Guadalupe Regional Medical Center
Guadalupe Regional Medical Center in Seguin, TX publishes cash prices for 357 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 Texas median for 237 of 272 procedures and above it for 34. By typical cash price it ranks #30 of 240 Texas hospitals and #2 of 15 hospitals in the San Antonio, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.
1215 E. Court St, Seguin, TX 78155 Collected Sep 27, 2026 Source price file (830) 379-2411
Acute care hospital Emergency department CMS star rating 2 of 5 CCN 450104 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Guadalupe Regional Medical Center in Seguin, TX:
- Feb 17, 2026 Warning notice
- May 20, 2026 Corrective action plan requested
- May 29, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE COMPLETE 3+ VIEWS | $161.50 | $323.00 | $33.06–$323.00 | 55% below | 50% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE COMPLETE 3+ VIEWS | $161.50 | $323.00 | $33.06–$323.00 | — | 50% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE COMPLETE 3+ VIEWS | $161.50 | $323.00 | $33.06–$323.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 TRANSCUTAN OXIMETRY L/B-PF | $40.00 | $80.00 | $36.00–$405.45 | 94% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 VUS:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | 70% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 XR:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | 70% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WC:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | 70% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 TRANSCUTAN OXIMETRY L/B-PF | $40.00 | $80.00 | $36.00–$405.45 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 TRANSCUTAN OXIMETRY L/B-PF | $40.00 | $80.00 | $36.00–$405.45 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 WC:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 VUS:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 XR:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 VUS:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 XR:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 WC:TRANSCUTAN OXIMETRY L/B | $213.00 | $426.00 | $73.51–$426.00 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS+SCOUT CHEST;1CS-PF | $54.00 | $108.00 | $48.60–$844.15 | 89% below | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS+SCOUT CHEST RG;1 C S | $319.50 | $639.00 | $88.79–$844.15 | 36% below | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS+SCOUT CHEST;1CS-PF | $54.00 | $108.00 | $48.60–$844.15 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS+SCOUT CHEST;1CS-PF | $54.00 | $108.00 | $48.60–$844.15 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS+SCOUT CHEST RG;1 C S | $319.50 | $639.00 | $88.79–$844.15 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS+SCOUT CHEST RG;1 C S | $319.50 | $639.00 | $88.79–$844.15 | — | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE &/OR JOINT IMAG WHOLE BDY | $996.50 | $1,993.00 | $243.14–$1,993.00 | 45% below | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE &/OR JOINT IMAG WHOLE BDY | $996.50 | $1,993.00 | $243.14–$1,993.00 | — | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE &/OR JOINT IMAG WHOLE BDY | $996.50 | $1,993.00 | $243.14–$1,993.00 | — | 50% |
| Breast ultrasound, complete, one breast CPT 76641 US,BREAST,UNI W/AXILLA;COMP-PF | $109.50 | $219.00 | $93.84–$382.30 | 75% below | 50% |
| Breast ultrasound, complete, one breast CPT 76641 US,BREAST,UNI W/AXILLA;COMP | $281.00 | $562.00 | $93.84–$562.00 | 36% below | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US,BREAST,UNI W/AXILLA;COMP-PF | $109.50 | $219.00 | $93.84–$382.30 | — | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US,BREAST,UNI W/AXILLA;COMP-PF | $109.50 | $219.00 | $93.84–$382.30 | — | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US,BREAST,UNI W/AXILLA;COMP | $281.00 | $562.00 | $93.84–$562.00 | — | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US,BREAST,UNI W/AXILLA;COMP | $281.00 | $562.00 | $93.84–$562.00 | — | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US,BREAST,UNI W/AXILLA;LIMT-PF | $75.50 | $151.00 | $67.95–$207.48 | 78% below | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US,BREAST,UNI W/AXILLA;LIMT | $281.00 | $562.00 | $77.76–$562.00 | 19% below | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US,BREAST,UNI W/AXILLA;LIMT-PF | $75.50 | $151.00 | $67.95–$207.48 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US,BREAST,UNI W/AXILLA;LIMT-PF | $75.50 | $151.00 | $67.95–$207.48 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US,BREAST,UNI W/AXILLA;LIMT | $281.00 | $562.00 | $77.76–$562.00 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US,BREAST,UNI W/AXILLA;LIMT | $281.00 | $562.00 | $77.76–$562.00 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO,CHEST,NC W/CM+NCI-PF | $234.00 | $468.00 | $175.06–$1,516.44 | 93% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO,CHEST,NC W/CM +NCI | $1,459.50 | $2,919.00 | $175.06–$2,919.00 | 55% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO,CHEST,NC W/CM+NCI-PF | $234.00 | $468.00 | $175.06–$1,516.44 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO,CHEST,NC W/CM+NCI-PF | $234.00 | $468.00 | $175.06–$1,516.44 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO,CHEST,NC W/CM +NCI | $1,459.50 | $2,919.00 | $175.06–$2,919.00 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO,CHEST,NC W/CM +NCI | $1,459.50 | $2,919.00 | $175.06–$2,919.00 | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIOGRAPHY,HEART,CA&BG-PF | $189.00 | $378.00 | $170.10–$1,511.64 | 89% below | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIOGRAPHY,HEART,CA & BG | $1,377.00 | $2,754.00 | $175.06–$2,754.00 | 17% below | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIOGRAPHY,HEART,CA&BG-PF | $189.00 | $378.00 | $170.10–$1,511.64 | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIOGRAPHY,HEART,CA & BG | $1,377.00 | $2,754.00 | $175.06–$2,754.00 | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIOGRAPHY,HEART,CA & BG | $2,275.00 | $4,550.00 | $175.06–$4,550.00 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT,HEART,NO CM,W/QNT EVL CC-PF | $70.00 | $140.00 | $63.00–$372.72 | 66% below | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT,HEART,W/O CM,W/QNT EVL CC | $107.00 | $214.00 | $86.58–$372.72 | 48% below | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT,HEART,NO CM,W/QNT EVL CC-PF | $70.00 | $140.00 | $63.00–$372.72 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT,HEART,NO CM,W/QNT EVL CC-PF | $70.00 | $140.00 | $63.00–$372.72 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT,HEART,W/O CM,W/QNT EVL CC | $107.00 | $214.00 | $86.58–$372.72 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT,HEART,W/O CM,W/QNT EVL CC | $107.00 | $214.00 | $86.58–$372.72 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT,ABDOMEN & PELVIS;WO/CM-PF | $224.00 | $448.00 | $172.72–$1,393.86 | 93% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT,ABDOMEN & PELVIS;WO/CM | $1,234.50 | $2,469.00 | $172.72–$2,469.00 | 63% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT,ABDOMEN & PELVIS;WO/CM-PF | $224.00 | $448.00 | $172.72–$1,393.86 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT,ABDOMEN & PELVIS;WO/CM-PF | $224.00 | $448.00 | $172.72–$1,393.86 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT,ABDOMEN & PELVIS;WO/CM | $1,234.50 | $2,469.00 | $172.72–$2,469.00 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT,ABDOMEN & PELVIS;WO/CM | $1,234.50 | $2,469.00 | $172.72–$2,469.00 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT,ABDOMEN & PELVIS; W/CM | $1,672.50 | $3,345.00 | $284.10–$3,345.00 | 57% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT,ABDOMEN & PELVIS; W/CM | $1,672.50 | $3,345.00 | $284.10–$3,345.00 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT,ABDOMEN & PELVIS; W/CM | $1,672.50 | $3,345.00 | $284.10–$3,345.00 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT,ABDOMEN & PELVIS;WO F/CM&FS | $1,990.00 | $3,980.00 | $318.44–$3,980.00 | 52% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT,ABDOMEN & PELVIS;WO F/CM&FS | $1,990.00 | $3,980.00 | $318.44–$3,980.00 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT,ABDOMEN & PELVIS;WO F/CM&FS | $1,990.00 | $3,980.00 | $318.44–$3,980.00 | — | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CM-PF | $216.00 | $432.00 | $175.06–$1,516.44 | 92% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CM | $1,256.50 | $2,513.00 | $175.06–$2,513.00 | 53% below | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CM-PF | $216.00 | $432.00 | $175.06–$1,516.44 | — | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CM-PF | $216.00 | $432.00 | $175.06–$1,516.44 | — | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CM | $1,256.50 | $2,513.00 | $175.06–$2,513.00 | — | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CM | $1,256.50 | $2,513.00 | $175.06–$2,513.00 | — | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CM-PF | $187.50 | $375.00 | $104.75–$686.76 | 91% below | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | 57% below | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CM-PF | $187.50 | $375.00 | $104.75–$686.76 | — | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CM-PF | $187.50 | $375.00 | $104.75–$686.76 | — | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE(SINUS)W/O CM-PF | $117.00 | $234.00 | $104.75–$686.76 | 93% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | 45% below | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE(SINUS)W/O CM-PF | $117.00 | $234.00 | $104.75–$686.76 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE(SINUS)W/O CM-PF | $117.00 | $234.00 | $104.75–$686.76 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 ER STROKE ALERT-BRAIN W/O CM | $926.00 | $1,852.00 | $99.74–$1,852.00 | 52% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CM | $926.00 | $1,852.00 | $99.74–$1,852.00 | 52% below | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 ER STROKE ALERT-BRAIN W/O CM | $926.00 | $1,852.00 | $99.74–$1,852.00 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CM | $926.00 | $1,852.00 | $99.74–$1,852.00 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 ER STROKE ALERT-BRAIN W/O CM | $926.00 | $1,852.00 | $99.74–$1,852.00 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CM | $926.00 | $1,852.00 | $99.74–$1,852.00 | — | 50% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CM | $1,256.50 | $2,513.00 | $139.26–$2,513.00 | 38% below | 50% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CM | $1,256.50 | $2,513.00 | $139.26–$2,513.00 | — | 50% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CM | $1,256.50 | $2,513.00 | $139.26–$2,513.00 | — | 50% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO F/CM&FS | $1,494.00 | $2,988.00 | $162.61–$2,988.00 | 36% below | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WO F/CM&FS | $1,494.00 | $2,988.00 | $162.61–$2,988.00 | — | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WO F/CM&FS | $1,494.00 | $2,988.00 | $162.61–$2,988.00 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | 59% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE, W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | 56% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE, W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE, W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CM | $1,256.50 | $2,513.00 | $175.06–$2,513.00 | 44% below | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CM | $1,256.50 | $2,513.00 | $175.06–$2,513.00 | — | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CM | $1,256.50 | $2,513.00 | $175.06–$2,513.00 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUPLEX S EXTRACRANIAL A;C/B-PF | $104.00 | $208.00 | $93.60–$455.75 | 93% below | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUPLEX SCAN EXTRACRANIAL A;C/B | $1,057.50 | $2,115.00 | $171.06–$2,115.00 | 27% below | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX S EXTRACRANIAL A;C/B-PF | $104.00 | $208.00 | $93.60–$455.75 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX S EXTRACRANIAL A;C/B-PF | $104.00 | $208.00 | $93.60–$455.75 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX SCAN EXTRACRANIAL A;C/B | $1,057.50 | $2,115.00 | $171.06–$2,115.00 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX SCAN EXTRACRANIAL A;C/B | $1,057.50 | $2,115.00 | $171.06–$2,115.00 | — | 50% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $161.50 | $323.00 | $30.58–$323.00 | 61% below | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $161.50 | $323.00 | $30.58–$323.00 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $161.50 | $323.00 | $30.58–$323.00 | — | 50% |
| Chest X-ray, single view CPT 71045 CHEST 1 VIEW | $161.50 | $323.00 | $23.22–$323.00 | 54% below | 50% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW | $161.50 | $323.00 | $23.22–$323.00 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW | $161.50 | $323.00 | $23.22–$323.00 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US,KIDNEY & BLADDER COMP-PF | $82.50 | $165.00 | $74.25–$382.30 | 89% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US,KIDNEY & AORTA COMPLETE-PF | $82.50 | $165.00 | $74.25–$382.30 | 89% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US, RETROPERITONEAL COMPLETE B | $403.00 | $806.00 | $98.97–$806.00 | 46% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US, RETROPERITONEAL COMPLETE A | $403.00 | $806.00 | $98.97–$806.00 | 46% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US,KIDNEY & AORTA COMPLETE-PF | $82.50 | $165.00 | $74.25–$382.30 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US,KIDNEY & BLADDER COMP-PF | $82.50 | $165.00 | $74.25–$382.30 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US,KIDNEY & AORTA COMPLETE-PF | $82.50 | $165.00 | $74.25–$382.30 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US,KIDNEY & BLADDER COMP-PF | $82.50 | $165.00 | $74.25–$382.30 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US, RETROPERITONEAL COMPLETE A | $403.00 | $806.00 | $98.97–$806.00 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US, RETROPERITONEAL COMPLETE B | $403.00 | $806.00 | $98.97–$806.00 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US, RETROPERITONEAL COMPLETE A | $403.00 | $806.00 | $98.97–$806.00 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US, RETROPERITONEAL COMPLETE B | $403.00 | $806.00 | $98.97–$806.00 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA,BONE DNSTY;HP/PLVS/SPN-PF | $37.50 | $75.00 | $33.75–$107.88 | 91% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA,BONE DNSTY;HIP/PELVS/SPINE | $377.00 | $754.00 | $35.28–$754.00 | 9% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA,BONE DNSTY;HP/PLVS/SPN-PF | $37.50 | $75.00 | $33.75–$107.88 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA,BONE DNSTY;HP/PLVS/SPN-PF | $37.50 | $75.00 | $33.75–$107.88 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA,BONE DNSTY;HIP/PELVS/SPINE | $377.00 | $754.00 | $35.28–$754.00 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA,BONE DNSTY;HIP/PELVS/SPINE | $377.00 | $754.00 | $35.28–$754.00 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA,BONE DNSTY;HP/PLVS/SPN-PF | $37.50 | $75.00 | $28.70–$86.58 | 83% below | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA,BONE DNSTY;RDS/WRIST/HEEL | $360.50 | $721.00 | $28.70–$721.00 | 64% above | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA,BONE DNSTY;HP/PLVS/SPN-PF | $37.50 | $75.00 | $28.70–$86.58 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA,BONE DNSTY;HP/PLVS/SPN-PF | $37.50 | $75.00 | $28.70–$86.58 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA,BONE DNSTY;RDS/WRIST/HEEL | $360.50 | $721.00 | $28.70–$721.00 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA,BONE DNSTY;RDS/WRIST/HEEL | $360.50 | $721.00 | $28.70–$721.00 | — | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 MFM-US,PREG F/M+FETAL T-ABD,1G | $570.00 | $1,140.00 | $165.34–$1,140.00 | 33% below | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 MFM-US,PRG F/M+FTL T-ABD,1G-PF | $104.00 | $208.00 | $93.60–$291.28 | — | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 MFM-US,PREG F/M+FETAL T-ABD,1G | $570.00 | $1,140.00 | $165.34–$1,140.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX,DX W/O CM-PF | $128.50 | $257.00 | $104.75–$686.76 | 93% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX,DX W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | 53% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX,DX W/O CM,F/U LW DSE | $926.00 | $1,852.00 | $104.75–$1,852.00 | 53% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX,DX W/O CM, HRES | $926.00 | $1,852.00 | $104.75–$1,852.00 | 53% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM-PF | $128.50 | $257.00 | $104.75–$686.76 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM-PF | $128.50 | $257.00 | $104.75–$686.76 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM, HRES | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM,F/U LW DSE | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM, HRES | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DX W/O CM,F/U LW DSE | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX,DX W CM | $1,256.50 | $2,513.00 | $156.45–$2,513.00 | 44% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX,DX W CM | $1,256.50 | $2,513.00 | $156.45–$2,513.00 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX,DX W CM | $1,256.50 | $2,513.00 | $156.45–$2,513.00 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO,DIGITAL,BILAT,ALL V-PF | $70.00 | $140.00 | $63.00–$408.75 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO,DIGITAL,BILATERAL,ALL V | $226.50 | $453.00 | $144.69–$453.00 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO,DIGITAL,BILAT,ALL V-PF | $70.00 | $140.00 | $63.00–$408.75 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO,DIGITAL,BILAT,ALL V-PF | $70.00 | $140.00 | $63.00–$408.75 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO,DIGITAL,BILATERAL,ALL V | $226.50 | $453.00 | $144.69–$453.00 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO,DIGITAL,BILATERAL,ALL V | $226.50 | $453.00 | $144.69–$453.00 | — | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO,DIGITAL,UNILAT,ALL V-PF | $65.00 | $130.00 | $58.50–$320.04 | 76% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO,DIGITAL,UNILATERAL,ALL V | $213.50 | $427.00 | $114.53–$427.00 | 22% below | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO,DIGITAL,UNILAT,ALL V-PF | $65.00 | $130.00 | $58.50–$320.04 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO,DIGITAL,UNILAT,ALL V-PF | $65.00 | $130.00 | $58.50–$320.04 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO,DIGITAL,UNILATERAL,ALL V | $213.50 | $427.00 | $114.53–$427.00 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO,DIGITAL,UNILATERAL,ALL V | $213.50 | $427.00 | $114.53–$427.00 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX SCAN LW EXT-A,CMP/BL-PF | $99.00 | $198.00 | $89.10–$875.53 | 96% below | 50% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX SCAN LW EXT-A,COMP/BILA | $739.50 | $1,479.00 | $215.95–$1,479.00 | 68% below | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN LW EXT-A,CMP/BL-PF | $99.00 | $198.00 | $89.10–$875.53 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN LW EXT-A,CMP/BL-PF | $99.00 | $198.00 | $89.10–$875.53 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN LW EXT-A,COMP/BILA | $739.50 | $1,479.00 | $215.95–$1,479.00 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN LW EXT-A,COMP/BILA | $739.50 | $1,479.00 | $215.95–$1,479.00 | — | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX SCAN EXT VEINS,COM/BILA | $739.50 | $1,479.00 | $168.23–$1,479.00 | 64% below | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX SCAN EXT VEINS,COM/BILA | $739.50 | $1,479.00 | $168.23–$1,479.00 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX SCAN EXT VEINS,COM/BILA | $739.50 | $1,479.00 | $168.23–$1,479.00 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCRD,I/DC,I/REC WP,W/S&CF | $1,655.00 | $3,310.00 | $180.19–$3,310.00 | 36% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCRD,I/DC,I/REC WP,W/S&CF E | $1,892.00 | $3,784.00 | $180.19–$3,784.00 | 27% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCRD,I/DC,I/REC WP,W/S&CF | $1,655.00 | $3,310.00 | $180.19–$3,310.00 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCRD,I/DC,I/REC WP,W/S&CF E | $1,892.00 | $3,784.00 | $180.19–$3,784.00 | — | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY DUCTAL SYS IMAG | $1,075.00 | $2,150.00 | $266.87–$2,150.00 | 36% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY DUCTAL SYS IMAG | $1,075.00 | $2,150.00 | $266.87–$2,150.00 | — | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY DUCTAL SYS IMAG | $1,075.00 | $2,150.00 | $266.87–$2,150.00 | — | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 H-SLEEP STUDY,UNATTENDED W/REC | $82.50 | $165.00 | $74.25–$426.68 | — | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY,UNATTENDED W/REC | $197.50 | $395.00 | $87.22–$426.68 | — | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W/CPAP W/TECH | $1,827.50 | $3,655.00 | $589.15–$3,655.00 | — | 50% |
| Knee X-ray, 3 views CPT 73562 KNEE, 3 VIEWS | $161.50 | $323.00 | $36.99–$323.00 | 54% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 KNEE, 3 VIEWS RIGHT | $161.50 | $323.00 | $36.99–$323.00 | 54% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 KNEE, 3 VIEWS LEFT | $161.50 | $323.00 | $36.99–$323.00 | 54% below | 50% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE, 3 VIEWS | $161.50 | $323.00 | $36.99–$323.00 | — | 50% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE, 3 VIEWS | $161.50 | $323.00 | $36.99–$323.00 | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE, 3 VIEWS LEFT | $161.50 | $323.00 | $36.99–$323.00 | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE, 3 VIEWS RIGHT | $161.50 | $323.00 | $36.99–$323.00 | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE, 3 VIEWS LEFT | $168.00 | $336.00 | $36.99–$336.00 | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE, 3 VIEWS RIGHT | $168.00 | $336.00 | $36.99–$336.00 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US,ABDOMINAL LIMITED-PF | $62.50 | $125.00 | $56.25–$382.30 | 91% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US,ABDOMINAL LIMITED | $345.50 | $691.00 | $79.47–$691.00 | 49% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US,ABDOMINAL LIMITED-PF | $62.50 | $125.00 | $56.25–$382.30 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US,ABDOMINAL LIMITED-PF | $62.50 | $125.00 | $56.25–$382.30 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US,ABDOMINAL LIMITED | $345.50 | $691.00 | $79.47–$691.00 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US,ABDOMINAL LIMITED | $345.50 | $691.00 | $79.47–$691.00 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LW-DOSE F/LUNG CANCER SC-PF | $109.50 | $219.00 | $98.55–$219.00 | 54% below | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW-DOSE F/LUNG CANCER SCRN | $926.00 | $1,852.00 | $104.75–$1,852.00 | 285% above | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LW-DOSE F/LUNG CANCER SC-PF | $109.50 | $219.00 | $98.55–$219.00 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LW-DOSE F/LUNG CANCER SC-PF | $109.50 | $219.00 | $98.55–$219.00 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW-DOSE F/LUNG CANCER SCRN | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW-DOSE F/LUNG CANCER SCRN | $926.00 | $1,852.00 | $104.75–$1,852.00 | — | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST W W/O CM;BILAT-PF | $208.00 | $416.00 | $187.20–$1,750.68 | — | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST W W/O CM;BILATERAL | $3,871.50 | $7,743.00 | $321.79–$7,743.00 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W W/O CM;BILAT-PF | $208.00 | $416.00 | $187.20–$1,750.68 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W W/O CM;BILAT-PF | $208.00 | $416.00 | $187.20–$1,750.68 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W W/O CM;BILATERAL | $3,871.50 | $7,743.00 | $321.79–$7,743.00 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W W/O CM;BILATERAL | $3,871.50 | $7,743.00 | $321.79–$7,743.00 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LWR EXT ANY JT W/O CM-PF | $182.00 | $364.00 | $163.80–$1,393.86 | 92% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LWR EXT ANY JT W/O CM | $1,475.50 | $2,951.00 | $190.19–$2,951.00 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LWR EXT ANY JT W/O CM-PF | $182.00 | $364.00 | $163.80–$1,393.86 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LWR EXT ANY JT W/O CM-PF | $182.00 | $364.00 | $163.80–$1,393.86 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LWR EXT ANY JT W/O CM | $1,475.50 | $2,951.00 | $190.19–$2,951.00 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LWR EXT ANY JT W/O CM | $1,475.50 | $2,951.00 | $190.19–$2,951.00 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LWR EXT ANY JT W/O CM F/CM | $2,251.50 | $4,503.00 | $361.25–$4,503.00 | 25% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LWR EXT ANY JT W/O CM F/CM | $2,251.50 | $4,503.00 | $361.25–$4,503.00 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LWR EXT ANY JT W/O CM F/CM | $2,251.50 | $4,503.00 | $361.25–$4,503.00 | — | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CM-PF | $260.00 | $520.00 | $184.08–$1,393.86 | 89% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRCP;W/O CM-PF | $260.00 | $520.00 | $184.08–$1,393.86 | 89% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CM | $1,475.50 | $2,951.00 | $184.08–$2,951.00 | 35% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRCP - W/O CM | $1,767.50 | $3,535.00 | $184.08–$3,535.00 | 23% below | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CM-PF | $260.00 | $520.00 | $184.08–$1,393.86 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP;W/O CM-PF | $260.00 | $520.00 | $184.08–$1,393.86 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CM-PF | $260.00 | $520.00 | $184.08–$1,393.86 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP;W/O CM-PF | $260.00 | $520.00 | $184.08–$1,393.86 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CM | $1,475.50 | $2,951.00 | $184.08–$2,951.00 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CM | $1,475.50 | $2,951.00 | $184.08–$2,951.00 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP - W/O CM | $1,767.50 | $3,535.00 | $184.08–$3,535.00 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP - W/O CM | $1,767.50 | $3,535.00 | $184.08–$3,535.00 | — | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO F/CM&FS-PF | $290.00 | $580.00 | $261.00–$2,738.22 | 91% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO F/CM&FS | $2,251.50 | $4,503.00 | $317.47–$4,503.00 | 31% below | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO F/CM&FS-PF | $290.00 | $580.00 | $261.00–$2,738.22 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO F/CM&FS-PF | $290.00 | $580.00 | $261.00–$2,738.22 