SelfPayRates
Hospital St. Louis, MO-IL

Carlinville Area Hospital

Listed in its price file as “Carlinville Area Hospital Association”.

Carlinville Area Hospital in Carlinville, IL publishes cash prices for 339 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 Illinois median for 172 of 337 procedures and above it for 161. By typical cash price it ranks #52 of 115 Illinois hospitals and #6 of 17 hospitals in the St. Louis, MO area, cheapest first. Click a procedure to compare it with other hospitals nearby.

20733 N Broad St, Carlinville, IL 62626 Collected Sep 27, 2026 Source price file (217) 854-3141

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 2 of 5 CCN 141347 · CMS hospital register NPI 1053425124

Scans and imaging

ProcedureCash price List priceInsurers payvs IllinoisOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W+WO CONTRAST $3,017.70 $4,311.00 $1,551.96–$6,158.57 3% above 30%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W+WO CONTRAST $3,017.70 $4,311.00 $1,100.00–$4,311.00 — 30%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2V - V $152.60 $218.00 $78.48–$311.43 57% below 30%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2V $381.50 $545.00 $196.20–$778.57 7% above 30%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2V - V $152.60 $218.00 $135.60–$3,396.04 — 30%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2V $381.50 $545.00 $338.99–$3,396.04 — 30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3V RIGHT $397.60 $568.00 $204.48–$811.43 16% above 30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3V RIGHT $397.60 $568.00 $353.30–$3,396.04 — 30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE/BRACHIAL INDICES $530.60 $758.00 $272.88–$1,082.86 30% above 30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE/BRACHIAL INDICES $530.60 $758.00 $471.48–$3,396.04 — 30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UE WO CONTRAST $1,990.80 $2,844.00 $1,023.84–$4,062.86 8% above 30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UE WO CONTRAST $1,990.80 $2,844.00 $1,100.00–$3,396.04 — 30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS $674.10 $963.00 $346.68–$1,375.71 3% above 30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS $674.10 $963.00 $598.99–$3,396.04 — 30%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN ENTIRE BODY $1,750.00 $2,500.00 $900.00–$3,571.43 11% above 30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN ENTIRE BODY $1,750.00 $2,500.00 $1,100.00–$3,396.04 — 30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RIGHT LTD $543.20 $776.00 $279.36–$1,108.57 24% above 30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LEFT LTD $543.20 $776.00 $279.36–$1,108.57 24% above 30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RIGHT LTD $543.20 $776.00 $482.67–$3,396.04 — 30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LEFT LTD $543.20 $776.00 $482.67–$3,396.04 — 30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD/PEL W+WO CONTRAST $4,438.00 $6,340.00 $2,282.40–$9,057.14 13% above 30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD/PEL W+WO CONTRAST $4,438.00 $6,340.00 $1,100.00–$6,340.00 — 30%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD/COW W+WO CONTRAST $2,996.00 $4,280.00 $1,540.80–$6,114.29 16% above 30%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD/COW W+WO CONTRAST $2,996.00 $4,280.00 $1,100.00–$4,280.00 — 30%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO PARATHYROID $2,807.00 $4,010.00 $1,443.60–$5,728.57 3% above 30%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO CAROTID ARTERIES $2,807.00 $4,010.00 $1,443.60–$5,728.57 3% above 30%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO PARATHYROID $2,807.00 $4,010.00 $1,100.00–$4,010.00 — 30%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO CAROTID ARTERIES $2,807.00 $4,010.00 $1,100.00–$4,010.00 — 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W/ CONTRAST $2,778.30 $3,969.00 $1,428.84–$5,670.00 6% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST PE ANGIO W/ CONTRAST $2,778.30 $3,969.00 $1,428.84–$5,670.00 6% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHEST PE ANGIO W/ CONTRAST $2,778.30 $3,969.00 $1,100.00–$3,969.00 — 30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W/ CONTRAST $2,778.30 $3,969.00 $1,100.00–$3,969.00 — 30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO CORONARY ARTERIES W+WO CONTRAST $2,778.30 $3,969.00 $1,428.84–$5,670.00 63% above 30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO CORONARY ARTERIES W+WO CONTRAST $2,778.30 $3,969.00 $1,100.00–$3,969.00 — 30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL WO CONTRAST $3,472.70 $4,961.00 $1,785.96–$7,087.14 7% below 