOD | $69.35 | $95.00 | $9.28–$74.00 | 32% above | 27% |
| Calcium blood test, total CPT 82310 LCHG CALCIUM I | $69.35 | $95.00 | $9.28–$74.00 | 32% above | 27% |
| Calcium blood test, total inpatient CPT 82310 LCHG CALCIUM I | $69.35 | $95.00 | $9.28–$74.00 | — | 27% |
| Calcium blood test, total inpatient CPT 82310 LCHG CALCIUM BLOOD | $69.35 | $95.00 | $9.28–$74.00 | — | 27% |
| Carcinoembryonic antigen (CEA) test CPT 82378 LCHG CEA BLOOD | $275.21 | $377.00 | $33.62–$139.47 | 103% above | 27% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 LCHG CEA BLOOD | $275.21 | $377.00 | $33.62–$139.47 | — | 27% |
| Chickenpox (varicella) immunity blood test CPT 86787 LCHG VARICELLA ZOSTER ANTIBODY IGG | $81.03 | $111.00 | $22.61–$74.00 | 13% above | 27% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 LCHG VARICELLA ZOSTER ANTIBODY IGG | $81.03 | $111.00 | $22.61–$74.00 | — | 27% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LCHG CHLAMYDIA TRACHOMATIS BY PCR | $266.45 | $365.00 | $55.00–$149.23 | 86% above | 27% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LCHG CHLAMYDIA DNA PROBE | $338.72 | $464.00 | $55.00–$149.23 | 137% above | 27% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LCHG CHLAMYDIA DNA PROBE I | $572.32 | $784.00 | $55.00–$149.23 | 300% above | 27% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LCHG CHLAMYDIA TRACHOMATIS BY PCR | $266.45 | $365.00 | $55.00–$149.23 | — | 27% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LCHG CHLAMYDIA DNA PROBE | $338.72 | $464.00 | $55.00–$149.23 | — | 27% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LCHG CHLAMYDIA DNA PROBE I | $572.32 | $784.00 | $55.00–$149.23 | — | 27% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LCHG LIPID PROFILE | $146.00 | $200.00 | $23.77–$74.23 | 64% above | 27% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LCHG LIPID PROFILE | $146.00 | $200.00 | $23.77–$74.23 | — | 27% |
| Complete blood count (CBC) with differential CPT 85025 LCHG CBC W AUTO DIFFERENTIAL | $98.55 | $135.00 | $13.91–$76.87 | 36% above | 27% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LCHG CBC W AUTO DIFFERENTIAL | $98.55 | $135.00 | $13.91–$76.87 | — | 27% |
| Complete blood count (CBC), no differential CPT 85027 LCHG CBC W/O AUTO DIFFERENTIAL | $154.76 | $212.00 | $11.59–$76.87 | 195% above | 27% |
| Complete blood count (CBC), no differential inpatient CPT 85027 LCHG CBC W/O AUTO DIFFERENTIAL | $154.76 | $212.00 | $11.59–$76.87 | — | 27% |
| Comprehensive metabolic panel (blood test) CPT 80053 LCHG COMPREHENSIVE METABOLIC PANEL | $171.55 | $235.00 | $18.55–$74.00 | 51% above | 27% |
| Comprehensive metabolic panel (blood test) CPT 80053 LCHG COMPREHENSIVE METABOLIC PANEL FAST | $171.55 | $235.00 | $18.55–$74.00 | 51% above | 27% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LCHG COMPREHENSIVE METABOLIC PANEL | $171.55 | $235.00 | $18.55–$74.00 | — | 27% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LCHG COMPREHENSIVE METABOLIC PANEL FAST | $171.55 | $235.00 | $18.55–$74.00 | — | 27% |
| Cortisol blood test, total CPT 82533 LCHG CORTISOL BLOOD | $220.46 | $302.00 | $28.99–$125.17 | 84% above | 27% |
| Cortisol blood test, total CPT 82533 LCHG CORTISOL BLOOD PM | $220.46 | $302.00 | $28.99–$125.17 | 84% above | 27% |
| Cortisol blood test, total CPT 82533 LCHG CORTISOL BLOOD AM | $220.46 | $302.00 | $28.99–$125.17 | 84% above | 27% |
| Cortisol blood test, total CPT 82533 LCHG DEXAMETHASONE SUPPRESSION TEST 1 SPEC | $220.46 | $302.00 | $28.99–$125.17 | 84% above | 27% |
| Cortisol blood test, total CPT 82533 LCHG CORTISOL SALIVA | $225.57 | $309.00 | $28.99–$125.17 | 88% above | 27% |
| Cortisol blood test, total inpatient CPT 82533 LCHG CORTISOL BLOOD | $220.46 | $302.00 | $28.99–$125.17 | — | 27% |
| Cortisol blood test, total inpatient CPT 82533 LCHG DEXAMETHASONE SUPPRESSION TEST 1 SPEC | $220.46 | $302.00 | $28.99–$125.17 | — | 27% |
| Cortisol blood test, total inpatient CPT 82533 LCHG CORTISOL BLOOD AM | $220.46 | $302.00 | $28.99–$125.17 | — | 27% |
| Cortisol blood test, total inpatient CPT 82533 LCHG CORTISOL BLOOD PM | $220.46 | $302.00 | $28.99–$125.17 | — | 27% |
| Cortisol blood test, total inpatient CPT 82533 LCHG CORTISOL SALIVA | $225.57 | $309.00 | $28.99–$125.17 | — | 27% |
| Creatine kinase (CK) blood test, total CPT 82550 LCHG CK BLOOD REFER | $71.54 | $98.00 | $11.59–$92.26 | 12% above | 27% |
| Creatine kinase (CK) blood test, total CPT 82550 LCHG CK BLOOD | $93.44 | $128.00 | $11.59–$92.26 | 47% above | 27% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 LCHG CK BLOOD REFER | $71.54 | $98.00 | $11.59–$92.26 | — | 27% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 LCHG CK BLOOD | $93.44 | $128.00 | $11.59–$92.26 | — | 27% |
| Creatinine blood test CPT 82565 LCHG CREATININE BLOOD | $71.54 | $98.00 | $9.28–$74.00 | 126% above | 27% |
| Creatinine blood test CPT 82565 LCHG CREATININE BLOOD I | $82.49 | $113.00 | $9.28–$74.00 | 160% above | 27% |
| Creatinine blood test inpatient CPT 82565 LCHG CREATININE BLOOD | $71.54 | $98.00 | $9.28–$74.00 | — | 27% |
| Creatinine blood test inpatient CPT 82565 LCHG CREATININE BLOOD I | $82.49 | $113.00 | $9.28–$74.00 | — | 27% |
| Cytomegalovirus (CMV) antibody test CPT 86644 LCHG CMV ANTIBODY IGG BLOOD | $194.18 | $266.00 | $25.51–$74.00 | 162% above | 27% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 LCHG CMV ANTIBODY IGG BLOOD | $194.18 | $266.00 | $25.51–$74.00 | — | 27% |
| D-dimer blood test (blood clot marker) CPT 85379 LCHG D-DIMER QUANTITITATIVE REF | $109.50 | $150.00 | $17.97–$74.00 | 52% above | 27% |
| D-dimer blood test (blood clot marker) CPT 85379 LCHG D-DIMER QUANTITATIVE | $180.31 | $247.00 | $17.97–$74.00 | 150% above | 27% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 LCHG D-DIMER QUANTITITATIVE REF | $109.50 | $150.00 | $17.97–$74.00 | — | 27% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 LCHG D-DIMER QUANTITATIVE | $180.31 | $247.00 | $17.97–$74.00 | — | 27% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 LCHG DHEA SULFATE | $300.76 | $412.00 | $39.42–$116.40 | 111% above | 27% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 LCHG DHEA SULFATE | $300.76 | $412.00 | $39.42–$116.40 | — | 27% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 LCHG ALCOHOL ETHYL BLOOD V | $252.58 | $346.00 | $55.00–$151.96 | 127% above | 27% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 LCHG SALICYLATE LEVEL BLOOD IV | $256.96 | $352.00 | $55.00–$151.96 | 131% above | 27% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 LCHG DRUG SCREEN SGLCLS A VI | $275.21 | $377.00 | $55.00–$151.96 | 148% above | 27% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LCHG ALCOHOL ETHYL BLOOD V | $252.58 | $346.00 | $55.00–$151.96 | — | 27% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LCHG SALICYLATE LEVEL BLOOD IV | $256.96 | $352.00 | $55.00–$151.96 | — | 27% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LCHG DRUG SCREEN SGLCLS A VI | $275.21 | $377.00 | $55.00–$151.96 | — | 27% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 LCHG LYTES (NA K CL CO2) BLOOD | $156.95 | $215.00 | $12.17–$74.00 | 208% above | 27% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 LCHG LYTES (NA K CL CO2) BLOOD | $156.95 | $215.00 | $12.17–$74.00 | — | 27% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 LCHG EPSTEIN-BARR VIRUS ANTIBODY VCA | $206.59 | $283.00 | $31.88–$74.00 | 150% above | 27% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 LCHG EPSTEIN-BARR VIRUS ANTIBODY IGM | $245.28 | $336.00 | $31.88–$74.00 | 197% above | 27% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 LCHG EPSTEIN-BARR VIRUS ANTIBODY IGG | $245.28 | $336.00 | $31.88–$74.00 | 197% above | 27% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 LCHG EPSTEIN-BARR VIRUS ANTIBODY VCA | $206.59 | $283.00 | $31.88–$74.00 | — | 27% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 LCHG EPSTEIN-BARR VIRUS ANTIBODY IGG | $245.28 | $336.00 | $31.88–$74.00 | — | 27% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 LCHG EPSTEIN-BARR VIRUS ANTIBODY IGM | $245.28 | $336.00 | $31.88–$74.00 | — | 27% |
| Estradiol blood test CPT 82670 LCHG ESTRADIOL III | $158.41 | $217.00 | $49.28–$219.64 | 28% above | 27% |
| Estradiol blood test CPT 82670 LCHG ESTRADIOL ULTRASENSITIVE | $304.41 | $417.00 | $49.28–$219.64 | 146% above | 27% |
| Estradiol blood test CPT 82670 LCHG ESTRADIOL | $472.31 | $647.00 | $49.28–$219.64 | 281% above | 27% |
| Estradiol blood test inpatient CPT 82670 LCHG ESTRADIOL III | $158.41 | $217.00 | $49.28–$219.64 | — | 27% |
| Estradiol blood test inpatient CPT 82670 LCHG ESTRADIOL ULTRASENSITIVE | $304.41 | $417.00 | $49.28–$219.64 | — | 27% |
| Estradiol blood test inpatient CPT 82670 LCHG ESTRADIOL | $472.31 | $647.00 | $49.28–$219.64 | — | 27% |
| FSH (follicle-stimulating hormone) test CPT 83001 LCHG FSH | $250.39 | $343.00 | $33.04–$164.71 | 116% above | 27% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 LCHG FSH | $250.39 | $343.00 | $33.04–$164.71 | — | 27% |
| Fecal calprotectin (stool inflammation test) CPT 83993 LCHG CALPROTECTIN FECAL | $251.12 | $344.00 | $34.78–$74.00 | 34% above | 27% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 LCHG CALPROTECTIN FECAL | $251.12 | $344.00 | $34.78–$74.00 | — | 27% |
| Ferritin blood test (iron stores) CPT 82728 LCHG FERRITIN | $182.50 | $250.00 | $24.35–$107.64 | 102% above | 27% |
| Ferritin blood test (iron stores) inpatient CPT 82728 LCHG FERRITIN | $182.50 | $250.00 | $24.35–$107.64 | — | 27% |
| Fibrinogen blood test CPT 85384 LCHG FIBRINOGEN ACTIVITY I | $85.41 | $117.00 | $17.39–$74.00 | 27% above | 27% |
| Fibrinogen blood test CPT 85384 LCHG FIBRINOGEN ACTIVITY | $143.08 | $196.00 | $17.39–$74.00 | 112% above | 27% |
| Fibrinogen blood test inpatient CPT 85384 LCHG FIBRINOGEN ACTIVITY I | $85.41 | $117.00 | $17.39–$74.00 | — | 27% |
| Fibrinogen blood test inpatient CPT 85384 LCHG FIBRINOGEN ACTIVITY | $143.08 | $196.00 | $17.39–$74.00 | — | 27% |
| Folate (folic acid) blood test CPT 82746 LCHG FOLATE | $142.35 | $195.00 | $26.09–$127.39 | 44% above | 27% |
| Folate (folic acid) blood test inpatient CPT 82746 LCHG FOLATE | $142.35 | $195.00 | $26.09–$127.39 | — | 27% |
| Free T3 thyroid hormone test CPT 84481 LCHG T3 FREE | $259.88 | $356.00 | $30.15–$164.71 | 167% above | 27% |
| Free T3 thyroid hormone test inpatient CPT 84481 LCHG T3 FREE | $259.88 | $356.00 | $30.15–$164.71 | — | 27% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 LCHG T4 FREE | $215.35 | $295.00 | $16.23–$92.26 | 167% above | 27% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 LCHG T4 FREE | $215.35 | $295.00 | $16.23–$92.26 | — | 27% |
| Free testosterone test CPT 84402 LCHG TESTOSTERONE FREE I | $289.81 | $397.00 | $45.22–$237.20 | 147% above | 27% |
| Free testosterone test CPT 84402 LCHG TESTOSTERONE FREE | $342.37 | $469.00 | $45.22–$237.20 | 191% above | 27% |
| Free testosterone test inpatient CPT 84402 LCHG TESTOSTERONE FREE I | $289.81 | $397.00 | $45.22–$237.20 | — | 27% |