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO F/CM&FS | $2,251.50 | $4,503.00 | $317.47–$4,503.00 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO F/CM&FS | $2,251.50 | $4,503.00 | $317.47–$4,503.00 | — | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CM-PF | $170.50 | $341.00 | $153.45–$1,393.86 | 92% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CM | $1,475.50 | $2,951.00 | $184.47–$2,951.00 | 33% below | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CM-PF | $170.50 | $341.00 | $153.45–$1,393.86 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CM-PF | $170.50 | $341.00 | $153.45–$1,393.86 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CM | $1,475.50 | $2,951.00 | $184.47–$2,951.00 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CM | $1,475.50 | $2,951.00 | $184.47–$2,951.00 | — | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO F/CM&FS-PF | $276.50 | $553.00 | $248.85–$2,738.22 | 91% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO F/CM&FS | $2,251.50 | $4,503.00 | $299.30–$4,503.00 | 25% below | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO F/CM&FS-PF | $276.50 | $553.00 | $248.85–$2,738.22 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO F/CM&FS-PF | $276.50 | $553.00 | $248.85–$2,738.22 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO F/CM&FS | $2,251.50 | $4,503.00 | $299.30–$4,503.00 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO F/CM&FS | $2,251.50 | $4,503.00 | $299.30–$4,503.00 | — | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CNL W/O CM,LMBR-PF | $190.00 | $380.00 | $171.00–$1,393.86 | 92% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CANAL W/O CM,LUMBAR | $1,475.50 | $2,951.00 | $179.98–$2,951.00 | 36% below | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CNL W/O CM,LMBR-PF | $190.00 | $380.00 | $171.00–$1,393.86 | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CNL W/O CM,LMBR-PF | $190.00 | $380.00 | $171.00–$1,393.86 | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CANAL W/O CM,LUMBAR | $1,475.50 | $2,951.00 | $179.98–$2,951.00 | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CANAL W/O CM,LUMBAR | $1,475.50 | $2,951.00 | $179.98–$2,951.00 | — | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPNL CNL W&WO CM,FS LUMBAR | $2,251.50 | $4,503.00 | $300.20–$4,503.00 | 30% below | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINAL CANAL W&W/O CM,LUMB | $2,251.50 | $4,503.00 | $300.20–$4,503.00 | 30% below | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINAL CANAL W&W/O CM,LUMB | $2,251.50 | $4,503.00 | $300.20–$4,503.00 | — | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPNL CNL W&WO CM,FS LUMBAR | $2,251.50 | $4,503.00 | $300.20–$4,503.00 | — | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINAL CANAL W&W/O CM,LUMB | $2,251.50 | $4,503.00 | $300.20–$4,503.00 | — | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPNL CNL W&WO CM,FS LUMBAR | $2,251.50 | $4,503.00 | $300.20–$4,503.00 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINAL CNL W/O CM,THRC-PF | $190.00 | $380.00 | $171.00–$1,393.86 | 91% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINAL CANAL W/O CM,THORAC | $1,475.50 | $2,951.00 | $179.08–$2,951.00 | 31% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINAL CNL W/O CM,THRC-PF | $190.00 | $380.00 | $171.00–$1,393.86 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINAL CNL W/O CM,THRC-PF | $190.00 | $380.00 | $171.00–$1,393.86 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINAL CANAL W/O CM,THORAC | $1,475.50 | $2,951.00 | $179.08–$2,951.00 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINAL CANAL W/O CM,THORAC | $1,475.50 | $2,951.00 | $179.08–$2,951.00 | — | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINAL CANAL W&W/O CM,CERV | $2,251.50 | $4,503.00 | $300.80–$4,503.00 | 31% below | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINAL CANAL W&W/O CM,CERV | $2,251.50 | $4,503.00 | $300.80–$4,503.00 | — | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINAL CANAL W&W/O CM,CERV | $2,251.50 | $4,503.00 | $300.80–$4,503.00 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINAL CANAL W/O CM,CER-PF | $190.00 | $380.00 | $171.00–$1,393.86 | 92% below | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINAL CANAL W/O CM,CERVIC | $1,475.50 | $2,951.00 | $179.38–$2,951.00 | 38% below | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINAL CANAL W/O CM,CER-PF | $190.00 | $380.00 | $171.00–$1,393.86 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINAL CANAL W/O CM,CER-PF | $190.00 | $380.00 | $171.00–$1,393.86 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINAL CANAL W/O CM,CERVIC | $1,475.50 | $2,951.00 | $179.38–$2,951.00 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINAL CANAL W/O CM,CERVIC | $1,475.50 | $2,951.00 | $179.38–$2,951.00 | — | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO F/CM&FS | $2,251.50 | $4,503.00 | $316.27–$4,503.00 | 34% below | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO F/CM&FS | $2,251.50 | $4,503.00 | $316.27–$4,503.00 | — | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO F/CM&FS | $2,251.50 | $4,503.00 | $316.27–$4,503.00 | — | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CM-PF | $195.00 | $390.00 | $175.50–$1,393.86 | 92% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CM | $1,475.50 | $2,951.00 | $214.91–$2,951.00 | 41% below | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CM-PF | $195.00 | $390.00 | $175.50–$1,393.86 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CM-PF | $195.00 | $390.00 | $175.50–$1,393.86 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CM | $1,475.50 | $2,951.00 | $214.91–$2,951.00 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CM | $1,475.50 | $2,951.00 | $214.91–$2,951.00 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT A/JT W/O CM-PF | $203.00 | $406.00 | $182.70–$1,393.86 | 89% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT ANY JT W/O CM | $1,475.50 | $2,951.00 | $190.49–$2,951.00 | 17% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT A/JT W/O CM-PF | $203.00 | $406.00 | $182.70–$1,393.86 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT A/JT W/O CM-PF | $203.00 | $406.00 | $182.70–$1,393.86 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT ANY JT W/O CM | $1,475.50 | $2,951.00 | $190.49–$2,951.00 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT ANY JT W/O CM | $1,475.50 | $2,951.00 | $190.49–$2,951.00 | — | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARD PERF IMAG,TOMO,MULTI | $2,657.00 | $5,314.00 | $391.88–$5,314.00 | 39% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARD PERF IMAG,TOMO,MULTI | $2,657.00 | $5,314.00 | $391.88–$5,314.00 | — | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARD PERF IMAG,TOMO,MULTI | $2,657.00 | $5,314.00 | $391.88–$5,314.00 | — | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET W/CA CT;SKLL BSE-MD THIGH | $1,994.50 | $3,989.00 | $1,490.60–$8,236.44 | 56% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET W/CA CT;SKLL BSE-MD THIGH | $4,350.00 | $8,700.00 | $1,490.60–$8,700.00 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US,PELVIC NON-OB LIMITED/FU-PF | $55.50 | $111.00 | $45.56–$382.30 | 89% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US,PELVIC NON-OB LIMITED OR FU | $266.50 | $533.00 | $45.56–$533.00 | 49% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US,PELVIC NON-OB LIMITED/FU-PF | $55.50 | $111.00 | $45.56–$382.30 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US,PELVIC NON-OB LIMITED/FU-PF | $55.50 | $111.00 | $45.56–$382.30 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US,PELVIC NON-OB LIMITED OR FU | $266.50 | $533.00 | $45.56–$533.00 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US,PELVIC NON-OB LIMITED OR FU | $266.50 | $533.00 | $45.56–$533.00 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US,PELVIS NON-OB COMPLETE-PF | $92.00 | $184.00 | $82.80–$382.30 | 89% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US,PELVIS NON-OB COMPLETE | $354.50 | $709.00 | $96.36–$709.00 | 59% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US,PELVIS NON-OB COMPLETE-PF | $92.00 | $184.00 | $82.80–$382.30 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US,PELVIS NON-OB COMPLETE-PF | $92.00 | $184.00 | $82.80–$382.30 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US,PELVIS NON-OB COMPLETE | $354.50 | $709.00 | $96.36–$709.00 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US,PELVIS NON-OB COMPLETE | $354.50 | $709.00 | $96.36–$709.00 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US,PREGNANT UTERUS 1/F GES-PF | $86.50 | $173.00 | $77.85–$314.06 | 87% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US,PREGNANT UTERUS 1/FIRST GES | $417.00 | $834.00 | $104.75–$834.00 | 37% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 MFM-US,PREG UTERUS 1/FIRST GES | $417.00 | $834.00 | $104.75–$834.00 | 37% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US,PREGNANT UTERUS 1/F GES-PF | $86.50 | $173.00 | $77.85–$314.06 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 MFM-US,PREG UTERUS 1/FIRST GES | $417.00 | $834.00 | $104.75–$834.00 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US,PREGNANT UTERUS 1/FIRST GES | $417.00 | $834.00 | $104.75–$834.00 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB/FETAL ULTRASOUND-PF | $92.50 | $185.00 | $83.25–$251.74 | 86% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB/FETAL ULTRASOUND | $388.50 | $777.00 | $104.75–$777.00 | 41% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 MFM-OB/FETAL ULTRASOUND | $388.50 | $777.00 | $104.75–$777.00 | 41% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB/FETAL ULTRASOUND-PF | $92.50 | $185.00 | $83.25–$251.74 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB/FETAL ULTRASOUND | $388.50 | $777.00 | $104.75–$777.00 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 MFM-OB/FETAL ULTRASOUND | $388.50 | $777.00 | $104.75–$777.00 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US,PREGNANT UTERUS LM/1+F-PF | $59.50 | $119.00 | $53.55–$382.30 | 88% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US,PREGNANT UTERUS LIM/1+FETUS | $266.50 | $533.00 | $74.34–$533.00 | 46% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 MFM-US,PREG UTERUS LIM/1+FETUS | $266.50 | $533.00 | $74.34–$533.00 | 46% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US,PREGNANT UTERUS LM/1+F-PF | $59.50 | $119.00 | $53.55–$382.30 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US,PREGNANT UTERUS LIM/1+FETUS | $266.50 | $533.00 | $74.34–$533.00 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 MFM-US,PREG UTERUS LIM/1+FETUS | $266.50 | $533.00 | $74.34–$533.00 | — | 50% |
| Screening mammogram, both breasts CPT 77067 MAMMO,D,SCREEN IMPLANTS;UNI-PF | $44.00 | $88.00 | $39.60–$338.04 | 86% below | 50% |
| Screening mammogram, both breasts CPT 77067 MAMMO,D,SCREEN IMPLANTS;PF | $46.00 | $92.00 | $41.40–$338.04 | 85% below | 50% |
| Screening mammogram, both breasts CPT 77067 MAMMO,DGTL,SCREENING,ALL V-PF | $46.00 | $92.00 | $41.40–$338.04 | 85% below | 50% |
| Screening mammogram, both breasts CPT 77067 MAMMO,DIGITAL,SCREENING,ALL V | $134.50 | $269.00 | $116.71–$338.04 | 56% below | 50% |
| Screening mammogram, both breasts CPT 77067 MAMMO,DGTL,SCREEN IMPLANTS;UNI | $226.50 | $453.00 | $116.71–$453.00 | 26% below | 50% |
| Screening mammogram, both breasts CPT 77067 MAMMO,DIGITAL,SCREEN IMPLANTS | $226.50 | $453.00 | $116.71–$453.00 | 26% below | 50% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO,DGTL,SCREENING;UNILAT-PF | $44.00 | $88.00 | $39.60–$338.04 | 86% below | 50% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO,DIGITAL,SCREENING;UNILAT | $121.50 | $243.00 | $109.35–$338.04 | 60% below | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,D,SCREEN IMPLANTS;UNI-PF | $44.00 | $88.00 | $39.60–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,D,SCREEN IMPLANTS;UNI-PF | $44.00 | $88.00 | $39.60–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,D,SCREEN IMPLANTS;PF | $46.00 | $92.00 | $41.40–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DGTL,SCREENING,ALL V-PF | $46.00 | $92.00 | $41.40–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DGTL,SCREENING,ALL V-PF | $46.00 | $92.00 | $41.40–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,D,SCREEN IMPLANTS;PF | $46.00 | $92.00 | $41.40–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DIGITAL,SCREENING,ALL V | $134.50 | $269.00 | $116.71–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DIGITAL,SCREENING,ALL V | $134.50 | $269.00 | $116.71–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DGTL,SCREEN IMPLANTS;UNI | $226.50 | $453.00 | $116.71–$453.00 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DIGITAL,SCREEN IMPLANTS | $226.50 | $453.00 | $116.71–$453.00 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DIGITAL,SCREEN IMPLANTS | $226.50 | $453.00 | $116.71–$453.00 | — | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO,DGTL,SCREEN IMPLANTS;UNI | $236.00 | $472.00 | $116.71–$472.00 | — | 50% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO,DGTL,SCREENING;UNILAT-PF | $44.00 | $88.00 | $39.60–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO,DGTL,SCREENING;UNILAT-PF | $44.00 | $88.00 | $39.60–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO,DIGITAL,SCREENING;UNILAT | $121.50 | $243.00 | $109.35–$338.04 | — | 50% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO,DIGITAL,SCREENING;UNILAT | $126.50 | $253.00 | $113.85–$338.04 | — | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER COMPLETE MIN 2 VIEWS | $161.50 | $323.00 | $31.60–$323.00 | 47% below | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER COMPLETE MIN 2 VIEWS | $161.50 | $323.00 | $31.60–$323.00 | — | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER COMPLETE MIN 2 VIEWS | $161.50 | $323.00 | $31.60–$323.00 | — | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY SLEEP STDY W/T | $1,544.00 | $3,088.00 | $563.88–$3,088.00 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWLW W/SPCH-PF | $78.00 | $156.00 | $70.20–$382.30 | 87% below | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWLLW W/C&V,RAD ONLY-PF | $78.00 | $156.00 | $70.20–$382.30 | 87% below | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOW FNCTN C&V+SCOUT,D,1CS | $319.50 | $639.00 | $113.03–$639.00 | 47% below | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWLW W/SPCH-PF | $78.00 | $156.00 | $70.20–$382.30 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWLW W/SPCH-PF | $78.00 | $156.00 | $70.20–$382.30 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWLLW W/C&V,RAD ONLY-PF | $78.00 | $156.00 | $70.20–$382.30 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWLLW W/C&V,RAD ONLY-PF | $78.00 | $156.00 | $70.20–$382.30 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOW FNCTN C&V+SCOUT,D,1CS | $319.50 | $639.00 | $113.03–$639.00 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOW FNCTN C&V+SCOUT,D,1CS | $319.50 | $639.00 | $113.03–$639.00 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW W/SPCH | $332.50 | $665.00 | $113.03–$665.00 | — | 50% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND, TRANSVAGINAL-PF | $90.50 | $181.00 | $81.45–$298.46 | 86% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND, TRANSVAGINAL | $353.50 | $707.00 | $104.75–$707.00 | 47% below | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL-PF | $90.50 | $181.00 | $81.45–$298.46 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL-PF | $90.50 | $181.00 | $81.45–$298.46 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL | $353.50 | $707.00 | $104.75–$707.00 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL | $353.50 | $707.00 | $104.75–$707.00 | — | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US,PREGNANT UTERUS TRANSVAG-PF | $73.00 | $146.00 | $65.70–$382.30 | 88% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 MFM-US,PREG UTERUS TRANSVAG | $345.50 | $691.00 | $85.24–$691.00 | 41% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US,PREGNANT UTERUS TRANSVAG | $345.50 | $691.00 | $85.24–$691.00 | 41% below | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US,PREGNANT UTERUS TRANSVAG-PF | $73.00 | $146.00 | $65.70–$382.30 | — | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US,PREGNANT UTERUS TRANSVAG | $345.50 | $691.00 | $85.24–$691.00 | — | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 MFM-US,PREG UTERUS TRANSVAG | $345.50 | $691.00 | $85.24–$691.00 | — | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US,ABDOMINAL COMPLETE-PF | $104.00 | $208.00 | $93.60–$382.30 | 88% below | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US,ABDOMINAL COMPLETE | $407.50 | $815.00 | $104.75–$815.00 | 53% below | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US,ABDOMINAL COMPLETE-PF | $104.00 | $208.00 | $93.60–$382.30 | — | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US,ABDOMINAL COMPLETE-PF | $104.00 | $208.00 | $93.60–$382.30 | — | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US,ABDOMINAL COMPLETE | $407.50 | $815.00 | $104.75–$815.00 | — | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US,ABDOMINAL COMPLETE | $407.50 | $815.00 | $104.75–$815.00 | — | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US,SCROTUM AND CONTENTS-PF | $70.50 | $141.00 | $63.45–$382.30 | 91% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US,SCROTUM AND CONTENTS | $356.50 | $713.00 | $91.35–$713.00 | 52% below | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US,SCROTUM AND CONTENTS-PF | $70.50 | $141.00 | $63.45–$382.30 | — | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US,SCROTUM AND CONTENTS-PF | $70.50 | $141.00 | $63.45–$382.30 | — | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US,SCROTUM AND CONTENTS | $356.50 | $713.00 | $91.35–$713.00 | — | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US,SCROTUM AND CONTENTS | $356.50 | $713.00 | $91.35–$713.00 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US,SOFT TISSUES HEAD & NECK-PF | $74.50 | $149.00 | $67.05–$382.30 | 88% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US,SOFT TISSUES HEAD & NECK | $345.50 | $691.00 | $100.29–$691.00 | 46% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US,SOFT TISSUES HEAD & NECK-PF | $74.50 | $149.00 | $67.05–$382.30 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US,SOFT TISSUES HEAD & NECK-PF | $74.50 | $149.00 | $67.05–$382.30 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US,SOFT TISSUES HEAD & NECK | $345.50 | $691.00 | $100.29–$691.00 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US,SOFT TISSUES HEAD & NECK | $345.50 | $691.00 | $100.29–$691.00 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI,UPPER+SCOUT ABD+DLYD;1CS-PF | $71.50 | $143.00 | $64.35–$844.15 | 90% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI,UPPER+SCOUT ABD+DELAYED;1CS | $319.50 | $639.00 | $112.10–$844.15 | 57% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI,UPPER+SCOUT ABD+DLYD;1CS-PF | $71.50 | $143.00 | $64.35–$844.15 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI,UPPER+SCOUT ABD+DLYD;1CS-PF | $71.50 | $143.00 | $64.35–$844.15 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI,UPPER+SCOUT ABD+DELAYED;1CS | $319.50 | $639.00 | $112.10–$844.15 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI,UPPER+SCOUT ABD+DELAYED;1CS | $319.50 | $639.00 | $112.10–$844.15 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN EXT-VEINS,UNI/LIM | $415.50 | $831.00 | $104.75–$831.00 | 48% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX SCAN EXT-VEINS,UNI/LIM | $415.50 | $831.00 | $104.75–$831.00 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX SCAN EXT-VEINS,UNI/LIM | $415.50 | $831.00 | $104.75–$831.00 | — | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST COMPLETE MIN 3 VIEWS | $161.50 | $323.00 | $37.25–$323.00 | 55% below | 50% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST COMPLETE MIN 3 VIEWS | $161.50 | $323.00 | $37.25–$323.00 | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST COMPLETE MIN 3 VIEWS | $161.50 | $323.00 | $37.25–$323.00 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP,UNI WITH PELVIS WP;2-3 V | $161.50 | $323.00 | $43.15–$323.00 | 60% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP,UNI WITH PELVIS WP;2-3 V | $161.50 | $323.00 | $43.15–$323.00 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP,UNI WITH PELVIS WP;2-3 V | $161.50 | $323.00 | $43.15–$323.00 | — | 50% |
| X-ray of the abdomen, 1 view CPT 74018 SITZ MARKER EXAM;DAY 5 | $161.50 | $323.00 | $27.41–$323.00 | 52% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 STIZ MARKER EXAM;DAY 1 | $161.50 | $323.00 | $27.41–$323.00 | 52% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN,1 VIEW | $161.50 | $323.00 | $27.41–$323.00 | 52% below | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 STIZ MARKER EXAM;DAY 1 | $161.50 | $323.00 | $27.41–$323.00 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN,1 VIEW | $161.50 | $323.00 | $27.41–$323.00 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 SITZ MARKER EXAM;DAY 5 | $161.50 | $323.00 | $27.41–$323.00 | — | 50% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE, 2 VIEWS | $161.50 | $323.00 | $29.12–$323.00 | 44% below | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE, 2 VIEWS RIGHT | $161.50 | $323.00 | $29.12–$323.00 | 44% below | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE, 2 VIEWS LEFT | $161.50 | $323.00 | $29.12–$323.00 | 44% below | 50% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE, 2 VIEWS | $161.50 | $323.00 | $29.12–$323.00 | — | 50% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE, 2 VIEWS | $161.50 | $323.00 | $29.12–$323.00 | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE, 2 VIEWS LEFT | $161.50 | $323.00 | $29.12–$323.00 | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE, 2 VIEWS RIGHT | $161.50 | $323.00 | $29.12–$323.00 | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE, 2 VIEWS RIGHT | $168.00 | $336.00 | $29.12–$336.00 | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE, 2 VIEWS LEFT | $168.00 | $336.00 | $29.12–$336.00 | — | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S), MINIMUM 2 VIEWS | $161.50 | $323.00 | $34.38–$323.00 | 33% below | 50% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S), MINIMUM 2 VIEWS | $161.50 | $323.00 | $34.38–$323.00 | — | 50% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S), MINIMUM 2 VIEWS | $161.50 | $323.00 | $34.38–$323.00 | — | 50% |
| X-ray of the foot, 2 views CPT 73620 FOOT, 2 VIEWS | $161.50 | $323.00 | $25.83–$323.00 | 52% below | 50% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT, 2 VIEWS LEFT | $161.50 | $323.00 | $25.83–$323.00 | 52% below | 50% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT, 2 VIEWS RIGHT | $161.50 | $323.00 | $25.83–$323.00 | 52% below | 50% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT, 2 VIEWS | $161.50 | $323.00 | $25.83–$323.00 | — | 50% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT, 2 VIEWS | $161.50 | $323.00 | $25.83–$323.00 | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT, 2 VIEWS LEFT | $161.50 | $323.00 | $25.83–$323.00 | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT, 2 VIEWS RIGHT | $161.50 | $323.00 | $25.83–$323.00 | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT, 2 VIEWS RIGHT | $168.00 | $336.00 | $25.83–$336.00 | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT, 2 VIEWS LEFT | $168.00 | $336.00 | $25.83–$336.00 | — | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT CMP,MIN 3V;WEIGHT BEARING | $161.50 | $323.00 | $30.96–$323.00 | 57% below | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT COMPLETE, MINIMUM 3 VIEWS | $161.50 | $323.00 | $30.96–$323.00 | 57% below | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT COMPLETE, MINIMUM 3 VIEWS | $161.50 | $323.00 | $30.96–$323.00 | — | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT CMP,MIN 3V;WEIGHT BEARING | $161.50 | $323.00 | $30.96–$323.00 | — | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT CMP,MIN 3V;WEIGHT BEARING | $161.50 | $323.00 | $30.96–$323.00 | — | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT COMPLETE, MINIMUM 3 VIEWS | $161.50 | $323.00 | $30.96–$323.00 | — | 50% |