30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL WO CONTRAST $3,472.70 $4,961.00 $1,100.00–$4,961.00 — 30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography $2,776.20 $3,966.00 $1,427.76–$5,665.71 38% below 30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W/ CONTRAST $4,013.10 $5,733.00 $2,063.88–$8,190.00 11% below 30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography $2,776.20 $3,966.00 $1,100.00–$3,966.00 — 30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W/ CONTRAST $4,013.10 $5,733.00 $1,100.00–$5,733.00 — 30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL W+WO CONTRAST $4,398.80 $6,284.00 $2,262.24–$8,977.14 15% below 30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL W+WO CONTRAST $4,398.80 $6,284.00 $1,100.00–$6,284.00 — 30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONTRAST $2,624.30 $3,749.00 $1,349.64–$5,355.71 8% above 30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST $2,624.30 $3,749.00 $1,100.00–$3,749.00 — 30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST $2,237.90 $3,197.00 $1,150.92–$4,567.14 13% above 30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST $2,237.90 $3,197.00 $1,100.00–$3,396.04 — 30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST $1,866.90 $2,667.00 $960.12–$3,810.00 8% above 30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES WO CONTRAST $1,866.90 $2,667.00 $960.12–$3,810.00 8% above 30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES WO CONTRAST $1,866.90 $2,667.00 $1,100.00–$3,396.04 — 30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST $1,866.90 $2,667.00 $1,100.00–$3,396.04 — 30%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN WO CONTRAST $1,871.80 $2,674.00 $962.64–$3,820.00 2% below 30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN WO CONTRAST $1,871.80 $2,674.00 $1,100.00–$3,396.04 — 30%
CT scan of the head with contrast CPT 70460 CT BRAIN W/ CONTRAST $2,691.50 $3,845.00 $1,384.20–$5,492.86 30% above 30%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/ CONTRAST $2,691.50 $3,845.00 $1,100.00–$3,845.00 — 30%
CT scan of the head without and with contrast CPT 70470 CT BRAIN W+WO CONTRAST $2,963.10 $4,233.00 $1,523.88–$6,047.14 19% above 30%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W+WO CONTRAST $2,963.10 $4,233.00 $1,100.00–$4,233.00 — 30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST $2,172.10 $3,103.00 $1,117.08–$4,432.86 3% below 30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST $2,172.10 $3,103.00 $1,100.00–$3,396.04 — 30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST $2,293.20 $3,276.00 $1,179.36–$4,680.00 3% below 30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST $2,293.20 $3,276.00 $1,100.00–$3,396.04 — 30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIC W/ CONTRAST $2,691.50 $3,845.00 $1,384.20–$5,492.86 22% above 30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIC W/ CONTRAST $2,691.50 $3,845.00 $1,100.00–$3,845.00 — 30%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID DOPPLER STUDY $413.00 $590.00 $212.40–$842.86 52% below 30%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER $1,222.20 $1,746.00 $628.56–$2,494.29 41% above 30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID DOPPLER STUDY $413.00 $590.00 $366.98–$3,396.04 — 30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DOPPLER $1,222.20 $1,746.00 $1,086.01–$3,396.04 — 30%
Chest CT scan without and with contrast CPT 71270 CT CHEST/LUNG W+WO CONTRAST $3,010.00 $4,300.00 $1,548.00–$6,142.86 2% above 30%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST/LUNG W+WO CONTRAST $3,010.00 $4,300.00 $1,100.00–$4,300.00 — 30%
Chest X-ray, 2 views CPT 71046 CHEST PEDS 2V - V $141.40 $202.00 $72.72–$288.57 54% below 30%
Chest X-ray, 2 views CPT 71046 CHEST 2V - V $141.40 $202.00 $72.72–$288.57 54% below 30%
Chest X-ray, 2 views CPT 71046 CHEST 2V $352.80 $504.00 $181.44–$720.00 14% above 30%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2V - V $141.40 $202.00 $125.64–$3,396.04 — 30%
Chest X-ray, 2 views inpatient CPT 71046 CHEST PEDS 2V - V $141.40 $202.00 $125.64–$3,396.04 — 30%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2V $352.80 $504.00 $313.49–$3,396.04 — 30%
Chest X-ray, single view CPT 71045 CHEST 1V - V $281.40 $402.00 $144.72–$574.29 13% above 30%
Chest X-ray, single view CPT 71045 CHEST 1V $281.40 $402.00 $144.72–$574.29 13% above 30%
Chest X-ray, single view inpatient CPT 71045 CHEST 1V - V $281.40 $402.00 $250.04–$3,396.04 — 30%
