Hospital

Greene County Medical Center

Greene County Medical Center in Jefferson, IA publishes cash prices for 273 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Iowa median for 199 of 267 procedures and above it for 68. By typical cash price it ranks #15 of 78 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1000 W Lincoln Way, Jefferson, IA 50129 Collected Sep 27, 2026 Source price file (515) 386-2114

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161325 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Greene County Medical Center in Jefferson, IA:

Sep 10, 2025 Warning notice
Dec 8, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE MIN 3 VIEWS	$160.72	$287.00	$149.00–$278.00	29% below	44%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE MIN 3 VIEWS	$160.72	$287.00	$177.00–$287.00	—	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS	$238.56	$426.00	$221.00–$413.00	26% below	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS	$238.56	$426.00	$264.00–$426.00	—	44%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM SGL CONTRAST STUDY	$408.80	$730.00	$379.00–$708.00	12% above	44%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM SGL CONTRAST STUDY	$408.80	$730.00	$452.00–$730.00	—	44%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE IMAGING WHOLE BODY	$584.08	$1,043.00	$542.00–$1,011.00	52% below	44%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE IMAGING WHOLE BODY	$584.08	$1,043.00	$646.00–$1,043.00	—	44%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST COMPLETE	$304.08	$543.00	$282.00–$526.00	17% below	44%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST COMPLETE	$304.08	$543.00	$336.00–$543.00	—	44%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST LIMITED	$282.24	$504.00	$262.00–$488.00	23% below	44%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST LIMITED	$282.24	$504.00	$312.00–$504.00	—	44%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST W WO CONTRAST	$2,139.20	$3,820.00	$1,986.00–$3,705.00	1% above	44%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST W WO CONTRAST	$2,139.20	$3,820.00	$2,368.00–$3,820.00	—	44%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART WO CONTRAST W CALCIUM SCORE	$49.84	$89.00	$46.00–$86.00	43% below	44%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART WO CONTRAST W CALCIUM SCORE	$49.84	$89.00	$55.00–$89.00	—	44%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$1,794.80	$3,205.00	$1,666.00–$3,108.00	36% below	44%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$1,794.80	$3,205.00	$1,987.00–$3,205.00	—	44%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$2,472.96	$4,416.00	$2,296.00–$4,283.00	23% below	44%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$2,472.96	$4,416.00	$2,737.00–$4,416.00	—	44%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELVIS W WO CONTR 1+ REG/SEC	$2,559.20	$4,570.00	$2,376.00–$4,432.00	29% below	44%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELVIS W WO CONTR 1+ REG/SEC	$2,559.20	$4,570.00	$2,833.00–$4,570.00	—	44%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,237.04	$2,209.00	$1,148.00–$2,142.00	27% below	44%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$1,237.04	$2,209.00	$1,369.00–$2,209.00	—	44%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$897.12	$1,602.00	$833.00–$1,553.00	34% below	44%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$897.12	$1,602.00	$993.00–$1,602.00	—	44%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$897.12	$1,602.00	$833.00–$1,553.00	31% below	44%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$897.12	$1,602.00	$993.00–$1,602.00	—	44%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN WO CONTRAST	$897.12	$1,602.00	$833.00–$1,553.00	34% below	44%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN WO CONTRAST	$897.12	$1,602.00	$993.00–$1,602.00	—	44%
CT scan of the head with contrast CPT 70460 HC CT HEAD OR BRAIN W CONTRAST	$1,237.04	$2,209.00	$1,148.00–$2,142.00	19% below	44%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD OR BRAIN W CONTRAST	$1,237.04	$2,209.00	$1,369.00–$2,209.00	—	44%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD OR BRAIN W WO CONTRAST	$1,280.16	$2,286.00	$1,188.00–$2,217.00	29% below	44%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD OR BRAIN W WO CONTRAST	$1,280.16	$2,286.00	$1,417.00–$2,286.00	—	44%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$897.12	$1,602.00	$833.00–$1,553.00	41% below	44%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$897.12	$1,602.00	$993.00–$1,602.00	—	44%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE WO CONTRAST	$897.12	$1,602.00	$833.00–$1,553.00	40% below	44%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE WO CONTRAST	$897.12	$1,602.00	$993.00–$1,602.00	—	44%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,237.04	$2,209.00	$1,148.00–$2,142.00	29% below	44%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$1,237.04	$2,209.00	$1,369.00–$2,209.00	—	44%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX SCAN; BILAT	$760.48	$1,358.00	$706.00–$1,317.00	—	44%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC CAROTID DUPLEX SCAN; BILAT	$760.48	$1,358.00	$841.00–$1,358.00	—	44%
Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS	$218.40	$390.00	$202.00–$378.00	6% above	44%
Chest X-ray, 2 views inpatient CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS	$218.40	$390.00	$241.00–$390.00	—	44%
Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW	$181.44	$324.00	$168.00–$314.00	8% above	44%
Chest X-ray, single view inpatient CPT 71045 HC X-RAY EXAM CHEST 1 VIEW	$181.44	$324.00	$200.00–$324.00	—	44%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US EXAM RETROPERITONEAL COMPL	$507.36	$906.00	$471.00–$878.00	17% below	44%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US EXAM RETROPERITONEAL COMPL	$507.36	$906.00	$561.00–$906.00	—	44%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL	$352.24	$629.00	$327.00–$610.00	10% below	44%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL	$352.24	$629.00	$389.00–$629.00	—	44%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST WO CONTRAST DIAG	$897.12	$1,602.00	$833.00–$1,553.00	36% below	44%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST WO CONTRAST DIAG	$897.12	$1,602.00	$993.00–$1,602.00	—	44%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W CONTRAST DIAG	$1,237.04	$2,209.00	$1,148.00–$2,142.00	32% below	44%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W CONTRAST DIAG	$1,237.04	$2,209.00	$1,369.00–$2,209.00	—	44%
Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BILAT	$378.00	$675.00	$351.00–$654.00	—	44%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BILAT	$378.00	$675.00	$418.00–$675.00	—	44%
Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNIL	$298.48	$533.00	$277.00–$517.00	2% above	44%
Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNIL	$298.48	$533.00	$330.00–$533.00	—	44%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LE ART/BPG; BILAT	$379.68	$678.00	$352.00–$657.00	—	44%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LE ART/BPG; BILAT	$379.68	$678.00	$420.00–$678.00	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXT VEINS; BILAT	$651.28	$1,163.00	$604.00–$1,128.00	—	44%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXT VEINS; BILAT	$651.28	$1,163.00	$721.00–$1,163.00	—	44%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/ DOPPLER COMPLETE	$1,306.48	$2,333.00	$1,213.00–$2,263.00	14% below	44%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/ DOPPLER COMPLETE	$1,306.48	$2,333.00	$1,446.00–$2,333.00	—	44%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING	$638.40	$1,140.00	$592.00–$1,105.00	46% below	44%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING	$638.40	$1,140.00	$706.00–$1,140.00	—	44%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATT & RESP EFFT	$336.56	$601.00	$312.00–$582.00	40% below	44%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATT & RESP EFFT	$336.56	$601.00	$372.00–$601.00	—	44%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC PSS W 4/> PARAM W CPAP/BIPAP 6+ YRS	$2,107.28	$3,763.00	$1,956.00–$3,650.00	33% below	44%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC PSS W 4/> PARAM W CPAP/BIPAP 6+ YRS	$2,107.28	$3,763.00	$2,333.00–$3,763.00	—	44%
Knee X-ray, 3 views CPT 73562 HC KNEE 3 VIEWS	$190.40	$340.00	$176.00–$329.00	13% below	44%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VIEWS	$190.40	$340.00	$210.00–$340.00	—	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US EXAM ABDOMEN LIMITED	$463.12	$827.00	$430.00–$802.00	6% below	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US EXAM ABDOMEN LIMITED	$463.12	$827.00	$512.00–$827.00	—	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LUNG CANCER SCREEN	$288.40	$515.00	$267.00–$499.00	37% below	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LUNG CANCER SCREEN	$288.40	$515.00	$319.00–$515.00	—	44%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOW EXTR ANY JOINT WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	44% below	44%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOW EXTR ANY JOINT WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOW EXTR ANY JOINT W WO CONTR	$1,472.24	$2,629.00	$1,367.00–$2,550.00	54% below	44%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOW EXTR ANY JOINT W WO CONTR	$1,472.24	$2,629.00	$1,629.00–$2,629.00	—	44%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	38% below	44%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W WO CONTRAST	$1,472.24	$2,629.00	$1,367.00–$2,550.00	57% below	44%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W WO CONTRAST	$1,472.24	$2,629.00	$1,629.00–$2,629.00	—	44%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	44% below	44%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W WO CONTRAST	$1,472.24	$2,629.00	$1,367.00–$2,550.00	59% below	44%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W WO CONTRAST	$1,472.24	$2,629.00	$1,629.00–$2,629.00	—	44%
MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	46% below	44%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR W WO CONTRAST	$1,472.24	$2,629.00	$1,367.00–$2,550.00	58% below	44%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR W WO CONTRAST	$1,472.24	$2,629.00	$1,629.00–$2,629.00	—	44%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	45% below	44%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL W WO CONTRAST	$1,472.24	$2,629.00	$1,367.00–$2,550.00	57% below	44%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL W WO CONTRAST	$1,472.24	$2,629.00	$1,629.00–$2,629.00	—	44%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	43% below	44%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W WO CONTRAST	$1,472.24	$2,629.00	$1,367.00–$2,550.00	55% below	44%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W WO CONTRAST	$1,472.24	$2,629.00	$1,629.00–$2,629.00	—	44%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	37% below	44%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UP EXTR ANY JOINT WO CONTRAST	$1,292.48	$2,308.00	$1,200.00–$2,238.00	43% below	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UP EXTR ANY JOINT WO CONTRAST	$1,292.48	$2,308.00	$1,430.00–$2,308.00	—	44%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM HEART MUSCLE SPECT MULT	$947.52	$1,692.00	$879.00–$1,641.00	66% below	44%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM HEART MUSCLE SPECT MULT	$947.52	$1,692.00	$1,049.00–$1,692.00	—	44%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET IMAGE W CT SKULL THIGH	$2,467.92	$4,407.00	$2,291.00–$4,274.00	42% below	44%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET IMAGE W CT SKULL THIGH	$2,467.92	$4,407.00	$2,732.00–$4,407.00	—	44%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LTD TRANSABDOMINAL	$432.32	$772.00	$401.00–$748.00	22% above	44%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LTD TRANSABDOMINAL	$432.32	$772.00	$478.00–$772.00	—	44%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US EXAM PELVIC COMP TRANSABDOMINAL	$507.92	$907.00	$471.00–$879.00	6% below	44%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US EXAM PELVIC COMP TRANSABDOMINAL	$507.92	$907.00	$562.00–$907.00	—	44%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB COMPLETE SNGL FETUS	$507.92	$907.00	$471.00–$879.00	8% below	44%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB COMPLETE SNGL FETUS	$507.92	$907.00	$562.00–$907.00	—	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB LESS THAN 14 WKS SNGL FETUS	$432.32	$772.00	$401.00–$748.00	6% below	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB LESS THAN 14 WKS SNGL FETUS	$432.32	$772.00	$478.00–$772.00	—	44%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S)	$432.32	$772.00	$401.00–$748.00	27% above	44%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S)	$432.32	$772.00	$478.00–$772.00	—	44%