| X-ray of the hand, 3 or more views CPT 73130 HAND MINIMUM 3 VIEWS | $161.50 | $323.00 | $33.66–$323.00 | 58% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND MINIMUM 3 VIEWS RIGHT | $161.50 | $323.00 | $33.66–$323.00 | 58% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND MINIMUM 3 VIEWS LEFT | $161.50 | $323.00 | $33.66–$323.00 | 58% below | 50% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MINIMUM 3 VIEWS | $161.50 | $323.00 | $33.66–$323.00 | — | 50% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MINIMUM 3 VIEWS | $161.50 | $323.00 | $33.66–$323.00 | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS RIGHT | $161.50 | $323.00 | $33.66–$323.00 | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS LEFT | $161.50 | $323.00 | $33.66–$323.00 | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS LEFT | $168.00 | $336.00 | $33.66–$336.00 | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS RIGHT | $168.00 | $336.00 | $33.66–$336.00 | — | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE,1-2 VIEWS STANDING | $161.50 | $323.00 | $30.92–$323.00 | 42% below | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE,1-2 VIEWS | $161.50 | $323.00 | $30.92–$323.00 | 42% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE,1-2 VIEWS STANDING LEFT | $161.50 | $323.00 | $30.92–$323.00 | 42% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE,1-2 VIEWS STANDING RIGHT | $161.50 | $323.00 | $30.92–$323.00 | 42% below | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE,1-2 VIEWS | $161.50 | $323.00 | $30.92–$323.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE,1-2 VIEWS STANDING | $161.50 | $323.00 | $30.92–$323.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE,1-2 VIEWS | $161.50 | $323.00 | $30.92–$323.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE,1-2 VIEWS STANDING | $161.50 | $323.00 | $30.92–$323.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE,1-2 VIEWS STANDING RIGHT | $161.50 | $323.00 | $30.92–$323.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE,1-2 VIEWS STANDING LEFT | $161.50 | $323.00 | $30.92–$323.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE,1-2 VIEWS STANDING LEFT | $168.00 | $336.00 | $30.92–$336.00 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE,1-2 VIEWS STANDING RIGHT | $168.00 | $336.00 | $30.92–$336.00 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE,LUMBOSACRAL 2/3 VIEWS | $161.50 | $323.00 | $36.27–$382.30 | 66% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE,LUMBOSACRAL 2/3 VIEWS | $161.50 | $323.00 | $36.27–$382.30 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE,LUMBOSACRAL 2/3 VIEWS | $161.50 | $323.00 | $36.27–$382.30 | — | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE,LUMBOSACRAL MIN 4 VIEWS | $271.50 | $543.00 | $47.21–$543.00 | 58% below | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE,LUMBOSACRAL MIN 4 VIEWS | $271.50 | $543.00 | $47.21–$543.00 | — | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE,LUMBOSACRAL MIN 4 VIEWS | $271.50 | $543.00 | $47.21–$543.00 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE,THORACIC 2 VIEWS | $161.50 | $323.00 | $29.89–$382.30 | 60% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE,THORACIC 2 VIEWS | $161.50 | $323.00 | $29.89–$382.30 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE,THORACIC 2 VIEWS | $161.50 | $323.00 | $29.89–$382.30 | — | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMP MIN 3 VIEWS | $161.50 | $323.00 | $33.96–$323.00 | 45% below | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP MIN 3 VIEWS | $161.50 | $323.00 | $33.96–$323.00 | — | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP MIN 3 VIEWS | $161.50 | $323.00 | $33.96–$323.00 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE,CERVICAL 2 OR 3 VIEWS | $161.50 | $323.00 | $35.97–$323.00 | 57% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE,CERVICAL 2 OR 3 VIEWS | $161.50 | $323.00 | $35.97–$323.00 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE,CERVICAL 2 OR 3 VIEWS | $161.50 | $323.00 | $35.97–$323.00 | — | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS | $161.50 | $323.00 | $25.28–$382.30 | 57% below | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS | $161.50 | $323.00 | $25.28–$382.30 | — | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS | $161.50 | $323.00 | $25.28–$382.30 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX MIN OF 2 VIEWS | $161.50 | $323.00 | $29.47–$323.00 | 51% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN OF 2 VIEWS | $161.50 | $323.00 | $29.47–$323.00 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN OF 2 VIEWS | $161.50 | $323.00 | $29.47–$323.00 | — | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSAMINASE;ALANINE AMINO | $56.50 | $113.00 | $5.30–$113.00 | 4% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSAMINASE;ALANINE AMINO | $56.50 | $113.00 | $5.30–$113.00 | — | 50% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSAMINASE;ALANINE AMINO | $56.50 | $113.00 | $5.30–$113.00 | — | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE;ASPARTATE AMINO | $56.50 | $113.00 | $5.18–$113.00 | 4% below | 50% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE;ASPARTATE AMINO | $56.50 | $113.00 | $5.18–$113.00 | — | 50% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE;ASPARTATE AMINO | $56.50 | $113.00 | $5.18–$113.00 | — | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $209.50 | $419.00 | $47.63–$419.00 | 46% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $209.50 | $419.00 | $47.63–$419.00 | — | 50% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $265.50 | $531.00 | $47.63–$531.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT OAK TREE | $5.00 | $10.00 | $4.50–$38.64 | 80% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT PIGWEED | $7.50 | $15.00 | $5.22–$38.64 | 71% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQN RICE IgE | $10.50 | $21.00 | $5.22–$38.64 | 59% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQN RICE IGE | $10.50 | $21.00 | $5.22–$38.64 | 59% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/ASPERGILLUS F | $12.50 | $25.00 | $5.22–$38.64 | 51% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/S MANGO FRT | $12.50 | $25.00 | $5.22–$38.64 | 51% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT APRICOT | $12.50 | $25.00 | $5.22–$38.64 | 51% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT WALNUT T | $14.50 | $29.00 | $5.22–$38.64 | 43% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT D.PTE... | $14.50 | $29.00 | $5.22–$38.64 | 43% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE:QNT/SQNT D.FARINA | $14.50 | $29.00 | $5.22–$38.64 | 43% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT OAK | $14.50 | $29.00 | $5.22–$38.64 | 43% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT LATEX | $14.95 | $29.90 | $5.22–$38.64 | 42% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IgE;QUANT/SQ CAE,EA | $14.95 | $29.90 | $5.22–$38.64 | 42% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QUANT/SQ CAE,EA | $14.95 | $29.90 | $5.22–$38.64 | 42% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT ALMOND | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT SHRIMP | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT TOMATO | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT SESAME S | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT WHEAT | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/S KIDNEY BEAN | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT MUSTARD | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT BANANA | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT ASCARIS | $15.00 | $30.00 | $5.22–$38.64 | 41% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT CAT EPT | $18.50 | $37.00 | $5.22–$38.64 | 28% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT&S PECAN/HCKRY | $18.50 | $37.00 | $5.22–$38.64 | 28% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT&S CANTALOUPE | $21.00 | $42.00 | $5.22–$42.00 | 18% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT PINTO BN | $21.00 | $42.00 | $5.22–$42.00 | 18% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT YEAST | $21.13 | $42.25 | $5.22–$42.25 | 18% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT SALMON, IGE | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT SESAME SEED | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT CACAO | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT CORN | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT SOYBEAN | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT SALMON, IgE | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT TUNA, IGE | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT SCALLOP | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT TUNA, IgE | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT COW MILK | $22.00 | $44.00 | $5.22–$44.00 | 14% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/PEANUT,TR PCP | $22.50 | $45.00 | $5.22–$45.00 | 12% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT RAGWEED | $26.75 | $53.50 | $5.22–$53.50 | 4% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT LIVE OAK | $26.75 | $53.50 | $5.22–$53.50 | 4% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT PEANUT | $26.75 | $53.50 | $5.22–$53.50 | 4% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT EGG YOLK | $26.75 | $53.50 | $5.22–$53.50 | 4% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT EGG WHT | $26.75 | $53.50 | $5.22–$53.50 | 4% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT DOG DNDR | $26.75 | $53.50 | $5.22–$53.50 | 4% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT PEACH | $27.00 | $54.00 | $5.22–$54.00 | 5% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT&S SHELLFISH | $59.50 | $119.00 | $5.22–$119.00 | 132% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT&S SHELLFISH | $59.50 | $119.00 | $5.22–$119.00 | 132% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT ALLERGY MOLD | $72.88 | $145.75 | $5.22–$145.75 | 184% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT TREE NUT | $134.50 | $269.00 | $5.22–$269.00 | 425% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN;QNT/SQNT CMP FOOD PNL | $267.50 | $535.00 | $5.22–$535.00 | 944% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT | $350.00 | $700.00 | $5.22–$700.00 | 1266% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT X 16 | $376.00 | $752.00 | $5.22–$752.00 | 1368% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT X 26 | $386.00 | $772.00 | $5.22–$772.00 | 1407% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT REGION X | $412.50 | $825.00 | $5.22–$825.00 | 1510% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE;QNT/SQNT X 23 | $427.00 | $854.00 | $5.22–$854.00 | 1567% above | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT OAK TREE | $5.00 | $10.00 | $4.50–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT OAK TREE | $5.00 | $10.00 | $4.50–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PIGWEED | $7.50 | $15.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PIGWEED | $7.50 | $15.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQN RICE IgE | $10.50 | $21.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQN RICE IGE | $10.50 | $21.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQN RICE IGE | $10.50 | $21.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT APRICOT | $12.50 | $25.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/S MANGO FRT | $12.50 | $25.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/ASPERGILLUS F | $12.50 | $25.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT APRICOT | $12.50 | $25.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/S MANGO FRT | $12.50 | $25.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/ASPERGILLUS F | $12.50 | $25.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE:QNT/SQNT D.FARINA | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT D.PTE... | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT OAK | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT WALNUT T | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT OAK | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT D.PTE... | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE:QNT/SQNT D.FARINA | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT WALNUT T | $14.50 | $29.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QUANT/SQ CAE,EA | $14.95 | $29.90 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT LATEX | $14.95 | $29.90 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QUANT/SQ CAE,EA | $14.95 | $29.90 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT LATEX | $14.95 | $29.90 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IgE;QUANT/SQ CAE,EA | $14.95 | $29.90 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT ALMOND | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT ALMOND | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT ASCARIS | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/S KIDNEY BEAN | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT WHEAT | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT TOMATO | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SHRIMP | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SESAME S | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT MUSTARD | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT BANANA | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT ASCARIS | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SHRIMP | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT BANANA | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT MUSTARD | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/S KIDNEY BEAN | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT WHEAT | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SESAME S | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT TOMATO | $15.00 | $30.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S PECAN/HCKRY | $18.50 | $37.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S PECAN/HCKRY | $18.50 | $37.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CAT EPT | $18.50 | $37.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CAT EPT | $18.50 | $37.00 | $5.22–$38.64 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PINTO BN | $21.00 | $42.00 | $5.22–$42.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S CANTALOUPE | $21.00 | $42.00 | $5.22–$42.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S CANTALOUPE | $21.00 | $42.00 | $5.22–$42.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PINTO BN | $21.00 | $42.00 | $5.22–$42.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT YEAST | $21.13 | $42.25 | $5.22–$42.25 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT YEAST | $21.13 | $42.25 | $5.22–$42.25 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT COW MILK | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT SESAME SEED | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT SALMON, IgE | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SOYBEAN | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT SALMON, IGE | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CORN | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CACAO | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CORN | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT COW MILK | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT TUNA, IGE | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SOYBEAN | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT TUNA, IgE | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SCALLOP | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT TUNA, IGE | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT SESAME SEED | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT SCALLOP | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT SALMON, IGE | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CACAO | $22.00 | $44.00 | $5.22–$44.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/PEANUT,TR PCP | $22.50 | $45.00 | $5.22–$45.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/PEANUT,TR PCP | $22.50 | $45.00 | $5.22–$45.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT LIVE OAK | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PEANUT | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT EGG YOLK | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT LIVE OAK | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT EGG WHT | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT DOG DNDR | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT RAGWEED | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT EGG WHT | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT DOG DNDR | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT RAGWEED | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT EGG YOLK | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PEANUT | $26.75 | $53.50 | $5.22–$53.50 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PEACH | $27.00 | $54.00 | $5.22–$54.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT PEACH | $27.00 | $54.00 | $5.22–$54.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT CATFISH | $53.50 | $107.00 | $5.22–$107.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S SHELLFISH | $59.50 | $119.00 | $5.22–$119.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S SHELLFISH | $59.50 | $119.00 | $5.22–$119.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT&S SHELLFISH | $59.50 | $119.00 | $5.22–$119.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT ALLERGY MOLD | $72.88 | $145.75 | $5.22–$145.75 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT ALLERGY MOLD | $72.88 | $145.75 | $5.22–$145.75 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT TREE NUT | $134.50 | $269.00 | $5.22–$269.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT TREE NUT | $134.50 | $269.00 | $5.22–$269.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN;QNT/SQNT CMP FOOD PNL | $267.50 | $535.00 | $5.22–$535.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN;QNT/SQNT CMP FOOD PNL | $267.50 | $535.00 | $5.22–$535.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT | $350.00 | $700.00 | $5.22–$700.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT | $350.00 | $700.00 | $5.22–$700.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT X 16 | $376.00 | $752.00 | $5.22–$752.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT X 16 | $376.00 | $752.00 | $5.22–$752.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT X 26 | $386.00 | $772.00 | $5.22–$772.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT X 26 | $386.00 | $772.00 | $5.22–$772.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT REGION X | $412.50 | $825.00 | $5.22–$825.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT REGION X | $412.50 | $825.00 | $5.22–$825.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT X 23 | $427.00 | $854.00 | $5.22–$854.00 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE;QNT/SQNT X 23 | $427.00 | $854.00 | $5.22–$854.00 | — | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE,A | $61.00 | $122.00 | $12.95–$122.00 | 18% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE,A | $61.00 | $122.00 | $12.95–$122.00 | — | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE,A | $80.00 | $160.00 | $12.95–$160.00 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES(ANA) | $29.71 | $59.42 | $12.09–$89.52 | 71% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY | $50.50 | $101.00 | $12.09–$101.00 | 51% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANT-BDY(ANA)E/1866 | $86.00 | $172.00 | $12.09–$172.00 | 17% below | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES(ANA) | $29.71 | $59.42 | $12.09–$89.52 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY | $50.50 | $101.00 | $12.09–$101.00 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY | $50.50 | $101.00 | $12.09–$101.00 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANT-BDY(ANA)E/1866 | $86.00 | $172.00 | $12.09–$172.00 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANT-BDY(ANA)E/1866 | $86.00 | $172.00 | $12.09–$172.00 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES(ANA) | $173.00 | $346.00 | $12.09–$346.00 | — | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $136.50 | $273.00 | $39.26–$273.00 | 31% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE | $136.50 | $273.00 | $39.26–$273.00 | — | 50% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE | $136.50 | $273.00 | $39.26–$273.00 | — | 50% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL,CALCIUM T | $123.00 | $246.00 | $8.46–$246.00 | 52% below | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL,CALCIUM T | $123.00 | $246.00 | $8.46–$246.00 | — | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL,CALCIUM T | $123.00 | $246.00 | $8.46–$246.00 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LVL IV-SURG;GRSS/MICRO E | $53.00 | $106.00 | $47.70–$268.20 | 83% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH LVL IV-SURG;GRSS/MICRO E | $53.00 | $106.00 | $47.70–$268.20 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH LVL IV-SURG;GRSS/MICRO E | $64.00 | $128.00 | $51.63–$268.20 | — | 50% |
| Blood culture for bacteria CPT 87040 CULTURE,BACTERIAL BLD,AEROBIC | $116.00 | $232.00 | $10.32–$232.00 | 51% below | 50% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE,BACTERIAL BLD,AEROBIC | $116.00 | $232.00 | $10.32–$232.00 | — | 50% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE,BACTERIAL BLD,AEROBIC | $116.00 | $232.00 | $10.32–$232.00 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 FORENSIC EXAM: VENIPUNCTURE | $12.50 | $25.00 | $8.83–$25.00 | 39% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION OF BLD,VENIPUNCTURE | $16.00 | $32.00 | $8.83–$32.00 | 22% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 FORENSIC EXAM: VENIPUNCTURE | $12.50 | $25.00 | $8.83–$25.00 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION OF BLD,VENIPUNCTURE | $16.00 | $32.00 | $8.83–$32.00 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION OF BLD,VENIPUNCTURE | $16.00 | $32.00 | $8.83–$32.00 | — | 50% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE;QUANTITATIVE BLOOD | $56.50 | $113.00 | $3.93–$113.00 | 15% above | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE;QUANTITATIVE BLOOD | $56.50 | $113.00 | $3.93–$113.00 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE;QUANTITATIVE BLOOD | $56.50 | $113.00 | $3.93–$113.00 | — | 50% |
| Blood lead test CPT 83655 LEAD | $44.00 | $88.00 | $12.11–$89.70 | 14% below | 50% |
| Blood lead test inpatient CPT 83655 LEAD | $44.00 | $88.00 | $12.11–$89.70 | — | 50% |
| Blood lead test inpatient CPT 83655 LEAD | $66.83 | $133.66 | $12.11–$133.66 | — | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN,CHORIONIC; QUAL | $96.50 | $193.00 | $7.52–$193.00 | 47% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN,CHORIONIC; QUAL | $96.50 | $193.00 | $7.52–$193.00 | — | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN,CHORIONIC; QUAL | $96.50 | $193.00 | $7.52–$193.00 | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO | $169.00 | $338.00 | $121.71–$630.24 | 91% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO | $169.00 | $338.00 | $121.71–$630.24 | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO | $169.00 | $338.00 | $121.71–$630.24 | — | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $135.00 | $270.00 | $5.18–$270.00 | 132% above | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $135.00 | $270.00 | $5.18–$270.00 | — | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $135.00 | $270.00 | $5.18–$270.00 | — | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TOXIN(S) | $129.00 | $258.00 | $37.27–$259.98 | 34% below | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFF,TG,APT;IH | $193.50 | $387.00 | $37.27–$387.00 | at median | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE TOXIN(S) | $129.00 | $258.00 | $37.27–$259.98 | — | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE TOXIN(S) | $129.00 | $258.00 | $37.27–$259.98 | — | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFF,TG,APT;IH | $193.50 | $387.00 | $37.27–$387.00 | — | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFF,TG,APT;IH | $193.50 | $387.00 | $37.27–$387.00 | — | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY/TUMOR ANQT CA 19-9 | $72.50 | $145.00 | $20.81–$154.20 | 45% below | 50% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY/TUMOR ANQT CA 19-9 | $72.50 | $145.00 | $20.81–$154.20 | — | 50% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY/TUMOR ANQT CA 19-9 | $72.50 | $145.00 | $20.81–$154.20 | — | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY ANTIGE,QUANT;CA125 | $72.50 | $145.00 | $20.81–$154.20 | 55% below | 50% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY ANTIGE,QUANT;CA125 | $72.50 | $145.00 | $20.81–$154.20 | — | 50% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY ANTIGE,QUANT;CA125 | $72.50 | $145.00 | $20.81–$154.20 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 XPR-SARS COV2 APT,HIGH TPT;UCC | $28.50 | $57.00 | $25.65–$57.00 | 66% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 RNA,QUAL R-TIME-PCR | $103.00 | $206.00 | $51.31–$206.00 | 24% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 PCR;CPL | $103.00 | $206.00 | $51.31–$206.00 | 24% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2(COVID19)UNIVERSITY | $103.00 | $206.00 | $51.31–$206.00 | 24% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2,COVID PCR TST:DM | $107.50 | $215.00 | $51.31–$215.00 | 30% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2,COVID PCR TST:DM | $107.50 | $215.00 | $51.31–$215.00 | 30% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 XPR-SARS COV2 APT,HIGH TPT;IH | $107.50 | $215.00 | $51.31–$215.00 | 30% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 XPR-SARS COV2 APT,HIGH TPT;UCC | $28.50 | $57.00 | $25.65–$57.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 RNA,QUAL R-TIME-PCR | $103.00 | $206.00 | $51.31–$206.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2(COVID19)UNIVERSITY | $103.00 | $206.00 | $51.31–$206.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 PCR;CPL | $103.00 | $206.00 | $51.31–$206.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 XPR-SARS COV2 APT,HIGH TPT;IH | $107.50 | $215.00 | $51.31–$215.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2,COVID PCR TST:DM | $107.50 | $215.00 | $51.31–$215.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2,COVID PCR TST:DM | $107.50 | $215.00 | $51.31–$215.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2,COVID PCR TST:DM | $107.50 | $215.00 | $51.31–$215.00 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 XPR-SARS COV2 APT,HIGH TPT;IH | $107.50 | $215.00 | $51.31–$215.00 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECT AGT DNA/RNA;CHLAMYDIA | $25.00 | $50.00 | $22.50–$259.98 | 80% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS,APT | $44.00 | $88.00 | $35.09–$259.98 | 65% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS,APT;IH | $66.00 | $132.00 | $35.09–$259.98 | 47% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INF AGT DNA/RNA;CHLAM E/7438SW | $76.50 | $153.00 | $35.09–$259.98 | 38% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECT AGT DNA/RNA;CHLAMYDIA | $25.00 | $50.00 | $22.50–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS,APT | $44.00 | $88.00 | $35.09–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS,APT | $44.00 | $88.00 | $35.09–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS,APT;IH | $66.00 | $132.00 | $35.09–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS,APT;IH | $66.00 | $132.00 | $35.09–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INF AGT DNA/RNA;CHLAM E/7438SW | $76.50 | $153.00 | $35.09–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INF AGT DNA/RNA;CHLAM E/7438SW | $76.50 | $153.00 | $35.09–$259.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECT AGT DNA/RNA;CHLAMYDIA | $91.00 | $182.00 | $35.09–$259.98 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL E/92145 | $25.00 | $50.00 | $13.39–$99.18 | 90% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $173.50 | $347.00 | $13.39–$347.00 | 29% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL E/92145 | $25.00 | $50.00 | $13.39–$99.18 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL E/92145 | $25.00 | $50.00 | $13.39–$99.18 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $173.50 | $347.00 | $13.39–$347.00 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $173.50 | $347.00 | $13.39–$347.00 | — | 50% |
| Complete blood count (CBC) with differential CPT 85025 BLD COUNT;COMP AUTOMATED & DIF | $49.00 | $98.00 | $7.77–$98.00 | 48% below | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 BLD COUNT;COMP AUTOMATED & DIF | $49.00 | $98.00 | $7.77–$98.00 | — | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 BLD COUNT;COMP AUTOMATED & DIF | $49.00 | $98.00 | $7.77–$98.00 | — | 50% |
| Complete blood count (CBC), no differential CPT 85027 BLD CNT;CMPLT (CBC), AUTOMATED | $49.00 | $98.00 | $6.47–$98.00 | 53% below | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 BLD CNT;CMPLT (CBC), AUTOMATED | $49.00 | $98.00 | $6.47–$98.00 | — | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 BLD CNT;CMPLT (CBC), AUTOMATED | $49.00 | $98.00 | $6.47–$98.00 | — | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $140.50 | $281.00 | $10.56–$281.00 | 61% below | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $140.50 | $281.00 | $10.56–$281.00 | — | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $140.50 | $281.00 | $10.56–$281.00 | — | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRAD PDTS,D-DIM;QUANT | $101.50 | $203.00 | $10.18–$203.00 | 45% below | 50% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRAD PDTS,D-DIM;QUANT | $101.50 | $203.00 | $10.18–$203.00 | — | 50% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRAD PDTS,D-DIM;QUANT | $101.50 | $203.00 | $10.18–$203.00 | — | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE | $86.50 | $173.00 | $22.23–$173.00 | 45% below | 50% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE | $86.50 | $173.00 | $22.23–$173.00 | — | 50% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE | $115.00 | $230.00 | $22.23–$230.00 | — | 50% |