Chest X-ray, single view inpatient CPT 71045 CHEST 1V $281.40 $402.00 $250.04–$3,396.04 — 30%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE $385.70 $551.00 $198.36–$787.14 28% above 30%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE $385.70 $551.00 $342.72–$3,396.04 — 30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US KIDNEY AND BLADDER $914.20 $1,306.00 $470.16–$1,865.71 9% above 30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US KIDNEY AND BLADDER $914.20 $1,306.00 $812.33–$3,396.04 — 30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY STUDY DEXA HIP OR SPINE $559.30 $799.00 $287.64–$1,141.43 13% above 30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY STUDY DEXA HIP OR SPINE $559.30 $799.00 $496.98–$3,396.04 — 30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY STUDY, WRIST $284.90 $407.00 $146.52–$581.43 21% above 30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY STUDY, WRIST $284.90 $407.00 $253.15–$3,396.04 — 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT BONY STERNUM $1,489.60 $2,128.00 $766.08–$3,040.00 21% below 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST CA SCREEN F/U $1,988.00 $2,840.00 $1,022.40–$4,057.14 5% above 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST/LUNG WO CONTRAST $1,988.00 $2,840.00 $1,022.40–$4,057.14 5% above 30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT BONY STERNUM $1,489.60 $2,128.00 $1,100.00–$3,396.04 — 30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST CA SCREEN F/U $1,988.00 $2,840.00 $1,100.00–$3,396.04 — 30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST/LUNG WO CONTRAST $1,988.00 $2,840.00 $1,100.00–$3,396.04 — 30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/LUNG W/ CONTRAST $2,603.30 $3,719.00 $1,338.84–$5,312.86 7% above 30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST/LUNG W/ CONTRAST $2,603.30 $3,719.00 $1,100.00–$3,719.00 — 30%
Diagnostic mammogram, both breasts both sides CPT 77066 DIG 3D MAM DIAG BILATERAL $436.80 $624.00 $224.64–$891.43 — 30%
Diagnostic mammogram, both breasts both sides CPT 77066 DIG MAM DIAG BILATERAL $436.80 $624.00 $224.64–$891.43 — 30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIG 3D MAM DIAG BILATERAL $436.80 $624.00 $388.13–$3,396.04 — 30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIG MAM DIAG BILATERAL $436.80 $624.00 $388.13–$3,396.04 — 30%
Diagnostic mammogram, one breast one side CPT 77065 DIG 3D MAM DIAG L UNILATERA $324.10 $463.00 $166.68–$661.43 2% above 30%
Diagnostic mammogram, one breast one side CPT 77065 DIG MAM DIAG L UNILATERA $324.10 $463.00 $166.68–$661.43 2% above 30%
Diagnostic mammogram, one breast one side CPT 77065 DIG MAM DIAG R UNILATERA $324.10 $463.00 $166.68–$661.43 2% above 30%
Diagnostic mammogram, one breast one side CPT 77065 DIG 3D MAM DIAG R UNILATERA $324.10 $463.00 $166.68–$661.43 2% above 30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIG MAM DIAG R UNILATERA $324.10 $463.00 $287.99–$3,396.04 — 30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIG 3D MAM DIAG R UNILATERA $324.10 $463.00 $287.99–$3,396.04 — 30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIG 3D MAM DIAG L UNILATERA $324.10 $463.00 $287.99–$3,396.04 — 30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIG MAM DIAG L UNILATERA $324.10 $463.00 $287.99–$3,396.04 — 30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN LOWER EXTREMITY BILATERAL $284.20 $406.00 $146.16–$580.00 — 30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LE BILATERAL $1,243.20 $1,776.00 $639.36–$2,537.14 — 30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX SCAN LOWER EXTREMITY BILATERAL $284.20 $406.00 $252.53–$3,396.04 — 30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL LE BILATERAL $1,243.20 $1,776.00 $1,100.00–$3,396.04 — 30%
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DUPLEX SCAN B/W $382.20 $546.00 $196.56–$780.00 73% below 30%
Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS BIL UE $1,376.90 $1,967.00 $708.12–$2,810.00 4% below 30%
Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS BIL LE $1,398.60 $1,998.00 $719.28–$2,854.29 3% below 30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DUPLEX SCAN B/W $382.20 $546.00 $339.61–$3,396.04 — 30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS BIL UE $1,376.90 $1,967.00 $1,100.00–$3,396.04 — 30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS BIL LE $1,398.60 $1,998.00 $1,100.00–$3,396.04 — 30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO W/ COLOR $2,331.70 $3,331.00 $1,199.16–$4,758.57 9% above 30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO W/COLOR W/CONTRAST $2,879.80 $4,114.00 $1,481.04–$5,877.14 34% above 30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO W/ COLOR $2,331.70 $3,331.00 $1,100.00–$3,396.04 — 30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO W/COLOR W/CONTRAST $2,879.80 $4,114.00 $1,100.00–$4,114.00 — 30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MINIMUM 3V LEFT $370.30 $529.00 $190.44–$755.71 7% above 30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MINIMUM 3V RIGHT $370.30 $529.00 $190.44–$755.71 7% above 30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW MINIMUM 3V LEFT $370.30 $529.00 $329.04–$3,396.04 — 30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW MINIMUM 3V RIGHT $370.30 $529.00 $329.04–$3,396.04 — 30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELLA TURCICA W/O CONTRAST $1,547.00 $2,210.00 $795.60–$3,157.14 11% below 30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC'S W/O CONTRAST $2,102.10 $3,003.00 $1,081.08–$4,290.00 21% above 30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS WO CONTRAST $2,102.10 $3,003.00 $1,081.08–$4,290.00 21% above 30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT MASTOIDS WO CONTRAST $2,102.10 $3,003.00 $1,081.08–$4,290.00 21% above 30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELLA TURCICA W/O CONTRAST $1,547.00 $2,210.00 $1,100.00–$3,396.04 — 30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC'S W/O CONTRAST $2,102.10 $3,003.00 $1,100.00–$3,396.04 — 30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS WO CONTRAST $2,102.10 $3,003.00 $1,100.00–$3,396.04 — 30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT MASTOIDS WO CONTRAST $2,102.10 $3,003.00 $1,100.00–$3,396.04 — 30%
Facial bones X-ray, complete, 3 or more views CPT 70150 ZYGOMATIC ARCHES $149.80 $214.00 $77.04–$305.71 65% below 30%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMPLETE $425.60 $608.00 $218.88–$868.57 2% below 30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 ZYGOMATIC ARCHES $149.80 $214.00 $133.11–$3,396.04 — 30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMPLETE $425.60 $608.00 $378.18–$3,396.04 — 30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY DUCT $1,946.70 $2,781.00 $1,001.16–$3,972.86 29% above 30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY DUCT $1,946.70 $2,781.00 $1,100.00–$3,396.04 — 30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY $842.10 $1,203.00 $433.08–$1,718.57 44% above 30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP STUDY $842.10 $1,203.00 $748.27–$3,396.04 — 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY, 4 OR MORE W/ CPAP $3,957.10 $5,653.00 $2,035.08–$8,075.71 18% below 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY, 4 OR MORE W/ CPAP $3,957.10 $5,653.00 $1,100.00–$5,653.00 — 30%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE 5 VIEW - V $122.50 $175.00 $63.00–$250.00 73% below 30%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE 5V $306.60 $438.00 $157.68–$625.71 33% below 30%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE 5 VIEW - V $122.50 $175.00 $108.85–$3,396.04 — 30%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE 5V $306.60 $438.00 $272.44–$3,396.04 — 30%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LE WO CONTRAST $1,934.10 $2,763.00 $994.68–$3,947.14 6% above 30%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LE WO CONTRAST $1,934.10 $2,763.00 $1,100.00–$3,396.04 — 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LIMITED $278.60 $398.00 $143.28–$568.57 61% below 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED $278.60 $398.00 $247.56–$3,396.04 — 30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US SOFT TISSUE $441.70 $631.00 $227.16–$901.43 9% above 30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US PC EXT NON-VASCULAR LIMITED $441.70 $631.00 $227.16–$901.43 9% above 30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXT NON-VASCULAR LMT $635.60 $908.00 $326.88–$1,297.14 57% above 30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US SOFT TISSUE $441.70 $631.00 $392.48–$3,396.04 — 30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US PC EXT NON-VASCULAR LIMITED $441.70 $631.00 $392.48–$3,396.04 — 30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXT NON-VASCULAR LMT $635.60 $908.00 $564.78–$3,396.04 — 30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST CA SCREEN $1,533.70 $2,191.00 $788.76–$3,130.00 171% above 30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST CA SCREEN $1,533.70 $2,191.00 $1,100.00–$3,396.04 — 30%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST $2,870.70 $4,101.00 $1,476.36–$5,858.57 4% above 30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST $2,870.70 $4,101.00 $1,100.00–$4,101.00 — 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE ANY JOINT WO CONTRAST $1,948.80 $2,784.00 $1,002.24–$3,977.14 32% below 30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE ANY JOINT WO CONTRAST $1,948.80 $2,784.00 $1,100.00–$3,396.04 — 30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JOINT W+WO CONTRAST $2,608.20 $3,726.00 $1,341.36–$5,322.86 29% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT W+WO CONTRAST $2,608.20 $3,726.00 $1,100.00–$3,726.00 — 30%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST $3,223.50 $4,605.00 $1,657.80–$6,578.57 17% above 30%