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO INCL CAD BILAT	$313.04	$559.00	$290.00–$542.00	—	44%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO INCL CAD BILAT	$313.04	$559.00	$346.00–$559.00	—	44%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER MIN 2 VIEWS	$137.20	$245.00	$127.00–$237.00	42% below	44%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER MIN 2 VIEWS	$137.20	$245.00	$151.00–$245.00	—	44%
Sleep study in a lab (polysomnography) CPT 95810 HC PSS W 4/> PARAM W TECH 6+ YRS	$1,887.76	$3,371.00	$1,752.00–$3,269.00	34% below	44%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC PSS W 4/> PARAM W TECH 6+ YRS	$1,887.76	$3,371.00	$2,090.00–$3,371.00	—	44%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING FUNCTION W CINE VIDEO	$476.56	$851.00	$442.00–$825.00	17% above	44%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOWING FUNCTION W CINE VIDEO	$476.56	$851.00	$527.00–$851.00	—	44%
Transvaginal pelvic ultrasound CPT 76830 HC US NON OB TRANSVAG	$568.40	$1,015.00	$527.00–$984.00	9% above	44%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US NON OB TRANSVAG	$568.40	$1,015.00	$629.00–$1,015.00	—	44%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL	$568.40	$1,015.00	$527.00–$984.00	25% above	44%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL	$568.40	$1,015.00	$629.00–$1,015.00	—	44%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$507.92	$907.00	$471.00–$879.00	27% below	44%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$507.92	$907.00	$562.00–$907.00	—	44%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM AND CONTENTS	$465.92	$832.00	$432.00–$807.00	14% below	44%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM AND CONTENTS	$465.92	$832.00	$515.00–$832.00	—	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$465.92	$832.00	$432.00–$807.00	at median	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$465.92	$832.00	$515.00–$832.00	—	44%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UGI W OR WO KUB	$431.76	$771.00	$400.00–$747.00	1% above	44%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC UGI W OR WO KUB	$431.76	$771.00	$478.00–$771.00	—	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXT VEINS UNIL/LIMIT	$313.04	$559.00	$290.00–$542.00	52% below	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXT VEINS UNIL/LIMIT	$313.04	$559.00	$346.00–$559.00	—	44%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMPL MIN 3 VIEWS	$160.72	$287.00	$149.00–$278.00	29% below	44%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMPL MIN 3 VIEWS	$160.72	$287.00	$177.00–$287.00	—	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$188.72	$337.00	$175.00–$326.00	3% below	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$188.72	$337.00	$208.00–$337.00	—	44%
X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW	$164.64	$294.00	$152.00–$285.00	8% below	44%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW	$164.64	$294.00	$182.00–$294.00	—	44%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VIEWS	$173.04	$309.00	$160.00–$299.00	1% below	44%
X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VIEWS	$173.04	$309.00	$191.00–$309.00	—	44%
X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER OR FINGERS MIN 2 VIEWS	$104.16	$186.00	$96.00–$180.00	38% below	44%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER OR FINGERS MIN 2 VIEWS	$104.16	$186.00	$115.00–$186.00	—	44%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEWS	$134.40	$240.00	$124.00–$232.00	20% below	44%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEWS	$134.40	$240.00	$148.00–$240.00	—	44%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT MIN 3 VIEWS	$159.04	$284.00	$147.00–$275.00	28% below	44%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT MIN 3 VIEWS	$159.04	$284.00	$176.00–$284.00	—	44%
X-ray of the hand, 3 or more views CPT 73130 HC HAND MIN 3 VIEWS	$155.12	$277.00	$144.00–$268.00	25% below	44%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND MIN 3 VIEWS	$155.12	$277.00	$171.00–$277.00	—	44%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VIEWS	$181.44	$324.00	$168.00–$314.00	10% below	44%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VIEWS	$181.44	$324.00	$200.00–$324.00	—	44%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBOSACR SPINE 2 OR 3 VIEWS	$236.32	$422.00	$219.00–$409.00	17% below	44%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBOSACR SPINE 2 OR 3 VIEWS	$236.32	$422.00	$261.00–$422.00	—	44%
X-ray of the lower back, 4 or more views CPT 72110 HC LUMBOSACR SPINE MIN 4 VIEWS	$268.80	$480.00	$249.00–$465.00	24% below	44%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBOSACR SPINE MIN 4 VIEWS	$268.80	$480.00	$297.00–$480.00	—	44%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VIEWS	$188.72	$337.00	$175.00–$326.00	26% below	44%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VIEWS	$188.72	$337.00	$208.00–$337.00	—	44%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES MIN 3 VIEWS	$190.40	$340.00	$176.00–$329.00	7% below	44%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES MIN 3 VIEWS	$190.40	$340.00	$210.00–$340.00	—	44%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2 OR 3 VIEWS	$222.32	$397.00	$206.00–$385.00	12% below	44%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2 OR 3 VIEWS	$222.32	$397.00	$246.00–$397.00	—	44%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS 1 OR 2 VIEWS	$208.32	$372.00	$193.00–$360.00	5% above	44%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS 1 OR 2 VIEWS	$208.32	$372.00	$230.00–$372.00	—	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM COCCYX MIN 2 VIEWS	$188.72	$337.00	$175.00–$326.00	15% below	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM COCCYX MIN 2 VIEWS	$188.72	$337.00	$208.00–$337.00	—	44%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) /ALL	$33.60	$60.00	$31.00–$58.00	20% below	44%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO (ALT) (SGPT)	$33.60	$60.00	$31.00–$58.00	20% below	44%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 AST/ALT J	$33.60	$60.00	$31.00–$58.00	20% below	44%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO (ALT) (SGPT)	$33.60	$60.00	$37.00–$60.00	—	44%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) /ALL	$33.60	$60.00	$37.00–$60.00	—	44%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 AST/ALT J	$33.60	$60.00	$37.00–$60.00	—	44%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/ALT J	$33.60	$60.00	$31.00–$58.00	15% below	44%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) /ALL	$33.60	$60.00	$31.00–$58.00	15% below	44%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) /ALL	$33.60	$60.00	$37.00–$60.00	—	44%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/ALT J	$33.60	$60.00	$37.00–$60.00	—	44%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS BATTERY E/J/L/M/O/P/R/T/W/C1/S1/L1/PL/G1/M2	$215.04	$384.00	$199.00–$372.00	6% below	44%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS BATTERY E/J/L/M/O/P/R/T/W/C1/S1/L1/PL/G1/M2	$215.04	$384.00	$238.00–$384.00	—	44%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN ALLERGEN MGLT QC/Q/J/L/M/W/S1/Z/L1/PL/O/C1/P/E/G1/F/G/PMP/A/X/T/W1	$15.68	$28.00	$14.00–$27.00	60% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2	$16.80	$30.00	$15.00–$29.00	57% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED, IGE ALG MSESA QC/Q/E/L/M/O/W/PL/J/C1/P/G1/F/G/PMP/A/W1	$16.80	$30.00	$15.00–$29.00	57% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 Chick Pea, IgE /L/M/W/PL/M2	$16.80	$30.00	$15.00–$29.00	57% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2	$16.80	$30.00	$15.00–$29.00	57% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE E/J/L/M/O/W/C1/S1/L1/PL/P/G1	$17.92	$32.00	$16.00–$31.00	54% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN IGE MMILK QC/Q/C1/E/J/L/M/O/W/L1/X/W1/PL/P/G1/S1/F/G/PMP/A	$17.92	$32.00	$16.00–$31.00	54% below	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN ALLERGEN MGLT QC/Q/J/L/M/W/S1/Z/L1/PL/O/C1/P/E/G1/F/G/PMP/A/X/T/W1	$15.68	$28.00	$17.00–$28.00	—	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED, IGE ALG MSESA QC/Q/E/L/M/O/W/PL/J/C1/P/G1/F/G/PMP/A/W1	$16.80	$30.00	$18.00–$30.00	—	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chick Pea, IgE /L/M/W/PL/M2	$16.80	$30.00	$18.00–$30.00	—	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2	$16.80	$30.00	$18.00–$30.00	—	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2	$16.80	$30.00	$18.00–$30.00	—	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE E/J/L/M/O/W/C1/S1/L1/PL/P/G1	$17.92	$32.00	$19.00–$32.00	—	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK ALLERGEN IGE MMILK QC/Q/C1/E/J/L/M/O/W/L1/X/W1/PL/P/G1/S1/F/G/PMP/A	$17.92	$32.00	$19.00–$32.00	—	44%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IgG QC/Y/V/C1/E/J/L/M/N/O/P/R/T/W/S1/L1/C2/P1/R1/X/S/D/N/PL/G1/F1/M2	$44.24	$79.00	$41.00–$76.00	36% below	44%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODIES MAYO MCCP E/J/L/M/O/P/R/W/C1/S1/W1/PL	$75.60	$135.00	$70.00–$130.00	9% above	44%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IgG QC/Y/V/C1/E/J/L/M/N/O/P/R/T/W/S1/L1/C2/P1/R1/X/S/D/N/PL/G1/F1/M2	$44.24	$79.00	$48.00–$79.00	—	44%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODIES MAYO MCCP E/J/L/M/O/P/R/W/C1/S1/W1/PL	$75.60	$135.00	$83.00–$135.00	—	44%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA W REFLEX C1/E/J/L/M/O/P/R/W/S1/X/PL/G1/M2	$107.52	$192.00	$99.00–$186.00	48% above	44%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA 10 PANEL L/M/O/T/W/S1/R/P/J/E/L1/PL/G1/M2	$107.52	$192.00	$99.00–$186.00	48% above	44%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA C1/E/J/L/L1/M/O/P/R/W/S1/PL/G1/M2	$107.52	$192.00	$99.00–$186.00	48% above	44%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA W REFLEX C1/E/J/L/M/O/P/R/W/S1/X/PL/G1/M2	$107.52	$192.00	$119.00–$192.00	—	44%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA C1/E/J/L/L1/M/O/P/R/W/S1/PL/G1/M2	$107.52	$192.00	$119.00–$192.00	—	44%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA 10 PANEL L/M/O/T/W/S1/R/P/J/E/L1/PL/G1/M2	$107.52	$192.00	$119.00–$192.00	—	44%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP E/J/M/N/O/P/Q/QC/D/S/X/Y/Z/C1/C2/L1/P1/PL/G1/M2/B1	$268.80	$480.00	$249.00–$465.00	71% above	44%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO-BNP E/J/M/N/O/P/Q/QC/D/S/X/Y/Z/C1/C2/L1/P1/PL/G1/M2/B1	$268.80	$480.00	$297.00–$480.00	—	44%
Basic metabolic panel (blood test) CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL	$60.48	$108.00	$56.00–$104.00	27% below	44%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE /ALL	$61.04	$109.00	$56.00–$105.00	26% below	44%
Basic metabolic panel (blood test) CPT 80048 BASIC FASTING PNL /ALL	$61.04	$109.00	$56.00–$105.00	26% below	44%
Basic metabolic panel (blood test) inpatient CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL	$60.48	$108.00	$66.00–$108.00	—	44%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE /ALL	$61.04	$109.00	$67.00–$109.00	—	44%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC FASTING PNL /ALL	$61.04	$109.00	$67.00–$109.00	—	44%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH 88305 /R1	$255.92	$457.00	$237.00–$443.00	44% above	44%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH 88305 /R1	$255.92	$457.00	$283.00–$457.00	—	44%