| Estradiol blood test CPT 82670 ESTRADIOL;TOTAL | $112.00 | $224.00 | $27.94–$224.00 | 26% below | 50% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL;TOTAL | $112.00 | $224.00 | $27.94–$224.00 | — | 50% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL;TOTAL | $112.00 | $224.00 | $27.94–$224.00 | — | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN;FSH | $66.00 | $132.00 | $18.58–$137.64 | 59% below | 50% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN;FSH | $66.00 | $132.00 | $18.58–$137.64 | — | 50% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN;FSH | $69.50 | $139.00 | $18.58–$139.00 | — | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $96.50 | $193.00 | $19.63–$193.00 | 55% below | 50% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL | $96.50 | $193.00 | $19.63–$193.00 | — | 50% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL | $96.50 | $193.00 | $19.63–$193.00 | — | 50% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $60.50 | $121.00 | $13.63–$121.00 | 41% below | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $60.50 | $121.00 | $13.63–$121.00 | — | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $60.50 | $121.00 | $13.63–$121.00 | — | 50% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID;SERUM | $52.00 | $104.00 | $14.70–$108.90 | 37% below | 50% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID;SERUM | $52.00 | $104.00 | $14.70–$108.90 | — | 50% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID;SERUM | $52.00 | $104.00 | $14.70–$108.90 | — | 50% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3; FR | $131.50 | $263.00 | $16.94–$263.00 | 13% below | 50% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3; FR | $131.50 | $263.00 | $16.94–$263.00 | — | 50% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3; FR | $166.50 | $333.00 | $16.94–$333.00 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE:FREE | $73.50 | $147.00 | $9.02–$147.00 | 29% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; FREE | $82.50 | $165.00 | $9.02–$165.00 | 20% below | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE:FREE | $73.50 | $147.00 | $9.02–$147.00 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE:FREE | $73.50 | $147.00 | $9.02–$147.00 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; FREE | $82.50 | $165.00 | $9.02–$165.00 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; FREE | $82.50 | $165.00 | $9.02–$165.00 | — | 50% |
| Free testosterone test CPT 84402 TESTOSTERONE; FREE | $100.50 | $201.00 | $25.47–$201.00 | 9% below | 50% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE | $100.50 | $201.00 | $25.47–$201.00 | — | 50% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE | $100.50 | $201.00 | $25.47–$201.00 | — | 50% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $171.50 | $343.00 | $154.35–$343.00 | 63% below | 50% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $171.50 | $343.00 | $154.35–$343.00 | — | 50% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $171.50 | $343.00 | $154.35–$343.00 | — | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,1H | $140.50 | $281.00 | $12.87–$281.00 | 13% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,2H | $140.50 | $281.00 | $12.87–$281.00 | 13% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,3H | $140.50 | $281.00 | $12.87–$281.00 | 13% below | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,2H | $140.50 | $281.00 | $12.87–$281.00 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,1H | $140.50 | $281.00 | $12.87–$281.00 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,3H | $140.50 | $281.00 | $12.87–$281.00 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,2H | $140.50 | $281.00 | $12.87–$281.00 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,1H | $140.50 | $281.00 | $12.87–$281.00 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TST,3 SPM,3H | $140.50 | $281.00 | $12.87–$281.00 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGT DNA/RNA;NG,DPT | $25.00 | $50.00 | $22.50–$259.98 | 82% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE,APT | $44.00 | $88.00 | $35.09–$259.98 | 69% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE,APT;IH | $66.00 | $132.00 | $35.09–$259.98 | 53% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGT DNA/RAN;NG,DPT | $75.00 | $150.00 | $35.09–$259.98 | 47% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INF AGT DNA/RNA;NG,DPTE/7438SW | $76.50 | $153.00 | $35.09–$259.98 | 46% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGT DNA/RNA;NG,DPT | $25.00 | $50.00 | $22.50–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE,APT | $44.00 | $88.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE,APT | $44.00 | $88.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE,APT;IH | $66.00 | $132.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE,APT;IH | $66.00 | $132.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGT DNA/RAN;NG,DPT | $75.00 | $150.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGT DNA/RAN;NG,DPT | $75.00 | $150.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INF AGT DNA/RNA;NG,DPTE/7438SW | $76.50 | $153.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INF AGT DNA/RNA;NG,DPTE/7438SW | $76.50 | $153.00 | $35.09–$259.98 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGT DNA/RNA;NG,DPT | $91.00 | $182.00 | $35.09–$259.98 | — | 50% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLR IGG/M/A ABS | $265.00 | $530.00 | $16.85–$530.00 | 103% above | 50% |
| H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLR IGG/M/A ABS | $265.00 | $530.00 | $16.85–$530.00 | — | 50% |
| H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLR IGG/M/A ABS | $265.00 | $530.00 | $16.85–$530.00 | — | 50% |
| H. pylori stool antigen test CPT 87338 INFECT AGENT H. PYLORI, STOOL | $81.50 | $163.00 | $14.38–$163.00 | at median | 50% |
| H. pylori stool antigen test inpatient CPT 87338 INFECT AGENT H. PYLORI, STOOL | $81.50 | $163.00 | $14.38–$163.00 | — | 50% |
| H. pylori stool antigen test inpatient CPT 87338 INFECT AGENT H. PYLORI, STOOL | $81.50 | $163.00 | $14.38–$163.00 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECT AGT DET;HIV-1 QUANT | $243.50 | $487.00 | $85.10–$630.36 | 25% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECT AGT DET;HIV-1 QUANT | $243.50 | $487.00 | $85.10–$630.36 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECT AGT DET;HIV-1 QUANT | $243.50 | $487.00 | $85.10–$630.36 | — | 50% |
| HIV-1 and HIV-2 antibody test CPT 86703 ANTI-BDY;HIV-1&HIV-2 SGL ASSAY | $79.50 | $159.00 | $13.71–$159.00 | 16% below | 50% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTI-BDY;HIV-1&HIV-2 SGL ASSAY | $79.50 | $159.00 | $13.71–$159.00 | — | 50% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTI-BDY;HIV-1&HIV-2 SGL ASSAY | $79.50 | $159.00 | $13.71–$159.00 | — | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 ANTIGEN,W HIV-1&HIV-2,1R | $93.50 | $187.00 | $24.08–$187.00 | 36% below | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 ANTIGEN,W HIV-1&HIV-2,1R | $93.50 | $187.00 | $24.08–$187.00 | — | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 ANTIGEN,W HIV-1&HIV-2,1R | $93.50 | $187.00 | $24.08–$187.00 | — | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK W/GENOTYPE,SP | $79.00 | $158.00 | $35.09–$259.98 | 11% above | 50% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK W/GENOTYPE,SP | $79.00 | $158.00 | $35.09–$259.98 | — | 50% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK W/GENOTYPE,SP | $79.00 | $158.00 | $35.09–$259.98 | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C) | $63.50 | $127.00 | $9.71–$127.00 | 31% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C) | $63.50 | $127.00 | $9.71–$127.00 | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C) | $63.50 | $127.00 | $9.71–$127.00 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE A/B E/2461 | $37.50 | $75.00 | $10.74–$79.56 | 41% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTI-BDY | $48.00 | $96.00 | $10.74–$96.00 | 25% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY | $61.00 | $122.00 | $10.74–$122.00 | 4% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE A/B E/2461 | $37.50 | $75.00 | $10.74–$79.56 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE A/B E/2461 | $37.50 | $75.00 | $10.74–$79.56 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTI-BDY | $48.00 | $96.00 | $10.74–$96.00 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTI-BDY | $48.00 | $96.00 | $10.74–$96.00 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY | $61.00 | $122.00 | $10.74–$122.00 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY | $61.00 | $122.00 | $10.74–$122.00 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGT;HEPATITIS B SURFACE | $10.75 | $21.50 | $9.67–$76.50 | 86% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGT;HEP B SR E/2461 | $37.50 | $75.00 | $10.33–$76.50 | 52% below | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGT;HEPATITIS B SURFACE | $10.75 | $21.50 | $9.67–$76.50 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGT;HEP B SR E/2461 | $37.50 | $75.00 | $10.33–$76.50 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGT;HEP B SR E/2461 | $37.50 | $75.00 | $10.33–$76.50 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGT;HEPATITIS B SURFACE | $62.50 | $125.00 | $10.33–$125.00 | — | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $11.50 | $23.00 | $10.35–$105.66 | 87% below | 50% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $11.50 | $23.00 | $10.35–$105.66 | — | 50% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $96.50 | $193.00 | $14.27–$193.00 | — | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 INFECT AGT DNA/RNA;HEP C,QUANT | $328.50 | $657.00 | $42.84–$657.00 | 3% above | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECT AGT DNA/RNA;HEP C,QUANT | $328.50 | $657.00 | $42.84–$657.00 | — | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECT AGT DNA/RNA;HEP C,QUANT | $328.50 | $657.00 | $42.84–$657.00 | — | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY;HERPES SIMPLEX,TYPE 1 | $9.50 | $19.00 | $8.55–$97.68 | 89% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANT-BDY;HERPES S T-1 E/S50047 | $39.00 | $78.00 | $13.19–$97.68 | 54% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY;HERPES SMPLX TYPE 1 | $55.00 | $110.00 | $13.19–$110.00 | 36% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANT-BDY;HERPES SMPLX T-1E/9446 | $70.00 | $140.00 | $13.19–$140.00 | 18% below | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY;HERPES SIMPLEX,TYPE 1 | $9.50 | $19.00 | $8.55–$97.68 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANT-BDY;HERPES S T-1 E/S50047 | $39.00 | $78.00 | $13.19–$97.68 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANT-BDY;HERPES S T-1 E/S50047 | $39.00 | $78.00 | $13.19–$97.68 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY;HERPES SIMPLEX,TYPE 1 | $54.65 | $109.30 | $13.19–$109.30 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY;HERPES SMPLX TYPE 1 | $55.00 | $110.00 | $13.19–$110.00 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY;HERPES SMPLX TYPE 1 | $55.00 | $110.00 | $13.19–$110.00 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANT-BDY;HERPES SMPLX T-1E/9446 | $70.00 | $140.00 | $13.19–$140.00 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANT-BDY;HERPES SMPLX T-1E/9446 | $70.00 | $140.00 | $13.19–$140.00 | — | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE 2 | $12.50 | $25.00 | $11.25–$143.40 | 86% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANT-BDY;HERPES S,T-2 E/S50047 | $39.00 | $78.00 | $19.35–$143.40 | 57% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY;HERPES SIMPLEX,TYPE 2 | $54.65 | $109.30 | $19.35–$143.40 | 39% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANT-BDY;HERPES SMPLX,T-2E/9446 | $70.00 | $140.00 | $19.35–$143.40 | 22% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANTI-BDY;HERPES SIMPLEX,TYPE 2 | $76.00 | $152.00 | $19.35–$152.00 | 16% below | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE 2 | $12.50 | $25.00 | $11.25–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE 2 | $32.75 | $65.50 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANT-BDY;HERPES S,T-2 E/S50047 | $39.00 | $78.00 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANT-BDY;HERPES S,T-2 E/S50047 | $39.00 | $78.00 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY;HERPES SIMPLEX,TYPE 2 | $54.65 | $109.30 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY;HERPES SIMPLEX,TYPE 2 | $59.00 | $118.00 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANT-BDY;HERPES SMPLX,T-2E/9446 | $70.00 | $140.00 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANT-BDY;HERPES SMPLX,T-2E/9446 | $70.00 | $140.00 | $19.35–$143.40 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTI-BDY;HERPES SIMPLEX,TYPE 2 | $76.00 | $152.00 | $19.35–$152.00 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTI-BDY;HERPES SIMPLEX,TYPE 2 | $76.00 | $152.00 | $19.35–$152.00 | — | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN, (hsCRP) | $107.50 | $215.00 | $12.95–$215.00 | 35% above | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN, (HSCRP) | $107.50 | $215.00 | $12.95–$215.00 | 35% above | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN, (HSCRP) | $107.50 | $215.00 | $12.95–$215.00 | — | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN, (HSCRP) | $107.50 | $215.00 | $12.95–$215.00 | — | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN, (hsCRP) | $107.50 | $215.00 | $12.95–$215.00 | — | 50% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE | $76.50 | $153.00 | $17.92–$153.00 | 49% below | 50% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE | $76.50 | $153.00 | $17.92–$153.00 | — | 50% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE | $121.50 | $243.00 | $17.92–$243.00 | — | 50% |
| Insulin blood test CPT 83525 INSULIN;TOTAL | $70.00 | $140.00 | $11.43–$140.00 | 18% below | 50% |
| Insulin blood test inpatient CPT 83525 INSULIN;TOTAL | $70.00 | $140.00 | $11.43–$140.00 | — | 50% |
| Insulin blood test inpatient CPT 83525 INSULIN;TOTAL | $70.00 | $140.00 | $11.43–$140.00 | — | 50% |
| Iron blood test (serum iron) CPT 83540 IRON | $11.00 | $22.00 | $6.47–$47.94 | 88% below | 50% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $11.00 | $22.00 | $6.47–$47.94 | — | 50% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $11.00 | $22.00 | $6.47–$47.94 | — | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY-IN HOUSE | $34.00 | $68.00 | $8.74–$68.00 | 65% below | 50% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY-IN HOUSE | $34.00 | $68.00 | $8.74–$68.00 | — | 50% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY-IN HOUSE | $34.00 | $68.00 | $8.74–$68.00 | — | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $131.00 | $262.00 | $8.68–$262.00 | 60% below | 50% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $131.00 | $262.00 | $8.68–$262.00 | — | 50% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $131.00 | $262.00 | $8.68–$262.00 | — | 50% |
| LH (luteinizing hormone) test CPT 83002 GONADLTROPIN;LUTEINIZING HORM | $66.00 | $132.00 | $18.52–$137.16 | 56% below | 50% |
| LH (luteinizing hormone) test inpatient CPT 83002 GONADLTROPIN;LUTEINIZING HORM | $66.00 | $132.00 | $18.52–$137.16 | — | 50% |
| LH (luteinizing hormone) test inpatient CPT 83002 GONADLTROPIN;LUTEINIZING HORM | $79.00 | $158.00 | $18.52–$158.00 | — | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $33.50 | $67.00 | $6.89–$67.00 | 66% below | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $33.50 | $67.00 | $6.89–$67.00 | — | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $33.50 | $67.00 | $6.89–$67.00 | — | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $153.00 | $306.00 | $8.17–$306.00 | 47% below | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $153.00 | $306.00 | $8.17–$306.00 | — | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $153.00 | $306.00 | $8.17–$306.00 | — | 50% |
| Lyme disease antibody test CPT 86618 ANTIBODY;BORRELIA BURGDORFERI | $90.42 | $180.84 | $17.03–$180.84 | 9% above | 50% |
| Lyme disease antibody test inpatient CPT 86618 ANTIBODY;BORRELIA BURGDORFERI | $90.42 | $180.84 | $17.03–$180.84 | — | 50% |
| Lyme disease antibody test inpatient CPT 86618 ANTIBODY;BORRELIA BURGDORFERI | $125.00 | $250.00 | $17.03–$250.00 | — | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM | $82.50 | $165.00 | $6.70–$165.00 | 79% above | 50% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $82.50 | $165.00 | $6.70–$165.00 | — | 50% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $82.50 | $165.00 | $6.70–$165.00 | — | 50% |
| Measles (rubeola) antibody test CPT 86765 ANTI-BDY;RUBEOLA | $11.00 | $22.00 | $9.90–$95.40 | 58% below | 50% |
| Measles (rubeola) antibody test CPT 86765 ANTI-BDY;RUBEOLA E/1341 | $53.00 | $106.00 | $12.88–$106.00 | 102% above | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTI-BDY;RUBEOLA | $11.00 | $22.00 | $9.90–$95.40 | — | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTI-BDY;RUBEOLA | $11.00 | $22.00 | $9.90–$95.40 | — | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA | $17.50 | $35.00 | $12.88–$95.40 | — | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTI-BDY;RUBEOLA E/1341 | $53.00 | $106.00 | $12.88–$106.00 | — | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTI-BDY;RUBEOLA E/1341 | $53.00 | $106.00 | $12.88–$106.00 | — | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES; SCREEN | $92.50 | $185.00 | $5.18–$185.00 | 4% below | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES; SCREEN | $92.50 | $185.00 | $5.18–$185.00 | — | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES; SCREEN | $92.50 | $185.00 | $5.18–$185.00 | — | 50% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $124.00 | $248.00 | $47.81–$354.12 | 51% below | 50% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $124.00 | $248.00 | $47.81–$354.12 | — | 50% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $124.00 | $248.00 | $47.81–$354.12 | — | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA;FREE | $43.25 | $86.50 | $18.39–$136.26 | 62% below | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA;FREE | $43.25 | $86.50 | $18.39–$136.26 | — | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA;FREE | $43.25 | $86.50 | $18.39–$136.26 | — | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN,TOTA | $105.50 | $211.00 | $18.39–$211.00 | 27% above | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN,TOTA | $105.50 | $211.00 | $18.39–$211.00 | — | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN,TOTA | $105.50 | $211.00 | $18.39–$211.00 | — | 50% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST, SUREPATH, IMAGED | $46.13 | $92.25 | $26.61–$196.26 | 37% below | 50% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH,CERV/VAG W/MAN&AUTO | $46.13 | $92.25 | $26.61–$196.26 | 37% below | 50% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP TEST, SUREPATH, IMAGED | $46.13 | $92.25 | $26.61–$196.26 | — | 50% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP TEST, SUREPATH, IMAGED | $46.13 | $92.25 | $26.61–$196.26 | — | 50% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH,CERV/VAG W/MAN&AUTO | $46.13 | $92.25 | $26.61–$196.26 | — | 50% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH,CERV/VAG W/MAN&AUTO | $46.13 | $92.25 | $26.61–$196.26 | — | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE(PARATHYROID HORM) | $107.50 | $215.00 | $41.28–$305.76 | 52% below | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE(PARATHYROID HORM) | $107.50 | $215.00 | $41.28–$305.76 | — | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE(PARATHYROID HORM) | $166.00 | $332.00 | $41.28–$332.00 | — | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TM,PRTL P/WB | $18.95 | $37.90 | $6.01–$44.52 | 64% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TM,PRTL E/1910 | $67.00 | $134.00 | $6.01–$134.00 | 26% above | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TM,PRTL | $76.50 | $153.00 | $6.01–$153.00 | 43% above | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TM,PRTL P/WB | $18.95 | $37.90 | $6.01–$44.52 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TM,PRTL P/WB | $58.50 | $117.00 | $6.01–$117.00 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TM,PRTL E/1910 | $67.00 | $134.00 | $6.01–$134.00 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TM,PRTL E/1910 | $67.00 | $134.00 | $6.01–$134.00 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TM,PRTL | $76.50 | $153.00 | $6.01–$153.00 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TM,PRTL | $76.50 | $153.00 | $6.01–$153.00 | — | 50% |
| Progesterone blood test CPT 84144 PROGESTERONE | $70.00 | $140.00 | $20.86–$154.56 | 42% below | 50% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $70.00 | $140.00 | $20.86–$154.56 | — | 50% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $70.00 | $140.00 | $20.86–$154.56 | — | 50% |
| Prolactin blood test CPT 84146 PROLACTIN | $70.50 | $141.00 | $19.38–$143.52 | 42% below | 50% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $70.50 | $141.00 | $19.38–$143.52 | — | 50% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $131.50 | $263.00 | $19.38–$263.00 | — | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $46.00 | $92.00 | $4.29–$92.00 | 3% below | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $46.00 | $92.00 | $4.29–$92.00 | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $46.00 | $92.00 | $4.29–$92.00 | — | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFCT AGNT W/DOO;INFLUENZA A | $42.00 | $84.00 | $16.55–$99.30 | 63% below | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFCT AGNT W/DOO;INFLUENZA B | $42.00 | $84.00 | $16.55–$99.30 | 63% below | 50% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFCT AGNT W/DOO;INFLUENZA A | $42.00 | $84.00 | $16.55–$99.30 | — | 50% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFCT AGNT W/DOO;INFLUENZA B | $42.00 | $84.00 | $16.55–$99.30 | — | 50% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFCT AGNT W/DOO;INFLUENZA A | $42.00 | $84.00 | $16.55–$99.30 | — | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFCT AGNT W/DOO;STEP,GRP A | $107.00 | $214.00 | $16.53–$214.00 | at median | 50% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFCT AGNT W/DOO;STEP,GRP A | $107.00 | $214.00 | $16.53–$214.00 | — | 50% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFCT AGNT W/DOO;STEP,GRP A | $111.50 | $223.00 | $16.53–$223.00 | — | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR;QUANTITATIVE | $5.50 | $11.00 | $4.95–$42.00 | 90% below | 50% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR;QUANTITATIVE | $5.50 | $11.00 | $4.95–$42.00 | — | 50% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR;QUANTITATIVE | $43.00 | $86.00 | $5.67–$86.00 | — | 50% |
| Rubella antibody test (immunity check) CPT 86762 ANTI-BDY;RUBELLA E/1341 | $53.00 | $106.00 | $14.39–$106.62 | 35% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 ANTI-BDY;RUBELLA | $60.50 | $121.00 | $14.39–$121.00 | 54% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 ANTIBODY;RUBELLA | $71.00 | $142.00 | $14.39–$142.00 | 81% above | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTI-BDY;RUBELLA E/1341 | $53.00 | $106.00 | $14.39–$106.62 | — | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTI-BDY;RUBELLA E/1341 | $53.00 | $106.00 | $14.39–$106.62 | — | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTI-BDY;RUBELLA | $60.50 | $121.00 | $14.39–$121.00 | — | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTI-BDY;RUBELLA | $60.50 | $121.00 | $14.39–$121.00 | — | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY;RUBELLA | $71.00 | $142.00 | $14.39–$142.00 | — | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY;RUBELLA | $71.00 | $142.00 | $14.39–$142.00 | — | 50% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES,DRT SMEAR C&I | $24.50 | $49.00 | $8.90–$65.94 | 76% below | 50% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES,DRT SMEAR C&I | $24.50 | $49.00 | $8.90–$65.94 | — | 50% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES,DRT SMEAR C&I | $24.50 | $49.00 | $8.90–$65.94 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCULT SCREEN;FECES CONSEC | $49.00 | $98.00 | $4.38–$98.00 | 9% above | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCULT SCREEN;FECES CONSEC | $49.00 | $98.00 | $4.38–$98.00 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCULT SCREEN;FECES CONSEC | $49.00 | $98.00 | $4.38–$98.00 | — | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD,OCCULT,FECAL HB QUAL 1-3 D | $38.50 | $77.00 | $15.92–$117.84 | 50% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD,OCCULT,FECAL HB QUAL 1-3 D | $38.50 | $77.00 | $15.92–$117.84 | — | 50% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD,OCCULT,FECAL HB QUAL 1-3 D | $40.50 | $81.00 | $15.92–$117.84 | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST;QUALITATIVE | $48.00 | $96.00 | $4.27–$96.00 | 15% below | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST;QUALITATIVE | $48.00 | $96.00 | $4.27–$96.00 | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST;QUALITATIVE | $55.00 | $110.00 | $4.27–$110.00 | — | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB CELL MED IMM MEAS GAMMA INT | $147.00 | $294.00 | $61.98–$459.12 | 33% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB CELL MED IMM MEAS GAMMA INT | $147.00 | $294.00 | $61.98–$459.12 | — | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB CELL MED IMM MEAS GAMMA INT | $147.00 | $294.00 | $61.98–$459.12 | — | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST;GAMMA INTRFN | $153.00 | $306.00 | $61.98–$459.12 | — | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE;TOTAL | $37.50 | $75.00 | $25.81–$191.22 | 70% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $92.50 | $185.00 | $25.81–$191.22 | 26% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL | $101.50 | $203.00 | $25.81–$203.00 | 19% below | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE;TOTAL | $37.50 | $75.00 | $25.81–$191.22 | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $92.50 | $185.00 | $25.81–$191.22 | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $92.50 | $185.00 | $25.81–$191.22 | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL | $101.50 | $203.00 | $25.81–$203.00 | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL | $101.50 | $203.00 | $25.81–$203.00 | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE;TOTAL | $229.50 | $459.00 | $25.81–$459.00 | — | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES,EA | $29.71 | $59.42 | $14.55–$107.76 | 70% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES,EA/3062 | $42.00 | $84.00 | $14.55–$107.76 | 57% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY,EA E/1016 | $44.00 | $88.00 | $14.55–$107.76 | 55% below | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES,EA | $29.71 | $59.42 | $14.55–$107.76 | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES,EA/3062 | $42.00 | $84.00 | $14.55–$107.76 | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES,EA/3062 | $42.00 | $84.00 | $14.55–$107.76 | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY,EA E/1016 | $44.00 | $88.00 | $14.55–$107.76 | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY,EA E/1016 | $44.00 | $88.00 | $14.55–$107.76 | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES,EA | $256.25 | $512.50 | $14.55–$512.50 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE | $49.80 | $99.60 | $16.80–$124.50 | 62% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE | $49.80 | $99.60 | $16.80–$124.50 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE | $89.50 | $179.00 | $16.80–$179.00 | — | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS,AMP P T | $42.00 | $84.00 | $35.09–$259.98 | 52% below | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMP P T | $47.50 | $95.00 | $35.09–$259.98 | 46% below | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS,AMP P T | $42.00 | $84.00 | $35.09–$259.98 | — | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMP P T | $47.50 | $95.00 | $35.09–$259.98 | — | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMP P T | $47.50 | $95.00 | $35.09–$259.98 | — | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS,AMP P T | $86.50 | $173.00 | $35.09–$259.98 | — | 50% |