| Free testosterone test inpatient CPT 84402 LCHG TESTOSTERONE FREE | $342.37 | $469.00 | $45.22–$237.20 | — | 27% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 LCHG GGT | $97.09 | $133.00 | $12.75–$74.00 | 82% above | 27% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 LCHG GGT | $97.09 | $133.00 | $12.75–$74.00 | — | 27% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 LCHG GENERAL HEALTH PANEL | $383.98 | $526.00 | $55.00–$92.04 | 39% above | 27% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 LCHG GENERAL HEALTH PANEL | $383.98 | $526.00 | $55.00–$92.04 | — | 27% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 LCHG GLUCOSE 1 HR POST PRANDIAL | $67.89 | $93.00 | $8.70–$74.67 | 37% above | 27% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 LCHG GLUCOSE 1 HR POST PRANDIAL | $67.89 | $93.00 | $8.70–$74.67 | — | 27% |
| Glucose tolerance test, 3 samples CPT 82951 LCHG GTT 3 SPEC + DOSE | $218.27 | $299.00 | $22.61–$139.47 | 143% above | 27% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 LCHG GTT 3 SPEC + DOSE | $218.27 | $299.00 | $22.61–$139.47 | — | 27% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 LCHG GC DNA PROBE | $243.09 | $333.00 | $55.00–$149.23 | 70% above | 27% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 LCHG GC AMPLIFIED PROBE | $266.45 | $365.00 | $55.00–$149.23 | 86% above | 27% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 LCHG GC DNA PROBE I | $551.88 | $756.00 | $55.00–$149.23 | 286% above | 27% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 LCHG GC DNA PROBE | $243.09 | $333.00 | $55.00–$149.23 | — | 27% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 LCHG GC AMPLIFIED PROBE | $266.45 | $365.00 | $55.00–$149.23 | — | 27% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 LCHG GC DNA PROBE I | $551.88 | $756.00 | $55.00–$149.23 | — | 27% |
| H. pylori antibody blood test CPT 86677 LCHG HELICOBACTER PYLORI ANTIBODY IGG | $253.31 | $347.00 | $29.57–$153.76 | 182% above | 27% |
| H. pylori antibody blood test inpatient CPT 86677 LCHG HELICOBACTER PYLORI ANTIBODY IGG | $253.31 | $347.00 | $29.57–$153.76 | — | 27% |
| H. pylori stool antigen test CPT 87338 LCHG HELICOBACTER PYLORI ANTIGEN STOOL | $254.04 | $348.00 | $25.51–$74.00 | 96% above | 27% |
| H. pylori stool antigen test inpatient CPT 87338 LCHG HELICOBACTER PYLORI ANTIGEN STOOL | $254.04 | $348.00 | $25.51–$74.00 | — | 27% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 LCHG HIV-1 RNA PCR QUANT | $980.39 | $1,343.00 | $55.00–$157.75 | 153% above | 27% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 LCHG HIV-1 RNA PCR QUANT | $980.39 | $1,343.00 | $55.00–$157.75 | — | 27% |
| HIV-1 and HIV-2 antibody test CPT 86703 LCHG HIV-1 HIV-2 ANTIBODY | $231.41 | $317.00 | $24.35–$79.07 | 199% above | 27% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 LCHG HIV-1 HIV-2 ANTIBODY | $231.41 | $317.00 | $24.35–$79.07 | — | 27% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 LCHG HIV-1 AG W HIV-1+HIV-2 AB | $244.55 | $335.00 | $42.90–$74.00 | 139% above | 27% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 LCHG HIV-1 AG W HIV-1+HIV-2 AB | $244.55 | $335.00 | $42.90–$74.00 | — | 27% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 LCHG HPV HIGH RISK TYPES | $368.65 | $505.00 | $55.00–$91.72 | 158% above | 27% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 LCHG HPV HIGH RISK TYPES | $368.65 | $505.00 | $55.00–$91.72 | — | 27% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LCHG HEMOGLOBIN A1C | $109.50 | $150.00 | $17.39–$74.67 | 59% above | 27% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 LCHG HEMOGLOBIN A1C | $109.50 | $150.00 | $17.39–$74.67 | — | 27% |
| Hemoglobin blood test CPT 85018 LCHG HEMOGLOBIN | $59.13 | $81.00 | $4.06–$74.00 | 238% above | 27% |
| Hemoglobin blood test CPT 85018 HC LAB HGB POCT (IP) | $59.13 | $81.00 | $4.06–$74.00 | 238% above | 27% |
| Hemoglobin blood test inpatient CPT 85018 LCHG HEMOGLOBIN | $59.13 | $81.00 | $4.06–$74.00 | — | 27% |
| Hepatitis B core antibody test (total) CPT 86704 LCHG HEPATITIS B CORE ANTIBODY | $160.60 | $220.00 | $21.45–$74.00 | 101% above | 27% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 LCHG HEPATITIS B CORE ANTIBODY | $160.60 | $220.00 | $21.45–$74.00 | — | 27% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 LCHG HEPATITIS B SURFACE ANTIBODY | $145.27 | $199.00 | $19.13–$74.00 | 96% above | 27% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 LCHG HEPATITIS B SURFACE ANTIBODY | $145.27 | $199.00 | $19.13–$74.00 | — | 27% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 LCHG HEPATITIS B SURFACE ANTIGEN | $139.43 | $191.00 | $18.55–$74.00 | 115% above | 27% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 LCHG HEPATITIS B SURFACE ANTIGEN | $139.43 | $191.00 | $18.55–$74.00 | — | 27% |
| Hepatitis C antibody blood test (screening) CPT 86803 LCHG HEPATITIS C ANTIBODY | $240.90 | $330.00 | $25.51–$74.00 | 205% above | 27% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 LCHG HEPATITIS C ANTIBODY | $240.90 | $330.00 | $25.51–$74.00 | — | 27% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 LCHG HEPATITIS C QUANTITATIVE | $243.82 | $334.00 | $55.00–$181.23 | 10% above | 27% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 LCHG HEPATITIS C RNA PCR QUANT | $578.16 | $792.00 | $55.00–$181.23 | 161% above | 27% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 LCHG HEPATITIS C QUANTITATIVE | $243.82 | $334.00 | $55.00–$181.23 | — | 27% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 LCHG HEPATITIS C RNA PCR QUANT | $578.16 | $792.00 | $55.00–$181.23 | — | 27% |
| Herpes blood test, HSV-1 antibody CPT 86695 LCHG HERPES SIMPLEX 1 ANTIBODY IGG | $178.12 | $244.00 | $23.19–$76.87 | 163% above | 27% |
| Herpes blood test, HSV-1 antibody CPT 86695 LCHG HERPES SIMPLEX 1 ANTIBODY IGM | $178.12 | $244.00 | $23.19–$76.87 | 163% above | 27% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 LCHG HERPES SIMPLEX 1 ANTIBODY IGM | $178.12 | $244.00 | $23.19–$76.87 | — | 27% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 LCHG HERPES SIMPLEX 1 ANTIBODY IGG | $178.12 | $244.00 | $23.19–$76.87 | — | 27% |
| Herpes blood test, HSV-2 antibody CPT 86696 LCHG HERPES SIMPLEX 2 ANTIBODY IGG | $261.34 | $358.00 | $34.20–$74.00 | 231% above | 27% |
| Herpes blood test, HSV-2 antibody CPT 86696 LCHG HERPES SIMPLEX 2 ANTIBODY IGM | $261.34 | $358.00 | $34.20–$74.00 | 231% above | 27% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 LCHG HERPES SIMPLEX 2 ANTIBODY IGG | $261.34 | $358.00 | $34.20–$74.00 | — | 27% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 LCHG HERPES SIMPLEX 2 ANTIBODY IGM | $261.34 | $358.00 | $34.20–$74.00 | — | 27% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 LCHG C-REACTIVE PROTEIN SENSITIVE | $174.47 | $239.00 | $23.19–$74.00 | 118% above | 27% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 LCHG C-REACTIVE PROTEIN SENSITIVE | $174.47 | $239.00 | $23.19–$74.00 | — | 27% |
| Homocysteine blood test CPT 83090 LCHG HOMOCYSTEINE BLOOD QUANT | $227.76 | $312.00 | $31.88–$74.00 | 93% above | 27% |
| Homocysteine blood test inpatient CPT 83090 LCHG HOMOCYSTEINE BLOOD QUANT | $227.76 | $312.00 | $31.88–$74.00 | — | 27% |
| Insulin blood test CPT 83525 LCHG INSULIN LEVEL | $154.03 | $211.00 | $20.29–$142.77 | 128% above | 27% |
| Insulin blood test inpatient CPT 83525 LCHG INSULIN LEVEL | $154.03 | $211.00 | $20.29–$142.77 | — | 27% |
| Iron blood test (serum iron) CPT 83540 LCHG IRON BLOOD | $105.85 | $145.00 | $11.59–$74.00 | 99% above | 27% |
| Iron blood test (serum iron) inpatient CPT 83540 LCHG IRON BLOOD | $105.85 | $145.00 | $11.59–$74.00 | — | 27% |
| Iron-binding capacity (TIBC) test CPT 83550 LCHG TIBC | $148.19 | $203.00 | $15.65–$74.67 | 139% above | 27% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 LCHG TIBC | $148.19 | $203.00 | $15.65–$74.67 | — | 27% |
| Kidney function blood test panel CPT 80069 LCHG RENAL FUNCTION PANEL | $183.96 | $252.00 | $15.65–$74.00 | 79% above | 27% |
| Kidney function blood test panel CPT 80069 LCHG RENAL FUNCTION PANEL FASTING | $183.96 | $252.00 | $15.65–$74.00 | 79% above | 27% |
| Kidney function blood test panel inpatient CPT 80069 LCHG RENAL FUNCTION PANEL FASTING | $183.96 | $252.00 | $15.65–$74.00 | — | 27% |
| Kidney function blood test panel inpatient CPT 80069 LCHG RENAL FUNCTION PANEL | $183.96 | $252.00 | $15.65–$74.00 | — | 27% |
| LH (luteinizing hormone) test CPT 83002 LCHG LH | $250.39 | $343.00 | $33.04–$166.90 | 157% above | 27% |
| LH (luteinizing hormone) test inpatient CPT 83002 LCHG LH | $250.39 | $343.00 | $33.04–$166.90 | — | 27% |
| Lactate (lactic acid) blood test CPT 83605 LCHG LACTIC ACID BLOOD | $194.18 | $266.00 | $20.29–$74.00 | 179% above | 27% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LCHG LACTIC ACID BLOOD | $194.18 | $266.00 | $20.29–$74.00 | — | 27% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LCHG LDH FLUID | $111.69 | $153.00 | $10.43–$74.00 | 123% above | 27% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LCHG LDH BLOOD | $111.69 | $153.00 | $10.43–$74.00 | 123% above | 27% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LCHG LDH CSF | $111.69 | $153.00 | $10.43–$74.00 | 123% above | 27% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LCHG LDH FLUID | $111.69 | $153.00 | $10.43–$74.00 | — | 27% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LCHG LDH CSF | $111.69 | $153.00 | $10.43–$74.00 | — | 27% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LCHG LDH BLOOD | $111.69 | $153.00 | $10.43–$74.00 | — | 27% |
| Lipase blood test (pancreas enzyme) CPT 83690 LCHG LIPASE BLOOD | $121.91 | $167.00 | $12.17–$74.00 | 77% above | 27% |
| Lipase blood test (pancreas enzyme) CPT 83690 LCHG LIPASE FLUID | $121.91 | $167.00 | $12.17–$74.00 | 77% above | 27% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LCHG LIPASE FLUID | $121.91 | $167.00 | $12.17–$74.00 | — | 27% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LCHG LIPASE BLOOD | $121.91 | $167.00 | $12.17–$74.00 | — | 27% |
| Liver function blood test panel CPT 80076 LCHG HEPATIC FUNCTION PANEL | $208.78 | $286.00 | $14.49–$74.00 | 105% above | 27% |
| Liver function blood test panel inpatient CPT 80076 LCHG HEPATIC FUNCTION PANEL | $208.78 | $286.00 | $14.49–$74.00 | — | 27% |
| Lyme disease antibody test CPT 86618 LCHG LYME DISEASE ANTIBODY SCREEN BLOOD | $229.22 | $314.00 | $30.15–$107.64 | 176% above | 27% |
| Lyme disease antibody test inpatient CPT 86618 LCHG LYME DISEASE ANTIBODY SCREEN BLOOD | $229.22 | $314.00 | $30.15–$107.64 | — | 27% |
| Magnesium blood test CPT 83735 LCHG MAGNESIUM RBC | $51.10 | $70.00 | $11.59–$74.00 | 3% below | 27% |
| Magnesium blood test CPT 83735 LCHG MAGNESIUM BLOOD | $91.25 | $125.00 | $11.59–$74.00 | 74% above | 27% |
| Magnesium blood test CPT 83735 LCHG MAGNESIUM URINE QUANT | $113.88 | $156.00 | $11.59–$74.00 | 117% above | 27% |
| Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM RBC | $51.10 | $70.00 | $11.59–$74.00 | — | 27% |
| Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM BLOOD | $91.25 | $125.00 | $11.59–$74.00 | — | 27% |
| Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM URINE QUANT | $113.88 | $156.00 | $11.59–$74.00 | — | 27% |
| Measles (rubeola) antibody test CPT 86765 LCHG RUBEOLA ANTIBODY IGM | $113.15 | $155.00 | $22.61–$74.00 | 37% above | 27% |
| Measles (rubeola) antibody test CPT 86765 LCHG RUBEOLA ANTIBODY IGG | $175.20 | $240.00 | $22.61–$74.00 | 112% above | 27% |
| Measles (rubeola) antibody test inpatient CPT 86765 LCHG RUBEOLA ANTIBODY IGM | $113.15 | $155.00 | $22.61–$74.00 | — | 27% |
| Measles (rubeola) antibody test inpatient CPT 86765 LCHG RUBEOLA ANTIBODY IGG | $175.20 | $240.00 | $22.61–$74.00 | — | 27% |
| Mono test (heterophile antibody, Monospot) CPT 86308 LCHG MONONUCLEOSIS SCREEN | $86.14 | $118.00 | $9.28–$74.00 | 56% above | 27% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 LCHG MONONUCLEOSIS SCREEN | $86.14 | $118.00 | $9.28–$74.00 | — | 27% |
| Mumps immunity blood test CPT 86735 LCHG MUMPS ANTIBODY IGM | $74.46 | $102.00 | $23.19–$74.00 | 13% below | 27% |
| Mumps immunity blood test CPT 86735 LCHG MUMPS ANTIBODY IGG | $176.66 | $242.00 | $23.19–$74.00 | 106% above | 27% |
| Mumps immunity blood test inpatient CPT 86735 LCHG MUMPS ANTIBODY IGM | $74.46 | $102.00 | $23.19–$74.00 | — | 27% |
| Mumps immunity blood test inpatient CPT 86735 LCHG MUMPS ANTIBODY IGG | $176.66 | $242.00 | $23.19–$74.00 | — | 27% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 LCHG PSA FREE I | $104.39 | $143.00 | $32.46–$77.83 | 13% above | 27% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 LCHG PSA FREE | $247.47 | $339.00 | $32.46–$77.83 | 168% above | 27% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 LCHG PSA FREE I | $104.39 | $143.00 | $32.46–$77.83 | — | 27% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 LCHG PSA FREE | $247.47 | $339.00 | $32.46–$77.83 | — | 27% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LCHG PSA TOTAL;PROSTATE HEALTH PNL | $104.39 | $143.00 | $32.46–$139.47 | 10% above | 27% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LCHG PROSTATE SPECIFIC ANTIGEN DIAG | $256.96 | $352.00 | $32.46–$139.47 | 171% above | 27% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LCHG PSA TOTAL;PROSTATE HEALTH PNL | $104.39 | $143.00 | $32.46–$139.47 | — | 27% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LCHG PROSTATE SPECIFIC ANTIGEN DIAG | $256.96 | $352.00 | $32.46–$139.47 | — | 27% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 LCHG CYTOPATH CERV/VAG THIN LAYER NL | $115.34 | $158.00 | $35.94–$74.00 | 28% above | 27% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 LCHG CYTOPATH CERV/VAG THIN LAYER | $196.37 | $269.00 | $35.94–$74.00 | 118% above | 27% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 LCHG CYTOPATH CERV/VAG THIN LAYER NL | $115.34 | $158.00 | $35.94–$74.00 | — | 27% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 LCHG CYTOPATH CERV/VAG THIN LAYER | $196.37 | $269.00 | $35.94–$74.00 | — | 27% |
| Parathyroid hormone (PTH) blood test CPT 83970 LCHG PTH HORMONE | $556.99 | $763.00 | $55.00–$285.49 | 168% above | 27% |
| Parathyroid hormone (PTH) blood test CPT 83970 LCHG PTH INTACT | $556.99 | $763.00 | $55.00–$285.49 | 168% above | 27% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 LCHG PTH INTACT | $556.99 | $763.00 | $55.00–$285.49 | — | 27% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 LCHG PTH HORMONE | $556.99 | $763.00 | $55.00–$285.49 | — | 27% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LCHG PTT I | $73.73 | $101.00 | $10.43–$74.00 | 40% above | 27% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LCHG PTT II | $116.07 | $159.00 | $10.43–$74.00 | 121% above | 27% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LCHG PTT | $116.07 | $159.00 | $10.43–$74.00 | 121% above | 27% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LCHG PTT I | $73.73 | $101.00 | $10.43–$74.00 | — | 27% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LCHG PTT II | $116.07 | $159.00 | $10.43–$74.00 | — | 27% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LCHG PTT | $116.07 | $159.00 | $10.43–$74.00 | — | 27% |
| Phosphorus (phosphate) blood test CPT 84100 LCHG PHOSPHORUS BLOOD | $83.22 | $114.00 | $8.12–$74.00 | 100% above | 27% |
| Phosphorus (phosphate) blood test CPT 84100 LCHG PHOSPHORUS BLOOD I | $83.22 | $114.00 | $8.12–$74.00 | 100% above | 27% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 LCHG PHOSPHORUS BLOOD I | $83.22 | $114.00 | $8.12–$74.00 | — | 27% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 LCHG PHOSPHORUS BLOOD | $83.22 | $114.00 | $8.12–$74.00 | — | 27% |
| Potassium blood test CPT 84132 LCHG POTASSIUM BLOOD | $67.16 | $92.00 | $8.70–$74.00 | 148% above | 27% |
| Potassium blood test inpatient CPT 84132 LCHG POTASSIUM BLOOD | $67.16 | $92.00 | $8.70–$74.00 | — | 27% |
| Progesterone blood test CPT 84144 LCHG PROGESTERONE I | $105.85 | $145.00 | $37.10–$144.94 | 12% below | 27% |
| Progesterone blood test CPT 84144 LCHG PROGESTERONE | $313.90 | $430.00 | $37.10–$144.94 | 160% above | 27% |
| Progesterone blood test inpatient CPT 84144 LCHG PROGESTERONE I | $105.85 | $145.00 | $37.10–$144.94 | — | 27% |
| Progesterone blood test inpatient CPT 84144 LCHG PROGESTERONE | $313.90 | $430.00 | $37.10–$144.94 | — | 27% |
| Prolactin blood test CPT 84146 LCHG PROLACTIN | $260.61 | $357.00 | $34.20–$208.67 | 116% above | 27% |
| Prolactin blood test inpatient CPT 84146 LCHG PROLACTIN | $260.61 | $357.00 | $34.20–$208.67 | — | 27% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LCHG PT II | $37.23 | $51.00 | $7.54–$74.00 | 15% above | 27% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LCHG PT I | $51.10 | $70.00 | $7.54–$74.00 | 58% above | 27% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LCHG PT-INR | $71.54 | $98.00 | $7.54–$74.00 | 122% above | 27% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LCHG PT II | $37.23 | $51.00 | $7.54–$74.00 | — | 27% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LCHG PT I | $51.10 | $70.00 | $7.54–$74.00 | — | 27% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LCHG PT-INR | $71.54 | $98.00 | $7.54–$74.00 | — | 27% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 LCHG DRUG SCREEN MULTI CLASS A NON-TLC II | $215.35 | $295.00 | $22.03–$74.00 | 276% above | 27% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 LCHG DRUG SCREEN MULTI CLASS A NON-TLC II | $215.35 | $295.00 | $22.03–$74.00 | — | 27% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 LCHG STREP A SCREEN DIRECT IMMUNO | $124.83 | $171.00 | $28.99–$74.00 | 174% above | 27% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC LAB STREP A POCT PBB BILL | $124.83 | $171.00 | $28.99–$74.00 | 174% above | 27% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 LCHG STREP A SCREEN DIRECT IMMUNO | $124.83 | $171.00 | $28.99–$74.00 | — | 27% |
| Renin blood test CPT 84244 LCHG RENIN | $297.11 | $407.00 | $38.84–$220.69 | 101% above | 27% |
| Renin blood test inpatient CPT 84244 LCHG RENIN | $297.11 | $407.00 | $38.84–$220.69 | — | 27% |
| Rh blood typing CPT 86901 LCHG BLOOD TYPE RH I | $68.62 | $94.00 | $5.22–$74.00 | 73% above | 27% |
| Rh blood typing inpatient CPT 86901 LCHG BLOOD TYPE RH I | $68.62 | $94.00 | $5.22–$74.00 | — | 27% |
| Rheumatoid factor (RF) test CPT 86431 LCHG RHEUMATOID FACTOR II | $49.64 | $68.00 | $9.86–$74.23 | 15% below | 27% |
| Rheumatoid factor (RF) test CPT 86431 LCHG RHEUMATOID FACTOR BLOOD QUANT | $100.01 | $137.00 | $9.86–$74.23 | 71% above | 27% |
| Rheumatoid factor (RF) test inpatient CPT 86431 LCHG RHEUMATOID FACTOR II | $49.64 | $68.00 | $9.86–$74.23 | — | 27% |
| Rheumatoid factor (RF) test inpatient CPT 86431 LCHG RHEUMATOID FACTOR BLOOD QUANT | $100.01 | $137.00 | $9.86–$74.23 | — | 27% |
| Rubella antibody test (immunity check) CPT 86762 LCHG RUBELLA IMMUNE STATUS | $194.18 | $266.00 | $25.51–$74.00 | 135% above | 27% |
| Rubella antibody test (immunity check) inpatient CPT 86762 LCHG RUBELLA IMMUNE STATUS | $194.18 | $266.00 | $25.51–$74.00 | — | 27% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 LCHG SED RATE WESTERGREN AUTO | $73.00 | $100.00 | $4.64–$74.00 | 75% above | 27% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 LCHG SED RATE WESTERGREN AUTO | $73.00 | $100.00 | $4.64–$74.00 | — | 27% |
| Sodium blood test CPT 84295 LCHG SODIUM BLOOD | $64.97 | $89.00 | $8.70–$74.00 | 162% above | 27% |
| Sodium blood test inpatient CPT 84295 LCHG SODIUM BLOOD | $64.97 | $89.00 | $8.70–$74.00 | — | 27% |
| Stool ova and parasites exam CPT 87177 LCHG O+P | $143.81 | $197.00 | $15.65–$83.44 | 121% above | 27% |
| Stool ova and parasites exam inpatient CPT 87177 LCHG O+P | $143.81 | $197.00 | $15.65–$83.44 | — | 27% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC LAB OCCULT BLOOD ONC POCT | $29.20 | $40.00 | $7.54–$74.00 | 38% above | 27% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 LCHG OCCULT BLOOD FECES | $44.53 | $61.00 | $7.54–$74.00 | 111% above | 27% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC LAB OCCULT BLOOD ONC POCT | $29.20 | $40.00 | $7.54–$74.00 | — | 27% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 LCHG OCCULT BLOOD FECES | $44.53 | $61.00 | $7.54–$74.00 | — | 27% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 LCHG OCCULT BLOOD FECES 1-3 IMMUNO | $90.52 | $124.00 | $28.41–$74.00 | 45% above | 27% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 LCHG OCCULT BLOOD FECES 1-3 IMMUNO | $90.52 | $124.00 | $28.41–$74.00 | — | 27% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 LCHG TREPONEMA PALLIDUM AB IGG BY ELISA | $45.26 | $62.00 | $23.19–$74.00 | 18% below | 27% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 LCHG TREPONEMA PALLIDUM AB IGG | $116.07 | $159.00 | $23.19–$74.00 | 111% above | 27% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 LCHG FTA ANTIBODY | $116.07 | $159.00 | $23.19–$74.00 | 111% above | 27% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 LCHG TREPONEMA PALLIDUM AB IGG BY ELISA | $45.26 | $62.00 | $23.19–$74.00 | — | 27% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 LCHG FTA ANTIBODY | $116.07 | $159.00 | $23.19–$74.00 | — | 27% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 LCHG TREPONEMA PALLIDUM AB IGG | $116.07 | $159.00 | $23.19–$74.00 | — | 27% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LCHG RPR | $59.13 | $81.00 | $7.54–$74.00 | 49% above | 27% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LCHG VDRL CSF | $71.54 | $98.00 | $7.54–$74.00 | 80% above | 27% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LCHG RPR REFER | $94.90 | $130.00 | $7.54–$74.00 | 139% above | 27% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LCHG RPR | $59.13 | $81.00 | $7.54–$74.00 | — | 27% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LCHG VDRL CSF | $71.54 | $98.00 | $7.54–$74.00 | — | 27% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LCHG RPR REFER | $94.90 | $130.00 | $7.54–$74.00 | — | 27% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 LCHG QUANTIFERON TB-GOLD | $474.50 | $650.00 | $55.00–$184.01 | 88% above | 27% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 LCHG QUANTIFERON TB-GOLD | $474.50 | $650.00 | $55.00–$184.01 | — | 27% |