Blood culture for bacteria CPT 87040 CULT BLOOD ROUTINE M/L/P/R/W/E/O/J/S1/L1/PL/G1	$61.04	$109.00	$56.00–$105.00	30% below	44%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD ROUTINE M/L/P/R/W/E/O/J/S1/L1/PL/G1	$61.04	$109.00	$67.00–$109.00	—	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 GCJ VENIPUNCTURE CHARGE	$14.00	$25.00	$13.00–$24.00	29% below	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PATERNITY TEST BILL ONLY J/O	$51.52	$92.00	$47.00–$89.00	160% above	44%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 GCJ VENIPUNCTURE CHARGE	$14.00	$25.00	$15.00–$25.00	—	44%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PATERNITY TEST BILL ONLY J/O	$51.52	$92.00	$57.00–$92.00	—	44%
Blood glucose (sugar) test CPT 82947 ASSAY QUANTITATIVE,BLOOD GLUCOSE	$28.00	$50.00	$26.00–$48.00	17% below	44%
Blood glucose (sugar) test CPT 82947 GLUCOSE FLUID QC/V/Z/Y/A/D/E/F/G/H/J/L/M/N/Q/R/S/T/X//C1/S1/O/L1/C2/P1/W1/R1/PL/P/G1/F1/M2	$33.60	$60.00	$31.00–$58.00	at median	44%
Blood glucose (sugar) test CPT 82947 GLUCOSE /ALL	$33.60	$60.00	$31.00–$58.00	at median	44%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING /ALL	$33.60	$60.00	$31.00–$58.00	at median	44%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY QUANTITATIVE,BLOOD GLUCOSE	$28.00	$50.00	$31.00–$50.00	—	44%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE /ALL	$33.60	$60.00	$37.00–$60.00	—	44%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING /ALL	$33.60	$60.00	$37.00–$60.00	—	44%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FLUID QC/V/Z/Y/A/D/E/F/G/H/J/L/M/N/Q/R/S/T/X//C1/S1/O/L1/C2/P1/W1/R1/PL/P/G1/F1/M2	$33.60	$60.00	$37.00–$60.00	—	44%
Blood lead test CPT 83655 LEAD	$45.92	$82.00	$42.00–$79.00	13% below	44%
Blood lead test CPT 83655 LEAD L/M/R/W/X/C1/S1/L1/PL/G1/M2	$45.92	$82.00	$42.00–$79.00	13% below	44%
Blood lead test CPT 83655 LEAD VENOUS W/DEMO MPBDV C/C1/J/L/L1/M/O/P/Q/QC/R/S1/T/W/X/Z/PL/E/G1/F1/C2/P1/V/Y/M2/D/S/SA/N	$52.08	$93.00	$48.00–$90.00	1% below	44%
Blood lead test inpatient CPT 83655 LEAD	$45.92	$82.00	$50.00–$82.00	—	44%
Blood lead test inpatient CPT 83655 LEAD L/M/R/W/X/C1/S1/L1/PL/G1/M2	$45.92	$82.00	$50.00–$82.00	—	44%
Blood lead test inpatient CPT 83655 LEAD VENOUS W/DEMO MPBDV C/C1/J/L/L1/M/O/P/Q/QC/R/S1/T/W/X/Z/PL/E/G1/F1/C2/P1/V/Y/M2/D/S/SA/N	$52.08	$93.00	$57.00–$93.00	—	44%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SCREEN ??? /ALL EXCEPT/B/H/J/V/L1/P1	$47.04	$84.00	$43.00–$81.00	24% below	44%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SCREEN ??? /ALL EXCEPT/B/H/J/V/L1/P1	$47.04	$84.00	$52.00–$84.00	—	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 RHIG WORKUP J/M1	$20.16	$36.00	$18.00–$34.00	65% below	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN Z/D/E/E/L/M/N/Q/S/T/W/X/C1/Q/L1/A/W1/R1/PL/G1/F1/M2	$20.16	$36.00	$18.00–$34.00	65% below	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN F/G/H/P/R/T/U/O/B/K/S1/B1/V1	$20.16	$36.00	$18.00–$34.00	65% below	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH (D) V/Z/Y/A/D/E/F/G/H/J/L/M/N/O/P/T/QC/S1/L1/C2/P1/R1/W1/PL/G1/V1/F1/M2	$28.56	$51.00	$26.00–$49.00	50% below	44%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 RHIG WORKUP J/M1	$20.16	$36.00	$22.00–$36.00	—	44%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE AND SCREEN F/G/H/P/R/T/U/O/B/K/S1/B1/V1	$20.16	$36.00	$22.00–$36.00	—	44%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE AND SCREEN Z/D/E/E/L/M/N/Q/S/T/W/X/C1/Q/L1/A/W1/R1/PL/G1/F1/M2	$20.16	$36.00	$22.00–$36.00	—	44%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/RH (D) V/Z/Y/A/D/E/F/G/H/J/L/M/N/O/P/T/QC/S1/L1/C2/P1/R1/W1/PL/G1/V1/F1/M2	$28.56	$51.00	$31.00–$51.00	—	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN V/Y/A/B/E/F/G/H/I/J/L/M/O/P/Q/R/T/W/S1/B1/L1/N/P1/W1/PL/G1/V1/M1/F1/M2/R1	$45.92	$82.00	$42.00–$79.00	20% below	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN V/Y/A/B/E/F/G/H/I/J/L/M/O/P/Q/R/T/W/S1/B1/L1/N/P1/W1/PL/G1/V1/M1/F1/M2/R1	$45.92	$82.00	$50.00–$82.00	—	44%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE MOLECULAR E/J/K/L/M/O/P/QC/R/T/V/W/Y/Z/C1/S1/C2/L1/P1/PL/G1/M2	$76.72	$137.00	$71.00–$132.00	29% below	44%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE MOLECULAR E/J/K/L/M/O/P/QC/R/T/V/W/Y/Z/C1/S1/C2/L1/P1/PL/G1/M2	$76.72	$137.00	$84.00–$137.00	—	44%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9 QC/V/Y/D/S/E/J/L/M/N/O/P/R/W/C1/S1/L1/C2/P1/A/X/PL/G1/W1/F1/M2	$89.60	$160.00	$83.00–$155.00	7% below	44%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9 QC/V/Y/D/S/E/J/L/M/N/O/P/R/W/C1/S1/L1/C2/P1/A/X/PL/G1/W1/F1/M2	$89.60	$160.00	$99.00–$160.00	—	44%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 D/L/M/N/O/P/R/S/X/W/E/J/C1/S1/L1/R1/PL/G1/F1	$122.64	$219.00	$113.00–$212.00	7% above	44%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 D/L/M/N/O/P/R/S/X/W/E/J/C1/S1/L1/R1/PL/G1/F1	$122.64	$219.00	$135.00–$219.00	—	44%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV 2 MOLECULAR Z/W/L/M/PL/G1/J/T/R/S1/O/C1/P/L1/E/S/SA/D/N/QC/Q/V/Y/P1/W1/A/G/F/H/V1/F1/K/B1/M2/B	$67.20	$120.00	$62.00–$116.00	41% below	44%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ	$91.84	$164.00	$85.00–$159.00	20% below	44%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV 2 MOLECULAR Z/W/L/M/PL/G1/J/T/R/S1/O/C1/P/L1/E/S/SA/D/N/QC/Q/V/Y/P1/W1/A/G/F/H/V1/F1/K/B1/M2/B	$67.20	$120.00	$74.00–$120.00	—	44%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ	$91.84	$164.00	$101.00–$164.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA BY NAA OTHER E/L/M/W/S1/J/L1/PL/O/C1/P/G1/M2	$40.88	$73.00	$37.00–$70.00	59% below	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1	$56.00	$100.00	$52.00–$97.00	44% below	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY NAA OTHER L/W/M/J/S1/L1/PL/O/C1/P/E/G1/M2	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY NAA E/J/L/M/S1/L1/PL/O/C1/P/G1/M2/X	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT/NG PCR, VAGINAL	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT/NG PCR, URINE	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GONORRHEA/CHLAMYDIA URINE E/J/L/M/O/P/T/W/S1/L1/PL/C1/G1/M2	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA URINE L/M/O/P/W/J/S1/L1/PL/G1/M2	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA BY NAA E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2	$123.76	$221.00	$114.00–$214.00	24% above	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA BY NAA OTHER E/L/M/W/S1/J/L1/PL/O/C1/P/G1/M2	$40.88	$73.00	$45.00–$73.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1	$56.00	$100.00	$62.00–$100.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY NAA OTHER L/W/M/J/S1/L1/PL/O/C1/P/E/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GONORRHEA/CHLAMYDIA URINE E/J/L/M/O/P/T/W/S1/L1/PL/C1/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY NAA E/J/L/M/S1/L1/PL/O/C1/P/G1/M2/X	$123.76	$221.00	$137.00–$221.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT/NG PCR, VAGINAL	$123.76	$221.00	$137.00–$221.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT/NG PCR, URINE	$123.76	$221.00	$137.00–$221.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA URINE L/M/O/P/W/J/S1/L1/PL/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA BY NAA E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE J/T/R	$83.44	$149.00	$77.00–$144.00	2% below	44%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE J/T/R	$83.44	$149.00	$92.00–$149.00	—	44%
Complete blood count (CBC) with differential CPT 85025 CHG COMPLETE CBC & AUTO DIFF WBC	$61.04	$109.00	$56.00–$105.00	1% below	44%
Complete blood count (CBC) with differential CPT 85025 AUTOMATED CBC BILL	$62.16	$111.00	$57.00–$107.00	1% above	44%
Complete blood count (CBC) with differential inpatient CPT 85025 CHG COMPLETE CBC & AUTO DIFF WBC	$61.04	$109.00	$67.00–$109.00	—	44%
Complete blood count (CBC) with differential inpatient CPT 85025 AUTOMATED CBC BILL	$62.16	$111.00	$68.00–$111.00	—	44%
Complete blood count (CBC), no differential CPT 85027 CBC (HEMOGRAM) Z/P1/B1/C1/C2/H/L1/M1/QC/S1/X/W1/A/E/R1/J/N/O/P/Q/R/U/T/PL/G1/V1/F1/M2	$53.76	$96.00	$49.00–$93.00	20% above	44%
Complete blood count (CBC), no differential CPT 85027 MANUAL DIFFERENTIAL BILL	$53.76	$96.00	$49.00–$93.00	20% above	44%
Complete blood count (CBC), no differential CPT 85027 CHG COMPLETE CBC	$61.04	$109.00	$56.00–$105.00	36% above	44%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC (HEMOGRAM) Z/P1/B1/C1/C2/H/L1/M1/QC/S1/X/W1/A/E/R1/J/N/O/P/Q/R/U/T/PL/G1/V1/F1/M2	$53.76	$96.00	$59.00–$96.00	—	44%
Complete blood count (CBC), no differential inpatient CPT 85027 MANUAL DIFFERENTIAL BILL	$53.76	$96.00	$59.00–$96.00	—	44%
Complete blood count (CBC), no differential inpatient CPT 85027 CHG COMPLETE CBC	$61.04	$109.00	$67.00–$109.00	—	44%
Comprehensive metabolic panel (blood test) CPT 80053 CHG METABOLIC PANEL,COMPREHENSIVE	$76.16	$136.00	$70.00–$131.00	36% below	44%
Comprehensive metabolic panel (blood test) CPT 80053 COMP FASTING PNL /ALL	$76.72	$137.00	$71.00–$132.00	35% below	44%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL /ALL	$76.72	$137.00	$71.00–$132.00	35% below	44%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHG METABOLIC PANEL,COMPREHENSIVE	$76.16	$136.00	$84.00–$136.00	—	44%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP FASTING PNL /ALL	$76.72	$137.00	$84.00–$137.00	—	44%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL /ALL	$76.72	$137.00	$84.00–$137.00	—	44%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER SENS QUANT SA/T/X/U/S1/N/B1/C2/L1/E/G/O	$50.96	$91.00	$47.00–$88.00	40% below	44%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER SENS QUANT SA/T/X/U/S1/N/B1/C2/L1/E/G/O	$50.96	$91.00	$56.00–$91.00	—	44%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE QC/V/Y/D/E/I/J/L/M/N/O/P/R/S/W/X/C1/S1/T/L1/C2/P1/PL/G1/F1/M2	$129.36	$231.00	$120.00–$224.00	16% above	44%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE QC/V/Y/D/E/I/J/L/M/N/O/P/R/S/W/X/C1/S1/T/L1/C2/P1/PL/G1/F1/M2	$129.36	$231.00	$143.00–$231.00	—	44%
Estradiol blood test CPT 82670 ESTRADIOL QC/V/Z/T/A/B/D/E/F/G/J/L/M/N/O/P/R/S/W/Z/C1/S1/L1/P1/W1/R1/PL/G1/F1/M2	$99.12	$177.00	$92.00–$171.00	24% below	44%
Estradiol blood test CPT 82670 PEDS ESTRADIOL ESOTERIX /H/L/M/W/O/S1/J/L1/C1/PL/P/E/G1/M2	$351.12	$627.00	$326.00–$608.00	170% above	44%
Estradiol blood test inpatient CPT 82670 ESTRADIOL QC/V/Z/T/A/B/D/E/F/G/J/L/M/N/O/P/R/S/W/Z/C1/S1/L1/P1/W1/R1/PL/G1/F1/M2	$99.12	$177.00	$109.00–$177.00	—	44%
Estradiol blood test inpatient CPT 82670 PEDS ESTRADIOL ESOTERIX /H/L/M/W/O/S1/J/L1/C1/PL/P/E/G1/M2	$351.12	$627.00	$388.00–$627.00	—	44%
FSH (follicle-stimulating hormone) test CPT 83001 FSH QC/V/Z/Y/A/D/E/F/G/I/J/LM/N/O/P/Q/R/S/W/X/S1/C1/L1/P1/W1/R1/PL/G1/V1/F1/M2	$65.52	$117.00	$60.00–$113.00	35% below	44%
FSH (follicle-stimulating hormone) test CPT 83001 PEDS FSH ESOTERIX /M/H/O/J/L1/P/C1/PL/E/G1/M2	$68.88	$123.00	$63.00–$119.00	32% below	44%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH QC/V/Z/Y/A/D/E/F/G/I/J/LM/N/O/P/Q/R/S/W/X/S1/C1/L1/P1/W1/R1/PL/G1/V1/F1/M2	$65.52	$117.00	$72.00–$117.00	—	44%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 PEDS FSH ESOTERIX /M/H/O/J/L1/P/C1/PL/E/G1/M2	$68.88	$123.00	$76.00–$123.00	—	44%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, F MCALPR Q/Z/X/W1/A/S/D/N/L/M/W/PL/F1/C2/P1/V/Y/M2	$180.32	$322.00	$167.00–$312.00	12% above	44%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, F MCALPR Q/Z/X/W1/A/S/D/N/L/M/W/PL/F1/C2/P1/V/Y/M2	$180.32	$322.00	$199.00–$322.00	—	44%
Ferritin blood test (iron stores) CPT 82728 FERRITIN /ALL	$75.04	$134.00	$69.00–$129.00	15% below	44%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$78.96	$141.00	$73.00–$136.00	11% below	44%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN /ALL	$75.04	$134.00	$83.00–$134.00	—	44%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$78.96	$141.00	$87.00–$141.00	—	44%
Folate (folic acid) blood test CPT 82746 FOLATE /ALL EXCEPT/H/T/U/	$57.68	$103.00	$53.00–$99.00	35% below	44%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE /ALL EXCEPT/H/T/U/	$57.68	$103.00	$63.00–$103.00	—	44%