| Uric acid blood test CPT 84550 URIC ACID; BLOOD | $56.50 | $113.00 | $4.52–$113.00 | 49% below | 50% |
| Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD | $56.50 | $113.00 | $4.52–$113.00 | — | 50% |
| Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD | $56.50 | $113.00 | $4.52–$113.00 | — | 50% |
| Urinalysis with microscope exam, automated CPT 81001 FORENSIC EXAM:UA WITH MICROS | $22.00 | $44.00 | $3.17–$44.00 | 81% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS,AUTOMATED W/MICRSPY | $46.00 | $92.00 | $3.17–$92.00 | 61% below | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 FORENSIC EXAM:UA WITH MICROS | $22.00 | $44.00 | $3.17–$44.00 | — | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 FORENSIC EXAM:UA WITH MICROS | $22.00 | $44.00 | $3.17–$44.00 | — | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS,AUTOMATED W/MICRSPY | $46.00 | $92.00 | $3.17–$92.00 | — | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS,AUTOMATED W/MICRSPY | $46.00 | $92.00 | $3.17–$92.00 | — | 50% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS,NON-AUTO W/MICROSPY | $46.00 | $92.00 | $4.02–$92.00 | 17% above | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS,NON-AUTO W/MICROSPY | $46.00 | $92.00 | $4.02–$92.00 | — | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS,NON-AUTO W/MICROSPY | $46.00 | $92.00 | $4.02–$92.00 | — | 50% |
| Urinalysis without microscope exam, automated CPT 81003 FORENSIC EXAM:UA W/O MICROS | $15.00 | $30.00 | $2.25–$30.00 | 72% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS,AUTO W/O MICROSCOPY | $31.00 | $62.00 | $2.25–$62.00 | 42% below | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 FORENSIC EXAM:UA W/O MICROS | $15.00 | $30.00 | $2.25–$30.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 FORENSIC EXAM:UA W/O MICROS | $15.00 | $30.00 | $2.25–$30.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS,AUTO W/O MICROSCOPY | $31.00 | $62.00 | $2.25–$62.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS,AUTO W/O MICROSCOPY | $31.00 | $62.00 | $2.25–$62.00 | — | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS,NON-AUTO W/O MICROS | $19.00 | $38.00 | $3.48–$38.00 | 47% below | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS,NON-AUTO W/O MICROS | $19.00 | $38.00 | $3.48–$38.00 | — | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS,NON-AUTO W/O MICROS | $19.00 | $38.00 | $3.48–$38.00 | — | 50% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE,BACTERIAL URINE | $56.50 | $113.00 | $8.07–$113.00 | 60% below | 50% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE,BACTERIAL URINE | $56.50 | $113.00 | $8.07–$113.00 | — | 50% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE,BACTERIAL URINE | $56.50 | $113.00 | $8.07–$113.00 | — | 50% |
| Urine pregnancy test, read by color change CPT 81025 FORENSIC EXAM: PREGNANCY TEST | $12.50 | $25.00 | $8.61–$51.66 | 86% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST,BY COLOR | $92.50 | $185.00 | $8.61–$185.00 | 3% above | 50% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST, BY COLOR | $93.50 | $187.00 | $8.61–$187.00 | 4% above | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 FORENSIC EXAM: PREGNANCY TEST | $12.50 | $25.00 | $8.61–$51.66 | — | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST,BY COLOR | $92.50 | $185.00 | $8.61–$185.00 | — | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) | $53.00 | $106.00 | $15.08–$111.66 | 42% below | 50% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) | $53.00 | $106.00 | $15.08–$111.66 | — | 50% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) | $53.00 | $106.00 | $15.08–$111.66 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D;25HYDROXY+FRACTIONS | $69.50 | $139.00 | $29.60–$219.30 | 41% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D;25HYDROXY +F;TTL | $113.00 | $226.00 | $29.60–$226.00 | 4% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D;25HYDROXY +FRACTIONS | $121.00 | $242.00 | $29.60–$242.00 | 3% above | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25HYDROXY+FRACTIONS | $69.50 | $139.00 | $29.60–$219.30 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25HYDROXY+FRACTIONS | $69.50 | $139.00 | $29.60–$219.30 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25HYDROXY +F;TTL | $113.00 | $226.00 | $29.60–$226.00 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25HYDROXY +F;TTL | $113.00 | $226.00 | $29.60–$226.00 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25HYDROXY +FRACTIONS | $121.00 | $242.00 | $29.60–$242.00 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25HYDROXY +FRACTIONS | $121.00 | $242.00 | $29.60–$242.00 | — | 50% |
| Zinc blood test CPT 84630 ZINC | $41.00 | $82.00 | $11.39–$84.36 | 41% below | 50% |
| Zinc blood test inpatient CPT 84630 ZINC | $41.00 | $82.00 | $11.39–$84.36 | — | 50% |
| Zinc blood test inpatient CPT 84630 ZINC | $41.00 | $82.00 | $11.39–$84.36 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN,HCG QUN E/3092 | $125.00 | $250.00 | $15.05–$250.00 | 11% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN,CHORIONIC;QUANT | $145.00 | $290.00 | $15.05–$290.00 | 29% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN,HCG QUN E/3092 | $125.00 | $250.00 | $15.05–$250.00 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN,HCG QUN E/3092 | $125.00 | $250.00 | $15.05–$250.00 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN,CHORIONIC;QUANT | $145.00 | $290.00 | $15.05–$290.00 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN,CHORIONIC;QUANT | $145.00 | $290.00 | $15.05–$290.00 | — | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY, PRIMARY; YOUNGER THAN AGE 12 | $5,602.10 | $11,204.19 | $194.02–$11,204.19 | — | 50% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION | $13,445.03 | $26,890.06 | $859.39–$26,890.06 | — | 50% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY, SHOULDER, SURGICAL; WITH ROTATOR CUFF REPAIR | $12,624.21 | $25,248.41 | $940.99–$25,248.41 | — | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY,BREAST W/D&I;1ST L +SG | $3,333.00 | $6,666.00 | $448.78–$6,666.00 | 5% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BIOPSY,BREAST W/D&I;1ST L+SG-P | $278.50 | $557.00 | $250.65–$2,102.93 | — | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BIOPSY,BREAST W/D&I;1ST L +SG | $3,333.00 | $6,666.00 | $448.78–$6,666.00 | — | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BIOPSY,BREAST W/D&I;1ST L +SG | $3,466.50 | $6,933.00 | $448.78–$6,933.00 | — | 50% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DISTAL METATAR | $9,044.23 | $18,088.45 | $806.31–$18,088.45 | — | 50% |
| Cardiac catheterization with coronary angiogram CPT 93458 CATH PLMT,CA,+INJ W/LF HEART C | $6,497.50 | $12,995.00 | $911.28–$12,995.00 | 45% below | 50% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 CATH PLMT,CA,+INJ W/LF HEART C | $6,497.50 | $12,995.00 | $911.28–$12,995.00 | — | 50% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 CATH PLMT,CA,+INJ W/LF HEART C | $6,497.50 | $12,995.00 | $911.28–$12,995.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL,MED FL | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | 31% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL,IN ICU | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | 31% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL,IN ER | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | 31% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL,IN CATH | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | 31% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL,RESP | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | 31% below | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,RESP | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,IN CATH | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,MED FL | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,IN ICU | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,RESP | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,IN ER | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,IN ICU | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,MED FL | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,IN CATH | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL,IN ER | $1,179.00 | $2,358.00 | $141.53–$2,358.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL | $3,066.42 | $6,132.83 | $141.53–$6,132.83 | — | 50% |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL | $4,202.48 | $8,404.96 | $398.58–$8,404.96 | — | 50% |
| Cataract surgery with lens implant CPT 66984 EYE CATARACT REM W/LENS | $4,378.50 | $8,757.00 | $498.35–$8,757.00 | 50% above | 50% |
| Cataract surgery with lens implant inpatient CPT 66984 EYE CATARACT REM W/LENS | $4,378.50 | $8,757.00 | $498.35–$8,757.00 | — | 50% |
| Cataract surgery with lens implant inpatient CPT 66984 EYE CATARACT REM W/LENS | $4,554.00 | $9,108.00 | $498.35–$9,108.00 | — | 50% |
| Cataract surgery with lens implant inpatient CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF LENS | $5,000.00 | $10,000.00 | $498.35–$10,000.00 | — | 50% |
| Cervical biopsy CPT 57500 BX CERVIX,1/+/EXC LSN,W/WO FGR | $745.50 | $1,491.00 | $96.82–$1,491.00 | 35% below | 50% |
| Cervical biopsy inpatient CPT 57500 BX CERVIX,1/+/EXC LSN,W/WO FGR | $745.50 | $1,491.00 | $96.82–$1,491.00 | — | 50% |
| Cervical biopsy inpatient CPT 57500 BX CERVIX,1/+/EXC LSN,W/WO FGR | $745.50 | $1,491.00 | $96.82–$1,491.00 | — | 50% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 ROUTINE OBSTETRIC CARE FOR CESAREAN DELIVERY, INCLUDING PRE-AND POST-DELIVERY CARE | $8,850.00 | $17,700.00 | $2,232.90–$17,700.00 | — | 50% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE, OR DORSAL SLIT; OLDER THAN 28 DAYS OF AGE | $4,863.65 | $9,727.29 | $179.55–$9,727.29 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 *CIRCUMCISION W/REG BLOCK | $237.50 | $475.00 | $134.51–$2,645.26 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION NEWBORN;CLAMP,O/D | $1,463.00 | $2,926.00 | $134.51–$2,926.00 | — | 50% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 *CIRCUMCISION,NEONATE | $359.00 | $718.00 | $200.98–$2,645.26 | — | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLD TRT DISTAL RADIAL FRAX;W/O | $330.50 | $661.00 | $133.22–$661.00 | 42% below | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION | $4,500.00 | $9,000.00 | $133.22–$9,000.00 | — | 50% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 ULTRASOUND EXAMINATION OF LOWER LARGE BOWEL USING AN ENDOSCOPE | $1,345.00 | $2,690.00 | $231.05–$2,690.00 | — | 50% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY,FLXBL;REM T/P/L ST | $1,672.00 | $3,344.00 | $410.02–$3,344.00 | — | 50% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE | $2,673.89 | $5,347.77 | $410.02–$5,347.77 | — | 50% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE | $2,261.24 | $4,522.47 | $390.99–$4,522.47 | — | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY | $1,465.00 | $2,930.00 | $306.49–$2,930.00 | — | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY; VIDEO ENDOSCOPY | $1,465.00 | $2,930.00 | $306.49–$2,930.00 | — | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN | $1,881.28 | $3,762.55 | $306.49–$3,762.55 | — | 50% |
| Complex cataract surgery with lens implant CPT 66982 EYE CATARACT REM W/LENS,CMPLX | $4,378.50 | $8,757.00 | $682.37–$8,757.00 | 1% below | 50% |
| Complex cataract surgery with lens implant inpatient CPT 66982 EYE CATARACT REM W/LENS,CMPLX | $4,378.50 | $8,757.00 | $682.37–$8,757.00 | — | 50% |
| Complex cataract surgery with lens implant inpatient CPT 66982 EYE CATARACT REM W/LENS,CMPLX | $4,554.00 | $9,108.00 | $682.37–$9,108.00 | — | 50% |
| Complex cataract surgery with lens implant inpatient CPT 66982 EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS | $4,850.00 | $9,700.00 | $682.37–$9,700.00 | — | 50% |
| Coronary stent placement, one artery CPT 92928 TC PLMT IC STENT,P,W/WO INTR,S | $13,448.50 | $26,897.00 | $487.62–$26,897.00 | 15% above | 50% |
| Coronary stent placement, one artery inpatient CPT 92928 TC PLMT IC STENT,P,W/WO INTR,S | $13,448.50 | $26,897.00 | $487.62–$26,897.00 | — | 50% |
| Coronary stent placement, one artery inpatient CPT 92928 TC PLMT IC STENT,P,W/WO INTR,S | $13,448.50 | $26,897.00 | $487.62–$26,897.00 | — | 50% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY, WITH INSERTION OF INDWELLING URETERAL STENT (EG, GIBBONS OR DOUBLE-J TYPE) | $5,522.80 | $11,045.60 | $360.55–$11,045.60 | — | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY (SEP PROC) | $781.50 | $1,563.00 | $216.11–$1,563.00 | 30% below | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE) | $4,298.56 | $8,597.12 | $216.11–$8,597.12 | 287% above | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY (SEP PROC) | $813.00 | $1,626.00 | $216.11–$1,626.00 | — | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE) | $4,298.56 | $8,597.12 | $216.11–$8,597.12 | — | 50% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL) | $4,132.03 | $8,264.06 | $267.51–$8,264.06 | — | 50% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA | $3,543.22 | $7,086.43 | $144.86–$7,086.43 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REM CERUMEN W/IRRG,LVG,UNI-GCP | $48.50 | $97.00 | $14.07–$97.00 | 61% below | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REM CERUMEN W/IRRG,LVG,UNI-GC | $106.50 | $213.00 | $14.07–$213.00 | 14% below | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REM CERUMEN W/IRRG,LVG,UNI | $106.50 | $213.00 | $14.07–$213.00 | 14% below | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM CERUMEN W/IRRG,LVG,UNI-GC | $111.00 | $222.00 | $14.07–$222.00 | — | 50% |
| Earwax removal with instruments, one ear CPT 69210 REM CERUMEN W/INST,UNI-GCP | $48.50 | $97.00 | $43.34–$97.00 | 72% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REM CERUMEN W/INST,UNI | $106.50 | $213.00 | $43.34–$213.00 | 38% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REM CERUMEN W/INST,UNI-GC | $106.50 | $213.00 | $43.34–$213.00 | 38% below | 50% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REM CERUMEN W/INST,UNI-GC | $111.00 | $222.00 | $43.34–$222.00 | — | 50% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASAL/SINUS ENDOSCOPY, SURGICAL WITH ETHMOIDECTOMY; TOTAL (ANTERIOR AND POSTERIOR) | $8,608.84 | $17,217.68 | $288.22–$17,217.68 | — | 50% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH FRONTAL SINUS EXPLORATION, INCLUDING REMOVAL OF TISSUE FROM FR | $19,174.53 | $38,349.05 | $336.84–$38,349.05 | — | 50% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY | $14,525.11 | $29,050.21 | $160.99–$29,050.21 | — | 50% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILLARY SI | $11,583.61 | $23,167.22 | $236.61–$23,167.22 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PAIN INJ D/T SUB,CER/THOR;+IMG | $1,031.50 | $2,063.00 | $238.88–$2,063.00 | 34% below | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PAIN INJ D/T SUB,CER/THOR;+IMG | $1,031.50 | $2,063.00 | $238.88–$2,063.00 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PAIN INJ D/T SUB,CER/THOR;+IMG | $1,031.50 | $2,063.00 | $238.88–$2,063.00 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PAIN INJ,PV FCT JT W/IMG,L/S;1 | $1,073.00 | $2,146.00 | $161.60–$2,146.00 | 37% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PAIN INJ,PV FCT JT W/IMG,L/S;1 | $1,073.00 | $2,146.00 | $161.60–$2,146.00 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PAIN INJ,PV FCT JT W/IMG,L/S;1 | $1,073.00 | $2,146.00 | $161.60–$2,146.00 | — | 50% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), | $10,878.90 | $21,757.80 | $481.00–$21,757.80 | — | 50% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), | $9,729.90 | $19,459.80 | $287.93–$19,459.80 | — | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY (FLEX) | $1,036.00 | $2,072.00 | $164.93–$2,072.00 | 31% above | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY (FLEX) | $1,036.00 | $2,072.00 | $164.93–$2,072.00 | — | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY (FLEX) | $1,077.50 | $2,155.00 | $164.93–$2,155.00 | — | 50% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY | $7,439.38 | $14,878.75 | $562.41–$14,878.75 | — | 50% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY | $8,639.30 | $17,278.60 | $611.03–$17,278.60 | — | 50% |
| Hammertoe correction surgery inpatient CPT 28285 CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY) | $9,374.46 | $18,748.91 | $492.37–$18,748.91 | — | 50% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP | $5,326.81 | $10,653.62 | $461.98–$10,653.62 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INTRO S/CM SIS/HYSTEROSAL | $387.50 | $775.00 | $216.89–$775.00 | 1% above | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INTRO S/CM SIS/HYSTERSL-P | $98.00 | $196.00 | $88.20–$216.89 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INTRO S/CM SIS/HYSTEROSAL | $387.50 | $775.00 | $216.89–$775.00 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INTRO S/CM SIS/HYSTEROSAL | $387.50 | $775.00 | $216.89–$775.00 | — | 50% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION (EG, ENDOMETRIAL RESECTION, ELECTROSURGICAL ABLATI | $9,883.16 | $19,766.31 | $1,872.47–$19,766.31 | — | 50% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D | $4,502.74 | $9,005.47 | $1,180.43–$9,005.47 | — | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-GCP | $136.50 | $273.00 | $86.97–$273.00 | 71% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 WC PF I&D ABSCESS SIMPLE/SNGL | $142.00 | $284.00 | $86.97–$284.00 | 70% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 H-I&D ABSCESS SIMPLE/SNGL | $161.50 | $323.00 | $86.97–$323.00 | 65% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 WC:I & D ABSCESS SIMPLE/SNGL | $279.50 | $559.00 | $86.97–$559.00 | 40% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-CL | $291.00 | $582.00 | $86.97–$582.00 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-MED FL | $291.00 | $582.00 | $86.97–$582.00 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-GC | $291.00 | $582.00 | $86.97–$582.00 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-ER | $291.00 | $582.00 | $86.97–$582.00 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-US | $291.00 | $582.00 | $86.97–$582.00 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL-RAD | $291.00 | $582.00 | $86.97–$582.00 | 38% below | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC PF I&D ABSCESS SIMPLE/SNGL | $142.00 | $284.00 | $86.97–$284.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SNGL-GCP | $142.00 | $284.00 | $86.97–$284.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC:I & D ABSCESS SIMPLE/SNGL | $279.50 | $559.00 | $86.97–$559.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SNGL-CL | $303.00 | $606.00 | $86.97–$606.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SNGL-US | $303.00 | $606.00 | $86.97–$606.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SNGL-RAD | $303.00 | $606.00 | $86.97–$606.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SNGL-GC | $303.00 | $606.00 | $86.97–$606.00 | — | 50% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE | $6,049.04 | $12,098.07 | $447.71–$12,098.07 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ;1 TENDON SHTH/LIGMNT/APNRS | $288.50 | $577.00 | $28.70–$577.00 | 35% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ:1 TENDON SHTH/LGMNT/APN-PF | $107.00 | $214.00 | $28.70–$282.20 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ;1 TENDON SHTH/LIGMNT/APNRS | $288.50 | $577.00 | $28.70–$577.00 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/INJ,MJ JT/BRS-P | $81.50 | $163.00 | $34.70–$282.20 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/INJ,MJ JT/BURSA | $300.50 | $601.00 | $34.70–$601.00 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT,ASP/INJ,IM JT/BURSA | $340.00 | $680.00 | $29.13–$680.00 | 46% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT,ASP/INJ,IM JT/BURSA | $340.00 | $680.00 | $29.13–$680.00 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT,ASP/INJ,IM JT/BURSA | $354.00 | $708.00 | $29.13–$708.00 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT,ASP/INJ,SM JT/BURSA | $291.00 | $582.00 | $27.42–$582.00 | 38% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT,ASP/INJ,SM JT/BURSA | $291.00 | $582.00 | $27.42–$582.00 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT,ASP/INJ,SM JT/BURSA | $291.00 | $582.00 | $27.42–$582.00 | — | 50% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPIC KNEE SURGERY WITH MENISCUS REPAIR ON EITHER THE MEDIAL OR LATERAL SIDE | $6,300.00 | $12,600.00 | $611.33–$12,600.00 | — | 50% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) I | $5,010.18 | $10,020.35 | $482.30–$10,020.35 | — | 50% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL SHAVING) | $6,094.72 | $12,189.43 | $500.02–$12,189.43 | — | 50% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY) | $5,443.53 | $10,887.06 | $551.54–$10,887.06 | — | 50% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY, SURGICAL, APPENDECTOMY | $9,047.99 | $18,095.98 | $514.91–$18,095.98 | — | 50% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S) AN | $10,092.76 | $20,185.52 | $809.75–$20,185.52 | — | 50% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY, SURGICAL; REPAIR INITIAL INGUINAL HERNIA | $10,670.60 | $21,341.20 | $371.96–$21,341.20 | — | 50% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAPAROSCOPY, SURGICAL; REPAIR RECURRENT INGUINAL HERNIA | $13,305.47 | $26,610.93 | $484.84–$26,610.93 | — | 50% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR TOTAL OOPHORECTOMY AND/OR SALP | $7,130.27 | $14,260.53 | $579.68–$14,260.53 | — | 50% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 EYE DISC 2ND M-CATARACT,LASER | $732.00 | $1,464.00 | $305.98–$1,464.00 | 47% below | 50% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 EYE DISC 2ND M-CATARACT,LASER | $732.00 | $1,464.00 | $305.98–$1,464.00 | — | 50% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 EYE DISC 2ND M-CATARACT,LASER | $761.50 | $1,523.00 | $305.98–$1,523.00 | — | 50% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING LASER | $833.00 | $1,666.00 | $305.98–$1,666.00 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR,I,SCLP,AXIL,TRNK,E;2.5LESS | $386.50 | $773.00 | $191.92–$773.00 | 29% below | 50% |
| Left heart catheterization, diagnostic CPT 93452 LT HEART CATH +INJ L/VENTRIC | $6,497.50 | $12,995.00 | $786.21–$12,995.00 | 34% below | 50% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LT HEART CATH +INJ L/VENTRIC | $6,497.50 | $12,995.00 | $786.21–$12,995.00 | — | 50% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LT HEART CATH +INJ L/VENTRIC | $6,497.50 | $12,995.00 | $786.21–$12,995.00 | — | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PAIN INJ D/T SUB,LMB/SCRL;+IMG | $1,161.00 | $2,322.00 | $234.64–$2,322.00 | — | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ D/T SUB,LUMB/SACRAL;+IMAG | $1,161.00 | $2,322.00 | $234.64–$2,322.00 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMINAL EPI;LUM/SAC,1 L | $1,073.00 | $2,146.00 | $224.29–$2,146.00 | 25% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PAIN INJ,A/S/E W/IMG;L/S SNGL | $1,116.00 | $2,232.00 | $224.29–$2,232.00 | 22% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMINAL EPI;LUM/SAC,1 L | $1,073.00 | $2,146.00 | $224.29–$2,146.00 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMINAL EPI;LUM/SAC,1 L | $1,073.00 | $2,146.00 | $224.29–$2,146.00 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PAIN INJ,A/S/E W/IMG;L/S SNGL | $1,116.00 | $2,232.00 | $224.29–$2,232.00 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PAIN INJ,A/S/E W/IMG;L/S SNGL | $1,161.00 | $2,322.00 | $224.29–$2,322.00 | — | 50% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY) | $11,604.58 | $23,209.16 | $563.64–$23,209.16 | — | 50% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER | $4,377.75 | $8,755.49 | $377.07–$8,755.49 | — | 50% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR | $4,624.83 | $9,249.65 | $109.24–$9,249.65 | — | 50% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC,B LESION+M,NOT HEAD;D 0.5- | $859.50 | $1,719.00 | $115.24–$1,719.00 | 6% below | 50% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EA | $4,111.60 | $8,223.19 | $115.24–$8,223.19 | 348% above | 50% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EA | $4,111.60 | $8,223.19 | $115.24–$8,223.19 | — | 50% |
| Nail removal (partial or complete), one nail CPT 11730 WC PF AVULSION NAIL PLT,SMPL;1 | $74.50 | $149.00 | $67.05–$263.56 | 79% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE,SMPL;1 | $286.00 | $572.00 | $105.40–$572.00 | 20% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 WC:AVULSION NAIL PLATE,SMPL;1 | $286.00 | $572.00 | $105.40–$572.00 | 20% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE | $3,791.82 | $7,583.64 | $105.40–$7,583.64 | 963% above | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 WC PF AVULSION NAIL PLT,SMPL;1 | $74.50 | $149.00 | $67.05–$263.56 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 WC PF AVULSION NAIL PLT,SMPL;1 | $77.50 | $155.00 | $69.75–$263.56 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 WC:AVULSION NAIL PLATE,SMPL;1 | $286.00 | $572.00 | $105.40–$572.00 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE,SMPL;1 | $286.00 | $572.00 | $105.40–$572.00 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 WC:AVULSION NAIL PLATE,SMPL;1 | $297.50 | $595.00 | $105.40–$595.00 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE | $3,791.82 | $7,583.64 | $105.40–$7,583.64 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE | $3,791.82 | $7,583.64 | $105.40–$7,583.64 | — | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 PAIN INJ,ANS/STR;OCCIPITAL NRV | $666.00 | $1,332.00 | $65.42–$1,332.00 | 56% above | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ,ANS/STR;OCCIPITAL NERVE | $693.00 | $1,386.00 | $65.42–$1,386.00 | 62% above | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 PAIN INJ,ANS/STR;OCCIPITAL NRV | $666.00 | $1,332.00 | $65.42–$1,332.00 | — | 50% |