MRI of the abdomen without contrast CPT 74181 MRCP $3,223.50 $4,605.00 $1,657.80–$6,578.57 17% above 30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST $3,223.50 $4,605.00 $1,100.00–$4,605.00 — 30%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP $3,223.50 $4,605.00 $1,100.00–$4,605.00 — 30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W+WO CONTRAST $3,726.80 $5,324.00 $1,916.64–$7,605.71 1% below 30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W+WO CONTRAST $3,726.80 $5,324.00 $1,100.00–$5,324.00 — 30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST $2,622.20 $3,746.00 $1,348.56–$5,351.43 11% below 30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST $2,622.20 $3,746.00 $1,100.00–$3,746.00 — 30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W+WO CONTRAST $4,351.20 $6,216.00 $2,237.76–$8,880.00 5% above 30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W+WO CONTRAST $4,351.20 $6,216.00 $1,100.00–$6,216.00 — 30%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR WO CONTRAST $2,881.20 $4,116.00 $1,481.76–$5,880.00 5% below 30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR WO CONTRAST $2,881.20 $4,116.00 $1,100.00–$4,116.00 — 30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W+WO CONTRAST $4,168.50 $5,955.00 $2,143.80–$8,507.14 at median 30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W+WO CONTRAST $4,168.50 $5,955.00 $1,100.00–$5,955.00 — 30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC WO CONTRAST $2,896.60 $4,138.00 $1,489.68–$5,911.43 3% below 30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC WO CONTRAST $2,896.60 $4,138.00 $1,100.00–$4,138.00 — 30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W+WO CONTRAST $4,499.60 $6,428.00 $2,314.08–$9,182.86 10% above 30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W+WO CONTRAST $4,499.60 $6,428.00 $1,100.00–$6,428.00 — 30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL WO CONTRAST $2,928.10 $4,183.00 $1,505.88–$5,975.71 2% below 30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL WO CONTRAST $2,928.10 $4,183.00 $1,100.00–$4,183.00 — 30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W+WO CONTRAST $4,019.40 $5,742.00 $2,067.12–$8,202.86 8% above 30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W+WO CONTRAST $4,019.40 $5,742.00 $1,100.00–$5,742.00 — 30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST $2,083.90 $2,977.00 $1,071.72–$4,252.86 23% below 30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST $2,083.90 $2,977.00 $1,100.00–$3,396.04 — 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JOINT WO CONTRAST $1,893.50 $2,705.00 $973.80–$3,864.29 35% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST $1,893.50 $2,705.00 $1,100.00–$3,396.04 — 30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE MIN 4 VIEWS W/OBL - V $231.70 $331.00 $119.16–$472.86 57% below 30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE MIN 4 VIEWS W/OBL $578.90 $827.00 $297.72–$1,181.43 6% above 30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE MIN 4 VIEWS W/OBL - V $231.70 $331.00 $205.88–$3,396.04 — 30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE MIN 4 VIEWS W/OBL $578.90 $827.00 $514.39–$3,396.04 — 30%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/ CONTRAST $2,691.50 $3,845.00 $1,384.20–$5,492.86 22% above 30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/ CONTRAST $2,691.50 $3,845.00 $1,100.00–$3,845.00 — 30%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST $2,070.60 $2,958.00 $1,064.88–$4,225.71 12% above 30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST $2,070.60 $2,958.00 $1,100.00–$3,396.04 — 30%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE $262.50 $375.00 $135.00–$535.71 2% below 30%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE $262.50 $375.00 $233.25–$3,396.04 — 30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM SPECT PERF REST+STRESS MULTI $3,406.90 $4,867.00 $1,752.12–$6,952.86 10% below 30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM SPECT PERF REST+STRESS MULTI $3,406.90 $4,867.00 $1,100.00–$4,867.00 — 30%
Pelvic CT scan without contrast CPT 72192 CT PELVIC W/O CONTRAST $1,864.80 $2,664.00 $959.04–$3,805.71 2% below 30%
Pelvic CT scan without contrast CPT 72192 CT CYSTOGRAM $1,864.80 $2,664.00 $959.04–$3,805.71 2% below 30%