Free T3 thyroid hormone test CPT 84481 FREE T3 QC/V/Z/Y/A/D/E/F/G/J/L/M/N/O/P/Q/R/S/W/1/S1/L1/P1/W1/R1/PL/G1/F1/M2	$60.48	$108.00	$56.00–$104.00	43% below	44%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 QC/V/Z/Y/A/D/E/F/G/J/L/M/N/O/P/Q/R/S/W/1/S1/L1/P1/W1/R1/PL/G1/F1/M2	$60.48	$108.00	$66.00–$108.00	—	44%
Free T4 (free thyroxine) thyroid blood test CPT 84439 TSH/FREE T4 J	$47.04	$84.00	$43.00–$81.00	27% below	44%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE QC/A/B/D/F/G/I/J/K/L/M/P/Q/R/S/T/W/X/S1/B1/L1/W1/PL/G1/V1/M2	$47.04	$84.00	$43.00–$81.00	27% below	44%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$47.04	$84.00	$43.00–$81.00	27% below	44%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 TSH/FREE T4 J	$47.04	$84.00	$52.00–$84.00	—	44%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE QC/A/B/D/F/G/I/J/K/L/M/P/Q/R/S/T/W/X/S1/B1/L1/W1/PL/G1/V1/M2	$47.04	$84.00	$52.00–$84.00	—	44%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$47.04	$84.00	$52.00–$84.00	—	44%
Free testosterone test CPT 84402 TESTOSTERONE MTTFB Q/QC/L/M/W/E/P/S1/T/C1/L1/PL/G1/T/B/F/M2/F1/F/G/PMP/A/X/D/S/SA/N/W1	$17.36	$31.00	$16.00–$30.00	84% below	44%
Free testosterone test CPT 84402 TESTOSTERONE FR,MALE C1/E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2	$89.60	$160.00	$83.00–$155.00	15% below	44%
Free testosterone test CPT 84402 TESTOS TL/FREE AND SHBG QC/Q/V/Y/P1	$89.60	$160.00	$83.00–$155.00	15% below	44%
Free testosterone test CPT 84402 TEST FR,FEMALE/CHILD C1/E/J/L/M/O/P/R/T/W/S1/L1/PL/G1/M2	$157.36	$281.00	$146.00–$272.00	49% above	44%
Free testosterone test inpatient CPT 84402 TESTOSTERONE MTTFB Q/QC/L/M/W/E/P/S1/T/C1/L1/PL/G1/T/B/F/M2/F1/F/G/PMP/A/X/D/S/SA/N/W1	$17.36	$31.00	$19.00–$31.00	—	44%
Free testosterone test inpatient CPT 84402 TESTOS TL/FREE AND SHBG QC/Q/V/Y/P1	$89.60	$160.00	$99.00–$160.00	—	44%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FR,MALE C1/E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2	$89.60	$160.00	$99.00–$160.00	—	44%
Free testosterone test inpatient CPT 84402 TEST FR,FEMALE/CHILD C1/E/J/L/M/O/P/R/T/W/S1/L1/PL/G1/M2	$157.36	$281.00	$174.00–$281.00	—	44%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLU CHALLENGE 50 GM QC/V/Z/A/B/D/E/F/G/H/I/L/M/N/Q/R/S/T/R/W/S1/M1/C2/P1/W1/Y/R1/PL/P/G1/V1/F1/M2	$53.20	$95.00	$49.00–$92.00	48% above	44%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLU CHALLENGE 50 GM QC/V/Z/A/B/D/E/F/G/H/I/L/M/N/Q/R/S/T/R/W/S1/M1/C2/P1/W1/Y/R1/PL/P/G1/V1/F1/M2	$53.20	$95.00	$58.00–$95.00	—	44%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2 HR H/I/J/K/N/T/U/C1/B1/W1/M2	$78.96	$141.00	$73.00–$136.00	6% below	44%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HR H/I/K/O/Q/R/J/C1/B1/F1	$91.28	$163.00	$84.00–$158.00	8% above	44%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2 HR H/I/J/K/N/T/U/C1/B1/W1/M2	$78.96	$141.00	$87.00–$141.00	—	44%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HR H/I/K/O/Q/R/J/C1/B1/F1	$91.28	$163.00	$101.00–$163.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA BY NAA OTHER E/L/M/W/S1/J/L1/PL/O/C1/P/G1/M2	$40.88	$73.00	$37.00–$70.00	55% below	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1	$56.00	$100.00	$52.00–$97.00	38% below	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA URINE L/M/P/E/J/O/W/S1/L1/PL/C1/G1/M2	$123.76	$221.00	$114.00–$214.00	36% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CT/NG PCR, VAGINAL	$123.76	$221.00	$114.00–$214.00	36% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY NAA E/L/M/W/J/S1/L1/PL/O/C1/P/G1/M2	$123.76	$221.00	$114.00–$214.00	36% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA BY NAA E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2	$123.76	$221.00	$114.00–$214.00	36% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CT/NG PCR, URINE	$123.76	$221.00	$114.00–$214.00	36% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA/CHLAMYDIA URINE E/J/L/M/O/P/T/W/S1/L1/PL/C1/G1/M2	$123.76	$221.00	$114.00–$214.00	36% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMYDIA BY NAA OTHER E/L/M/W/S1/J/L1/PL/O/C1/P/G1/M2	$40.88	$73.00	$45.00–$73.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1	$56.00	$100.00	$62.00–$100.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CT/NG PCR, VAGINAL	$123.76	$221.00	$137.00–$221.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY NAA E/L/M/W/J/S1/L1/PL/O/C1/P/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMYDIA BY NAA E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA URINE L/M/P/E/J/O/W/S1/L1/PL/C1/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA/CHLAMYDIA URINE E/J/L/M/O/P/T/W/S1/L1/PL/C1/G1/M2	$123.76	$221.00	$137.00–$221.00	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CT/NG PCR, URINE	$123.76	$221.00	$137.00–$221.00	—	44%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN W1/A/E/F/G/J/L/M/N/O/P/QC/R/T/V/Y/Z/C1/S1/L1/P1/X/PL/G1/M2	$193.76	$346.00	$179.00–$335.00	73% above	44%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN W1/A/E/F/G/J/L/M/N/O/P/QC/R/T/V/Y/Z/C1/S1/L1/P1/X/PL/G1/M2	$193.76	$346.00	$214.00–$346.00	—	44%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 ULTRASENSITIVE VIRAL LOAD L/M/W/E/J/C1/L1/S/D/N/PL/O//G1/F1/M2	$299.60	$535.00	$278.00–$518.00	11% above	44%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 ULTRASENSITIVE VIRAL LOAD L/M/W/E/J/C1/L1/S/D/N/PL/O//G1/F1/M2	$299.60	$535.00	$331.00–$535.00	—	44%
HIV-1 and HIV-2 antibody test CPT 86703 HIV AB /J/L/M/O/P/R/W	$56.00	$100.00	$52.00–$97.00	15% above	44%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV AB /J/L/M/O/P/R/W	$56.00	$100.00	$62.00–$100.00	—	44%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN V/Q/Z/QC/E/J/L/M/N/O/P/R/W/C1/D/S/L1/S1/PL/Y/P1/F1/M2	$33.04	$59.00	$30.00–$57.00	56% below	44%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN V/Q/Z/QC/E/J/L/M/N/O/P/R/W/C1/D/S/L1/S1/PL/Y/P1/F1/M2	$33.04	$59.00	$36.00–$59.00	—	44%
HPV test for high-risk types, one combined (pooled) result CPT 87624 CHG IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$92.96	$166.00	$86.00–$161.00	2% below	44%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 CHG IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$92.96	$166.00	$102.00–$166.00	—	44%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C W/eAG QC/V/Z/Y/B/D/F/J/K/N/Q/S/U/S1/L1/P1/V1/F1	$49.84	$89.00	$46.00–$86.00	18% below	44%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C W/eAG QC/V/Z/Y/B/D/F/J/K/N/Q/S/U/S1/L1/P1/V1/F1	$49.84	$89.00	$55.00–$89.00	—	44%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB Q/QC/V/Y/E/J/L/M/O/P/R/W/S1/L1/C2/P1/PL/G1/M2	$53.76	$96.00	$49.00–$93.00	21% below	44%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB Q/QC/V/Y/E/J/L/M/O/P/R/W/S1/L1/C2/P1/PL/G1/M2	$53.76	$96.00	$59.00–$96.00	—	44%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG E/J/L/M/O/P/R/W/C1/S1/L1/PL/G1/M2	$45.92	$82.00	$42.00–$79.00	30% below	44%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP PANEL CHRONIC B MCHSBP QC/Q/E/J/L/M/T/W/S1/L1/W1/PL/C1/P/G1/F1/C2/P1/V/Y/M2/D/S/SA/N	$45.92	$82.00	$42.00–$79.00	30% below	44%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF AG E/J/L/M/O/P/R/W/C1/S1/L1/PL/G1/M2	$45.92	$82.00	$50.00–$82.00	—	44%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP PANEL CHRONIC B MCHSBP QC/Q/E/J/L/M/T/W/S1/L1/W1/PL/C1/P/G1/F1/C2/P1/V/Y/M2/D/S/SA/N	$45.92	$82.00	$50.00–$82.00	—	44%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB E/J/L/M/O/P/T/W/C1/S1/L1/PL/G1/M2	$72.24	$129.00	$67.00–$125.00	7% below	44%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB E/J/L/M/O/P/T/W/C1/S1/L1/PL/G1/M2	$72.24	$129.00	$79.00–$129.00	—	44%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HEPATITIS C RT PCR E/J/L/M/O/P/R/W/C1/S1/L1/D/N/S/X/A/PL/G1/W1/F1/M2	$250.32	$447.00	$232.00–$433.00	3% below	44%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HEPATITIS C RT PCR E/J/L/M/O/P/R/W/C1/S1/L1/D/N/S/X/A/PL/G1/W1/F1/M2	$250.32	$447.00	$277.00–$447.00	—	44%
Herpes blood test, HSV-1 antibody CPT 86695 TORCH PROFILE IgG	$22.96	$41.00	$21.00–$39.00	66% below	44%
Herpes blood test, HSV-1 antibody CPT 86695 TORCH PROFILE IgG MTRCHG D/S/M/L/W/C1/S1/N/L1/J/X/PL/O/P/E/G1/F1/M2/T/W1	$22.96	$41.00	$21.00–$39.00	66% below	44%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 TORCH PROFILE IgG MTRCHG D/S/M/L/W/C1/S1/N/L1/J/X/PL/O/P/E/G1/F1/M2/T/W1	$22.96	$41.00	$25.00–$41.00	—	44%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 TORCH PROFILE IgG	$22.96	$41.00	$25.00–$41.00	—	44%
Herpes blood test, HSV-2 antibody CPT 86696 TORCH PROFILE IgG MTRCHG D/S/M/L/W/C1/S1/N/L1/J/X/PL/O/P/E/G1/F1/M2/T/W1	$22.96	$41.00	$21.00–$39.00	60% below	44%
Herpes blood test, HSV-2 antibody CPT 86696 TORCH PROFILE IgG	$22.96	$41.00	$21.00–$39.00	60% below	44%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 TORCH PROFILE IgG MTRCHG D/S/M/L/W/C1/S1/N/L1/J/X/PL/O/P/E/G1/F1/M2/T/W1	$22.96	$41.00	$25.00–$41.00	—	44%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 TORCH PROFILE IgG	$22.96	$41.00	$25.00–$41.00	—	44%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP A/D/E/F/G/J/L/M/N/O/P/QC/R/S/W/V/Z/Y/L1/S1/P1/X/PL/G1/F1/M2	$76.16	$136.00	$70.00–$131.00	2% below	44%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP A/D/E/F/G/J/L/M/N/O/P/QC/R/S/W/V/Z/Y/L1/S1/P1/X/PL/G1/F1/M2	$76.16	$136.00	$84.00–$136.00	—	44%
Homocysteine blood test CPT 83090 HOMOCYSTEINE QC/V/Y/D/E/J/L/M/N/O/P/R/S/W/C1/S1/L1/P1/X/PL/G1/F1/M2	$84.00	$150.00	$78.00–$145.00	11% below	44%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE QC/V/Y/D/E/J/L/M/N/O/P/R/S/W/C1/S1/L1/P1/X/PL/G1/F1/M2	$84.00	$150.00	$93.00–$150.00	—	44%
Insulin blood test CPT 83525 INSULIN QC/V/Y/D/E/J/L/M/N/O/P/R/S/W/C1/S1/L1/P1/PL/G1/F1/M2	$72.80	$130.00	$67.00–$126.00	5% below	44%
Insulin blood test inpatient CPT 83525 INSULIN QC/V/Y/D/E/J/L/M/N/O/P/R/S/W/C1/S1/L1/P1/PL/G1/F1/M2	$72.80	$130.00	$80.00–$130.00	—	44%
Iron blood test (serum iron) CPT 83540 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1	$33.60	$60.00	$31.00–$58.00	18% below	44%
Iron blood test (serum iron) CPT 83540 IRON /ALL EXCEPT/H/T/U	$33.60	$60.00	$31.00–$58.00	18% below	44%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$34.72	$62.00	$32.00–$60.00	15% below	44%
Iron blood test (serum iron) CPT 83540 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1	$35.28	$63.00	$32.00–$61.00	14% below	44%
Iron blood test (serum iron) inpatient CPT 83540 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1	$33.60	$60.00	$37.00–$60.00	—	44%
Iron blood test (serum iron) inpatient CPT 83540 IRON /ALL EXCEPT/H/T/U	$33.60	$60.00	$37.00–$60.00	—	44%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$34.72	$62.00	$38.00–$62.00	—	44%
Iron blood test (serum iron) inpatient CPT 83540 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1	$35.28	$63.00	$39.00–$63.00	—	44%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY N/Z/A/D/E/F/G/K/O/Q/R/S/T/L1/R1/PL/J/G1/F1/M2/C1	$39.76	$71.00	$36.00–$68.00	18% below	44%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1	$39.76	$71.00	$36.00–$68.00	18% below	44%
Iron-binding capacity (TIBC) test CPT 83550 CHG IRON BINDING TEST	$42.00	$75.00	$39.00–$72.00	14% below	44%
Iron-binding capacity (TIBC) test CPT 83550 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1	$42.00	$75.00	$39.00–$72.00	14% below	44%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY N/Z/A/D/E/F/G/K/O/Q/R/S/T/L1/R1/PL/J/G1/F1/M2/C1	$39.76	$71.00	$44.00–$71.00	—	44%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1	$39.76	$71.00	$44.00–$71.00	—	44%
Iron-binding capacity (TIBC) test inpatient CPT 83550 CHG IRON BINDING TEST	$42.00	$75.00	$46.00–$75.00	—	44%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1	$42.00	$75.00	$46.00–$75.00	—	44%
Kidney function blood test panel CPT 80069 RENAL FASTING PNL /ALL	$70.00	$125.00	$65.00–$121.00	20% below	44%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PNL P/QC/V/Y/B/D/E/H/N/R/S/T/X/Q/C1/S1/B1/M1/L1/C2/P1/R1/V1/F1/M2	$70.00	$125.00	$65.00–$121.00	20% below	44%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PNL P/QC/V/Y/B/D/E/H/N/R/S/T/X/Q/C1/S1/B1/M1/L1/C2/P1/R1/V1/F1/M2	$70.00	$125.00	$77.00–$125.00	—	44%