| Pacemaker implant (dual chamber) CPT 33208 I/R PERM PACEMAKER W/TE;A&V | $20,149.00 | $40,298.00 | $435.47–$40,298.00 | 6% above | 50% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 I/R PERM PACEMAKER W/TE;A&V | $20,149.00 | $40,298.00 | $435.47–$40,298.00 | — | 50% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 I/R PERM PACEMAKER W/TE;A&V | $20,955.00 | $41,910.00 | $435.47–$41,910.00 | — | 50% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 INSERTION OR REPLACEMENT OF A PERMANENT DUAL-CHAMBER PACEMAKER WITH TRANSVENOUS ELECTRODES FOR BOTH | $31,875.00 | $63,750.00 | $435.47–$63,750.00 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS; WITH IMAGING GUIDANCE-PF | $208.00 | $416.00 | $187.20–$1,159.84 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS;W/US-P | $216.50 | $433.00 | $194.85–$1,159.84 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS;W/CT-P | $216.50 | $433.00 | $194.85–$1,159.84 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS; WITH IMAGING GUIDANCE | $1,529.50 | $3,059.00 | $263.33–$3,059.00 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS;W/IMAG | $1,591.00 | $3,182.00 | $263.33–$3,182.00 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS;W/US | $1,591.00 | $3,182.00 | $263.33–$3,182.00 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS;W/CT | $1,591.00 | $3,182.00 | $263.33–$3,182.00 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL&MATRIX P/C,PERMAN-GCP | $243.50 | $487.00 | $114.38–$487.00 | 69% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL&MATRIX P/C,PERM-GC | $616.50 | $1,233.00 | $114.38–$1,233.00 | 22% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL&MATRIX P/C,PERMAN | $616.50 | $1,233.00 | $114.38–$1,233.00 | 22% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL&MATRIX P/C,PERMAN-GCP | $253.50 | $507.00 | $114.38–$507.00 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL&MATRIX P/C,PERM-GC | $641.50 | $1,283.00 | $114.38–$1,283.00 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL | $4,300.00 | $8,600.00 | $114.38–$8,600.00 | — | 50% |
| Prostate biopsy CPT 55700 BIOPSY,PROSTATE;NDL/PNH,1/+,AA | $2,752.50 | $5,505.00 | $217.91–$5,505.00 | 5% above | 50% |
| Prostate biopsy CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH | $3,614.00 | $7,228.00 | $217.91–$7,228.00 | 38% above | 50% |
| Prostate biopsy inpatient CPT 55700 BIOPSY,PROSTATE;NDL/PNH,1/+,AA | $2,752.50 | $5,505.00 | $217.91–$5,505.00 | — | 50% |
| Prostate biopsy inpatient CPT 55700 BIOPSY,PROSTATE;NDL/PNH,1/+,AA | $2,863.00 | $5,726.00 | $217.91–$5,726.00 | — | 50% |
| Prostate biopsy inpatient CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH | $3,614.00 | $7,228.00 | $217.91–$7,228.00 | — | 50% |
| Prostate biopsy inpatient CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH | $5,617.56 | $11,235.11 | $217.91–$11,235.11 | — | 50% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE | $11,363.00 | $22,726.00 | $1,078.42–$22,726.00 | — | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PAIN DEST FCT JT NRV,W/I;L/S,1 | $1,832.50 | $3,665.00 | $401.62–$3,665.00 | 35% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PAIN DEST FCT JT NRV,W/I;L/S,1 | $1,832.50 | $3,665.00 | $401.62–$3,665.00 | — | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PAIN DEST FCT JT NRV,W/I;L/S,1 | $1,832.50 | $3,665.00 | $401.62–$3,665.00 | — | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LES | $3,926.17 | $7,852.33 | $452.36–$7,852.33 | — | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 WC PF INCISION/REM FB SQT,SMPL | $142.50 | $285.00 | $128.25–$379.92 | 78% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 I&R FB SQT,SIMPLE ER | $531.50 | $1,063.00 | $129.38–$1,063.00 | 17% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 I&R FB SQT,SIMPLE SURG FL | $531.50 | $1,063.00 | $129.38–$1,063.00 | 17% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 WC:INCISION/REM FB SQT,SIMPLE | $531.50 | $1,063.00 | $129.38–$1,063.00 | 17% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE | $4,469.04 | $8,938.08 | $129.38–$8,938.08 | 600% above | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 WC PF INCISION/REM FB SQT,SMPL | $142.50 | $285.00 | $128.25–$379.92 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 WC PF INCISION/REM FB SQT,SMPL | $148.50 | $297.00 | $129.38–$379.92 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R FB SQT,SIMPLE ER | $531.50 | $1,063.00 | $129.38–$1,063.00 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 WC:INCISION/REM FB SQT,SIMPLE | $531.50 | $1,063.00 | $129.38–$1,063.00 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R FB SQT,SIMPLE SURG FL | $531.50 | $1,063.00 | $129.38–$1,063.00 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 WC:INCISION/REM FB SQT,SIMPLE | $553.00 | $1,106.00 | $129.38–$1,106.00 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE | $4,469.04 | $8,938.08 | $129.38–$8,938.08 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE | $4,469.04 | $8,938.08 | $129.38–$8,938.08 | — | 50% |
| Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY | $7,566.93 | $15,133.86 | $622.09–$15,133.86 | — | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $1,820.88 | $3,641.76 | $306.49–$3,641.76 | — | 50% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR WITHOUT CARTILAGE SCORING, CONTOURING OR REPLACEMENT WIT | $11,041.73 | $22,083.46 | $610.61–$22,083.46 | — | 50% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE | $7,061.19 | $14,122.37 | $672.22–$14,122.37 | 28% above | 50% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE | $7,061.19 | $14,122.37 | $672.22–$14,122.37 | — | 50% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE | $7,061.19 | $14,122.37 | $672.22–$14,122.37 | — | 50% |
| Short arm splint (forearm and hand) CPT 29125 APPL SHORT ARM SPLINT, STATIC | $167.50 | $335.00 | $60.82–$335.00 | 42% below | 50% |
| Short leg splint (calf to foot) CPT 29515 APPL LOWER LEG SPLINT | $167.50 | $335.00 | $53.12–$335.00 | 46% below | 50% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHROSCOPY, SHOULDER, SURGICAL; DISTAL CLAVICULECTOMY INCLUDING DISTAL ARTICULAR SURFACE (MUMFORD P | $8,049.16 | $16,098.32 | $602.06–$16,098.32 | — | 50% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY, WITH | $11,892.38 | $23,784.75 | $148.24–$23,784.75 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WC PF SMPL RPR SCALP,ETC 2.5/- | $57.00 | $114.00 | $51.30–$263.56 | 86% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WC:SMPL RPR SCALP,ETC 2.5CM/- | $225.50 | $451.00 | $83.84–$451.00 | 47% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S SCLP,NCK,TRK,E;2.5-LESS | $225.50 | $451.00 | $83.84–$451.00 | 47% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 WC PF SMPL RPR SCALP,ETC 2.5/- | $57.00 | $114.00 | $51.30–$263.56 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 WC:SMPL RPR SCALP,ETC 2.5CM/- | $225.50 | $451.00 | $83.84–$451.00 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S SCLP,NCK,TRK,E;2.5-LESS | $225.50 | $451.00 | $83.84–$451.00 | — | 50% |
| Skin biopsy, punch, one lesion CPT 11104 WC PF PUNCH BPSY SKN,SMPL CL;1 | $65.00 | $130.00 | $58.50–$379.92 | 86% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 WC:PUNCH BIOPSY SKIN,SMPL CL;1 | $269.50 | $539.00 | $108.11–$539.00 | 41% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN,SMPL CL;1 | $269.50 | $539.00 | $108.11–$539.00 | 41% below | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 WC PF PUNCH BPSY SKN,SMPL CL;1 | $65.00 | $130.00 | $58.50–$379.92 | — | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 WC:PUNCH BIOPSY SKIN,SMPL CL;1 | $269.50 | $539.00 | $108.11–$539.00 | — | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN,SMPL CL;1 | $269.50 | $539.00 | $108.11–$539.00 | — | 50% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS ANY,U/T 15-GCP | $95.00 | $190.00 | $84.35–$263.56 | 70% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS ANY AREA,U/T 15 | $264.00 | $528.00 | $84.35–$528.00 | 17% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS ANY,U/T 15-GC | $264.00 | $528.00 | $84.35–$528.00 | 17% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS | $3,269.37 | $6,538.73 | $84.35–$6,538.73 | 926% above | 50% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS ANY,U/T 15-GCP | $99.00 | $198.00 | $84.35–$263.56 | — | 50% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS ANY,U/T 15-GC | $275.00 | $550.00 | $84.35–$550.00 | — | 50% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS | $3,269.37 | $6,538.73 | $84.35–$6,538.73 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAG-P | $108.50 | $217.00 | $97.65–$847.67 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAG (PRO) | $125.00 | $250.00 | $112.50–$847.67 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 H-SPINAL PUNCTURE,LUMBAR,DIAG | $125.00 | $250.00 | $112.50–$847.67 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAG-MF | $574.50 | $1,149.00 | $128.58–$1,149.00 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAG | $574.50 | $1,149.00 | $128.58–$1,149.00 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAG | $600.00 | $1,200.00 | $128.58–$1,200.00 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 WC:SMPL RPR SCALP,ETC. 2.6/7.5 | $236.00 | $472.00 | $101.30–$472.00 | 50% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S SCLP,NCK,TRK,E;2.6-7.5 | $245.50 | $491.00 | $101.30–$491.00 | 48% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 WC:SMPL RPR SCALP,ETC. 2.6/7.5 | $236.00 | $472.00 | $101.30–$472.00 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 WC:SMPL RPR SCALP,ETC. 2.6/7.5 | $236.00 | $472.00 | $101.30–$472.00 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S SCLP,NCK,TRK,E;2.6-7.5 | $245.50 | $491.00 | $101.30–$491.00 | — | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR S FACIAL AREAS;2.5CM-LESS | $165.00 | $330.00 | $99.50–$330.00 | 61% below | 50% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, CO | $6,048.80 | $12,097.60 | $659.04–$12,097.60 | — | 50% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,N/C A/PL SP W/IM | $965.50 | $1,931.00 | $283.06–$1,931.00 | 32% below | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE, WITH IMAGE GUIDANCE-PF | $216.00 | $432.00 | $194.40–$955.61 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESS,N/C A/PL SP W/I-P | $225.00 | $450.00 | $202.50–$955.61 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE, WITH IMAGE GUIDANCE | $965.50 | $1,931.00 | $283.06–$1,931.00 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,N/C A/PL SP W/IM | $965.50 | $1,931.00 | $283.06–$1,931.00 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,N/C A/PL SP W/IM | $1,004.50 | $2,009.00 | $283.06–$2,009.00 | — | 50% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER | $4,891.20 | $9,782.40 | $276.53–$9,782.40 | — | 50% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12 | $4,710.11 | $9,420.22 | $264.85–$9,420.22 | — | 50% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVER | $4,759.00 | $9,518.00 | $232.79–$9,518.00 | — | 50% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY, PRIMARY OR SECONDARY; YOUNGER THAN AGE 12 | $4,752.11 | $9,504.21 | $244.72–$9,504.21 | — | 50% |
| Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY | $17,800.00 | $35,600.00 | $1,120.23–$35,600.00 | — | 50% |
| Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY | $16,100.00 | $32,200.00 | $1,119.03–$32,200.00 | — | 50% |
| Total shoulder replacement inpatient CPT 23472 ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACEMENT (EG, TOTA | $21,437.34 | $42,874.68 | $1,264.35–$42,874.68 | — | 50% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER) | $4,591.91 | $9,183.82 | $528.81–$9,183.82 | — | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT;FAC/CHG 1/2MUS | $300.50 | $601.00 | $35.99–$601.00 | 48% below | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PNT;FAC/CHG 1/2MUS | $300.50 | $601.00 | $35.99–$601.00 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY,BREAST W/D&I;1ST L +US | $3,466.50 | $6,933.00 | $446.46–$6,933.00 | 26% above | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY,BREAST W/D&I;1ST L+US-P | $263.00 | $526.00 | $236.70–$2,102.93 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY,BREAST W/D&I;1ST L +US | $3,466.50 | $6,933.00 | $446.46–$6,933.00 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BIOPSY WITH ULTRASOUND GUIDANCE FOR THE FIRST LESION, INCLUDING THE PLACEMENT OF A BREAST LOC | $3,500.00 | $7,000.00 | $446.46–$7,000.00 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY,BREAST W/D&I;1ST L +US | $3,605.50 | $7,211.00 | $446.46–$7,211.00 | — | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD;W/TRNSNDO BLLN DILTN<30MM | $2,246.00 | $4,492.00 | $960.26–$4,492.00 | — | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD,FLEX,TRANSORAL;W/BIOPSY,1+ | $1,382.50 | $2,765.00 | $338.94–$2,765.00 | — | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD | $1,552.00 | $3,104.00 | $338.94–$3,104.00 | — | 50% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD;W/DRCT SUBMUCOSAL INJ,ANY | $1,329.00 | $2,658.00 | $361.09–$2,658.00 | 82% above | 50% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD;W/DRCT SUBMUCOSAL INJ,ANY | $1,329.00 | $2,658.00 | $361.09–$2,658.00 | — | 50% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD;W/DRCT SUBMUCOSAL INJ,ANY | $1,382.50 | $2,765.00 | $361.09–$2,765.00 | — | 50% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD;W/REM TMR,PLYP,LSN B/SNARE | $2,159.50 | $4,319.00 | $445.07–$4,319.00 | 90% above | 50% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION | $4,757.31 | $9,514.61 | $445.07–$9,514.61 | 318% above | 50% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD;W/REM TMR,PLYP,LSN B/SNARE | $2,159.50 | $4,319.00 | $445.07–$4,319.00 | — | 50% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD;W/REM TMR,PLYP,LSN B/SNARE | $2,246.00 | $4,492.00 | $445.07–$4,492.00 | — | 50% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION | $4,757.31 | $9,514.61 | $445.07–$9,514.61 | — | 50% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION | $4,757.31 | $9,514.61 | $445.07–$9,514.61 | — | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD;W/INSRT OF GUIDEWIRE F/B D | $2,159.50 | $4,319.00 | $372.31–$4,319.00 | 195% above | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD;W/INSRT OF GUIDEWIRE F/B D | $2,159.50 | $4,319.00 | $372.31–$4,319.00 | — | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD;W/INSRT OF GUIDEWIRE F/B D | $2,246.00 | $4,492.00 | $372.31–$4,492.00 | — | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY | $2,300.70 | $4,601.39 | $259.53–$4,601.39 | 118% above | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD | $1,382.50 | $2,765.00 | $259.53–$2,765.00 | — | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY | $2,300.70 | $4,601.39 | $259.53–$4,601.39 | — | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY | $2,300.70 | $4,601.39 | $259.53–$4,601.39 | — | 50% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH LITHOTRIPSY INCLUDING INSERTION OF INDW | $6,022.26 | $12,044.52 | $371.57–$12,044.52 | — | 50% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 ROUTINE OBSTETRIC CARE FOR VAGINAL DELIVERY AFTER PRIOR CESAREAN DELIVERY INCLUDING PRE-AND POST-DEL | $4,600.00 | $9,200.00 | $2,101.57–$9,200.00 | — | 50% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 ROUTINE OBSTETRIC CARE FOR VAGINAL DELIVERY, INCLUDING PRE-AND POST-DELIVERY CARE | $4,600.00 | $9,200.00 | $2,039.41–$9,200.00 | — | 50% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INCLUDING POSTOPERATIVE SEMEN EXAMINATION(S | $5,765.64 | $11,531.28 | $304.57–$11,531.28 | — | 50% |
| Wart removal, up to 14 warts CPT 17110 DEST BENIGN LESIONS;U/T 14-GCP | $98.00 | $196.00 | $88.20–$263.56 | 54% below | 50% |
| Wart removal, up to 14 warts CPT 17110 WC:DEST LSNS,SKIN TAGS:U/T 14 | $269.50 | $539.00 | $103.58–$539.00 | 28% above | 50% |
| Wart removal, up to 14 warts CPT 17110 DEST LSNS,SKIN TAGS;U/T 14-ER | $280.50 | $561.00 | $103.58–$561.00 | 33% above | 50% |
| Wart removal, up to 14 warts CPT 17110 DEST BENIGN LESIONS;U/T 14-GC | $280.50 | $561.00 | $103.58–$561.00 | 33% above | 50% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST BENIGN LESIONS;U/T 14-GCP | $102.00 | $204.00 | $91.80–$263.56 | — | 50% |
| Wart removal, up to 14 warts inpatient CPT 17110 WC:DEST LSNS,SKIN TAGS:U/T 14 | $269.50 | $539.00 | $103.58–$539.00 | — | 50% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST BENIGN LESIONS;U/T 14-GC | $292.00 | $584.00 | $103.58–$584.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC PF DEBRIDE SKN&SBQ 1ST 20SQ | $83.00 | $166.00 | $74.70–$484.85 | 92% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC:DEBRIDE-SKN&SBQ 1ST 20SQ CM | $486.50 | $973.00 | $117.19–$973.00 | 53% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;IR | $506.00 | $1,012.00 | $117.19–$1,012.00 | 51% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;OR | $506.00 | $1,012.00 | $117.19–$1,012.00 | 51% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;MF | $506.00 | $1,012.00 | $117.19–$1,012.00 | 51% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;ER | $506.00 | $1,012.00 | $117.19–$1,012.00 | 51% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC PF DEBRIDE SKN&SBQ 1ST 20SQ | $83.00 | $166.00 | $74.70–$484.85 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC PF DEBRIDE SKN&SBQ 1ST 20SQ | $83.00 | $166.00 | $74.70–$484.85 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC:DEBRIDE-SKN&SBQ 1ST 20SQ CM | $486.50 | $973.00 | $117.19–$973.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC:DEBRIDE-SKN&SBQ 1ST 20SQ CM | $486.50 | $973.00 | $117.19–$973.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;ER | $506.00 | $1,012.00 | $117.19–$1,012.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;MF | $506.00 | $1,012.00 | $117.19–$1,012.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;OR | $506.00 | $1,012.00 | $117.19–$1,012.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;IR | $506.00 | $1,012.00 | $117.19–$1,012.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE-SKN&SBQ 1ST 20SQ CM;OR | $526.50 | $1,053.00 | $117.19–$1,053.00 | — | 50% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIX | $6,496.04 | $12,992.07 | $661.73–$12,992.07 | — | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION,BLD/BLD COMPONENTS | $972.50 | $1,945.00 | $37.11–$1,945.00 | 3% above | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION,BLD/BLD COMPONENTS | $972.50 | $1,945.00 | $37.11–$1,945.00 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION,BLD/BLD COMPONENTS | $1,011.50 | $2,023.00 | $37.11–$2,023.00 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DEMO EVAL IPPB, SUBSQ | $245.00 | $490.00 | $6.88–$719.43 | 20% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TRMT F/OBSTR-SPTM MDI,IN | $245.00 | $490.00 | $6.88–$719.43 | 20% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DEMO EVAL IPPB | $245.00 | $490.00 | $6.88–$719.43 | 20% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TRNT F/OBSTR-SPTM MDI,SQ | $304.50 | $609.00 | $6.88–$719.43 | 50% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TRMT F/OBSTR-SPTM HHN,IN | $304.50 | $609.00 | $6.88–$719.43 | 50% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRT;EZ PAP INITIAL | $304.50 | $609.00 | $6.88–$719.43 | 50% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRT;EZ PAP SUBSEQNT | $304.50 | $609.00 | $6.88–$719.43 | 50% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TRMT F/OBSTR-SPTM HHN,SQ | $304.50 | $609.00 | $6.88–$719.43 | 50% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DEMO EVAL IPPB | $245.00 | $490.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT F/OBSTR-SPTM MDI,IN | $245.00 | $490.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT F/OBSTR-SPTM MDI,IN | $245.00 | $490.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DEMO EVAL IPPB, SUBSQ | $245.00 | $490.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DEMO EVAL IPPB | $245.00 | $490.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DEMO EVAL IPPB, SUBSQ | $255.00 | $510.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRT;EZ PAP INITIAL | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRNT F/OBSTR-SPTM MDI,SQ | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRT;EZ PAP INITIAL | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT F/OBSTR-SPTM HHN,SQ | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT F/OBSTR-SPTM HHN,IN | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT F/OBSTR-SPTM HHN,IN | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRT;EZ PAP SUBSEQNT | $304.50 | $609.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT F/OBSTR-SPTM HHN,SQ | $317.00 | $634.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRNT F/OBSTR-SPTM MDI,SQ | $317.00 | $634.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRT;EZ PAP SUBSEQNT | $317.00 | $634.00 | $6.88–$719.43 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TRMT INITAL;SPUTUM SCTN | $518.50 | $1,037.00 | $6.88–$1,037.00 | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADM INFSN 1HR, FRST DRG | $743.50 | $1,487.00 | $115.24–$1,487.00 | 22% above | 50% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM INFSN 1HR, FRST DRG | $743.50 | $1,487.00 | $115.24–$1,487.00 | — | 50% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM INFSN 1HR, FRST DRG | $743.50 | $1,487.00 | $115.24–$1,487.00 | — | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 H-CRITICAL C 99291 1ST 30-74M | $459.00 | $918.00 | $251.69–$2,831.81 | — | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY ROOM LEVEL VI | $1,260.50 | $2,521.00 | $251.69–$2,831.81 | — | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY ROOM LEVEL VI W/P | $1,260.50 | $2,521.00 | $251.69–$2,831.81 | — | 50% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM,ROUTINE, without interpretation and report | $194.50 | $389.00 | $13.01–$389.00 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG;TRACING ONLY W/O INTER&RPT | $148.50 | $297.00 | $5.39–$297.00 | 50% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG;TRACING ONLY W/RHYTHM STP | $187.50 | $375.00 | $5.39–$375.00 | 37% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG;TRACING ONLY W/O INTER&RPT | $148.50 | $297.00 | $5.39–$297.00 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG;TRACING ONLY W/O INTER&RPT | $148.50 | $297.00 | $5.39–$297.00 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG;TRACING ONLY W/RHYTHM STP | $187.50 | $375.00 | $5.39–$375.00 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG;TRACING ONLY W/RHYTHM STP | $187.50 | $375.00 | $5.39–$375.00 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PALLIATIVE 99281 ER NO DOC R | $34.50 | $69.00 | $10.36–$265.03 | 88% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 H-ER 99281 NO DOC REQ | $34.50 | $69.00 | $10.36–$265.03 | 88% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 H-ER 99281 NO DOC REQ W/P | $34.50 | $69.00 | $10.36–$265.03 | 88% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY RM TRIAGE - BCBS | $46.00 | $92.00 | $10.36–$265.03 | 84% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL ONLY-ER RM CHG | $69.50 | $139.00 | $10.36–$265.03 | 76% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1 | $189.27 | $378.53 | $10.36–$378.53 | 34% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL I W/P | $193.50 | $387.00 | $10.36–$387.00 | 33% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL I | $193.50 | $387.00 | $10.36–$387.00 | 33% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 H-ER 99281 NO DOC REQ | $34.50 | $69.00 | $10.36–$265.03 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PALLIATIVE 99281 ER NO DOC R | $36.00 | $72.00 | $10.36–$265.03 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY RM TRIAGE - BCBS | $46.00 | $92.00 | $10.36–$265.03 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE REMOVAL ONLY-ER RM CHG | $69.50 | $139.00 | $10.36–$265.03 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM LEVEL I | $193.50 | $387.00 | $10.36–$387.00 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PALLIATIVE 99282 ER SF MDM | $64.50 | $129.00 | $38.14–$481.15 | 87% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 H-ER 99282 SF MDM | $64.50 | $129.00 | $38.14–$481.15 | 87% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 H-ER 99282 SF MDM W/P | $64.50 | $129.00 | $38.14–$481.15 | 87% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL II W/P | $285.00 | $570.00 | $38.14–$570.00 | 41% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL II | $285.00 | $570.00 | $38.14–$570.00 | 41% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 | $488.05 | $976.10 | $38.14–$976.10 | 1% above | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 H-ER 99282 SF MDM | $64.50 | $129.00 | $38.14–$481.15 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PALLIATIVE 99282 ER SF MDM | $67.50 | $135.00 | $38.14–$481.15 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY ROOM LEVEL II | $285.00 | $570.00 | $38.14–$570.00 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PALLIATIVE 99283 ER LOW MDM | $107.00 | $214.00 | $64.98–$845.73 | 87% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 H-ER 99283 LOW MDM | $107.00 | $214.00 | $64.98–$845.73 | 87% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 H-ER 99283 LOW MDM W/P | $107.00 | $214.00 | $64.98–$845.73 | 87% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL III W/P | $376.50 | $753.00 | $64.98–$845.73 | 54% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL III | $376.50 | $753.00 | $64.98–$845.73 | 54% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 | $1,088.68 | $2,177.36 | $64.98–$2,177.36 | 32% above | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 H-ER 99283 LOW MDM | $107.00 | $214.00 | $64.98–$845.73 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PALLIATIVE 99283 ER LOW MDM | $111.50 | $223.00 | $64.98–$845.73 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM LEVEL III | $376.50 | $753.00 | $64.98–$845.73 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 H-ER 99284 MODERATE MDM W/P | $201.00 | $402.00 | $110.61–$1,372.35 | 85% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PALLIATIVE 99284 ER MEDIUM MDM | $201.00 | $402.00 | $110.61–$1,372.35 | 85% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 H-ER 99284 MODERATE MDM | $201.00 | $402.00 | $110.61–$1,372.35 | 85% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL IV | $597.50 | $1,195.00 | $110.61–$1,372.35 | 56% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL IV W/P | $597.50 | $1,195.00 | $110.61–$1,372.35 | 56% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 | $2,798.95 | $5,597.90 | $110.61–$5,597.90 | 105% above | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 H-ER 99284 MODERATE MDM | $201.00 | $402.00 | $110.61–$1,372.35 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PALLIATIVE 99284 ER MEDIUM MDM | $209.50 | $419.00 | $110.61–$1,372.35 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM LEVEL IV | $597.50 | $1,195.00 | $110.61–$1,372.35 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 H-ER 99285 HIGH MDM | $297.50 | $595.00 | $160.35–$2,010.48 | 87% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PALLIATIVE 99285 ER HIGH MDM | $297.50 | $595.00 | $160.35–$2,010.48 | 87% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL V | $927.00 | $1,854.00 | $160.35–$2,010.48 | 60% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL V W/P | $927.00 | $1,854.00 | $160.35–$2,010.48 | 60% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5 | $3,359.26 | $6,718.51 | $160.35–$6,718.51 | 44% above | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 H-ER 99285 HIGH MDM | $297.50 | $595.00 | $160.35–$2,010.48 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PALLIATIVE 99285 ER HIGH MDM | $309.50 | $619.00 | $160.35–$2,010.48 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM LEVEL V | $927.00 | $1,854.00 | $160.35–$2,010.48 | — | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIO STRESS TST:TRACING ONLY | $580.00 | $1,160.00 | $33.22–$1,160.00 | 60% below | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIO STRESS TST:TRACING ONLY | $580.00 | $1,160.00 | $33.22–$1,160.00 | — | 50% |