| Testosterone blood test, total (not free testosterone) CPT 84403 LCHG TESTOSTERONE TOTAL | $340.18 | $466.00 | $45.80–$237.20 | 196% above | 27% |
| Testosterone blood test, total (not free testosterone) CPT 84403 LCHG TESTOSTERONE TOTAL I | $340.18 | $466.00 | $45.80–$237.20 | 196% above | 27% |
| Testosterone blood test, total (not free testosterone) CPT 84403 LCHG TESTOSTERONE TOTAL II | $340.18 | $466.00 | $45.80–$237.20 | 196% above | 27% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 LCHG TESTOSTERONE TOTAL II | $340.18 | $466.00 | $45.80–$237.20 | — | 27% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 LCHG TESTOSTERONE TOTAL I | $340.18 | $466.00 | $45.80–$237.20 | — | 27% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 LCHG TESTOSTERONE TOTAL | $340.18 | $466.00 | $45.80–$237.20 | — | 27% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LCHG MICROSOMAL ANTIBODY LIVER/KIDNEY | $127.75 | $175.00 | $25.51–$131.77 | 82% above | 27% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LCHG THYROID PEROXIDASE ANTIBODY I | $196.37 | $269.00 | $25.51–$131.77 | 181% above | 27% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LCHG MICROSOMAL ANTIBODY | $196.37 | $269.00 | $25.51–$131.77 | 181% above | 27% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LCHG THYROID PEROXIDASE ANTIBODY | $196.37 | $269.00 | $25.51–$131.77 | 181% above | 27% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LCHG MICROSOMAL ANTIBODY LIVER/KIDNEY | $127.75 | $175.00 | $25.51–$131.77 | — | 27% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LCHG MICROSOMAL ANTIBODY | $196.37 | $269.00 | $25.51–$131.77 | — | 27% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LCHG THYROID PEROXIDASE ANTIBODY I | $196.37 | $269.00 | $25.51–$131.77 | — | 27% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LCHG THYROID PEROXIDASE ANTIBODY | $196.37 | $269.00 | $25.51–$131.77 | — | 27% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LCHG TSH | $164.25 | $225.00 | $29.57–$127.39 | 88% above | 27% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LCHG TSH | $164.25 | $225.00 | $29.57–$127.39 | — | 27% |
| Total IgE blood test CPT 82785 LCHG ALLERGEN IGE | $190.53 | $261.00 | $28.99–$139.47 | 87% above | 27% |
| Total IgE blood test CPT 82785 LCHG IGE | $276.67 | $379.00 | $28.99–$139.47 | 171% above | 27% |
| Total IgE blood test inpatient CPT 82785 LCHG ALLERGEN IGE | $190.53 | $261.00 | $28.99–$139.47 | — | 27% |
| Total IgE blood test inpatient CPT 82785 LCHG IGE | $276.67 | $379.00 | $28.99–$139.47 | — | 27% |
| Total cholesterol blood test CPT 82465 LCHG CHOLESTEROL BLOOD | $65.70 | $90.00 | $7.54–$74.00 | 42% above | 27% |
| Total cholesterol blood test inpatient CPT 82465 LCHG CHOLESTEROL BLOOD | $65.70 | $90.00 | $7.54–$74.00 | — | 27% |
| Total thyroxine (T4) blood test CPT 84436 LCHG T4 TOTAL | $93.44 | $128.00 | $12.17–$74.00 | 80% above | 27% |
| Total thyroxine (T4) blood test inpatient CPT 84436 LCHG T4 TOTAL | $93.44 | $128.00 | $12.17–$74.00 | — | 27% |
| Total triiodothyronine (T3) blood test CPT 84480 LCHG T3 TOTAL | $191.99 | $263.00 | $24.93–$92.26 | 79% above | 27% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 LCHG T3 TOTAL | $191.99 | $263.00 | $24.93–$92.26 | — | 27% |
| Transferrin blood test CPT 84466 LCHG TRANSFERRIN | $210.24 | $288.00 | $22.61–$109.82 | 121% above | 27% |
| Transferrin blood test inpatient CPT 84466 LCHG TRANSFERRIN | $210.24 | $288.00 | $22.61–$109.82 | — | 27% |
| Trichomonas test (NAAT) CPT 87661 LCHG TRICHOMONAS VAGINALIS AMPLIFIED PROBE I | $102.93 | $141.00 | $55.00–$91.72 | 25% below | 27% |
| Trichomonas test (NAAT) CPT 87661 LCHG TRICHOMONAS VAGINALIS AMPLIFIED PROBE | $199.29 | $273.00 | $55.00–$91.72 | 46% above | 27% |
| Trichomonas test (NAAT) inpatient CPT 87661 LCHG TRICHOMONAS VAGINALIS AMPLIFIED PROBE I | $102.93 | $141.00 | $55.00–$91.72 | — | 27% |
| Trichomonas test (NAAT) inpatient CPT 87661 LCHG TRICHOMONAS VAGINALIS AMPLIFIED PROBE | $199.29 | $273.00 | $55.00–$91.72 | — | 27% |
| Triglycerides blood test CPT 84478 LCHG TRIGLYCERIDES FLUID | $32.12 | $44.00 | $10.43–$74.00 | 40% below | 27% |
| Triglycerides blood test CPT 84478 LCHG TRIGLYCERIDES BLOOD | $108.04 | $148.00 | $10.43–$74.00 | 100% above | 27% |
| Triglycerides blood test inpatient CPT 84478 LCHG TRIGLYCERIDES FLUID | $32.12 | $44.00 | $10.43–$74.00 | — | 27% |
| Triglycerides blood test inpatient CPT 84478 LCHG TRIGLYCERIDES BLOOD | $108.04 | $148.00 | $10.43–$74.00 | — | 27% |
| Troponin test, quantitative CPT 84484 LCHG TROPONIN T | $229.22 | $314.00 | $22.03–$74.00 | 171% above | 27% |
| Troponin test, quantitative CPT 84484 LCHG TROPONIN I | $229.22 | $314.00 | $22.03–$74.00 | 171% above | 27% |
| Troponin test, quantitative inpatient CPT 84484 LCHG TROPONIN T | $229.22 | $314.00 | $22.03–$74.00 | — | 27% |
| Troponin test, quantitative inpatient CPT 84484 LCHG TROPONIN I | $229.22 | $314.00 | $22.03–$74.00 | — | 27% |
| Uric acid blood test CPT 84550 LCHG URIC ACID BLOOD | $61.32 | $84.00 | $8.12–$74.00 | 21% above | 27% |
| Uric acid blood test inpatient CPT 84550 LCHG URIC ACID BLOOD | $61.32 | $84.00 | $8.12–$74.00 | — | 27% |
| Urinalysis with microscope exam, automated CPT 81001 LCHG URINALYSIS ROUTINE AUTO | $69.35 | $95.00 | $5.80–$74.00 | 86% above | 27% |
| Urinalysis with microscope exam, automated CPT 81001 LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC | $75.19 | $103.00 | $5.80–$74.00 | 102% above | 27% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 LCHG URINALYSIS ROUTINE AUTO | $69.35 | $95.00 | $5.80–$74.00 | — | 27% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC | $75.19 | $103.00 | $5.80–$74.00 | — | 27% |
| Urinalysis without microscope exam, automated CPT 81003 LCHG KETONES QUALITATIVE URINE AUTO | $48.91 | $67.00 | $4.06–$74.00 | 96% above | 27% |
| Urinalysis without microscope exam, automated CPT 81003 LCHG SPECIFIC GRAVITY URINE AUTO | $48.91 | $67.00 | $4.06–$74.00 | 96% above | 27% |
| Urinalysis without microscope exam, automated CPT 81003 LCHG URINALYSIS DIPSTICK AUTO | $56.94 | $78.00 | $4.06–$74.00 | 128% above | 27% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LCHG SPECIFIC GRAVITY URINE AUTO | $48.91 | $67.00 | $4.06–$74.00 | — | 27% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LCHG KETONES QUALITATIVE URINE AUTO | $48.91 | $67.00 | $4.06–$74.00 | — | 27% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LCHG URINALYSIS DIPSTICK AUTO | $56.94 | $78.00 | $4.06–$74.00 | — | 27% |
| Urinalysis without microscope exam, manual CPT 81002 LCHG URINALYSIS DIPSTICK | $9.49 | $13.00 | $6.38–$74.00 | 31% below | 27% |
| Urinalysis without microscope exam, manual CPT 81002 LCHG URINALYSIS DIPSTICK | $9.49 | $13.00 | $6.38–$74.00 | 31% below | 27% |
| Urinalysis without microscope exam, manual CPT 81002 LCHG URINALYSIS DIPSTICK | $44.53 | $61.00 | $6.38–$74.00 | 223% above | 27% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 LCHG URINALYSIS DIPSTICK | $44.53 | $61.00 | $6.38–$74.00 | — | 27% |
| Urine culture for bacteria, with colony count CPT 87086 LCHG CULTURE URINE | $164.25 | $225.00 | $14.49–$74.00 | 118% above | 27% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 LCHG CULTURE URINE | $164.25 | $225.00 | $14.49–$74.00 | — | 27% |
| Urine microalbumin (albumin) test CPT 82043 LCHG MICROALBUMIN URINE RANDOM QUANT | $116.07 | $159.00 | $10.43–$121.88 | 88% above | 27% |
| Urine microalbumin (albumin) test inpatient CPT 82043 LCHG MICROALBUMIN URINE RANDOM QUANT | $116.07 | $159.00 | $10.43–$121.88 | — | 27% |
| Urine pregnancy test, read by color change CPT 81025 LCHG HCG URINE QUALITATIVE | $132.13 | $181.00 | $15.07–$74.00 | 167% above | 27% |
| Urine pregnancy test, read by color change CPT 81025 HC LAB HCG URINE QUAL POCT PBB BILL | $132.13 | $181.00 | $15.07–$74.00 | 167% above | 27% |
| Urine pregnancy test, read by color change inpatient CPT 81025 LCHG HCG URINE QUALITATIVE | $132.13 | $181.00 | $15.07–$74.00 | — | 27% |
| Vitamin B12 (cobalamin) blood test CPT 82607 LCHG VITAMIN B12 | $116.80 | $160.00 | $26.67–$116.40 | 14% above | 27% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 LCHG VITAMIN B12 | $116.80 | $160.00 | $26.67–$116.40 | — | 27% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LCHG ANTITHROMBIN III ACTIVITY | $150.38 | $206.00 | $52.17–$74.00 | 3% below | 27% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LCHG VITAMIN D 25-HYDROXY | $219.00 | $300.00 | $52.17–$74.00 | 41% above | 27% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 LCHG ANTITHROMBIN III ACTIVITY | $150.38 | $206.00 | $52.17–$74.00 | — | 27% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 LCHG VITAMIN D 25-HYDROXY | $219.00 | $300.00 | $52.17–$74.00 | — | 27% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 LCHG VITAMIN D 1 25 DIHYDROXY | $519.03 | $711.00 | $55.00–$186.68 | 224% above | 27% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 LCHG VITAMIN D 1 25 DIHYDROXY | $519.03 | $711.00 | $55.00–$186.68 | — | 27% |
| Zinc blood test CPT 84630 LCHG ZINC BLOOD | $140.16 | $192.00 | $20.29–$74.00 | 75% above | 27% |
| Zinc blood test inpatient CPT 84630 LCHG ZINC BLOOD | $140.16 | $192.00 | $20.29–$74.00 | — | 27% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LCHG HCG BETA BLOOD TUMOR MARKER | $202.94 | $278.00 | $26.67–$74.00 | 72% above | 27% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LCHG HCG BETA BLOOD QUANTITATIVE | $202.94 | $278.00 | $26.67–$74.00 | 72% above | 27% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LCHG HCG BETA BLOOD TUMOR MARKER | $202.94 | $278.00 | $26.67–$74.00 | — | 27% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LCHG HCG BETA BLOOD QUANTITATIVE | $202.94 | $278.00 | $26.67–$74.00 | — | 27% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 HC CHEMODENERV MUSC FOR MIGRAINE | $560.64 | $768.00 | $55.00–$290.50 | 24% below | 27% |
| Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERV MUSC FOR MIGRAINE | $560.64 | $768.00 | $55.00–$290.50 | — | 27% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC TX FX FIBULA DISTAL CLSD W/O MANIP | $503.70 | $690.00 | $55.00–$754.24 | 4% below | 27% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC TX FX FIBULA DISTAL CLSD W/O MANIP | $503.70 | $690.00 | $55.00–$754.24 | — | 27% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC TX FX METATARSAL CLSD EA W/O MANIP | $433.62 | $594.00 | $55.00–$541.31 | 28% below | 27% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC TX FX METATARSAL CLSD EA W/O MANIP | $433.62 | $594.00 | $55.00–$541.31 | — | 27% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE EXTERNAL | $1,979.76 | $2,712.00 | $55.00–$571.05 | 101% above | 27% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE EXTERNAL | $1,979.76 | $2,712.00 | $55.00–$571.05 | — | 27% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC CIRCUMCISION > 28 DAYS | $4,486.58 | $6,146.00 | $55.00–$500.46 | 383% above | 27% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC CIRCUMCISION > 28 DAYS | $4,486.58 | $6,146.00 | $55.00–$500.46 | — | 27% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC TX FX RADIAL DISTAL CLSD W/O MANIP | $2,271.03 | $3,111.00 | $55.00–$857.58 | 269% above | 27% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC TX FX RADIAL DISTAL CLSD W/O MANIP | $2,271.03 | $3,111.00 | $55.00–$857.58 | — | 27% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALIGNANT LESION 1ST | $131.40 | $180.00 | $55.00–$142.03 | 27% below | 27% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC TYMPANOSTOMY WITH LOCAL | $868.70 | $1,190.00 | $55.00–$339.54 | 66% above | 27% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC TYMPANOSTOMY WITH LOCAL | $868.70 | $1,190.00 | $55.00–$339.54 | — | 27% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE UNI | $55.48 | $76.00 | $40.80–$88.00 | 37% below | 27% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE UNI | $55.48 | $76.00 | $40.80–$88.00 | 37% below | 27% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE UNI | $55.48 | $76.00 | $40.80–$88.00 | 37% below | 27% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE UNI | $55.48 | $76.00 | $40.80–$88.00 | — | 27% |
| Earwax removal with instruments, one ear CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT UNI | $95.63 | $131.00 | $55.00–$88.00 | 14% above | 27% |
| Earwax removal with instruments, one ear CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT UNI | $151.84 | $208.00 | $55.00–$88.00 | 81% above | 27% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT UNI | $151.84 | $208.00 | $55.00–$88.00 | — | 27% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ EPIDURAL CERVICAL THOR W IMG | $1,320.57 | $1,809.00 | $55.00–$272.60 | 15% above | 27% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ EPIDURAL CERVICAL THOR W IMG | $1,320.57 | $1,809.00 | $55.00–$272.60 | — | 27% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ FACET JNT L/S SNGL LVL | $1,602.35 | $2,195.00 | $55.00–$230.10 | 5% above | 27% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC IR FACET LUMBAR SINGLE LEVEL | $1,660.02 | $2,274.00 | $55.00–$230.10 | 8% above | 27% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ FACET JNT L/S SNGL LVL | $1,602.35 | $2,195.00 | $55.00–$230.10 | — | 27% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC IR FACET LUMBAR SINGLE LEVEL | $1,660.02 | $2,274.00 | $55.00–$230.10 | — | 27% |
| Hysteroscopy with endometrial ablation CPT 58563 HC HYSTEROSCOPY ENDOMET ABLATION | $8,918.41 | $12,217.00 | $55.00–$608.41 | 10% above | 27% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HC HYSTEROSCOPY ENDOMET ABLATION | $8,918.41 | $12,217.00 | $55.00–$608.41 | — | 27% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION INTRAUTERINE DEVICE | $541.66 | $742.00 | $55.00–$127.54 | 78% above | 27% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION INTRAUTERINE DEVICE | $541.66 | $742.00 | $55.00–$127.54 | — | 27% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SMPL SNGL | $239.44 | $328.00 | $55.00–$274.88 | 18% below | 27% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SMPL SNGL | $386.90 | $530.00 | $55.00–$274.88 | 33% above | 27% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SMPL SNGL | $386.90 | $530.00 | $55.00–$274.88 | — | 27% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TNDN LIGMNT SNGL APNUROS | $107.31 | $147.00 | $55.00–$97.23 | 69% below | 27% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TNDN LIGMNT SNGL APNUROS | $531.44 | $728.00 | $55.00–$97.23 | 56% above | 27% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TNDN LIGMNT SNGL APNUROS | $586.19 | $803.00 | $55.00–$97.23 | 72% above | 27% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TNDN LIGMNT SNGL APNUROS | $531.44 | $728.00 | $55.00–$97.23 | — | 27% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS JOINT MAJOR WO US | $531.44 | $728.00 | $55.00–$112.93 | 23% above | 27% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS JOINT MAJOR WO US | $584.73 | $801.00 | $55.00–$112.93 | 35% above | 27% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS JOINT MAJOR WO US | $531.44 | $728.00 | $55.00–$112.93 | — | 27% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS JOINT INTERMED WO US | $560.64 | $768.00 | $55.00–$92.35 | 75% above | 27% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS JOINT INTERMED WO US | $567.21 | $777.00 | $55.00–$92.35 | 77% above | 27% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS JT INTERMEDIATE | $603.20 | $754.00 | $75.63–$92.35 | 88% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS JOINT INTERMED WO US | $560.64 | $768.00 | $55.00–$92.35 | — | 27% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS JOINT SMALL WO US | $560.64 | $768.00 | $55.00–$89.69 | 81% above | 27% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS JOINT SMALL WO US | $579.62 | $794.00 | $55.00–$89.69 | 87% above | 27% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS JOINT SMALL WO US | $560.64 | $768.00 | $55.00–$89.69 | — | 27% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC YAG LASER SURGERY | $1,081.13 | $1,481.00 | $55.00–$799.71 | 8% below | 27% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC YAG LASER SURGERY | $1,081.13 | $1,481.00 | $55.00–$799.71 | — | 27% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC WND RPR INT SC AX TK XT <2.5CM | $562.10 | $770.00 | $55.00–$384.88 | 8% above | 27% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC WND RPR INT SC AX TK XT <2.5CM | $874.54 | $1,198.00 | $55.00–$384.88 | 68% above | 27% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC WND RPR INT SC AX TK XT <2.5CM | $562.10 | $770.00 | $55.00–$384.88 | — | 27% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LHC W LT VENT W S+I | $795.70 | $1,090.00 | $55.00–$1,707.83 | 88% below | 27% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LHC W LT VENT W S+I | $795.70 | $1,090.00 | $55.00–$1,707.83 | — | 27% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ EPIDURAL LUMBAR SACRAL W IMG | $1,239.54 | $1,698.00 | $55.00–$251.90 | 8% above | 27% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ EPIDURAL LUMBAR SACRAL W IMG | $1,239.54 | $1,698.00 | $55.00–$251.90 | — | 27% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRANSFORAM NERVE L/S SNGL | $1,586.29 | $2,173.00 | $55.00–$283.31 | 48% above | 27% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRANSFORAM NERVE L/S SNGL | $1,586.29 | $2,173.00 | $55.00–$283.31 | — | 27% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKIN BENIGN <=0.5CM TRUNK/ARM/LEG | $321.20 | $440.00 | $55.00–$216.47 | 8% below | 27% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKIN BENIGN <=0.5CM TRUNK/ARM/LEG | $486.18 | $666.00 | $55.00–$216.47 | 40% above | 27% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC SKIN BENIGN <=0.5CM TRUNK/ARM/LEG | $321.20 | $440.00 | $55.00–$216.47 | — | 27% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC REMV LESN BENIGN FACE <= 0.5CM | $854.83 | $1,171.00 | $55.00–$277.07 | 66% above | 27% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC REMV LESN BENIGN FACE <= 0.5CM | $1,065.80 | $1,460.00 | $55.00–$277.07 | 107% above | 27% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC REMV LESN BENIGN FACE <= 0.5CM | $854.83 | $1,171.00 | $55.00–$277.07 | — | 27% |
| Nail removal (partial or complete), one nail CPT 11730 HC REMV NAIL PLATE PART OR CMPLT SNGL | $222.65 | $305.00 | $55.00–$136.87 | 5% below | 27% |
| Nail removal (partial or complete), one nail CPT 11730 HC REMV NAIL PLATE PART OR CMPLT SNGL | $335.07 | $459.00 | $55.00–$136.87 | 43% above | 27% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE SIMPLE SINGLE | $356.80 | $446.00 | $87.89–$136.87 | 52% above | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMV NAIL PLATE PART OR CMPLT SNGL | $222.65 | $305.00 | $55.00–$136.87 | — | 27% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJ AA STRD NERVE GR OCCIPITAL | $560.64 | $768.00 | $55.00–$127.39 | 21% above | 27% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJ AA STRD NERVE GR OCCIPITAL | $560.64 | $768.00 | $55.00–$127.39 | — | 27% |
| Paracentesis with imaging guidance CPT 49083 HC PARACENTESIS ABD W GUIDANCE | $1,553.44 | $2,128.00 | $55.00–$265.33 | 21% above | 27% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC PARACENTESIS ABD W GUIDANCE | $1,553.44 | $2,128.00 | $55.00–$265.33 | — | 27% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL NAIL FINGER OR TOE | $408.80 | $560.00 | $55.00–$262.48 | 25% above | 27% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL NAIL FINGER OR TOE | $616.85 | $845.00 | $55.00–$262.48 | 89% above | 27% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL NAIL FINGER OR TOE | $408.80 | $560.00 | $55.00–$262.48 | — | 27% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTRUCT FACET JNT W IMG L/S SNG LVL | $3,757.31 | $5,147.00 | $55.00–$490.32 | 52% above | 27% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTRUCT FACET JNT W IMG L/S SNG LVL | $3,757.31 | $5,147.00 | $55.00–$490.32 | — | 27% |
| Removal of a breast lump, open surgery CPT 19120 HC BREAST MASS BIOPSY/EXCISION | $1,420.58 | $1,946.00 | $55.00–$1,031.03 | 17% below | 27% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC BREAST MASS BIOPSY/EXCISION | $1,420.58 | $1,946.00 | $55.00–$1,031.03 | — | 27% |
| Removal of a foreign object under the skin, simple CPT 10120 HC FOR BODY REMOV SUBCUTANEOUS SIMPL | $421.21 | $577.00 | $55.00–$271.17 | 26% above | 27% |
| Removal of a foreign object under the skin, simple CPT 10120 HC FOR BODY REMOV SUBCUTANEOUS SIMPL | $631.45 | $865.00 | $55.00–$271.17 | 89% above | 27% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC FOR BODY REMOV SUBCUTANEOUS SIMPL | $421.21 | $577.00 | $55.00–$271.17 | — | 27% |
| Septoplasty to straighten the nasal septum CPT 30520 HC NASAL SEPTOPLASTY OR SUBMUCOUS RESECT | $1,542.49 | $2,113.00 | $55.00–$1,729.06 | 57% below | 27% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 HC NASAL SEPTOPLASTY OR SUBMUCOUS RESECT | $1,542.49 | $2,113.00 | $55.00–$1,729.06 | — | 27% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLICATION CAST ELBOW TO FINGER | $451.14 | $618.00 | $55.00–$157.40 | 87% above | 27% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLICATION CAST ELBOW TO FINGER | $451.14 | $618.00 | $55.00–$157.40 | — | 27% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLIC SPLINT SHORT ARM STATIC | $129.94 | $178.00 | $55.00–$102.00 | 26% below | 27% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLIC SPLINT SHORT ARM STATIC | $235.06 | $322.00 | $55.00–$102.00 | 34% above | 27% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLIC SPLINT SHORT ARM STATIC | $235.06 | $322.00 | $55.00–$102.00 | — | 27% |