Kidney function blood test panel inpatient CPT 80069 RENAL FASTING PNL /ALL	$70.00	$125.00	$77.00–$125.00	—	44%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE QC/V/Z/Y/A/B/D/E/F/G/I/J/L/M/N/O/P/Q/R/S/W1/S1/L1/C1/C2/P1/W1/R1/PL/G1/F1/M2	$65.52	$117.00	$60.00–$113.00	29% below	44%
LH (luteinizing hormone) test CPT 83002 PEDS LH ESOTERIX /M/H/J/L1/P/C1/PL/E/G1/M2	$68.88	$123.00	$63.00–$119.00	26% below	44%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE QC/V/Z/Y/A/B/D/E/F/G/I/J/L/M/N/O/P/Q/R/S/W1/S1/L1/C1/C2/P1/W1/R1/PL/G1/F1/M2	$65.52	$117.00	$72.00–$117.00	—	44%
LH (luteinizing hormone) test inpatient CPT 83002 PEDS LH ESOTERIX /M/H/J/L1/P/C1/PL/E/G1/M2	$68.88	$123.00	$76.00–$123.00	—	44%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, FLUID V/I/J/L/M/Q/D/L1/O/P1/PL/C1/R/P/E/G1/M2	$41.44	$74.00	$38.00–$71.00	36% below	44%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE /ALL	$50.96	$91.00	$47.00–$88.00	21% below	44%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, FLUID V/I/J/L/M/Q/D/L1/O/P1/PL/C1/R/P/E/G1/M2	$41.44	$74.00	$45.00–$74.00	—	44%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE /ALL	$50.96	$91.00	$56.00–$91.00	—	44%
Liver function blood test panel CPT 80076 CHG HEPATIC FUNCTION PANEL	$58.80	$105.00	$54.00–$101.00	30% below	44%
Liver function blood test panel CPT 80076 HEPATIC FUNC PANEL /ALL EXCEPT M/L/W/PL/G1	$58.80	$105.00	$54.00–$101.00	30% below	44%
Liver function blood test panel inpatient CPT 80076 CHG HEPATIC FUNCTION PANEL	$58.80	$105.00	$65.00–$105.00	—	44%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNC PANEL /ALL EXCEPT M/L/W/PL/G1	$58.80	$105.00	$65.00–$105.00	—	44%
Lyme disease antibody test CPT 86618 LYME AB IGG J/L/M/P/W/L1/PL/O/C1/E/G1/M2	$39.20	$70.00	$36.00–$67.00	56% below	44%
Lyme disease antibody test CPT 86618 LYME DIS AB SERO A/C1/C2/E/J/L/L1/M/O/P/QC/R/S1/V/W/Y/P1/R1/X/G1/M2	$49.28	$88.00	$45.00–$85.00	44% below	44%
Lyme disease antibody test CPT 86618 LYME AB IGM J/L/M/P/W/L1/PL/O/C1/G1/T/M2	$78.96	$141.00	$73.00–$136.00	11% below	44%
Lyme disease antibody test inpatient CPT 86618 LYME AB IGG J/L/M/P/W/L1/PL/O/C1/E/G1/M2	$39.20	$70.00	$43.00–$70.00	—	44%
Lyme disease antibody test inpatient CPT 86618 LYME DIS AB SERO A/C1/C2/E/J/L/L1/M/O/P/QC/R/S1/V/W/Y/P1/R1/X/G1/M2	$49.28	$88.00	$54.00–$88.00	—	44%
Lyme disease antibody test inpatient CPT 86618 LYME AB IGM J/L/M/P/W/L1/PL/O/C1/G1/T/M2	$78.96	$141.00	$87.00–$141.00	—	44%
Magnesium blood test CPT 83735 MAGNESIUM /ALL	$45.92	$82.00	$42.00–$79.00	5% below	44%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$45.92	$82.00	$42.00–$79.00	5% below	44%
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$45.92	$82.00	$50.00–$82.00	—	44%
Magnesium blood test inpatient CPT 83735 MAGNESIUM /ALL	$45.92	$82.00	$50.00–$82.00	—	44%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IgG QC/Y/V/C1/E/J/L/M/P/W/S1/L1/P1/X/R1/PL/R/G1/M2	$43.68	$78.00	$40.00–$75.00	20% below	44%
Measles (rubeola) antibody test CPT 86765 MUMPS IgG SCREEN MMPPG Z/E/J/L/M/O/W/C1/W1/PL/G1/M2/X/D/S/SA/N/QC/Q	$57.68	$103.00	$53.00–$99.00	5% above	44%
Measles (rubeola) antibody test CPT 86765 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2	$95.20	$170.00	$88.00–$164.00	74% above	44%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IgG QC/Y/V/C1/E/J/L/M/P/W/S1/L1/P1/X/R1/PL/R/G1/M2	$43.68	$78.00	$48.00–$78.00	—	44%
Measles (rubeola) antibody test inpatient CPT 86765 MUMPS IgG SCREEN MMPPG Z/E/J/L/M/O/W/C1/W1/PL/G1/M2/X/D/S/SA/N/QC/Q	$57.68	$103.00	$63.00–$103.00	—	44%
Measles (rubeola) antibody test inpatient CPT 86765 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2	$95.20	$170.00	$105.00–$170.00	—	44%
Mono test (heterophile antibody, Monospot) CPT 86308 CHG HETEROPHILE ANTIBODIES,SCREEN	$26.32	$47.00	$24.00–$45.00	46% below	44%
Mono test (heterophile antibody, Monospot) CPT 86308 INFECTIOUS MONO SCRN /ALL	$33.04	$59.00	$30.00–$57.00	32% below	44%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 CHG HETEROPHILE ANTIBODIES,SCREEN	$26.32	$47.00	$29.00–$47.00	—	44%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 INFECTIOUS MONO SCRN /ALL	$33.04	$59.00	$36.00–$59.00	—	44%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL J/	$202.16	$361.00	$187.00–$350.00	82% above	44%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$202.16	$361.00	$187.00–$350.00	82% above	44%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$202.16	$361.00	$223.00–$361.00	—	44%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL J/	$202.16	$361.00	$223.00–$361.00	—	44%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1	$78.96	$141.00	$73.00–$136.00	19% below	44%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1	$78.96	$141.00	$87.00–$141.00	—	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 GEN HEALTH WELLNESS PSA H/J/C1	$19.60	$35.00	$18.00–$33.00	80% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 CHG PROSTATE SPECIFIC ANTIGEN,TOTAL	$83.44	$149.00	$77.00–$144.00	13% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROST SPEC AG SCREEN QC/A/B/D/E/F/G/H/O/Q/R/S/T/X/S1/L1/W1/V1/F1/C1/B1	$83.44	$149.00	$77.00–$144.00	13% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG QC/A/B/F/G/H/I/J/O/Q/R/S/T/X/S1/L1/W1/V1/F1/B1	$83.44	$149.00	$77.00–$144.00	13% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1	$87.36	$156.00	$81.00–$151.00	9% below	44%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 GEN HEALTH WELLNESS PSA H/J/C1	$19.60	$35.00	$21.00–$35.00	—	44%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG PROSTATE SPECIFIC ANTIGEN,TOTAL	$83.44	$149.00	$92.00–$149.00	—	44%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROST SPEC AG SCREEN QC/A/B/D/E/F/G/H/O/Q/R/S/T/X/S1/L1/W1/V1/F1/C1/B1	$83.44	$149.00	$92.00–$149.00	—	44%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC AG QC/A/B/F/G/H/I/J/O/Q/R/S/T/X/S1/L1/W1/V1/F1/B1	$83.44	$149.00	$92.00–$149.00	—	44%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1	$87.36	$156.00	$96.00–$156.00	—	44%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT /ALL EXCEPT/H/U/G1	$134.40	$240.00	$124.00–$232.00	24% below	44%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT /ALL EXCEPT/H/U/G1	$134.40	$240.00	$148.00–$240.00	—	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLAS TIME PARTIAL	$33.60	$60.00	$31.00–$58.00	25% below	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT /ALL	$35.28	$63.00	$32.00–$61.00	22% below	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 PT/PTT Z/J/C2/R1	$35.28	$63.00	$32.00–$61.00	22% below	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAGULANT E/J/L/M/O/P/W/C1/S1/L1/PL/G1/M2	$40.32	$72.00	$37.00–$69.00	11% below	44%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLAS TIME PARTIAL	$33.60	$60.00	$37.00–$60.00	—	44%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT /ALL	$35.28	$63.00	$39.00–$63.00	—	44%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PT/PTT Z/J/C2/R1	$35.28	$63.00	$39.00–$63.00	—	44%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAGULANT E/J/L/M/O/P/W/C1/S1/L1/PL/G1/M2	$40.32	$72.00	$44.00–$72.00	—	44%
Progesterone blood test CPT 84144 PROGESTERONE Q/QC/V/Z/Y/A/B/E/F/G/J/L/M/O/P/R/W/X/S1/L1/P1/W1/PL/G1/M2	$91.28	$163.00	$84.00–$158.00	6% below	44%
Progesterone blood test inpatient CPT 84144 PROGESTERONE Q/QC/V/Z/Y/A/B/E/F/G/J/L/M/O/P/R/W/X/S1/L1/P1/W1/PL/G1/M2	$91.28	$163.00	$101.00–$163.00	—	44%
Prolactin blood test CPT 84146 PROLACTIN ALL EXCEPT B/B1/H/K/M1/T/U	$105.84	$189.00	$98.00–$183.00	6% above	44%
Prolactin blood test inpatient CPT 84146 PROLACTIN ALL EXCEPT B/B1/H/K/M1/T/U	$105.84	$189.00	$117.00–$189.00	—	44%
Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME	$34.16	$61.00	$31.00–$59.00	4% above	44%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$34.72	$62.00	$32.00–$60.00	6% above	44%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/PTT Z/J/C2/R1	$34.72	$62.00	$32.00–$60.00	6% above	44%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME /ALL	$34.72	$62.00	$32.00–$60.00	6% above	44%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME M/W/L/MCFARLAND/PL/G1	$34.72	$62.00	$32.00–$60.00	6% above	44%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME	$34.16	$61.00	$37.00–$61.00	—	44%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/PTT Z/J/C2/R1	$34.72	$62.00	$38.00–$62.00	—	44%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME M/W/L/MCFARLAND/PL/G1	$34.72	$62.00	$38.00–$62.00	—	44%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME /ALL	$34.72	$62.00	$38.00–$62.00	—	44%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$34.72	$62.00	$38.00–$62.00	—	44%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 EMPLOYMENT DRUG SCN J	$66.08	$118.00	$61.00–$114.00	8% below	44%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 EMPLOYMENT DRUG SCN J	$66.08	$118.00	$73.00–$118.00	—	44%
Rapid flu test (influenza antigen) CPT 87804 CHG IAADIADOO INFLUENZA	$33.60	$60.00	$31.00–$58.00	28% below	44%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA IA W DO	$38.08	$68.00	$35.00–$65.00	18% below	44%
Rapid flu test (influenza antigen) inpatient CPT 87804 CHG IAADIADOO INFLUENZA	$33.60	$60.00	$37.00–$60.00	—	44%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA IA W DO	$38.08	$68.00	$42.00–$68.00	—	44%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CHG IAADIADOO STREPTOCOCCUS GROUP A	$43.68	$78.00	$40.00–$75.00	13% below	44%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC	$44.24	$79.00	$41.00–$76.00	12% below	44%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CHG IAADIADOO STREPTOCOCCUS GROUP A	$43.68	$78.00	$48.00–$78.00	—	44%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC	$44.24	$79.00	$48.00–$79.00	—	44%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QC/V/Z/Y/A/D/E/F/G/I/J/L/M/N/O/P/S/W/X/C1/S1/L1/P1/PL/G1/F1/M2	$33.60	$60.00	$31.00–$58.00	31% below	44%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QC/V/Z/Y/A/D/E/F/G/I/J/L/M/N/O/P/S/W/X/C1/S1/L1/P1/PL/G1/F1/M2	$33.60	$60.00	$37.00–$60.00	—	44%
Rubella antibody test (immunity check) CPT 86762 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2	$20.72	$37.00	$19.00–$35.00	65% below	44%
Rubella antibody test (immunity check) CPT 86762 TORCH PROFILE IgG	$22.96	$41.00	$21.00–$39.00	61% below	44%
Rubella antibody test (immunity check) CPT 86762 TORCH PROFILE IgG MTRCHG D/S/M/L/W/C1/S1/N/L1/J/X/PL/O/P/E/G1/F1/M2/T/W1	$22.96	$41.00	$21.00–$39.00	61% below	44%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN Z/D/E/L/M/N/O/P/Q/R/S/W/X/C1/R1/F1	$50.96	$91.00	$47.00–$88.00	13% below	44%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG QC/Y/V/J/L/M/O/P/R/W/S1/L1/P1/PL/G1/T/M2	$50.96	$91.00	$47.00–$88.00	13% below	44%
Rubella antibody test (immunity check) inpatient CPT 86762 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2	$20.72	$37.00	$22.00–$37.00	—	44%
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH PROFILE IgG	$22.96	$41.00	$25.00–$41.00	—	44%
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH PROFILE IgG MTRCHG D/S/M/L/W/C1/S1/N/L1/J/X/PL/O/P/E/G1/F1/M2/T/W1	$22.96	$41.00	$25.00–$41.00	—	44%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN Z/D/E/L/M/N/O/P/Q/R/S/W/X/C1/R1/F1	$50.96	$91.00	$56.00–$91.00	—	44%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG QC/Y/V/J/L/M/O/P/R/W/S1/L1/P1/PL/G1/T/M2	$50.96	$91.00	$56.00–$91.00	—	44%
Stool ova and parasites exam CPT 87177 Expanded O&P (UHL) E/J/L/M/O/P/R/W/C1/L1/S1/PL/G1/M2	$27.44	$49.00	$25.00–$47.00	44% below	44%