| Group psychotherapy session CPT 90853 TBC:GROUP PSYCHOTHERAPY-1 HOUR | $23.50 | $47.00 | $21.15–$84.93 | 90% below | 50% |
| Group psychotherapy session CPT 90853 TBC:GROUP PSYCHOTHERAPY-2 HRS | $47.00 | $94.00 | $26.92–$94.00 | 79% below | 50% |
| Group psychotherapy session CPT 90853 TBC:GROUP PSYCHOTHERAPY-3 HRS | $70.50 | $141.00 | $26.92–$141.00 | 69% below | 50% |
| Group psychotherapy session CPT 90853 HP-GROUP PSYCHOTHER 1/2HR SUBQ | $129.00 | $258.00 | $26.92–$258.00 | 44% below | 50% |
| Group psychotherapy session CPT 90853 HP-GROUP PSYCHOTHER 1/2HR INIT | $246.50 | $493.00 | $26.92–$493.00 | 8% above | 50% |
| Group psychotherapy session CPT 90853 HP-GROUP PSYCHOTHER INITAL | $250.50 | $501.00 | $26.92–$501.00 | 10% above | 50% |
| Group psychotherapy session CPT 90853 HP-GROUP PSYCHOTHER SUBQ | $250.50 | $501.00 | $26.92–$501.00 | 10% above | 50% |
| Group psychotherapy session inpatient CPT 90853 TBC:GROUP PSYCHOTHERAPY-1 HOUR | $23.50 | $47.00 | $21.15–$84.93 | — | 50% |
| Group psychotherapy session inpatient CPT 90853 TBC:GROUP PSYCHOTHERAPY-2 HRS | $47.00 | $94.00 | $26.92–$94.00 | — | 50% |
| Group psychotherapy session inpatient CPT 90853 TBC:GROUP PSYCHOTHERAPY-3 HRS | $70.50 | $141.00 | $26.92–$141.00 | — | 50% |
| Group psychotherapy session inpatient CPT 90853 HP-GROUP PSYCHOTHER 1/2HR SUBQ | $134.50 | $269.00 | $26.92–$269.00 | — | 50% |
| Group psychotherapy session inpatient CPT 90853 HP-GROUP PSYCHOTHER 1/2HR INIT | $246.50 | $493.00 | $26.92–$493.00 | — | 50% |
| Group psychotherapy session inpatient CPT 90853 HP-GROUP PSYCHOTHER INITAL | $250.50 | $501.00 | $26.92–$501.00 | — | 50% |
| Group psychotherapy session inpatient CPT 90853 HP-GROUP PSYCHOTHER SUBQ | $261.00 | $522.00 | $26.92–$522.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATION,31M-1H OB&N | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATION,31M-1HR ER | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATION,31M-1H GIPC | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATION,31M-1HR OR | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATION,31M-1HR RR | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATN,31M-1HR;OBS | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFSN,HYDRATION,31M-1HR IC | $598.00 | $1,196.00 | $29.47–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR OB&N | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR RR | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR IC | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR RAD | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR ER | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR GIPC | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR SURGICAL FLOOR | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR;OBS | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN,1HR OR | $598.00 | $1,196.00 | $55.98–$1,196.00 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; WC | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; GC | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; OB&N | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM,THER/DIAG;OBS | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; GIPC | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG;GASTRO | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; RR | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; ER | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 MFM-INJ SUBQ/IM, THER/DIAG;US | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; US | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; OR | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; CT | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM, THER/DIAG; NUCMD | $79.00 | $158.00 | $13.30–$224.65 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 TBC PS;DIAGNOSTIC EVALUATION | $61.00 | $122.00 | $54.90–$168.33 | 84% below | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 TBC:PSYCH/DIAG INTERV EXAM | $61.00 | $122.00 | $54.90–$168.33 | 84% below | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 TBC:CANS ASSESSMENT | $61.00 | $122.00 | $54.90–$168.33 | 84% below | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 ASSESSMENT & REF F/TBC | $62.50 | $125.00 | $56.25–$168.33 | 84% below | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 ASSESSMENT & REF F/VETERANS | $75.00 | $150.00 | $67.50–$168.33 | 80% below | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HP-PSYCHIATRIC DIAG INTER EXAM | $323.50 | $647.00 | $151.91–$647.00 | 16% below | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 TBC PS:DIAGNOSTIC EVALUATION | $61.00 | $122.00 | $54.90–$168.33 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 TBC PS;DIAGNOSTIC EVALUATION | $61.00 | $122.00 | $54.90–$168.33 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 TBC:PSYCH/DIAG INTERV EXAM | $61.00 | $122.00 | $54.90–$168.33 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 ASSESSMENT & REF F/TBC | $62.50 | $125.00 | $56.25–$168.33 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 ASSESSMENT & REF F/VETERANS | $75.00 | $150.00 | $67.50–$168.33 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 GC:PSYCHIATRIC DIAG EVALUATION | $184.50 | $369.00 | $151.91–$369.00 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HP-PSYCHIATRIC DIAG INTER EXAM | $323.50 | $647.00 | $151.91–$647.00 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 GC-PSYCHIATRIC DIAG EVALUATION | $336.50 | $673.00 | $151.91–$673.00 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HP-PSYCHIATRIC DIAG EVALUATION | $336.50 | $673.00 | $151.91–$673.00 | — | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 THERAPY PR NEUROMUSC RE-ED 15M | $100.50 | $201.00 | $32.09–$201.00 | 12% below | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT-TH/PR NEUROMUSC RE-ED 15MIN | $100.50 | $201.00 | $32.09–$201.00 | 12% below | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 PF THRPY PR NEUROMSC RE-ED 15M | $100.50 | $201.00 | $32.09–$201.00 | 12% below | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PF THRPY PR NEUROMSC RE-ED 15M | $100.50 | $201.00 | $32.09–$201.00 | — | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PF THRPY PR NEUROMSC RE-ED 15M | $100.50 | $201.00 | $32.09–$201.00 | — | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT-TH/PR NEUROMUSC RE-ED 15MIN | $100.50 | $201.00 | $32.09–$201.00 | — | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 THERAPY PR NEUROMUSC RE-ED 15M | $100.50 | $201.00 | $32.09–$201.00 | — | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT-TH/PR NEUROMUSC RE-ED 15MIN | $100.50 | $201.00 | $32.09–$201.00 | — | 50% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 THERAPY PR NEUROMUSC RE-ED 15M | $100.50 | $201.00 | $32.09–$201.00 | — | 50% |
| New patient office visit, about 30 minutes CPT 99203 GC NEW PAT 99203 PF L 30-44M | $59.50 | $119.00 | $53.55–$300.62 | 77% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 GC NEW PAT 99203 VISIT CHG | $91.00 | $182.00 | $81.90–$300.62 | 64% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 GC NEW PAT 99203 FAC 1500 | $91.00 | $182.00 | $81.90–$300.62 | 64% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 WC PF VISIT NEW LOW 30-44M W/P | $120.00 | $240.00 | $102.39–$300.62 | 53% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 WC PF VISIT NEW PAT LOW 30-44M | $120.00 | $240.00 | $102.39–$300.62 | 53% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 PALLIATIVE 99203 30-44M OP;NEW | $125.50 | $251.00 | $102.39–$300.62 | 51% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 WC VISIT LEVEL 3-NEW PT W/PROC | $187.50 | $375.00 | $102.39–$375.00 | 27% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 WC VISIT LVL 3-NW PT FAC 1500 | $187.50 | $375.00 | $102.39–$375.00 | 27% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 WC LVL 3-NW PT W/PROC FAC 1500 | $187.50 | $375.00 | $102.39–$375.00 | 27% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 WC VISIT LEVEL 3 - NEW PT | $187.50 | $375.00 | $102.39–$375.00 | 27% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 OC VISIT LEVEL 3 - NEW PT | $187.50 | $375.00 | $102.39–$375.00 | 27% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 OC VISIT LEVEL 3-NEW PT W/PROC | $187.50 | $375.00 | $102.39–$375.00 | 27% below | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 GC NEW PAT 99203 PF L 30-44M | $62.00 | $124.00 | $55.80–$300.62 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 GC NEW PAT 99203 FAC 1500 | $95.00 | $190.00 | $85.50–$300.62 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 GC NEW PAT 99203 VISIT CHG | $95.00 | $190.00 | $85.50–$300.62 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC PF VISIT NEW PAT LOW 30-44M | $120.00 | $240.00 | $102.39–$300.62 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC PF VISIT NEW LOW 30-44M W/P | $125.00 | $250.00 | $102.39–$300.62 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PALLIATIVE 99203 30-44M OP;NEW | $125.50 | $251.00 | $102.39–$300.62 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC VISIT LVL 3-NW PT FAC 1500 | $187.50 | $375.00 | $102.39–$375.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OC VISIT LEVEL 3 - NEW PT | $187.50 | $375.00 | $102.39–$375.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC VISIT LEVEL 3 - NEW PT | $187.50 | $375.00 | $102.39–$375.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC VISIT LEVEL 3-NEW PT W/PROC | $195.00 | $390.00 | $102.39–$390.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC LVL 3-NW PT W/PROC FAC 1500 | $195.00 | $390.00 | $102.39–$390.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OC VISIT LEVEL 3-NEW PT W/PROC | $195.00 | $390.00 | $102.39–$390.00 | — | 50% |
| New patient office visit, about 45 minutes CPT 99204 GC NEW PAT 99204 VISIT CHG | $98.50 | $197.00 | $88.65–$507.01 | 69% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 GC NEW PAT 99204 FAC 1500 | $98.50 | $197.00 | $88.65–$507.01 | 69% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 GC NEW PAT 99204 PF M 45-59M | $102.00 | $204.00 | $91.80–$507.01 | 68% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 WC PF VISIT NEW MOD 45-59M W/P | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 WC LVL 4-NW PT W/PROC FAC 1500 | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 WC VISIT LVL 4-NW PT FAC 1500 | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 WC PF VISIT NEW PAT MOD 45-59M | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 OC VISIT LEVEL 4-NEW PT W/PROC | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 OC VISIT LEVEL 4 - NEW PT | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 WC VISIT LEVEL 4-NEW PT W/PROC | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 WC VISIT LEVEL 4 - NEW PT | $194.50 | $389.00 | $154.29–$507.01 | 39% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 PALLIATIVE 99204 45-59M OP;NEW | $211.00 | $422.00 | $154.29–$507.01 | 34% below | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 GC NEW PAT 99204 VISIT CHG | $102.50 | $205.00 | $92.25–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 GC NEW PAT 99204 FAC 1500 | $102.50 | $205.00 | $92.25–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 GC NEW PAT 99204 PF M 45-59M | $106.50 | $213.00 | $95.85–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OC VISIT LEVEL 4 - NEW PT | $194.50 | $389.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC VISIT LEVEL 4 - NEW PT | $194.50 | $389.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC PF VISIT NEW PAT MOD 45-59M | $194.50 | $389.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC VISIT LVL 4-NW PT FAC 1500 | $194.50 | $389.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC LVL 4-NW PT W/PROC FAC 1500 | $202.50 | $405.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OC VISIT LEVEL 4-NEW PT W/PROC | $202.50 | $405.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC VISIT LEVEL 4-NEW PT W/PROC | $202.50 | $405.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC PF VISIT NEW MOD 45-59M W/P | $202.50 | $405.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PALLIATIVE 99204 45-59M OP;NEW | $211.00 | $422.00 | $154.29–$507.01 | — | 50% |
| New patient office visit, about 60 minutes CPT 99205 GC NEW PAT 99205 VISIT CHG | $113.00 | $226.00 | $101.70–$662.18 | 66% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 GC NEW PAT 99205 FAC 1500 | $113.00 | $226.00 | $101.70–$662.18 | 66% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 GC NEW PAT 99205 PF H 60-74MIN | $131.00 | $262.00 | $117.90–$662.18 | 61% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 WC VISIT LEVEL 5-NEW PT W/PROC | $202.00 | $404.00 | $181.80–$662.18 | 40% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 WC VISIT LVL 5-NW PT FAC 1500 | $202.00 | $404.00 | $181.80–$662.18 | 40% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 WC VISIT LEVEL 5 - NEW PT | $202.00 | $404.00 | $181.80–$662.18 | 40% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 OC VISIT LEVEL 5 - NEW PT | $202.00 | $404.00 | $181.80–$662.18 | 40% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 WC LVL 5-NW PT W/PROC FAC 1500 | $202.00 | $404.00 | $181.80–$662.18 | 40% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 OC VISIT LEVEL 5-NEW PT W/PROC | $202.00 | $404.00 | $181.80–$662.18 | 40% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 WC PF VISIT NEW HGH 60-74M W/P | $263.50 | $527.00 | $203.38–$662.18 | 22% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 WC PF VISIT NEW PAT HGH 60-74M | $263.50 | $527.00 | $203.38–$662.18 | 22% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 PALLIATIVE 99205 60-74M OP;NEW | $275.00 | $550.00 | $203.38–$662.18 | 18% below | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 GC NEW PAT 99205 FAC 1500 | $118.00 | $236.00 | $106.20–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 GC NEW PAT 99205 VISIT CHG | $118.00 | $236.00 | $106.20–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 GC NEW PAT 99205 PF H 60-74MIN | $136.50 | $273.00 | $122.85–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OC VISIT LEVEL 5 - NEW PT | $202.00 | $404.00 | $181.80–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC VISIT LEVEL 5 - NEW PT | $202.00 | $404.00 | $181.80–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC VISIT LVL 5-NW PT FAC 1500 | $202.00 | $404.00 | $181.80–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC VISIT LEVEL 5-NEW PT W/PROC | $210.50 | $421.00 | $189.45–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC LVL 5-NW PT W/PROC FAC 1500 | $210.50 | $421.00 | $189.45–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OC VISIT LEVEL 5-NEW PT W/PROC | $210.50 | $421.00 | $189.45–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC PF VISIT NEW PAT HGH 60-74M | $263.50 | $527.00 | $203.38–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC PF VISIT NEW HGH 60-74M W/P | $274.50 | $549.00 | $203.38–$662.18 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PALLIATIVE 99205 60-74M OP;NEW | $275.00 | $550.00 | $203.38–$662.18 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GC NEW PAT 99202 PF SF 15-29M | $45.00 | $90.00 | $40.50–$198.10 | 77% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC PF VISIT NEW SF 15-29M W/P | $71.00 | $142.00 | $63.90–$198.10 | 64% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC PF VISIT NEW PAT SF 15-29M | $71.00 | $142.00 | $63.90–$198.10 | 64% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 PALLIATIVE 99202 15-29M OP;NEW | $84.00 | $168.00 | $66.57–$198.10 | 57% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GC NEW PAT 99202 FAC 1500 | $91.00 | $182.00 | $66.57–$198.10 | 53% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GC NEW PAT 992xx VISIT CHG | $91.00 | $182.00 | $66.57–$198.10 | 53% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GC NEW PAT 99202 VISIT CHG | $91.00 | $182.00 | $66.57–$198.10 | 53% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OC VISIT LEVEL 1 - NEW PT | $173.00 | $346.00 | $66.57–$346.00 | 11% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC VISIT LEVEL 1-NEW PT W/PROC | $173.00 | $346.00 | $66.57–$346.00 | 11% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC LVL 1-NW PT W/PROC FAC 1500 | $173.00 | $346.00 | $66.57–$346.00 | 11% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC VISIT LEVEL 1 - NEW PT | $173.00 | $346.00 | $66.57–$346.00 | 11% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OC VISIT LEVEL 1-NEW PT W/PROC | $173.00 | $346.00 | $66.57–$346.00 | 11% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC VISIT LVL 1-NW PT FAC 1500 | $173.00 | $346.00 | $66.57–$346.00 | 11% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OC VISIT LEVEL 2 - NEW PT | $180.00 | $360.00 | $66.57–$360.00 | 8% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC VISIT LEVEL 2 - NEW PT | $180.00 | $360.00 | $66.57–$360.00 | 8% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC LVL 2-NW PT W/PROC FAC 1500 | $180.00 | $360.00 | $66.57–$360.00 | 8% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC VISIT LVL 2-NW PT FAC 1500 | $180.00 | $360.00 | $66.57–$360.00 | 8% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC VISIT LEVEL 2-NEW PT W/PROC | $180.00 | $360.00 | $66.57–$360.00 | 8% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OC VISIT LEVEL 2-NEW PT W/PROC | $180.00 | $360.00 | $66.57–$360.00 | 8% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GC NEW PAT 99202 PF SF 15-29M | $47.00 | $94.00 | $42.30–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC PF VISIT NEW PAT SF 15-29M | $71.00 | $142.00 | $63.90–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC PF VISIT NEW SF 15-29M W/P | $74.00 | $148.00 | $66.57–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PALLIATIVE 99202 15-29M OP;NEW | $84.00 | $168.00 | $66.57–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GC NEW PAT 99202 VISIT CHG | $95.00 | $190.00 | $66.57–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GC NEW PAT 992XX VISIT CHG | $95.00 | $190.00 | $66.57–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GC NEW PAT 99202 FAC 1500 | $95.00 | $190.00 | $66.57–$198.10 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OC VISIT LEVEL 1 - NEW PT | $173.00 | $346.00 | $66.57–$346.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC VISIT LEVEL 1 - NEW PT | $173.00 | $346.00 | $66.57–$346.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC VISIT LVL 1-NW PT FAC 1500 | $173.00 | $346.00 | $66.57–$346.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OC VISIT LEVEL 1-NEW PT W/PROC | $173.00 | $346.00 | $66.57–$346.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC VISIT LEVEL 2 - NEW PT | $180.00 | $360.00 | $66.57–$360.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC LVL 1-NW PT W/PROC FAC 1500 | $180.00 | $360.00 | $66.57–$360.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC VISIT LVL 2-NW PT FAC 1500 | $180.00 | $360.00 | $66.57–$360.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OC VISIT LEVEL 2 - NEW PT | $180.00 | $360.00 | $66.57–$360.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC VISIT LEVEL 1-NEW PT W/PROC | $180.00 | $360.00 | $66.57–$360.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC LVL 2-NW PT W/PROC FAC 1500 | $187.50 | $375.00 | $66.57–$375.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC VISIT LEVEL 2-NEW PT W/PROC | $187.50 | $375.00 | $66.57–$375.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OC VISIT LEVEL 2-NEW PT W/PROC | $187.50 | $375.00 | $66.57–$375.00 | — | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THER;INITAL INDIV 15M | $68.00 | $136.00 | $34.61–$136.00 | 16% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THER;INITAL INDIV 15M | $68.00 | $136.00 | $34.61–$136.00 | — | 50% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL:LOW 30MINS | $211.50 | $423.00 | $96.44–$423.00 | — | 50% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL:LOW 30MINS REHAB | $211.50 | $423.00 | $96.44–$423.00 | — | 50% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL:LOW 30MINS REHAB | $211.50 | $423.00 | $96.44–$423.00 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL:HIGH 45MINS REHAB | $225.50 | $451.00 | $95.54–$451.00 | 26% below | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL:HIGH 45MINS REHAB | $225.50 | $451.00 | $95.54–$451.00 | 26% below | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL:HIGH 45MINS | $225.50 | $451.00 | $95.54–$451.00 | 26% below | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PF PT EVAL:HIGH 45MINS | $225.50 | $451.00 | $95.54–$451.00 | 26% below | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL:HIGH 45MINS REHAB | $225.50 | $451.00 | $95.54–$451.00 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PF PT EVAL:HIGH 45MINS | $225.50 | $451.00 | $95.54–$451.00 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL:HIGH 45MINS | $225.50 | $451.00 | $95.54–$451.00 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL:HIGH 45MINS REHAB | $235.00 | $470.00 | $95.54–$470.00 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL:HIGH 45MINS+GAIT BELT | $239.00 | $478.00 | $95.54–$478.00 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL:LOW 20MINS REHAB | $211.50 | $423.00 | $95.54–$423.00 | 11% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL:LOW 20MINS REHAB | $211.50 | $423.00 | $95.54–$423.00 | 11% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL:LOW 20MINS | $211.50 | $423.00 | $95.54–$423.00 | 11% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PF PT EVAL:LOW 20MINS | $211.50 | $423.00 | $95.54–$423.00 | 11% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL:LOW 20MINS REHAB | $211.50 | $423.00 | $95.54–$423.00 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL:LOW 20MINS | $211.50 | $423.00 | $95.54–$423.00 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PF PT EVAL:LOW 20MINS | $211.50 | $423.00 | $95.54–$423.00 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL:LOW 20MINS REHAB | $220.00 | $440.00 | $95.54–$440.00 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL:LOW 20MINS+GAIT BELT | $224.50 | $449.00 | $95.54–$449.00 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL:MODERATE 30MINS | $218.50 | $437.00 | $95.54–$437.00 | 23% below | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL:MODERATE 30MINS REHAB | $218.50 | $437.00 | $95.54–$437.00 | 23% below | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PF PT EVAL:MODERATE 30MINS | $218.50 | $437.00 | $95.54–$437.00 | 23% below | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL:MODERATE 30MINS REHAB | $218.50 | $437.00 | $95.54–$437.00 | 23% below | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL:MODERATE 30MINS | $218.50 | $437.00 | $95.54–$437.00 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PF PT EVAL:MODERATE 30MINS | $218.50 | $437.00 | $95.54–$437.00 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL:MODERATE 30MINS REHAB | $218.50 | $437.00 | $95.54–$437.00 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL:MODERATE 30MINS REHAB | $227.50 | $455.00 | $95.54–$455.00 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL:MODERATE 30M+GAIT BELT | $231.50 | $463.00 | $95.54–$463.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PF MAN/TH,MYOFASCIAL REL 15M E | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PF MANUAL THRPY-TRACTION 15M E | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY,JT/MOBIL 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-TRACTION 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PF MANUAL THRPY,JT/MOBIL 15M E | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT-MAN/TH MYOFASCIAL REL 15MN | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT-MANUAL THRPY JT/MOB 15MIN E | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MAN/TH,MYOFASCIAL REL 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | 21% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT-MAN/TH MYOFASCIAL REL 15MN | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF MAN/TH,MYOFASCIAL REL 15M E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF MANUAL THRPY-TRACTION 15M E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY,JT/MOBIL 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-TRACTION 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT-MANUAL THRPY JT/MOB 15MIN E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT-MAN/TH MYOFASCIAL REL 15MN | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF MANUAL THRPY-TRACTION 15M E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF MAN/TH,MYOFASCIAL REL 15M E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF MANUAL THRPY,JT/MOBIL 15M E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY,JT/MOBIL 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MAN/TH,MYOFASCIAL REL 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-TRACTION 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF MANUAL THRPY,JT/MOBIL 15M E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT-MANUAL THRPY JT/MOB 15MIN E | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MAN/TH,MYOFASCIAL REL 15MIN EA | $89.50 | $179.00 | $25.80–$179.00 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PF THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | 27% below | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | 27% below | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT-THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | 27% below | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PF THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PF THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT-THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT-THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | — | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPY EX 15MIN EA | $90.50 | $181.00 | $27.98–$181.00 | — | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 GC PREV MED EST 18-39YRS PRO F | $61.00 | $122.00 | $54.90–$350.49 | 37% below | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 GC PREV MED EST 18-39YRS FAC | $115.00 | $230.00 | $103.50–$350.49 | 19% above | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 GC PREV MED EST 18-39Y FAC1500 | $115.00 | $230.00 | $103.50–$350.49 | 19% above | 50% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 GC PREV MED EST 18-39YRS PRO F | $63.50 | $127.00 | $57.15–$350.49 | — | 50% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 GC PREV MED EST 18-39YRS FAC | $120.00 | $240.00 | $108.00–$350.49 | — | 50% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 GC PREV MED EST 18-39Y FAC1500 | $120.00 | $240.00 | $108.00–$350.49 | — | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 GC PREV MED EST 40-64YRS PRO F | $61.00 | $122.00 | $54.90–$379.59 | 71% below | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 GC PREV MED EST 40-64Y FAC1500 | $115.00 | $230.00 | $103.50–$379.59 | 46% below | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 GC PREV MED EST 40-64YRS FAC | $115.00 | $230.00 | $103.50–$379.59 | 46% below | 50% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 GC PREV MED EST 40-64YRS PRO F | $63.50 | $127.00 | $57.15–$379.59 | — | 50% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 GC PREV MED EST 40-64Y FAC1500 | $120.00 | $240.00 | $108.00–$379.59 | — | 50% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 GC PREV MED EST 40-64YRS FAC | $120.00 | $240.00 | $108.00–$379.59 | — | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 GC PREV MED EST 65+YRS PRO F | $61.00 | $122.00 | $54.90–$400.36 | 65% below | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 GC PREV MED EST 65+YRS FAC | $115.00 | $230.00 | $103.50–$400.36 | 35% below | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 GC PREV MED EST 65+Y FAC1500 | $115.00 | $230.00 | $103.50–$400.36 | 35% below | 50% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 GC PREV MED EST 65+YRS PRO F | $63.50 | $127.00 | $57.15–$400.36 | — | 50% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 GC PREV MED EST 65+Y FAC1500 | $120.00 | $240.00 | $108.00–$400.36 | — | 50% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 GC PREV MED EST 65+YRS FAC | $120.00 | $240.00 | $108.00–$400.36 | — | 50% |