| Short leg splint (calf to foot) CPT 29515 HC APPLIC SPLINT SHORT LEG | $235.06 | $322.00 | $55.00–$125.89 | 13% above | 27% |
| Short leg splint (calf to foot) CPT 29515 HC APPLIC SPLINT SHORT LEG | $330.69 | $453.00 | $55.00–$125.89 | 60% above | 27% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLIC SPLINT SHORT LEG | $235.06 | $322.00 | $55.00–$125.89 | — | 27% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RPR SCLP/TRNK/EXTRM SMPL <= 2.5CM | $468.66 | $642.00 | $55.00–$109.71 | 44% above | 27% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RPR SCLP/TRNK/EXTRM SMPL <= 2.5CM | $558.45 | $765.00 | $55.00–$109.71 | 72% above | 27% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC WND RPR SIM SC AX TK XT 1-2.5CM | $594.40 | $743.00 | $69.78–$109.71 | 83% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RPR SCLP/TRNK/EXTRM SMPL <= 2.5CM | $468.66 | $642.00 | $55.00–$109.71 | — | 27% |
| Skin biopsy, punch, one lesion CPT 11104 HC BIOPSY SKIN PUNCH SNGL LSN | $648.97 | $889.00 | $55.00–$117.36 | 170% above | 27% |
| Skin biopsy, punch, one lesion CPT 11104 HC BIOPSY SKIN PUNCH SNGL LSN | $970.17 | $1,329.00 | $55.00–$117.36 | 304% above | 27% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC BIOPSY SKIN PUNCH SNGL LSN | $648.97 | $889.00 | $55.00–$117.36 | — | 27% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC SKIN MALIG TRNK/EXTRM <=0.5CM | $392.74 | $538.00 | $55.00–$311.03 | 7% above | 27% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL SKIN TAGS <= 15 LESIONS | $179.58 | $246.00 | $55.00–$197.17 | 27% above | 27% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL SKIN TAGS <= 15 LESIONS | $338.72 | $464.00 | $55.00–$197.17 | 139% above | 27% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL SKIN TAGS <= 15 LESIONS | $179.58 | $246.00 | $55.00–$197.17 | — | 27% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE | $1,239.54 | $1,698.00 | $55.00–$153.24 | 105% above | 27% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE | $1,239.54 | $1,698.00 | $55.00–$153.24 | — | 27% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RPR SCLP/TRNK/EXTRM SMPL 2.6-7.5 CM | $479.61 | $657.00 | $55.00–$143.68 | 138% above | 27% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RPR SCLP/TRNK/EXTRM SMPL 2.6-7.5 CM | $598.60 | $820.00 | $55.00–$143.68 | 196% above | 27% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC WND RPR SIM SC AX TK XT 2.6-7.5CM | $636.80 | $796.00 | $91.98–$143.68 | 215% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RPR SCLP/TRNK/EXTRM SMPL 2.6-7.5 CM | $479.61 | $657.00 | $55.00–$143.68 | — | 27% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC WND RPR SIM FACE 1-2.5CM | $219.73 | $301.00 | $55.00–$135.36 | 29% below | 27% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HP WND RPR SIM FACE 1-2.5CM | $233.60 | $292.00 | $86.72–$135.36 | 24% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC WND RPR SIM FACE 1-2.5CM | $386.17 | $529.00 | $55.00–$135.36 | 25% above | 27% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC WND RPR SIM FACE 1-2.5CM | $386.17 | $529.00 | $55.00–$135.36 | — | 27% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC BIOPSY SKIN TANGENTIAL SNGL LSN | $1,471.68 | $2,016.00 | $55.00–$95.13 | 513% above | 27% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC BIOPSY SKIN TANGENTIAL SNGL LSN | $1,537.38 | $2,106.00 | $55.00–$95.13 | 541% above | 27% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC BIOPSY SKIN TANGENTIAL SNGL LSN | $1,471.68 | $2,016.00 | $55.00–$95.13 | — | 27% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W IMAGING | $1,729.37 | $2,369.00 | $55.00–$272.15 | 44% above | 27% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W IMAGING | $1,729.37 | $2,369.00 | $55.00–$272.15 | — | 27% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1 OR 2 MUSC | $531.44 | $728.00 | $55.00–$92.84 | 53% above | 27% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1 OR 2 MUSC | $564.29 | $773.00 | $55.00–$92.84 | 62% above | 27% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER POINT 1 OR 2 MUSC | $531.44 | $728.00 | $55.00–$92.84 | — | 27% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST PERC 1ST LESN US | $3,109.07 | $4,259.00 | $55.00–$383.77 | 56% above | 27% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST PERC 1ST LESN US | $3,109.07 | $4,259.00 | $55.00–$383.77 | — | 27% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD W BALLOON DILATION ESOPHAGUS<30MM | $2,526.53 | $3,461.00 | $55.00–$382.41 | 5% below | 27% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD W BALLOON DILATION ESOPHAGUS<30MM | $2,526.53 | $3,461.00 | $55.00–$382.41 | — | 27% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD FLEX TRANSORAL W BX SNGL OR MULT | $3,268.21 | $4,477.00 | $55.00–$345.66 | 107% above | 27% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD FLEX TRANSORAL W BX SNGL OR MULT | $3,268.21 | $4,477.00 | $55.00–$345.66 | — | 27% |
| Wart removal, up to 14 warts CPT 17110 HC DESTR BENIGN LESION OTHER SKIN TAG <14 | $216.81 | $297.00 | $55.00–$177.15 | 10% above | 27% |
| Wart removal, up to 14 warts CPT 17110 HC DESTR BENIGN LESION OTHER SKIN TAG <14 | $355.51 | $487.00 | $55.00–$177.15 | 81% above | 27% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTR BENIGN LESION OTHER SKIN TAG <14 | $216.81 | $297.00 | $55.00–$177.15 | — | 27% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SUBQ TISSUE 1ST 20 CM OR LESS | $572.32 | $784.00 | $55.00–$152.56 | 7% above | 27% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SUBQ TISSUE 1ST 20 CM OR LESS | $697.15 | $955.00 | $55.00–$152.56 | 31% above | 27% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SUBQ TISSUE 1ST 20 CM OR LESS | $572.32 | $784.00 | $55.00–$152.56 | — | 27% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 LCHG TRANSFUSION SERVICE FEE | $700.80 | $960.00 | $55.00–$107.75 | 20% above | 27% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC OP BLOOD ADMIN 1-3 UNITS | $869.43 | $1,191.00 | $55.00–$107.75 | 49% above | 27% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC OP BLOOD ADMIN 10-12 UNIT | $869.43 | $1,191.00 | $55.00–$107.75 | 49% above | 27% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC OP BLOOD ADMIN 4-6 UNITS | $869.43 | $1,191.00 | $55.00–$107.75 | 49% above | 27% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC OP BLOOD ADMIN 7-9 UNITS | $869.43 | $1,191.00 | $55.00–$107.75 | 49% above | 27% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD/BLOOD COM | $903.01 | $1,237.00 | $55.00–$107.75 | 55% above | 27% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 LCHG TRANSFUSION SERVICE FEE | $700.80 | $960.00 | $55.00–$107.75 | — | 27% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC OP BLOOD ADMIN 4-6 UNITS | $869.43 | $1,191.00 | $55.00–$107.75 | — | 27% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC OP BLOOD ADMIN 1-3 UNITS | $869.43 | $1,191.00 | $55.00–$107.75 | — | 27% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC OP BLOOD ADMIN 7-9 UNITS | $869.43 | $1,191.00 | $55.00–$107.75 | — | 27% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC OP BLOOD ADMIN 10-12 UNIT | $869.43 | $1,191.00 | $55.00–$107.75 | — | 27% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD/BLOOD COM | $903.01 | $1,237.00 | $55.00–$107.75 | — | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG SPUTUM INDUCTION INIT | $146.73 | $201.00 | $13.53–$55.00 | 70% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT W/MED SUBSEQUENT | $172.28 | $236.00 | $13.53–$55.00 | 99% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TREATMENT SUBSEQ | $172.28 | $236.00 | $13.53–$55.00 | 99% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TREATMENT INIT | $216.08 | $296.00 | $13.53–$55.00 | 150% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TREATMENT INIT | $216.08 | $296.00 | $13.53–$55.00 | 150% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TREATMENT INIT | $216.08 | $296.00 | $13.53–$55.00 | 150% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT W/MED | $216.08 | $296.00 | $13.53–$55.00 | 150% above | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG SPUTUM INDUCTION INIT | $146.73 | $201.00 | $13.53–$55.00 | — | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI TREATMENT SUBSEQ | $172.28 | $236.00 | $13.53–$55.00 | — | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT W/MED SUBSEQUENT | $172.28 | $236.00 | $13.53–$55.00 | — | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI TREATMENT INIT | $216.08 | $296.00 | $13.53–$55.00 | — | 27% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT W/MED | $216.08 | $296.00 | $13.53–$55.00 | — | 27% |
| Chemotherapy IV infusion, first hour CPT 96413 HC IV INF CHEMO 1 HR | $662.11 | $907.00 | $55.00–$223.01 | 18% above | 27% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC IV INF CHEMO 1 HR | $662.11 | $907.00 | $55.00–$223.01 | — | 27% |
| Critical care, first 30 to 74 minutes CPT 99291 HC EMERG CRITICAL CARE 30 TO 74 MINUTES | $2,255.70 | $3,090.00 | $55.00–$390.92 | 26% above | 27% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC EMERG CRITICAL CARE 30 TO 74 MINUTES | $2,255.70 | $3,090.00 | $55.00–$390.92 | — | 27% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG RECORD AWAKE & DROWSY | $1,138.07 | $1,559.00 | $55.00–$685.99 | 72% above | 27% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG RECORD AWAKE & DROWSY | $1,138.07 | $1,559.00 | $55.00–$685.99 | — | 27% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC EKG 12 LEAD W INTERP AND REPORT GLOBAL | $248.93 | $341.00 | $24.61–$127.61 | 204% above | 27% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC EKG 12 LEAD W INTERP AND REPORT GLOBAL | $248.93 | $341.00 | $24.61–$127.61 | 204% above | 27% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12 LEAD | $231.41 | $317.00 | $10.64–$78.40 | 57% above | 27% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12 LEAD | $231.41 | $317.00 | $10.64–$78.40 | 57% above | 27% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12 LEAD | $231.41 | $317.00 | $10.64–$78.40 | 57% above | 27% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG 12 LEAD | $231.41 | $317.00 | $10.64–$78.40 | — | 27% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPT VISIT LEVEL 1 | $237.98 | $326.00 | $20.78–$88.00 | 27% above | 27% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPT VISIT LEVEL 1 | $237.98 | $326.00 | $20.78–$88.00 | — | 27% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPT VISIT LEVEL 2 | $465.01 | $637.00 | $55.00–$88.00 | 45% above | 27% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPT VISIT LEVEL 2 | $465.01 | $637.00 | $55.00–$88.00 | — | 27% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPT VISIT LEVEL 3 | $851.91 | $1,167.00 | $55.00–$129.78 | 40% above | 27% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPT VISIT LEVEL 3 | $851.91 | $1,167.00 | $55.00–$129.78 | — | 27% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPT VISIT LEVEL 4 | $1,581.18 | $2,166.00 | $55.00–$220.82 | 71% above | 27% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPT VISIT LEVEL 4 | $1,581.18 | $2,166.00 | $55.00–$220.82 | — | 27% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPT VISIT LEVEL 5 | $2,044.00 | $2,800.00 | $55.00–$319.94 | 39% above | 27% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPT VISIT LEVEL 5 | $2,044.00 | $2,800.00 | $55.00–$319.94 | — | 27% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HCHG CARD STRESS TEST CARDIOLYTE | $965.79 | $1,323.00 | $55.00–$313.61 | 22% above | 27% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARD STRESS TEST ROUTINE | $1,106.68 | $1,516.00 | $55.00–$313.61 | 40% above | 27% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HCHG CARD STRESS TEST CARDIOLYTE | $965.79 | $1,323.00 | $55.00–$313.61 | — | 27% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARD STRESS TEST ROUTINE | $1,106.68 | $1,516.00 | $55.00–$313.61 | — | 27% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY W PT 50 MIN | $635.10 | $870.00 | $89.11–$180.98 | 235% above | 27% |