Stool ova and parasites exam inpatient CPT 87177 Expanded O&P (UHL) E/J/L/M/O/P/R/W/C1/L1/S1/PL/G1/M2	$27.44	$49.00	$30.00–$49.00	—	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUALITATIVE QC/V/Y/D/E/F/N/O/P/R/S/T/X/S1/F1	$28.00	$50.00	$26.00–$48.00	42% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, RESP TO THERAPY L/M/W/L1/J/O/P/S1/T/R/PL/C1/E/G1/M2	$28.00	$50.00	$26.00–$48.00	42% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR CONFIRM L/M/W/L1/A/PL/E/G1/M2	$28.00	$50.00	$26.00–$48.00	42% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, RESP TO THERAPY L/M/W/L1/J/O/P/S1/T/R/PL/C1/E/G1/M2	$28.00	$50.00	$31.00–$50.00	—	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUALITATIVE QC/V/Y/D/E/F/N/O/P/R/S/T/X/S1/F1	$28.00	$50.00	$31.00–$50.00	—	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR CONFIRM L/M/W/L1/A/PL/E/G1/M2	$28.00	$50.00	$31.00–$50.00	—	44%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD C1	$220.64	$394.00	$204.00–$382.00	40% above	44%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD E/J/L/M/O/P/R/W/T/S1/C1/L1	$220.64	$394.00	$204.00–$382.00	40% above	44%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD E/J/L/M/O/P/R/W/T/S1/C1/L1	$220.64	$394.00	$244.00–$394.00	—	44%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD C1	$220.64	$394.00	$244.00–$394.00	—	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE MTTFB Q/QC/L/M/W/E/P/S1/T/C1/L1/PL/G1/T/B/F/M2/F1/F/G/PMP/A/X/D/S/SA/N/W1	$17.92	$32.00	$16.00–$31.00	83% below	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOT/BIOAVAIL MTTBS QC/Q/E/J/L/M/O/W/C1/S1/T/L1/PL/P/G1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/W1	$58.80	$105.00	$54.00–$101.00	43% below	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,TOTAL Q/V/Y/A/E/F/G/J/L/M/O/P/R/W/C1/S1/L1/P1/W1/R1/PL/G1/M1/M2/X	$91.28	$163.00	$84.00–$158.00	12% below	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOS TL/FREE AND SHBG QC/Q/V/Y/P1	$91.28	$163.00	$84.00–$158.00	12% below	44%
Testosterone blood test, total (not free testosterone) CPT 84403 CAH PROFILE 7 ENDO SC IMC/S1/J/T/L1/PL/O/C1/P/E/G1/M2	$198.80	$355.00	$184.00–$344.00	93% above	44%
Testosterone blood test, total (not free testosterone) CPT 84403 BASELINE PED TESTOST ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2	$344.40	$615.00	$319.00–$596.00	234% above	44%
Testosterone blood test, total (not free testosterone) CPT 84403 PEDIATRIC TESTOSTERONE ESOTERIX /M/H/S1/L1/PL/O/J/C1/P/E/G1/M2	$344.40	$615.00	$319.00–$596.00	234% above	44%
Testosterone blood test, total (not free testosterone) CPT 84403 24HOUR PED TESTOSTER ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2	$344.40	$615.00	$319.00–$596.00	234% above	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE MTTFB Q/QC/L/M/W/E/P/S1/T/C1/L1/PL/G1/T/B/F/M2/F1/F/G/PMP/A/X/D/S/SA/N/W1	$17.92	$32.00	$19.00–$32.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOT/BIOAVAIL MTTBS QC/Q/E/J/L/M/O/W/C1/S1/T/L1/PL/P/G1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/W1	$58.80	$105.00	$65.00–$105.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE,TOTAL Q/V/Y/A/E/F/G/J/L/M/O/P/R/W/C1/S1/L1/P1/W1/R1/PL/G1/M1/M2/X	$91.28	$163.00	$101.00–$163.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOS TL/FREE AND SHBG QC/Q/V/Y/P1	$91.28	$163.00	$101.00–$163.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAH PROFILE 7 ENDO SC IMC/S1/J/T/L1/PL/O/C1/P/E/G1/M2	$198.80	$355.00	$220.00–$355.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 BASELINE PED TESTOST ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2	$344.40	$615.00	$381.00–$615.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PEDIATRIC TESTOSTERONE ESOTERIX /M/H/S1/L1/PL/O/J/C1/P/E/G1/M2	$344.40	$615.00	$381.00–$615.00	—	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 24HOUR PED TESTOSTER ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2	$344.40	$615.00	$381.00–$615.00	—	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO/MICROSOM QC/V/Y/E/L/M/O/P/R/W/C1/F/S1/L1/P1/X/R1/PL/G1/M2	$47.04	$84.00	$43.00–$81.00	38% below	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID AB GROUP J/L/M/O/P/R/W/C1/S1/L1/X/PL/G1/M2	$75.60	$135.00	$70.00–$130.00	at median	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 LKM ANTIBODIES MLKM QC/Q/D/E/L/M/N/O/S/W/C1/S1/L1/W1/J/PL/P/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1	$89.60	$160.00	$83.00–$155.00	19% above	44%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-TPO/MICROSOM QC/V/Y/E/L/M/O/P/R/W/C1/F/S1/L1/P1/X/R1/PL/G1/M2	$47.04	$84.00	$52.00–$84.00	—	44%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID AB GROUP J/L/M/O/P/R/W/C1/S1/L1/X/PL/G1/M2	$75.60	$135.00	$83.00–$135.00	—	44%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LKM ANTIBODIES MLKM QC/Q/D/E/L/M/N/O/S/W/C1/S1/L1/W1/J/PL/P/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1	$89.60	$160.00	$99.00–$160.00	—	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 GEN HEALTH WELL TSH E//H/J	$16.80	$30.00	$15.00–$29.00	83% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEONATAL SCREEN SCANNED J/O/C2/H	$59.92	$107.00	$55.00–$103.00	38% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEONATAL SCREEN E/B/C1	$59.92	$107.00	$55.00–$103.00	38% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH/FREE T4 J	$83.44	$149.00	$77.00–$144.00	14% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY THYROID STIM HORMONE	$83.44	$149.00	$77.00–$144.00	14% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE /ALL EXCEPT /K/L/M/W/P/U/B1/P1/Y/V/PL/G1/L1	$83.44	$149.00	$77.00–$144.00	14% below	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 GEN HEALTH WELL TSH E//H/J	$16.80	$30.00	$18.00–$30.00	—	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NEONATAL SCREEN SCANNED J/O/C2/H	$59.92	$107.00	$66.00–$107.00	—	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NEONATAL SCREEN E/B/C1	$59.92	$107.00	$66.00–$107.00	—	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE /ALL EXCEPT /K/L/M/W/P/U/B1/P1/Y/V/PL/G1/L1	$83.44	$149.00	$92.00–$149.00	—	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY THYROID STIM HORMONE	$83.44	$149.00	$92.00–$149.00	—	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH/FREE T4 J	$83.44	$149.00	$92.00–$149.00	—	44%
Trichomonas test (NAAT) CPT 87661 CHG IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$87.36	$156.00	$81.00–$151.00	6% below	44%
Trichomonas test (NAAT) inpatient CPT 87661 CHG IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$87.36	$156.00	$96.00–$156.00	—	44%
Uric acid blood test CPT 84550 URIC ACID /ALL	$33.60	$60.00	$31.00–$58.00	7% below	44%
Uric acid blood test inpatient CPT 84550 URIC ACID /ALL	$33.60	$60.00	$37.00–$60.00	—	44%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS /B/E/F/G/J/N/O/T/U/V/Y/B1/C1/L1/P1/R1	$31.36	$56.00	$29.00–$54.00	25% below	44%
Urinalysis with microscope exam, automated CPT 81001 CHG URINALYSIS, AUTO, W/SCOPE	$31.36	$56.00	$29.00–$54.00	25% below	44%
Urinalysis with microscope exam, automated CPT 81001 URINE MICROSCOPIC S/D/S1/V/M1/W1/QC/G1/V1/F1/M2/C1	$32.48	$58.00	$30.00–$56.00	22% below	44%
Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URINALYSIS, AUTO, W/SCOPE	$31.36	$56.00	$34.00–$56.00	—	44%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS /B/E/F/G/J/N/O/T/U/V/Y/B1/C1/L1/P1/R1	$31.36	$56.00	$34.00–$56.00	—	44%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE MICROSCOPIC S/D/S1/V/M1/W1/QC/G1/V1/F1/M2/C1	$32.48	$58.00	$35.00–$58.00	—	44%
Urinalysis with microscope exam, manual CPT 81000 CHG URINALYSIS, NONAUTO, W/SCOPE	$14.00	$25.00	$13.00–$24.00	46% below	44%
Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINALYSIS, NONAUTO, W/SCOPE	$14.00	$25.00	$15.00–$25.00	—	44%
Urinalysis without microscope exam, automated CPT 81003 CHG URINALYSIS, AUTO, W/O SCOPE	$12.88	$23.00	$11.00–$22.00	50% below	44%
Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK /T/V1	$15.12	$27.00	$14.00–$26.00	41% below	44%
Urinalysis without microscope exam, automated CPT 81003 HC AUTOM URINALYSIS WO MICRO	$31.36	$56.00	$29.00–$54.00	22% above	44%
Urinalysis without microscope exam, automated CPT 81003 URINE MACROSCOPIC BILL	$38.64	$69.00	$35.00–$66.00	50% above	44%
Urinalysis without microscope exam, automated CPT 81003 URINE MACROSCOPIC /ALL EXCEPT/N/S1/Z/V/P1	$38.64	$69.00	$35.00–$66.00	50% above	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URINALYSIS, AUTO, W/O SCOPE	$12.88	$23.00	$14.00–$23.00	—	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIPSTICK /T/V1	$15.12	$27.00	$16.00–$27.00	—	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC AUTOM URINALYSIS WO MICRO	$31.36	$56.00	$34.00–$56.00	—	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACROSCOPIC BILL	$38.64	$69.00	$42.00–$69.00	—	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACROSCOPIC /ALL EXCEPT/N/S1/Z/V/P1	$38.64	$69.00	$42.00–$69.00	—	44%
Urinalysis without microscope exam, manual CPT 81002 CHG URINALYSIS NONAUTO W/O SCOPE	$11.76	$21.00	$10.00–$20.00	49% below	44%
Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URINALYSIS NONAUTO W/O SCOPE	$11.76	$21.00	$13.00–$21.00	—	44%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE L/M/P/R/W/E/O/J/S1/L1/PL/G1/X	$33.04	$59.00	$30.00–$57.00	44% below	44%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE L/M/P/R/W/E/O/J/S1/L1/PL/G1/X	$33.04	$59.00	$36.00–$59.00	—	44%
Urine pregnancy test, read by color change CPT 81025 CHG URINE PREGNANCY TEST	$22.96	$41.00	$21.00–$39.00	45% below	44%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY, VISUAL COLOR	$24.64	$44.00	$22.00–$42.00	41% below	44%
Urine pregnancy test, read by color change CPT 81025 HCG SCREEN URINE /ALL EXCEPT/J	$47.04	$84.00	$43.00–$81.00	12% above	44%
Urine pregnancy test, read by color change inpatient CPT 81025 CHG URINE PREGNANCY TEST	$22.96	$41.00	$25.00–$41.00	—	44%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY, VISUAL COLOR	$24.64	$44.00	$27.00–$44.00	—	44%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG SCREEN URINE /ALL EXCEPT/J	$47.04	$84.00	$52.00–$84.00	—	44%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 QC/V/Z/Y/A/B/D/E/F/G/I/J/K/L/M/N/O/P/Q/R/S1/S1/L1/C2/P1/W1/R1/PL/G1/V1/F1/M2	$72.80	$130.00	$67.00–$126.00	13% below	44%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 QC/V/Z/Y/A/B/D/E/F/G/I/J/K/L/M/N/O/P/Q/R/S1/S1/L1/C2/P1/W1/R1/PL/G1/V1/F1/M2	$72.80	$130.00	$80.00–$130.00	—	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25 HYDROXY Q/QC/V/Z/Y/A/B/D/E/F/G/J/K/L1/N/H/C2/P1/W1/L/M/W/O/S/X/PL/G1/V1/M1/F1/M2	$104.16	$186.00	$96.00–$180.00	17% below	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CHG ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED	$104.16	$186.00	$96.00–$180.00	17% below	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,25 HYDROXY Q/QC/V/Z/Y/A/B/D/E/F/G/J/K/L1/N/H/C2/P1/W1/L/M/W/O/S/X/PL/G1/V1/M1/F1/M2	$104.16	$186.00	$115.00–$186.00	—	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CHG ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED	$104.16	$186.00	$115.00–$186.00	—	44%
Zinc blood test CPT 84630 ZINC MZN_S QC/Q/D/E/J/L/M/N/O/P/R/S/T/W/X/C1/S1/L1/W1/PL/G1/F1/C2/P1/V/Y/M2	$57.12	$102.00	$53.00–$98.00	9% above	44%
Zinc blood test inpatient CPT 84630 ZINC MZN_S QC/Q/D/E/J/L/M/N/O/P/R/S/T/W/X/C1/S1/L1/W1/PL/G1/F1/C2/P1/V/Y/M2	$57.12	$102.00	$63.00–$102.00	—	44%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN, QUANT	$61.60	$110.00	$57.00–$106.00	30% below	44%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE /ALL	$62.72	$112.00	$58.00–$108.00	29% below	44%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP QUAD SCREEN SCAN H/J	$76.16	$136.00	$70.00–$131.00	14% below	44%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN, QUANT	$61.60	$110.00	$68.00–$110.00	—	44%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE /ALL	$62.72	$112.00	$69.00–$112.00	—	44%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP QUAD SCREEN SCAN H/J	$76.16	$136.00	$84.00–$136.00	—	44%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Botox injections for chronic migraine CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$589.12	$1,052.00	$547.00–$1,020.00	50% above	44%
Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$589.12	$1,052.00	$652.00–$1,052.00	—	44%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREOTACTIC	$1,947.68	$3,478.00	$1,808.00–$3,373.00	33% below	44%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREOTACTIC	$1,947.68	$3,478.00	$2,156.00–$3,478.00	—	44%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CL TX DSTL FIB FX WO MANIP	$517.44	$924.00	$480.00–$896.00	20% above	44%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CL TX DSTL FIB FX WO MANIP	$517.44	$924.00	$572.00–$924.00	—	44%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CL TX METATARSAL FX WO MANIP	$372.96	$666.00	$346.00–$646.00	at median	44%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CL TX METATARSAL FX WO MANIP	$372.96	$666.00	$412.00–$666.00	—	44%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION	$281.12	$502.00	$261.00–$486.00	66% below	44%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION	$281.12	$502.00	$311.00–$502.00	—	44%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC TX FRACTURE D RADIUS/ULNA WO MANIP	$599.76	$1,071.00	$556.00–$1,038.00	41% above	44%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC TX FRACTURE D RADIUS/ULNA WO MANIP	$599.76	$1,071.00	$664.00–$1,071.00	—	44%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$1,144.08	$2,043.00	$1,062.00–$1,981.00	33% above	44%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$1,144.08	$2,043.00	$1,266.00–$2,043.00	—	44%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE IMPACTED EAR WAX UNI	$56.00	$100.00	$52.00–$97.00	17% below	44%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOVE IMPACTED EAR WAX UNI	$56.00	$100.00	$62.00–$100.00	—	44%
Earwax removal with instruments, one ear CPT 69210 HC REMOVAL IMPACTED CERUMEN (EARWAX)	$117.60	$210.00	$109.00–$203.00	14% above	44%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVAL IMPACTED CERUMEN (EARWAX)	$117.60	$210.00	$130.00–$210.00	—	44%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ INTERLAM C/T W IMG	$756.00	$1,350.00	$702.00–$1,309.00	38% below	44%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ INTERLAM C/T W IMG	$756.00	$1,350.00	$837.00–$1,350.00	—	44%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$896.56	$1,601.00	$832.00–$1,552.00	30% below	44%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$896.56	$1,601.00	$992.00–$1,601.00	—	44%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC LIGATION OF HEMORRHOID(S)	$1,206.80	$2,155.00	$1,120.00–$2,090.00	85% above	44%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC LIGATION OF HEMORRHOID(S)	$1,206.80	$2,155.00	$1,336.00–$2,155.00	—	44%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSC SMPL OR SGL	$278.32	$497.00	$258.00–$482.00	12% above	44%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSC SMPL OR SGL	$278.32	$497.00	$308.00–$497.00	—	44%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT	$442.40	$790.00	$410.00–$766.00	79% above	44%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT	$442.40	$790.00	$489.00–$790.00	—	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN/INJ MAJOR JNT/BURSA	$530.32	$947.00	$492.00–$918.00	50% above	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN/INJ MAJOR JNT/BURSA	$530.32	$947.00	$587.00–$947.00	—	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJ INTERM JNT/BURSA	$486.08	$868.00	$451.00–$841.00	58% above	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJ INTERM JNT/BURSA	$486.08	$868.00	$538.00–$868.00	—	44%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ JOINT/BURSA W/O US	$442.40	$790.00	$410.00–$766.00	60% above	44%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ JOINT/BURSA W/O US	$442.40	$790.00	$489.00–$790.00	—	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC INT REP S/A/T/EX 2.5 CM/<	$595.28	$1,063.00	$552.00–$1,031.00	67% above	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC INT REP S/A/T/EX 2.5 CM/<	$595.28	$1,063.00	$659.00–$1,063.00	—	44%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ INTERLAM L/S W IMG	$756.00	$1,350.00	$702.00–$1,309.00	36% below	44%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ INTERLAM L/S W IMG	$756.00	$1,350.00	$837.00–$1,350.00	—	44%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV	$986.16	$1,761.00	$915.00–$1,708.00	25% below	44%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV	$986.16	$1,761.00	$1,091.00–$1,761.00	—	44%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/<	$795.20	$1,420.00	$738.00–$1,377.00	187% above	44%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/<	$795.20	$1,420.00	$880.00–$1,420.00	—	44%
Nail removal (partial or complete), one nail CPT 11730 HC SPL AVULSE NP SGL	$278.32	$497.00	$258.00–$482.00	31% above	44%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC SPL AVULSE NP SGL	$278.32	$497.00	$308.00–$497.00	—	44%
Occipital nerve block (injection for headaches) CPT 64405 HC INJ ANESTH/STER GREATER OCCIPITAL NERVE	$896.56	$1,601.00	$832.00–$1,552.00	122% above	44%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJ ANESTH/STER GREATER OCCIPITAL NERVE	$896.56	$1,601.00	$992.00–$1,601.00	—	44%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING	$535.92	$957.00	$497.00–$928.00	53% below	44%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING	$535.92	$957.00	$593.00–$957.00	—	44%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$559.44	$999.00	$519.00–$969.00	29% above	44%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED	$559.44	$999.00	$619.00–$999.00	—	44%
Prostate biopsy CPT 55700 HC BX PROSTATE NDLE PUNCH	$2,087.68	$3,728.00	$1,938.00–$3,616.00	9% above	44%
Prostate biopsy inpatient CPT 55700 HC BX PROSTATE NDLE PUNCH	$2,087.68	$3,728.00	$2,311.00–$3,728.00	—	44%
Prostate removal (prostatectomy), laparoscopic CPT 55866 HC LAPARO RADICAL PROSTATECTOMY	$8,072.40	$14,415.00	$7,495.00–$13,982.00	91% above	44%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 HC LAPARO RADICAL PROSTATECTOMY	$8,072.40	$14,415.00	$5,835.00–$14,415.00	—	44%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY LUMB/SAC FACET JNT UNIL	$1,710.80	$3,055.00	$1,588.00–$2,963.00	22% below	44%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTROY LUMB/SAC FACET JNT UNIL	$1,710.80	$3,055.00	$1,894.00–$3,055.00	—	44%
Removal of a foreign object under the skin, simple CPT 10120 HC INC & REM FB SQ SMPL	$559.44	$999.00	$519.00–$969.00	81% above	44%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INC & REM FB SQ SMPL	$559.44	$999.00	$619.00–$999.00	—	44%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE	$4,803.12	$8,577.00	$4,460.00–$8,319.00	43% above	44%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE	$4,803.12	$8,577.00	$5,317.00–$8,577.00	—	44%
Short arm cast (elbow to hand) CPT 29075 HC APPLY SHORT ARM CAST	$188.72	$337.00	$175.00–$326.00	17% below	44%
Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY SHORT ARM CAST	$188.72	$337.00	$208.00–$337.00	—	44%
Short arm splint (forearm and hand) CPT 29125 HC APPLY SHORT ARM SPLINT STATIC	$223.44	$399.00	$207.00–$387.00	25% above	44%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SHORT ARM SPLINT STATIC	$223.44	$399.00	$247.00–$399.00	—	44%
Short leg splint (calf to foot) CPT 29515 HC APPLY SHORT LEG SPLINT	$143.92	$257.00	$133.00–$249.00	14% below	44%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY SHORT LEG SPLINT	$143.92	$257.00	$159.00–$257.00	—	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SREP S/N/A/G/TR/E 2.5 CM/<	$202.72	$362.00	$188.00–$351.00	11% below	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SREP S/N/A/G/TR/E 2.5 CM/<	$202.72	$362.00	$224.00–$362.00	—	44%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN SINGLE LESION	$559.44	$999.00	$519.00–$969.00	115% above	44%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN SINGLE LESION	$559.44	$999.00	$619.00–$999.00	—	44%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC TR-EXT MAL+MARG 0.5 < CM	$1,080.80	$1,930.00	$1,003.00–$1,872.00	168% above	44%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC TR-EXT MAL+MARG 0.5 < CM	$1,080.80	$1,930.00	$1,196.00–$1,930.00	—	44%
Skin tag removal, up to 15 tags CPT 11200 HC REM SKIN TAGS TO 15	$474.32	$847.00	$440.00–$821.00	176% above	44%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REM SKIN TAGS TO 15	$474.32	$847.00	$525.00–$847.00	—	44%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAG	$346.08	$618.00	$321.00–$599.00	29% below	44%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAG	$346.08	$618.00	$383.00–$618.00	—	44%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SREP S/N/A/G/TR/E 2.6-7.5 CM	$202.72	$362.00	$188.00–$351.00	17% below	44%
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 SREP S/N/A/G/TR/E 2.6-7.5 CM	$202.72	$362.00	$224.00–$362.00	—	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SREP F/E/N/L/MM 2.5 CM/<	$202.72	$362.00	$188.00–$351.00	19% below	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SREP F/E/N/L/MM 2.5 CM/<	$202.72	$362.00	$224.00–$362.00	—	44%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGNTL BX SKIN SINGLE LES	$278.32	$497.00	$258.00–$482.00	33% above	44%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGNTL BX SKIN SINGLE LES	$278.32	$497.00	$308.00–$497.00	—	44%
Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$493.92	$882.00	$458.00–$855.00	47% below	44%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$493.92	$882.00	$546.00–$882.00	—	44%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL	$442.40	$790.00	$410.00–$766.00	47% above	44%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL	$442.40	$790.00	$489.00–$790.00	—	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG	$1,378.16	$2,461.00	$1,279.00–$2,387.00	34% below	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG	$1,378.16	$2,461.00	$1,525.00–$2,461.00	—	44%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC CYSTO W LITHOTRIPSY	$3,339.28	$5,963.00	$3,100.00–$5,784.00	95% above	44%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 HC CYSTO W LITHOTRIPSY	$3,339.28	$5,963.00	$3,697.00–$5,963.00	—	44%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W LITHOTRIPSY	$4,524.80	$8,080.00	$4,201.00–$7,837.00	44% below	44%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 HC CYSTO/URETERO W LITHOTRIPSY	$4,524.80	$8,080.00	$5,009.00–$8,080.00	—	44%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 HC VASECTOMY UNIL OR BILAT	$1,988.56	$3,551.00	$1,846.00–$3,444.00	—	44%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 HC VASECTOMY UNIL OR BILAT	$1,988.56	$3,551.00	$2,201.00–$3,551.00	—	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN TO SQ TISSUE	$559.44	$999.00	$519.00–$969.00	31% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SKIN TO SQ TISSUE	$559.44	$999.00	$619.00–$999.00	—	44%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD OR COMPONENT PER UNIT	$595.28	$1,063.00	$552.00–$1,031.00	4% above	44%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD OR COMPONENT PER UNIT	$595.28	$1,063.00	$659.00–$1,063.00	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI AIRWAY INHALATION TX SUBQ	$94.64	$169.00	$87.00–$163.00	18% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$94.64	$169.00	$87.00–$163.00	18% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT INITIAL	$94.64	$169.00	$87.00–$163.00	18% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI AIRWAY INHALATION TX INITIAL	$94.64	$169.00	$87.00–$163.00	18% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT SUBQ	$94.64	$169.00	$87.00–$163.00	18% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT SUBQ	$94.64	$169.00	$104.00–$169.00	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$94.64	$169.00	$104.00–$169.00	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI AIRWAY INHALATION TX SUBQ	$94.64	$169.00	$104.00–$169.00	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI AIRWAY INHALATION TX INITIAL	$94.64	$169.00	$104.00–$169.00	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT INITIAL	$94.64	$169.00	$104.00–$169.00	—	44%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO, IV INFUSION, 1 HR	$355.60	$635.00	$330.00–$615.00	35% below	44%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO, IV INFUSION, 1 HR	$355.60	$635.00	$393.00–$635.00	—	44%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 PR COMPREHENSIVE HEARING TEST	$19.60	$35.00	$18.00–$33.00	81% below	44%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 PR COMPREHENSIVE HEARING TEST	$19.60	$35.00	$21.00–$35.00	—	44%