Pelvic CT scan without contrast inpatient CPT 72192 CT CYSTOGRAM $1,864.80 $2,664.00 $1,100.00–$3,396.04 — 30%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIC W/O CONTRAST $1,864.80 $2,664.00 $1,100.00–$3,396.04 — 30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIC-LIMITED $331.10 $473.00 $170.28–$675.71 40% below 30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIC-LIMITED $331.10 $473.00 $294.21–$3,396.04 — 30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS $954.10 $1,363.00 $490.68–$1,947.14 16% above 30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS $954.10 $1,363.00 $847.79–$3,396.04 — 30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE $704.90 $1,007.00 $362.52–$1,438.57 5% below 30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE $704.90 $1,007.00 $626.35–$3,396.04 — 30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14WKS $508.20 $726.00 $261.36–$1,037.14 25% below 30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14WKS $508.20 $726.00 $451.57–$3,396.04 — 30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED $424.90 $607.00 $218.52–$867.14 16% below 30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED $424.90 $607.00 $377.55–$3,396.04 — 30%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS LEFT $318.50 $455.00 $163.80–$650.00 10% below 30%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS RIGHT $318.50 $455.00 $163.80–$650.00 10% below 30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS RIGHT $318.50 $455.00 $283.01–$3,396.04 — 30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS LEFT $318.50 $455.00 $283.01–$3,396.04 — 30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RIGHT W/ 1V CHEST $511.00 $730.00 $262.80–$1,042.86 6% above 30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LEFT W/ 1V CHEST $511.00 $730.00 $262.80–$1,042.86 6% above 30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RIGHT W/ 1V CHEST $511.00 $730.00 $454.06–$3,396.04 — 30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LEFT W/ 1V CHEST $511.00 $730.00 $454.06–$3,396.04 — 30%
Screening mammogram, both breasts both sides CPT 77067 DIG MAM SCREENING BILATERAL $315.00 $450.00 $162.00–$642.86 — 30%
Screening mammogram, both breasts both sides CPT 77067 DIG 3D MAM SCREENING BILATERAL $315.00 $450.00 $162.00–$642.86 — 30%
Screening mammogram, both breasts CPT 77067 DIG MAM SPECIAL SCREENING $296.10 $423.00 $152.28–$604.29 9% above 30%
Screening mammogram, both breasts CPT 77067 DIG 3D MAM SPECIAL SCREENING $296.10 $423.00 $152.28–$604.29 9% above 30%
Screening mammogram, both breasts one side CPT 77067 DIG MAM SCREENING UNILATERAL LEFT $305.90 $437.00 $157.32–$624.29 13% above 30%
Screening mammogram, both breasts inpatient both sides CPT 77067 DIG 3D MAM SCREENING BILATERAL $315.00 $450.00 $279.90–$3,396.04 — 30%
Screening mammogram, both breasts inpatient both sides CPT 77067 DIG MAM SCREENING BILATERAL $315.00 $450.00 $279.90–$3,396.04 — 30%
Screening mammogram, both breasts inpatient CPT 77067 DIG MAM SPECIAL SCREENING $296.10 $423.00 $263.11–$3,396.04 — 30%
Screening mammogram, both breasts inpatient CPT 77067 DIG 3D MAM SPECIAL SCREENING $296.10 $423.00 $263.11–$3,396.04 — 30%
Screening mammogram, both breasts inpatient one side CPT 77067 DIG MAM SCREENING UNILATERAL LEFT $305.90 $437.00 $271.81–$3,396.04 — 30%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS COMPLETE $420.00 $600.00 $216.00–$857.14 2% below 30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS COMPLETE $420.00 $600.00 $373.20–$3,396.04 — 30%
Skull X-ray, fewer than 4 views CPT 70250 SKULL PARTIAL $336.70 $481.00 $173.16–$687.14 6% above 30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL PARTIAL $336.70 $481.00 $299.18–$3,396.04 — 30%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY, 4 OR MORE PAR, DIAG $3,649.10 $5,213.00 $1,876.68–$7,447.14 9% below 30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY, 4 OR MORE PAR, DIAG $3,649.10 $5,213.00 $1,100.00–$5,213.00 — 30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Pharynx Study w Speech $591.50 $845.00 $304.20–$1,207.14 10% below 30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Pharynx Study w Speech $591.50 $845.00 $525.59–$3,396.04 — 30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTRAST $2,331.70 $3,331.00 $1,199.16–$4,758.57 8% above 30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONTRAST $2,331.70 $3,331.00 $1,100.00–$3,396.04 — 30%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAG NON OB $780.50 $1,115.00 $401.40–$1,592.86 18% above 30%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAG NON OB $780.50 $1,115.00 $693.53–$3,396.04 — 30%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB $769.30 $1,099.00 $395.64–$1,570.00 47% above 30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB $769.30 $1,099.00 $683.58–$3,396.04 — 30%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE $1,061.90 $1,517.00 $546.12–$2,167.14 at median 30%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE $1,061.90 $1,517.00 $943.57–$3,396.04 — 30%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS $809.20 $1,156.00 $416.16–$1,651.43 7% above 30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS $809.20 $1,156.00 $719.03–$3,396.04 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US ECHOGRAPHY SOFT TISSUES HEAD+NECK $332.50 $475.00 $171.00–$678.57 52% below 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID $733.60 $1,048.00 $377.28–$1,497.14 7% above 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD AND NECK $733.60 $1,048.00 $377.28–$1,497.14 7% above 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US PAROTID $733.60 $1,048.00 $377.28–$1,497.14 7% above 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid one side CPT 76536 US PAROTID RIGHT $507.50 $725.00 $261.00–$1,035.71 26% below 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid one side CPT 76536 US PAROTID LEFT $698.60 $998.00 $359.28–$1,425.71 2% above 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US ECHOGRAPHY SOFT TISSUES HEAD+NECK $332.50 $475.00 $295.45–$3,396.04 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US PAROTID $733.60 $1,048.00 $651.86–$3,396.04 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID $733.60 $1,048.00 $651.86–$3,396.04 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD AND NECK $733.60 $1,048.00 $651.86–$3,396.04 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient one side CPT 76536 US PAROTID RIGHT $507.50 $725.00 $450.95–$3,396.04 — 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient one side CPT 76536 US PAROTID LEFT $698.60 $998.00 $620.76–$3,396.04 — 30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER W/FILMS SINGLE CONTRAST $806.40 $1,152.00 $414.72–$1,645.71 2% above 30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER W/FILMS SINGLE CONTRAST $806.40 $1,152.00 $716.54–$3,396.04 — 30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2V RIGHT $399.70 $571.00 $205.56–$815.71 28% above 30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2V LEFT $399.70 $571.00 $205.56–$815.71 28% above 30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2V RIGHT $399.70 $571.00 $355.16–$3,396.04 — 30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2V LEFT $399.70 $571.00 $355.16–$3,396.04 — 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS LEFT LE $980.70 $1,401.00 $504.36–$2,001.43 29% above 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS LEFT UE $980.70 $1,401.00 $504.36–$2,001.43 29% above 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS RIGHT LE $980.70 $1,401.00 $504.36–$2,001.43 29% above 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS RIGHT UE $980.70 $1,401.00 $504.36–$2,001.43 29% above 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS LEFT LE $980.70 $1,401.00 $871.42–$3,396.04 — 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS RIGHT LE $980.70 $1,401.00 $871.42–$3,396.04 — 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS RIGHT UE $980.70 $1,401.00 $871.42–$3,396.04 — 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS LEFT UE $980.70 $1,401.00 $871.42–$3,396.04 — 30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LT 2 OR 3 VIEWS $383.60 $548.00 $197.28–$782.86 24% above 30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LT 2 OR 3 VIEWS $383.60 $548.00 $340.86–$3,396.04 — 30%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V OR FLAT PLATE - V $118.30 $169.00 $60.84–$241.43 56% below 30%
X-ray of the abdomen, 1 view CPT 74018 GALLBLADDER SURGICAL S/FILM $173.60 $248.00 $89.28–$354.29 35% below 30%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V OR FLAT PLATE $295.40 $422.00 $151.92–$602.86 11% above 30%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1V OR FLAT PLATE - V $118.30 $169.00 $105.12–$3,396.04 — 30%
X-ray of the abdomen, 1 view inpatient CPT 74018 GALLBLADDER SURGICAL S/FILM $173.60 $248.00 $154.26–$3,396.04 — 30%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1V OR FLAT PLATE $295.40 $422.00 $262.48–$3,396.04 — 30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE - V $158.20 $226.00 $81.36–$322.86 65% below 30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE $394.80 $564.00 $203.04–$805.71 13% below 30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE - V $158.20 $226.00 $140.57–$3,396.04 — 30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE $394.80 $564.00 $350.81–$3,396.04 — 30%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE & 2V OBLIQUE - V $185.50 $265.00 $95.40–$378.57 68% below 30%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 4 VIEWS - V $193.20 $276.00 $99.36–$394.29 67% below 