| Family therapy with the patient, 50 minutes CPT 90847 HC OP FAMILY PSYCHOTHERAPY W PT 50 MIN | $635.10 | $870.00 | $55.00–$180.98 | 235% above | 27% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OP FAMILY PSYCHOTHERAPY W PT 50 MIN | $635.10 | $870.00 | $55.00–$180.98 | — | 27% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY W PT 50 MIN | $635.10 | $870.00 | $89.11–$180.98 | — | 27% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY WO PT 50 MIN | $605.17 | $829.00 | $85.97–$173.16 | 231% above | 27% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY WO PT 50 MIN | $605.17 | $829.00 | $85.97–$173.16 | — | 27% |
| Group psychotherapy session CPT 90853 HC OP GROUP PSYCHOTHERAPY SESSION | $552.61 | $757.00 | $21.08–$88.00 | 610% above | 27% |
| Group psychotherapy session inpatient CPT 90853 HC OP GROUP PSYCHOTHERAPY SESSION | $552.61 | $757.00 | $21.08–$88.00 | — | 27% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION HYDRATION 1ST HR | $489.10 | $670.00 | $55.00–$107.47 | 71% above | 27% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION HYDRATION 1ST HR | $489.10 | $670.00 | $55.00–$107.47 | — | 27% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION THERAPEUTIC 1ST HR | $662.11 | $907.00 | $55.00–$130.74 | 109% above | 27% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION THERAPEUTIC 1ST HR | $662.11 | $907.00 | $55.00–$130.74 | — | 27% |
| IV push of a medicine, first drug CPT 96374 HC IV PUSH INITIAL OR SINGLE | $223.38 | $306.00 | $55.00–$103.36 | 35% above | 27% |
| IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INITIAL OR SINGLE | $223.38 | $306.00 | $55.00–$103.36 | — | 27% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ THER/PROPH/DIAG SUBQ/IM | $33.58 | $46.00 | $24.99–$55.00 | 58% below | 27% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ THER/PROPH/DIAG SUBQ/IM | $33.58 | $46.00 | $24.99–$55.00 | 58% below | 27% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ THER/PROPH/DIAG SUBQ/IM | $195.64 | $268.00 | $24.99–$55.00 | 147% above | 27% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ THER/PROPH/DIAG SUBQ/IM | $195.64 | $268.00 | $24.99–$55.00 | — | 27% |
| New patient office visit, about 30 minutes CPT 99203 HC FACLTY OP NEW LEVEL 3 | $151.11 | $207.00 | $55.00–$143.32 | 23% below | 27% |
| New patient office visit, about 30 minutes CPT 99203 HC FACLTY OP NEW LEVEL 3 | $216.81 | $297.00 | $55.00–$143.32 | 10% above | 27% |
| New patient office visit, about 30 minutes CPT 99203 HC FACLTY OP NEW LEVEL 3 | $324.12 | $444.00 | $55.00–$143.32 | 64% above | 27% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC FACLTY OP NEW LEVEL 3 | $324.12 | $444.00 | $55.00–$143.32 | — | 27% |
| New patient office visit, about 45 minutes CPT 99204 HC FACLTY OP NEW LEVEL 4 | $260.00 | $325.00 | $174.94–$233.98 | 13% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 HC FACLTY OP NEW LEVEL 4 | $371.20 | $464.00 | $174.94–$233.98 | 61% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 HP OP NEW PT LEVEL IV | $371.20 | $464.00 | $174.94–$233.98 | 61% above | 20% |
| New patient office visit, about 45 minutes CPT 99204 HC FACLTY OP NEW LEVEL 4 | $452.60 | $620.00 | $55.00–$233.98 | 97% above | 27% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC FACLTY OP NEW LEVEL 4 | $452.60 | $620.00 | $55.00–$233.98 | — | 27% |
| New patient office visit, about 60 minutes CPT 99205 HC FACLTY OP NEW LEVEL 5 | $306.60 | $420.00 | $55.00–$318.02 | 1% above | 27% |
| New patient office visit, about 60 minutes CPT 99205 HC FACLTY OP NEW LEVEL 5 | $438.00 | $600.00 | $55.00–$318.02 | 44% above | 27% |
| New patient office visit, about 60 minutes CPT 99205 HC FACLTY OP NEW LEVEL 5 | $658.46 | $902.00 | $55.00–$318.02 | 116% above | 27% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC FACLTY OP NEW LEVEL 5 | $658.46 | $902.00 | $55.00–$318.02 | — | 27% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC EXAM SPORTS SCHOOL | $29.20 | $40.00 | $55.00–$88.00 | 78% below | 27% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC EXAM SPORTS SCHOOL | $29.20 | $40.00 | $55.00–$88.00 | 78% below | 27% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC FACLTY OP NEW LEVEL 2 | $106.58 | $146.00 | $55.00–$88.00 | 18% below | 27% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC FACLTY OP NEW LEVEL 2 | $152.57 | $209.00 | $55.00–$88.00 | 17% above | 27% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC FACLTY OP NEW LEVEL 2 | $257.69 | $353.00 | $55.00–$88.00 | 97% above | 27% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC EXAM SPORTS SCHOOL | $29.20 | $40.00 | $55.00–$88.00 | — | 27% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC FACLTY OP NEW LEVEL 2 | $257.69 | $353.00 | $55.00–$88.00 | — | 27% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MNT INIT INDIV EA 15 MIN | $53.29 | $73.00 | $31.85–$88.00 | 11% below | 27% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MNT INIT INDIV EA 15 MIN | $53.29 | $73.00 | $31.85–$88.00 | — | 27% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PHYSCN PREVENT NEW PT 18-39YRS | $91.25 | $125.00 | $55.00–$165.98 | 35% below | 27% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PHYSCN PREVENT NEW PT 18-39YRS | $280.32 | $384.00 | $55.00–$165.98 | 101% above | 27% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PHYSCN PREVENT NEW PT 18-39YRS | $91.25 | $125.00 | $55.00–$165.98 | — | 27% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PHYSCN PREVENT NEW PT 40-64YRS | $91.25 | $125.00 | $55.00–$201.43 | 40% below | 27% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PHYSCN PREVENT NEW PT 40-64YRS | $325.58 | $446.00 | $55.00–$201.43 | 116% above | 27% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PHYSCN PREVENT NEW PT 40-64YRS | $91.25 | $125.00 | $55.00–$201.43 | — | 27% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC INIT PM E/M NEW PAT 65 AND OVER | $91.25 | $125.00 | $55.00–$216.38 | 49% below | 27% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC INIT PM E/M NEW PAT 65 AND OVER | $352.59 | $483.00 | $55.00–$216.38 | 97% above | 27% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 HC INIT PM E/M NEW PAT 65 AND OVER | $91.25 | $125.00 | $55.00–$216.38 | — | 27% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC PHYSCN PREVENT ESTAB PT 18-39YRS | $91.25 | $125.00 | $55.00–$151.63 | 41% below | 27% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC PHYSCN PREVENT ESTAB PT 18-39YRS | $253.31 | $347.00 | $55.00–$151.63 | 63% above | 27% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC PHYSCN PREVENT ESTAB PT 18-39YRS | $91.25 | $125.00 | $55.00–$151.63 | — | 27% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC PHYSCN PREVENT ESTAB PT 40-64YRS | $91.25 | $125.00 | $55.00–$164.74 | 46% below | 27% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC PHYSCN PREVENT ESTAB PT 40-64YRS | $275.21 | $377.00 | $55.00–$164.74 | 63% above | 27% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PHYSCN PREVENT ESTAB PT 40-64YRS | $91.25 | $125.00 | $55.00–$164.74 | — | 27% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC PHYSCN PREVENT ESTAB PT 65+YRS | $91.25 | $125.00 | $55.00–$173.34 | 39% below | 27% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC PHYSCN PREVENT ESTAB PT 65+YRS | $290.54 | $398.00 | $55.00–$173.34 | 95% above | 27% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC PHYSCN PREVENT ESTAB PT 65+YRS | $91.25 | $125.00 | $55.00–$173.34 | — | 27% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN | $458.44 | $628.00 | $60.36–$121.58 | 331% above | 27% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN | $458.44 | $628.00 | $60.36–$121.58 | — | 27% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN | $567.94 | $778.00 | $79.46–$160.95 | 301% above | 27% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN | $567.94 | $778.00 | $79.46–$160.95 | — | 27% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN | $578.89 | $793.00 | $117.58–$237.51 | 172% above | 27% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN | $578.89 | $793.00 | $117.58–$237.51 | — | 27% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC FACLTY OP EST PT LEVEL 5 | $202.94 | $278.00 | $55.00–$254.34 | 33% below | 27% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC FACLTY OP EST PT LEVEL 5 | $273.75 | $375.00 | $55.00–$254.34 | 10% below | 27% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC FACLTY OP EST PT LEVEL 5 | $291.27 | $399.00 | $55.00–$254.34 | 5% below | 27% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC FACLTY OP EST PT LEVEL 5 | $273.75 | $375.00 | $55.00–$254.34 | — | 27% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE OUTPT VISIT EST LEVEL 3 | $110.23 | $151.00 | $55.00–$116.28 | 33% below | 27% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE OUTPT VISIT EST LEVEL 3 | $153.30 | $210.00 | $55.00–$116.28 | 7% below | 27% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE OUTPT VISIT EST LEVEL 3 | $193.45 | $265.00 | $55.00–$116.28 | 18% above | 27% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE OUTPT VISIT EST LEVEL 3 | $193.45 | $265.00 | $55.00–$116.28 | — | 27% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE OUTPT VISIT EST LEVEL 4 | $151.84 | $208.00 | $55.00–$171.75 | 20% below | 27% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE OUTPT VISIT EST LEVEL 4 | $217.54 | $298.00 | $55.00–$171.75 | 14% above | 27% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE OUTPT VISIT EST LEVEL 4 | $219.00 | $300.00 | $55.00–$171.75 | 15% above | 27% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE OUTPT VISIT EST LEVEL 4 | $219.00 | $300.00 | $55.00–$171.75 | — | 27% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC FACLTY OP EST PT LEVEL 2 | $67.89 | $93.00 | $46.54–$88.00 | 27% below | 27% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC FACLTY OP EST PT LEVEL 2 | $96.36 | $132.00 | $46.54–$88.00 | 3% above | 27% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC FACLTY OP EST PT LEVEL 2 | $164.25 | $225.00 | $46.54–$88.00 | 75% above | 27% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC FACLTY OP EST PT LEVEL 2 | $164.25 | $225.00 | $46.54–$88.00 | — | 27% |