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 30-74 MIN	$1,268.96	$2,266.00	$1,178.00–$2,198.00	44% above	44%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 30-74 MIN	$1,268.96	$2,266.00	$1,404.00–$2,266.00	—	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 12 LEAD EKG; TRACING ONLY	$138.32	$247.00	$128.00–$239.00	13% below	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PR ELECTROCARDIOGRAM, TRACING	$138.32	$247.00	$128.00–$239.00	13% below	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC 12 LEAD EKG; TRACING ONLY	$138.32	$247.00	$153.00–$247.00	—	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PR ELECTROCARDIOGRAM, TRACING	$138.32	$247.00	$153.00–$247.00	—	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL 1 VISIT	$106.40	$190.00	$98.00–$184.00	50% above	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL 1 VISIT	$106.40	$190.00	$117.00–$190.00	—	44%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL 2 VISIT	$159.60	$285.00	$148.00–$276.00	3% above	44%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL 2 VISIT	$159.60	$285.00	$176.00–$285.00	—	44%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL 3 VISIT	$257.60	$460.00	$239.00–$446.00	10% below	44%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL 3 VISIT	$257.60	$460.00	$285.00–$460.00	—	44%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL 4 VISIT	$419.44	$749.00	$389.00–$726.00	24% below	44%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL 4 VISIT	$419.44	$749.00	$464.00–$749.00	—	44%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL 5 VISIT	$966.00	$1,725.00	$897.00–$1,673.00	12% above	44%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL 5 VISIT	$966.00	$1,725.00	$1,069.00–$1,725.00	—	44%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CVSLR STRESS TEST; TRACING	$443.52	$792.00	$411.00–$768.00	34% below	44%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CVSLR STRESS TEST; TRACING	$443.52	$792.00	$491.00–$792.00	—	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PR IV INFUSION, HYDRATION, 31-60 MIN	$119.84	$214.00	$111.00–$207.00	58% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION IV INFUSION INIT 31-60 MIN	$355.60	$635.00	$330.00–$615.00	26% above	44%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PR IV INFUSION, HYDRATION, 31-60 MIN	$119.84	$214.00	$132.00–$214.00	—	44%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION IV INFUSION INIT 31-60 MIN	$355.60	$635.00	$393.00–$635.00	—	44%
IV infusion of a medicine, first hour CPT 96365 HC THER/PROPH/DX IV INF INIT UP TO 1HR	$286.16	$511.00	$265.00–$495.00	9% below	44%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THER/PROPH/DX IV INF INIT UP TO 1HR	$286.16	$511.00	$316.00–$511.00	—	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PR INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$56.56	$101.00	$52.00–$97.00	37% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$96.32	$172.00	$89.00–$166.00	7% above	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PR INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$56.56	$101.00	$62.00–$101.00	—	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$96.32	$172.00	$106.00–$172.00	—	44%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCLE RE-EDUC EA 15M	$79.52	$142.00	$73.00–$137.00	13% below	44%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCLE RE-EDUC EA 15M	$79.52	$142.00	$88.00–$142.00	—	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC INIT NUTRITION THERAPY; EACH 15M	$28.56	$51.00	$26.00–$51.00	33% below	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC INIT NUTRITION THERAPY; EACH 15M	$28.56	$51.00	$31.00–$51.00	—	44%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX	$256.48	$458.00	$119.00–$444.00	43% above	44%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX	$256.48	$458.00	$283.00–$458.00	—	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX	$176.40	$315.00	$119.00–$305.00	18% below	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX	$176.40	$315.00	$195.00–$315.00	—	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX	$149.52	$267.00	$119.00–$258.00	23% below	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX	$149.52	$267.00	$165.00–$267.00	—	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX	$162.96	$291.00	$119.00–$282.00	19% below	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX	$162.96	$291.00	$180.00–$291.00	—	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY EA 15M	$72.24	$129.00	$67.00–$125.00	25% below	44%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY EA 15M	$72.24	$129.00	$79.00–$129.00	—	44%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAP EXERCISE ROM EA 15M	$72.24	$129.00	$67.00–$125.00	23% below	44%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAP EXERCISE ROM EA 15M	$72.24	$129.00	$79.00–$129.00	—	44%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE/TOBACCO COUNSELING 3-10 MIN	$26.32	$47.00	$24.00–$47.00	28% below	44%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE/TOBACCO COUNSELING 3-10 MIN	$26.32	$47.00	$29.00–$47.00	—	44%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND LANG COMPREHEN	$431.20	$770.00	$119.00–$746.00	42% above	44%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND LANG COMPREHEN	$431.20	$770.00	$477.00–$770.00	—	44%
Speech therapy session, individual CPT 92507 HC SPEECH/HEARING THERAPY	$175.28	$313.00	$119.00–$303.00	20% below	44%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH/HEARING THERAPY	$175.28	$313.00	$194.00–$313.00	—	44%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$73.36	$131.00	$68.00–$127.00	63% below	44%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$73.36	$131.00	$81.00–$131.00	—	44%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHOSPASM PRE & POST BD	$302.96	$541.00	$281.00–$524.00	23% below	44%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHOSPASM PRE & POST BD	$302.96	$541.00	$335.00–$541.00	—	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITY DIR EA 15M	$73.92	$132.00	$68.00–$128.00	27% below	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITY DIR EA 15M	$73.92	$132.00	$81.00–$132.00	—	44%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 MRNA VACC (MODERNA SPIKEVAX) 50 MCG/0.5ML IM SUSY	$371.10	$371.10	$192.00–$359.00	38% above	—
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 MRNA VACC (MODERNA SPIKEVAX) 50 MCG/0.5ML IM SUSY	$371.10	$371.10	$230.00–$371.00	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$156.24	$279.00	$145.00–$270.00	2% below	44%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$156.24	$279.00	$172.00–$279.00	—	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA (FLULAVAL) IIV3 PREFILLED SYRINGE	$19.75	$19.75	$10.00–$19.00	9% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$71.12	$127.00	$66.00–$123.00	228% above	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$127.00	$127.00	$66.00–$123.00	486% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA (FLULAVAL) IIV3 PREFILLED SYRINGE	$19.75	$19.75	$12.00–$19.00	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$71.12	$127.00	$78.00–$127.00	—	44%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$127.00	$127.00	$78.00–$127.00	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE	$347.76	$621.00	$322.00–$602.00	16% above	44%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE	$347.76	$621.00	$385.00–$621.00	—	44%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$53.76	$96.00	$49.00–$93.00	58% below	44%
Hepatitis A vaccine, adult dose CPT 90632 HC IM ADULT HEP-A VACCINE	$63.28	$113.00	$58.00–$109.00	51% below	44%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$53.76	$96.00	$59.00–$96.00	—	44%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC IM ADULT HEP-A VACCINE	$63.28	$113.00	$70.00–$113.00	—	44%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$38.64	$69.00	$35.00–$66.00	65% below	44%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$38.64	$69.00	$42.00–$69.00	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY	$98.15	$98.15	$51.00–$95.00	23% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG COUNT IM	$131.04	$234.00	$121.00–$226.00	65% above	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY	$98.15	$98.15	$60.00–$98.00	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG COUNT IM	$131.04	$234.00	$145.00–$234.00	—	44%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MMR VIRUS IMMUNIZATION, SUBCUT	$45.92	$82.00	$42.00–$79.00	56% below	44%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC SQ MMR VACCINE	$71.68	$128.00	$66.00–$124.00	32% below	44%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MMR VIRUS IMMUNIZATION, SUBCUT	$45.92	$82.00	$50.00–$82.00	—	44%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC SQ MMR VACCINE	$71.68	$128.00	$79.00–$128.00	—	44%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$156.80	$280.00	$145.00–$271.00	33% below	44%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$156.80	$280.00	$173.00–$280.00	—	44%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$239.12	$427.00	$222.00–$414.00	2% below	44%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$239.12	$427.00	$264.00–$427.00	—	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$336.56	$601.00	$312.00–$582.00	33% below	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$610.65	$610.65	$317.00–$592.00	22% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$336.56	$601.00	$372.00–$601.00	—	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$610.65	$610.65	$378.00–$610.00	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ/IM	$33.60	$60.00	$31.00–$58.00	85% below	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$62.16	$111.00	$57.00–$107.00	72% below	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ/IM	$33.60	$60.00	$37.00–$60.00	—	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$62.16	$111.00	$68.00–$111.00	—	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TD VACCINE NO PRSRV >= 7 IM	$23.52	$42.00	$21.00–$40.00	61% below	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$24.64	$44.00	$22.00–$42.00	59% below	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TD VACCINE NO PRSRV >= 7 IM	$23.52	$42.00	$26.00–$42.00	—	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$24.64	$44.00	$27.00–$44.00	—	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE >7 YO, IM	$56.56	$101.00	$52.00–$97.00	33% below	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE >7 IM	$59.36	$106.00	$55.00–$102.00	29% below	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY	$183.38	$183.38	$95.00–$177.00	118% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TDAP VACCINE >7 YO, IM	$56.56	$101.00	$62.00–$101.00	—	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE >7 IM	$59.36	$106.00	$65.00–$106.00	—	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY	$183.38	$183.38	$113.00–$183.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$16.24	$29.00	$15.00–$28.00	54% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADM 1 VACCINE	$16.24	$29.00	$15.00–$28.00	54% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$24.00	$24.00	$12.00–$23.00	31% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA (FLULAVAL) IIV3 PREFILLED SYRINGE	$24.50	$24.50	$12.00–$23.00	30% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY	$27.83	$27.83	$14.00–$27.00	20% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$60.00	$60.00	$31.00–$58.00	71% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$16.24	$29.00	$17.00–$29.00	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADM 1 VACCINE	$16.24	$29.00	$17.00–$29.00	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$24.00	$24.00	$14.00–$24.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA (FLULAVAL) IIV3 PREFILLED SYRINGE	$24.50	$24.50	$15.00–$24.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY	$27.83	$27.83	$17.00–$27.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$60.00	$60.00	$37.00–$60.00	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADM EA ADDTL VACCINE	$15.68	$28.00	$14.00–$27.00	46% below	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR IMMUNIZ,ADMIN,EACH ADDL	$25.20	$45.00	$23.00–$43.00	12% below	44%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADM EA ADDTL VACCINE	$15.68	$28.00	$17.00–$28.00	—	44%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR IMMUNIZ,ADMIN,EACH ADDL	$25.20	$45.00	$27.00–$45.00	—	44%

Source file: https://www.gcmchealth.com/filesimages/PriceTransparency/426037888_Greene-County-Medical-Center_StandardCharges.csv