| Psychiatric evaluation with medical services CPT 90792 ETBHN PSYCH DX EVL W/MED SVC | $317.00 | $634.00 | $151.91–$634.00 | 3% below | 50% |
| Psychiatric evaluation with medical services CPT 90792 ETBHN PSYCH DX EVL W/MS;AH,W,H | $387.00 | $774.00 | $151.91–$774.00 | 18% above | 50% |
| Psychiatric evaluation with medical services inpatient CPT 90792 GC:PSYCH DIAG EVAL W/MED SRVCS | $211.00 | $422.00 | $151.91–$422.00 | — | 50% |
| Psychiatric evaluation with medical services inpatient CPT 90792 GC-PSYCH DIAG EVAL W/MED SRVCS | $330.00 | $660.00 | $151.91–$660.00 | — | 50% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 TBC:PSYCH/CRISIS 1ST 60MINS | $61.00 | $122.00 | $54.90–$151.91 | 81% below | 50% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 TBC:PSYCH/CRISIS 1ST 60MINS | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 30 minutes CPT 90832 TBC:IND PSYCHTHRPY-MCD P/30MIN | $33.50 | $67.00 | $30.15–$151.91 | 83% below | 50% |
| Psychotherapy session, 30 minutes CPT 90832 CD:INDIVID PSYCHTHRPY 20-30MN | $33.50 | $67.00 | $30.15–$151.91 | 83% below | 50% |
| Psychotherapy session, 30 minutes CPT 90832 TBC:INDIVID PSYCHOTHRPY 20-30M | $33.50 | $67.00 | $30.15–$151.91 | 83% below | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HP-INDIV PSYCHOTHERAPY 20-30MN | $209.50 | $419.00 | $76.53–$419.00 | 9% above | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 TBC:IND PSYCHTHRPY-MCD P/30MIN | $33.50 | $67.00 | $30.15–$151.91 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 CD:INDIVID PSYCHTHRPY 20-30MN | $33.50 | $67.00 | $30.15–$151.91 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 CD:INDIV PSYCHOTHERAPY 30MINS | $33.50 | $67.00 | $30.15–$151.91 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 TBC:INDIVID PSYCHOTHRPY 20-30M | $33.50 | $67.00 | $30.15–$151.91 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 TBC:INDIV PSYCHOTHERAPY 30MINS | $33.50 | $67.00 | $30.15–$151.91 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 GC:INDIV PSYCHOTHERAPY 30MINS | $89.00 | $178.00 | $76.53–$178.00 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HP-INDIV PSYCHOTHERAPY 20-30MN | $209.50 | $419.00 | $76.53–$419.00 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HP-INDIV PSYCHOTHERAPY 30MINS | $218.00 | $436.00 | $76.53–$436.00 | — | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 GC-INDIV PSYCHOTHERAPY 30MINS | $218.00 | $436.00 | $76.53–$436.00 | — | 50% |
| Psychotherapy session, 45 minutes CPT 90834 TBC:INDIVID PSYCHOTHRPY 45-50M | $61.00 | $122.00 | $54.90–$151.91 | 78% below | 50% |
| Psychotherapy session, 45 minutes CPT 90834 CD:INDIVID PSYCHTHRPY 45-50MN | $61.00 | $122.00 | $54.90–$151.91 | 78% below | 50% |
| Psychotherapy session, 45 minutes CPT 90834 TBC PS;INDIVIDUAL PSYCHTHERAPY | $61.00 | $122.00 | $54.90–$151.91 | 78% below | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HP-INDIV PSYCHOTHERAPY 45-50MN | $308.50 | $617.00 | $101.14–$617.00 | 12% above | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 CD:INDIV PSYCHOTHERAPY 45MINS | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 TBC PS;INDIVIDUAL PSYCHTHERAPY | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 CD:INDIVID PSYCHTHRPY 45-50MN | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 TBC:INDIV PSYCHOTHERAPY 45MINS | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 TBC:INDIVID PSYCHOTHRPY 45-50M | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 TBC PS:INDIV PSYCHOTHERAPY 45M | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 GC:INDIV PSYCHOTHERAPY 45MINS | $117.00 | $234.00 | $101.14–$234.00 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HP-INDIV PSYCHOTHERAPY 45-50MN | $308.50 | $617.00 | $101.14–$617.00 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 GC-INDIV PSYCHOTHERAPY 45MINS | $321.00 | $642.00 | $101.14–$642.00 | — | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HP-INDIV PSYCHOTHERAPY 45MINS | $321.00 | $642.00 | $101.14–$642.00 | — | 50% |
| Psychotherapy session, 60 minutes CPT 90837 TBC:INDIVID PSYCHOTHRPY 60MIN | $61.00 | $122.00 | $54.90–$151.91 | 78% below | 50% |
| Psychotherapy session, 60 minutes CPT 90837 CD:INDIVID PSYCHTHRPY 60MN | $61.00 | $122.00 | $54.90–$151.91 | 78% below | 50% |
| Psychotherapy session, 60 minutes CPT 90837 TBC:IND PSYCHTHRPY-MCD P/60MIN | $67.00 | $134.00 | $60.30–$151.91 | 76% below | 50% |
| Psychotherapy session, 60 minutes CPT 90837 HP-INDIV PSYCHOTHERAPY 60MINS | $308.50 | $617.00 | $149.08–$617.00 | 12% above | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 TBC:INDIV PSYCHOTHERAPY 60MINS | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 CD:INDIVID PSYCHTHRPY 60MN | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 TBC:INDIVID PSYCHOTHRPY 60MIN | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 CD:INDIV PSYCHOTHERAPY 60MINS | $61.00 | $122.00 | $54.90–$151.91 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 TBC:IND PSYCHTHRPY-MCD P/60MIN | $67.00 | $134.00 | $60.30–$151.91 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 GC:INDIV PSYCHOTHERAPY 60MINS | $173.50 | $347.00 | $149.08–$347.00 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HP-INDIV PSYCHOTHERAPY 60MINS | $308.50 | $617.00 | $149.08–$617.00 | — | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 GC-INDIV PSYCHOTHERAPY 60MINS | $321.00 | $642.00 | $149.08–$642.00 | — | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 H-SMOKING/TOBACCO CSSTN; 3-10M | $22.00 | $44.00 | $13.61–$48.48 | 53% below | 50% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 H-SMOKING/TOBACCO CSSTN; 3-10M | $22.00 | $44.00 | $13.61–$48.48 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 GC ESTAB PAT 99215 PF 40-54MIN | $87.50 | $175.00 | $78.75–$434.98 | 72% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 GC ESTAB PAT 99215 FAC 1500 | $98.50 | $197.00 | $88.65–$434.98 | 68% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 GC ESTAB PAT 99215 VISIT CHG | $98.50 | $197.00 | $88.65–$434.98 | 68% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC LVL5-EST PT W/PROC FAC 1500 | $202.00 | $404.00 | $167.73–$434.98 | 35% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC VISIT LVL 5-ESTABLISHED PAT | $202.00 | $404.00 | $167.73–$434.98 | 35% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC VISIT LVL 5-EST PAT W/PROC | $202.00 | $404.00 | $167.73–$434.98 | 35% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OC VISIT LVL 5-ESTABLISHED PAT | $202.00 | $404.00 | $167.73–$434.98 | 35% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OC VISIT LVL 5-EST PAT W/PROC | $202.00 | $404.00 | $167.73–$434.98 | 35% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC LVL 5-EST PT FAC 1500 | $202.00 | $404.00 | $167.73–$434.98 | 35% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 PALLIATIVE 99215 40-54M OP;EST | $231.50 | $463.00 | $167.73–$463.00 | 25% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC PF VISIT EST HGH 40-54M W/P | $263.50 | $527.00 | $167.73–$527.00 | 15% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC PF VISIT ESTAB HIGH 40-54M | $263.50 | $527.00 | $167.73–$527.00 | 15% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GC ESTAB PAT 99215 PF 40-54MIN | $91.00 | $182.00 | $81.90–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GC ESTAB PAT 99215 TH 40-54MIN | $91.00 | $182.00 | $81.90–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GC ESTAB PAT 99215 FAC 1500 | $102.50 | $205.00 | $92.25–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GC ESTAB PAT 99215 VISIT CHG | $102.50 | $205.00 | $92.25–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OC VISIT LVL 5-ESTABLISHED PAT | $202.00 | $404.00 | $167.73–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC LVL 5-EST PT FAC 1500 | $202.00 | $404.00 | $167.73–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC VISIT LVL 5-ESTABLISHED PAT | $202.00 | $404.00 | $167.73–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC LVL5-EST PT W/PROC FAC 1500 | $210.50 | $421.00 | $167.73–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC VISIT LVL 5-EST PAT W/PROC | $210.50 | $421.00 | $167.73–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OC VISIT LVL 5-EST PAT W/PROC | $210.50 | $421.00 | $167.73–$434.98 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PALLIATIVE 99215 40-54M OP;EST | $231.50 | $463.00 | $167.73–$463.00 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC PF VISIT ESTAB HIGH 40-54M | $263.50 | $527.00 | $167.73–$527.00 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC PF VISIT EST HGH 40-54M W/P | $274.50 | $549.00 | $167.73–$549.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GC ESTAB PAT 99213 PF 20-29MIN | $45.00 | $90.00 | $40.50–$200.87 | 79% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT/OB | $76.00 | $152.00 | $68.40–$200.87 | 64% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GC ESTAB PAT 99213 FAC 1500 | $91.00 | $182.00 | $81.90–$200.87 | 57% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GC ESTAB PAT 99213 VISIT CHG | $91.00 | $182.00 | $81.90–$200.87 | 57% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PALLIATIVE 99213 20-29M OP;EST | $118.00 | $236.00 | $84.33–$236.00 | 44% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC PF VISIT EST LOW 20-29M W/P | $120.00 | $240.00 | $84.33–$240.00 | 43% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC PF VISIT ESTAB LOW 20-29M | $120.00 | $240.00 | $84.33–$240.00 | 43% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3:E&M ESTAB PAT VISIT,MP | $125.00 | $250.00 | $84.33–$250.00 | 41% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3:ER E&M ESTAB PAT VISIT | $125.00 | $250.00 | $84.33–$250.00 | 41% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC LVL 3-EST PT FAC 1500 | $187.50 | $375.00 | $84.33–$375.00 | 11% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OC VISIT LVL 3-ESTABLISHED PAT | $187.50 | $375.00 | $84.33–$375.00 | 11% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC LVL3-EST PT W/PROC FAC 1500 | $187.50 | $375.00 | $84.33–$375.00 | 11% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC VISIT LVL 3-ESTABLISHED PAT | $187.50 | $375.00 | $84.33–$375.00 | 11% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC VISIT LVL 3-EST PAT W/PROC | $187.50 | $375.00 | $84.33–$375.00 | 11% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OC VISIT LVL 3-EST PAT W/PROC | $187.50 | $375.00 | $84.33–$375.00 | 11% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GC ESTAB PAT 99213 PF 20-29MIN | $47.00 | $94.00 | $42.30–$200.87 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GC ESTAB PAT 99213 TH 20-29MIN | $47.00 | $94.00 | $42.30–$200.87 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT/OB | $76.00 | $152.00 | $68.40–$200.87 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GC ESTAB PAT 99213 FAC 1500 | $95.00 | $190.00 | $84.33–$200.87 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GC ESTAB PAT 99213 VISIT CHG | $95.00 | $190.00 | $84.33–$200.87 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PALLIATIVE 99213 20-29M OP;EST | $118.00 | $236.00 | $84.33–$236.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC PF VISIT ESTAB LOW 20-29M | $120.00 | $240.00 | $84.33–$240.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3:E&M ESTAB PAT VISIT,MP | $125.00 | $250.00 | $84.33–$250.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC PF VISIT EST LOW 20-29M W/P | $125.00 | $250.00 | $84.33–$250.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3:ER E&M ESTAB PAT VISIT | $125.00 | $250.00 | $84.33–$250.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC LVL 3-EST PT FAC 1500 | $187.50 | $375.00 | $84.33–$375.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC VISIT LVL 3-ESTABLISHED PAT | $187.50 | $375.00 | $84.33–$375.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OC VISIT LVL 3-ESTABLISHED PAT | $187.50 | $375.00 | $84.33–$375.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OC VISIT LVL 3-EST PAT W/PROC | $195.00 | $390.00 | $84.33–$390.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC LVL3-EST PT W/PROC FAC 1500 | $195.00 | $390.00 | $84.33–$390.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC VISIT LVL 3-EST PAT W/PROC | $195.00 | $390.00 | $84.33–$390.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GC ESTAB PAT 99214 PF 30-39MIN | $59.50 | $119.00 | $53.55–$307.53 | 78% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GC ESTAB PAT 99214 FAC 1500 | $91.00 | $182.00 | $81.90–$307.53 | 67% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GC ESTAB PAT 99214 VISIT CHG | $91.00 | $182.00 | $81.90–$307.53 | 67% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PALLIATIVE 99214 30-39M OP;EST | $172.50 | $345.00 | $119.33–$345.00 | 37% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC VISIT LVL 4-EST PAT W/PROC | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OC VISIT LVL 4-ESTABLISHED PAT | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OC VISIT LVL 4-EST PAT W/PROC | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC PF VISIT ESTAB MOD 30-39M | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC LVL 4-EST PT FAC 1500 | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC VISIT LVL 4-ESTABLISHED PAT | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC LVL4-EST PT W/PROC FAC 1500 | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC PF VISIT EST MOD 30-39M W/P | $194.50 | $389.00 | $119.33–$389.00 | 29% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GC ESTAB PAT 99214 PF 30-39MIN | $62.00 | $124.00 | $55.80–$307.53 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GC ESTAB PAT 99214 TH 30-39MIN | $62.00 | $124.00 | $55.80–$307.53 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GC ESTAB PAT 99214 FAC 1500 | $95.00 | $190.00 | $85.50–$307.53 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GC ESTAB PAT 99214 VISIT CHG | $95.00 | $190.00 | $85.50–$307.53 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PALLIATIVE 99214 30-39M OP;EST | $172.50 | $345.00 | $119.33–$345.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC LVL 4-EST PT FAC 1500 | $194.50 | $389.00 | $119.33–$389.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC PF VISIT ESTAB MOD 30-39M | $194.50 | $389.00 | $119.33–$389.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OC VISIT LVL 4-ESTABLISHED PAT | $194.50 | $389.00 | $119.33–$389.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC VISIT LVL 4-ESTABLISHED PAT | $194.50 | $389.00 | $119.33–$389.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OC VISIT LVL 4-EST PAT W/PROC | $202.50 | $405.00 | $119.33–$405.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC LVL4-EST PT W/PROC FAC 1500 | $202.50 | $405.00 | $119.33–$405.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC VISIT LVL 4-EST PAT W/PROC | $202.50 | $405.00 | $119.33–$405.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC PF VISIT EST MOD 30-39M W/P | $202.50 | $405.00 | $119.33–$405.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GC ESTAB PAT 99212 PF 10-19MIN | $24.00 | $48.00 | $21.60–$99.74 | 85% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BILIARY CATH REM,XRAY D-99212 | $43.00 | $86.00 | $38.70–$99.74 | 74% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PALLIATIVE 99212 10-19M OP;EST | $70.50 | $141.00 | $52.11–$141.00 | 57% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC PF VISIT ESTAB SF 10-19M | $71.00 | $142.00 | $52.11–$142.00 | 57% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC PF VISIT EST SF 10-19M W/P | $71.00 | $142.00 | $52.11–$142.00 | 57% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GC ESTAB PAT 99212 VISIT CHG | $91.00 | $182.00 | $52.11–$182.00 | 45% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GC ESTAB PAT 99212 FAC 1500 | $91.00 | $182.00 | $52.11–$182.00 | 45% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC LVL2-EST PT W/PROC FAC 1500 | $180.00 | $360.00 | $52.11–$360.00 | 10% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC VISIT LVL 2-ESTABLISHED PAT | $180.00 | $360.00 | $52.11–$360.00 | 10% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC VISIT LVL 2-EST PAT W/PROC | $180.00 | $360.00 | $52.11–$360.00 | 10% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OC VISIT LVL 2-ESTABLISHED PAT | $180.00 | $360.00 | $52.11–$360.00 | 10% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OC VISIT LVL 2-EST PAT W/PROC | $180.00 | $360.00 | $52.11–$360.00 | 10% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC LVL 2-EST PT FAC 1500 | $180.00 | $360.00 | $52.11–$360.00 | 10% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GC ESTAB PAT 99212 PF 10-19MIN | $25.00 | $50.00 | $22.50–$99.74 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GC ESTAB PAT 99212 TH 10-19MIN | $25.00 | $50.00 | $22.50–$99.74 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 BILIARY CATH REM,XRAY D-99212 | $43.00 | $86.00 | $38.70–$99.74 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PALLIATIVE 99212 10-19M OP;EST | $70.50 | $141.00 | $52.11–$141.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC PF VISIT ESTAB SF 10-19M | $71.00 | $142.00 | $52.11–$142.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC PF VISIT EST SF 10-19M W/P | $74.00 | $148.00 | $52.11–$148.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GC ESTAB PAT 99212 VISIT CHG | $95.00 | $190.00 | $52.11–$190.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GC ESTAB PAT 99212 FAC 1500 | $95.00 | $190.00 | $52.11–$190.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC LVL 2-EST PT FAC 1500 | $180.00 | $360.00 | $52.11–$360.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC VISIT LVL 2-ESTABLISHED PAT | $180.00 | $360.00 | $52.11–$360.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OC VISIT LVL 2-ESTABLISHED PAT | $180.00 | $360.00 | $52.11–$360.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC VISIT LVL 2-EST PAT W/PROC | $187.50 | $375.00 | $52.11–$375.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC LVL2-EST PT W/PROC FAC 1500 | $187.50 | $375.00 | $52.11–$375.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OC VISIT LVL 2-EST PAT W/PROC | $187.50 | $375.00 | $52.11–$375.00 | — | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 WC OP CONSULT 99243 LW 30MNS+ | $195.00 | $390.00 | $105.35–$390.00 | — | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 GC CONSULT 99243 LOW 30MINS+ | $195.00 | $390.00 | $105.35–$390.00 | — | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 WC OP CONSULT 99244 MD 40MNS+ | $283.00 | $566.00 | $150.79–$601.23 | — | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 GC CONSULT 99244 MOD 40MINS+ | $283.00 | $566.00 | $150.79–$601.23 | — | 50% |
| Speech and language evaluation inpatient CPT 92523 EVAL OF SPEECH SOUND;W/LC & E | $297.50 | $595.00 | $218.31–$775.78 | — | 50% |
| Speech therapy session, individual inpatient CPT 92507 TRT/SPEECH,LNGG,VC,INDIVIDUAL | $126.50 | $253.00 | $73.26–$307.53 | — | 50% |
| Speech therapy session, individual inpatient CPT 92507 TRT SPEECH,LNGG,VC,INDIVIDUAL | $126.50 | $253.00 | $73.26–$307.53 | — | 50% |
| Speech therapy session, individual inpatient CPT 92507 TRT/SPCH,LNGG,VC,SNGL MRN&EVNG | $252.00 | $504.00 | $73.26–$504.00 | — | 50% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY; PFT SIMPLE | $311.00 | $622.00 | $24.68–$622.00 | 21% below | 50% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY; PFT SIMPLE | $311.00 | $622.00 | $24.68–$622.00 | — | 50% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY; PFT SIMPLE | $311.00 | $622.00 | $24.68–$622.00 | — | 50% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM RSPN;PFT PRE&POST | $401.00 | $802.00 | $35.37–$802.00 | 36% below | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM RSPN;PFT PRE&POST | $401.00 | $802.00 | $35.37–$802.00 | — | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM RSPN;PFT PRE&POST | $401.00 | $802.00 | $35.37–$802.00 | — | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPY ACT DIR PAT CONT 15MIN | $90.50 | $181.00 | $34.52–$181.00 | 23% below | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PF THERAPY ACT DIR PAT CNT 15M | $90.50 | $181.00 | $34.52–$181.00 | 23% below | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT-TH/ACT DIR PAT CONT 15MN EA | $90.50 | $181.00 | $34.52–$181.00 | 23% below | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPY ACT DIR PAT CONT 15MIN | $90.50 | $181.00 | $34.52–$181.00 | — | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPY ACT DIR PAT CONT 15MIN | $90.50 | $181.00 | $34.52–$181.00 | — | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT-TH/ACT DIR PAT CONT 15MN EA | $90.50 | $181.00 | $34.52–$181.00 | — | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PF THERAPY ACT DIR PAT CNT 15M | $90.50 | $181.00 | $34.52–$181.00 | — | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT-TH/ACT DIR PAT CONT 15MN EA | $90.50 | $181.00 | $34.52–$181.00 | — | 50% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PF THERAPY ACT DIR PAT CNT 15M | $90.50 | $181.00 | $34.52–$181.00 | — | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY,THERAPEUTIC S/P | $349.00 | $698.00 | $84.10–$698.00 | 40% above | 50% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY,THERAPEUTIC S/P | $349.00 | $698.00 | $84.10–$698.00 | — | 50% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY,THERAPEUTIC S/P | $349.00 | $698.00 | $84.10–$698.00 | — | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACC (ABRYSVO), BIVALENT | $442.50 | $885.00 | $398.25–$885.00 | — | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACC, BIVALENT/PF 120 MCG/0.5 ML VIAL | $442.50 | $885.00 | $398.25–$885.00 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH, PERTUSS (ACELL), TET VACC | $73.00 | $146.00 | $65.70–$146.00 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, 1 OB | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, 1 OR | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, 1 ICU | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, 1 ER | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF PPV VACCINE;GC | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, 1 INFSN TH | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF FLU VACCINE;GC | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, 1 RR | $79.00 | $158.00 | $18.99–$224.65 | 2% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, 1 OB | $79.00 | $158.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, 1 ICU | $79.00 | $158.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, 1 INFSN TH | $79.00 | $158.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, 1 RR | $79.00 | $158.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, 1 ER | $79.00 | $158.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, 1 OR | $79.00 | $158.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF PPV VACCINE;GC | $82.50 | $165.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN F/RABIES IMMUNIZATION;GC | $82.50 | $165.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF FLU VACCINE;GC | $82.50 | $165.00 | $18.99–$224.65 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN,EA+VACC-ER | $29.00 | $58.00 | $13.52–$58.00 | 46% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN,EA+VACC-OR | $29.00 | $58.00 | $13.52–$58.00 | 46% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN,EA+VACC-OB | $29.00 | $58.00 | $13.52–$58.00 | 46% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN,EA+VACC-INF | $29.00 | $58.00 | $13.52–$58.00 | 46% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-ER | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-OR | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-OR | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-OB | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-INF | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-OB | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-INF | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN,EA+VACC-ER | $29.00 | $58.00 | $13.52–$58.00 | — | 50% |
Source file: https://www.grmedcenter.com/wp-content/uploads/2026/05/741386053_GuadalupeRegionalMedicalCenter_standardcharges.csv