| Spirometry (breathing test) CPT 94010 HC SPIROMETRY | $147.46 | $202.00 | $47.22–$282.21 | 47% below | 27% |
| Spirometry (breathing test) CPT 94010 HC PFT INDUSTRIAL | $221.19 | $303.00 | $47.22–$282.21 | 21% below | 27% |
| Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY | $147.46 | $202.00 | $47.22–$282.21 | — | 27% |
| Spirometry (breathing test) inpatient CPT 94010 HC PFT INDUSTRIAL | $221.19 | $303.00 | $47.22–$282.21 | — | 27% |
| Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATOR PRE/POST TEST | $623.42 | $854.00 | $55.00–$235.19 | 28% above | 27% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATOR PRE/POST TEST | $623.42 | $854.00 | $55.00–$235.19 | — | 27% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THER | $246.01 | $337.00 | $55.00–$164.10 | 23% above | 27% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THER | $246.01 | $337.00 | $55.00–$164.10 | — | 27% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC VARICELLA (CHICKEN POX) VACCINE | $445.30 | $610.00 | $55.00–$108.99 | 170% above | 27% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC VARICELLA (CHICKEN POX) VACCINE | $445.30 | $610.00 | $55.00–$108.99 | — | 27% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP IPV KINRIX 4-6YRS IM | $83.95 | $115.00 | $55.00–$88.01 | at median | 27% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP IPV KINRIX 4-6YRS IM | $229.48 | $314.36 | $55.00–$88.01 | 173% above | 27% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC DTAP IPV KINRIX 4-6YRS IM | $229.48 | $314.36 | $55.00–$88.01 | — | 27% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DTAP VACCINE < 7 YRS IM | $95.63 | $131.00 | $37.10–$88.00 | 126% above | 27% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DTAP VACCINE < 7 YRS IM | $95.63 | $131.00 | $37.10–$88.00 | — | 27% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC VACCINE DTAP HEP IPV INTRAMUSCULAR | $231.41 | $317.00 | $55.00–$108.99 | 67% above | 27% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC VACCINE DTAP HEP IPV INTRAMUSCULAR | $231.41 | $317.00 | $55.00–$108.99 | — | 27% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP HIB-IP VACCINE, IM | $81.76 | $112.00 | $55.00–$111.89 | 30% below | 27% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP HIB-IP VACCINE, IM | $81.76 | $112.00 | $55.00–$111.89 | — | 27% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC DTAP IPV HIB HEPB VACCINE IM | $542.38 | $742.98 | $55.00–$88.01 | 193% above | 27% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC DTAP IPV HIB HEPB VACCINE IM | $542.38 | $742.98 | $55.00–$88.01 | — | 27% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC FLU VACCINE IIV3 SPLIT PF 0.5 ML IM | $75.19 | $103.00 | $22.61–$88.00 | 136% above | 27% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC FLU VACCINE IIV3 SPLIT PF 0.5 ML IM | $75.19 | $103.00 | $22.61–$88.00 | — | 27% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC HPV VIRUS VACCINE 9 VAL IM | $584.73 | $801.00 | $55.00–$88.01 | 84% above | 27% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC HPV VIRUS VACCINE 9 VAL IM | $584.73 | $801.00 | $55.00–$88.01 | 84% above | 27% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC HPV VIRUS VACCINE 9 VAL IM | $584.73 | $801.00 | $55.00–$88.01 | 84% above | 27% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC HPV VIRUS VACCINE 9 VAL IM | $584.73 | $801.00 | $55.00–$88.01 | — | 27% |
| Hepatitis A vaccine, adult dose CPT 90632 HC HEPA VACCINE ADULT IM | $250.39 | $343.00 | $55.00–$124.64 | 90% above | 27% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEPA VACCINE ADULT IM | $250.39 | $343.00 | $55.00–$124.64 | — | 27% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEPATITIS A VACCINE PEDIATRIC/ADOL | $118.26 | $162.00 | $49.86–$88.00 | 128% above | 27% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEPATITIS A VACCINE PEDIATRIC/ADOL | $118.26 | $162.00 | $49.86–$88.00 | — | 27% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPATITIS B VACCINE ADULT IM | $212.43 | $291.00 | $55.00–$124.64 | 84% above | 27% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPATITIS B VACCINE ADULT IM | $212.43 | $291.00 | $55.00–$124.64 | — | 27% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEPATITIS B 3 DOSE | $32.85 | $45.00 | $54.49–$88.00 | 42% below | 27% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEPATITIS B 3 DOSE | $32.85 | $45.00 | $54.49–$88.00 | — | 27% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC HIB 3 DOSE | $94.17 | $129.00 | $42.32–$88.00 | 87% above | 27% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC HIB 3 DOSE | $94.17 | $129.00 | $42.32–$88.00 | — | 27% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HIB 4 DOSE | $59.13 | $81.00 | $39.42–$88.00 | 42% above | 27% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HIB 4 DOSE | $59.13 | $81.00 | $39.42–$88.00 | — | 27% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC FLU VACCINE PRSV FREE INC ANTIG IM | $72.27 | $99.00 | $55.00–$129.86 | 9% below | 27% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC FLU VACCINE PRSV FREE INC ANTIG IM | $72.27 | $99.00 | $55.00–$129.86 | — | 27% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MEASLES MUMPS RUBELLA MMR VACCINE | $269.37 | $369.00 | $55.00–$88.00 | 76% above | 27% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MEASLES MUMPS RUBELLA MMR VACCINE | $269.37 | $369.00 | $55.00–$88.00 | — | 27% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC MMRV VACCINE LIVE SUBQ USE | $350.40 | $480.00 | $55.00–$475.37 | 38% above | 27% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC MMRV VACCINE LIVE SUBQ USE | $870.16 | $1,192.00 | $55.00–$475.37 | 243% above | 27% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC MMRV VACCINE LIVE SUBQ USE | $870.16 | $1,192.00 | $55.00–$475.37 | — | 27% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL VACCINE IM | $462.09 | $633.00 | $55.00–$449.86 | 101% above | 27% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL VACCINE IM | $462.09 | $633.00 | $55.00–$449.86 | — | 27% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC MENACWY TT VACCINE IM | $584.63 | $800.86 | $55.00–$88.01 | 187% above | 27% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC MENACWY TT VACCINE IM | $584.63 | $800.86 | $55.00–$88.01 | — | 27% |
| Meningococcal B vaccine (Trumenba) CPT 90621 HC MENINGOCOCCAL B VACCINE IM | $678.60 | $929.59 | $55.00–$88.01 | 252% above | 27% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC MENINGOCOCCAL B VACCINE IM | $678.60 | $929.59 | $55.00–$88.01 | — | 27% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PREVNAR - 13 VACCINE | $640.94 | $878.00 | $55.00–$456.82 | 119% above | 27% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PREVNAR - 13 VACCINE | $640.94 | $878.00 | $55.00–$456.82 | — | 27% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PCV20 VACCINE IM | $256.23 | $351.00 | $55.00–$523.64 | 12% below | 27% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PCV20 VACCINE IM | $256.23 | $351.00 | $55.00–$523.64 | — | 27% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMO POLYSAC VACCINE >=2YRS SUBQ IM | $137.97 | $189.00 | $55.00–$236.53 | 2% below | 27% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMO POLYSAC VACCINE >=2YRS SUBQ IM | $137.97 | $189.00 | $55.00–$236.53 | — | 27% |
| Polio vaccine, inactivated (IPV) CPT 90713 HC POLIOVIRUS VACC (IPV) INACTIVATED | $120.45 | $165.00 | $42.32–$88.00 | 101% above | 27% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC POLIOVIRUS VACC (IPV) INACTIVATED | $120.45 | $165.00 | $42.32–$88.00 | — | 27% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC VAC RSV MONOCLONAL ANTIBODY 1 ML | $443.11 | $607.00 | $55.00–$88.01 | 57% below | 27% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC VAC RSV MONOCLONAL ANTIBODY 1 ML | $443.11 | $607.00 | $55.00–$88.01 | — | 27% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC VAC RSV MONOCLONAL ANTIBODY 0.5 ML | $443.11 | $607.00 | $55.00–$88.01 | 57% below | 27% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC VAC RSV MONOCLONAL ANTIBODY 0.5 ML | $443.11 | $607.00 | $55.00–$88.01 | — | 27% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC ROTAVIRUS VACC 2 DOSE ORAL | $419.02 | $574.00 | $55.00–$111.89 | 175% above | 27% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC ROTAVIRUS VACC 2 DOSE ORAL | $419.02 | $574.00 | $55.00–$111.89 | — | 27% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC ROTATEQ (ROTAVIRUS VACCINE) | $350.40 | $480.00 | $55.00–$147.85 | 201% above | 27% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC ROTATEQ (ROTAVIRUS VACCINE) | $350.40 | $480.00 | $55.00–$147.85 | — | 27% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC ZOSTER VACCINE RECOMBINANT IM | $492.75 | $675.00 | $55.00–$88.01 | 149% above | 27% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC ZOSTER VACCINE RECOMBINANT IM | $492.75 | $675.00 | $55.00–$88.01 | — | 27% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TD PRESERVE FREE 7 YRS AND OLDER | $121.18 | $166.00 | $53.91–$88.00 | 192% above | 27% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TD PRESERVE FREE 7 YRS AND OLDER | $121.18 | $166.00 | $53.91–$88.00 | — | 27% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE > 7 YRS IM | $56.21 | $77.00 | $55.00–$88.00 | 31% below | 27% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE > 7 YRS IM | $56.21 | $77.00 | $55.00–$88.00 | — | 27% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN 1 SNGL/COMB VAC/TOXOID | $33.58 | $46.00 | $36.01–$88.00 | 13% below | 27% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN 1 SNGL/COMB VAC/TOXOID | $33.58 | $46.00 | $36.01–$88.00 | 13% below | 27% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN 1 SNGL/COMB VAC/TOXOID | $58.40 | $80.00 | $36.01–$88.00 | 51% above | 27% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN 1 SNGL/COMB VAC/TOXOID | $58.40 | $80.00 | $36.01–$88.00 | — | 27% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ ADMIN EA ADDL SNGL/COMB VAC | $25.55 | $35.00 | $25.52–$88.00 | 21% below | 27% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ ADMIN EA ADDL SNGL/COMB VAC | $25.55 | $35.00 | $25.52–$88.00 | 21% below | 27% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ ADMIN EA ADDL SNGL/COMB VAC | $38.69 | $53.00 | $25.52–$88.00 | 19% above | 27% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ ADMIN EA ADDL SNGL/COMB VAC | $38.69 | $53.00 | $25.52–$88.00 | — | 27% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.edgertonhospital.com/media/3405/390819992_edgerton-hospital-and-health-services_standardcharges.csv