30%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE & 2V OBLIQUE $463.40 $662.00 $238.32–$945.71 20% below 30%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 4 VIEWS $483.00 $690.00 $248.40–$985.71 16% below 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE & 2V OBLIQUE - V $185.50 $265.00 $164.83–$3,396.04 — 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 4 VIEWS - V $193.20 $276.00 $171.67–$3,396.04 — 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE & 2V OBLIQUE $463.40 $662.00 $411.76–$3,396.04 — 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 4 VIEWS $483.00 $690.00 $429.18–$3,396.04 — 30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2V - V $121.10 $173.00 $62.28–$247.14 68% below 30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2V $303.10 $433.00 $155.88–$618.57 20% below 30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2V - V $121.10 $173.00 $107.61–$3,396.04 — 30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2V $303.10 $433.00 $269.33–$3,396.04 — 30%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES $284.90 $407.00 $146.52–$581.43 6% below 30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES $284.90 $407.00 $253.15–$3,396.04 — 30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS - V $158.20 $226.00 $81.36–$322.86 57% below 30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS $394.80 $564.00 $203.04–$805.71 7% above 30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS - V $158.20 $226.00 $140.57–$3,396.04 — 30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS $394.80 $564.00 $350.81–$3,396.04 — 30%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS $406.70 $581.00 $209.16–$830.00 16% above 30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS $406.70 $581.00 $361.38–$3,396.04 — 30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM+COCCYX 2 VIEWS $556.50 $795.00 $286.20–$1,135.71 54% above 30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM+COCCYX 2 VIEWS $556.50 $795.00 $494.49–$3,396.04 — 30%

Lab tests

ProcedureCash price List priceInsurers payvs IllinoisOff list
ACTH blood test CPT 82024 ACTH(REF) $231.70 $331.00 $119.16–$472.86 19% above 30%
ACTH blood test inpatient CPT 82024 ACTH(REF) $231.70 $331.00 $205.88–$3,396.04 — 30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT) $93.10 $133.00 $47.88–$190.00 77% above 30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ASSOC CHG ALT $93.10 $133.00 $47.88–$190.00 77% above 30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ASSOC CHG ALT $93.10 $133.00 $82.73–$3,396.04 — 30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) $93.10 $133.00 $82.73–$3,396.04 — 30%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT $27.30 $39.00 $14.04–$55.71 48% below 30%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST) $94.50 $135.00 $48.60–$192.86 80% above 30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT $27.30 $39.00 $24.26–$3,396.04 — 30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) $94.50 $135.00 $83.97–$3,396.04 — 30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP PANEL ACUTE HEP A HEP B HEP C $417.20 $596.00 $214.56–$851.43 60% above 30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP PANEL ACUTE HEP A HEP B HEP C $417.20 $596.00 $370.71–$3,396.04 — 30%
Albumin blood test CPT 82040 ALBUMIN $101.50 $145.00 $52.20–$207.14 145% above 30%
Albumin blood test inpatient CPT 82040 ALBUMIN $101.50 $145.00 $90.19–$3,396.04 — 30%
Aldosterone blood test CPT 82088 URINE 24 HR ALDOSTERONE REF $235.90 $337.00 $121.32–$481.43 47% above 30%
Aldosterone blood test CPT 82088 ALDOSTERONE(REF) $283.50 $405.00 $145.80–$578.57 77% above 30%
Aldosterone blood test CPT 82088 ALDOSTERONE/RENIN RATIO(REF) $283.50 $405.00 $145.80–$578.57 77% above 30%
Aldosterone blood test inpatient CPT 82088 URINE 24 HR ALDOSTERONE REF $235.90 $337.00 $209.61–$3,396.04 — 30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE/RENIN RATIO(REF) $283.50 $405.00 $251.91–$3,396.04 — 30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE(REF) $283.50 $405.00 $251.91–$3,396.04 — 30%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSOC ALK PHOS TOTAL $116.90 $167.00 $60.12–$238.57 134% above 30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSP $116.90 $167.00 $60.12–$238.57 134% above 30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOSP $116.90 $167.00 $103.87–$3,396.04 — 30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSOC ALK PHOS TOTAL $116.90 $167.00 $103.87–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen CPT 86003 QUEEN PALM IGE(REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ACACIA IGE(REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 OLIVE TREE IGE(REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PEACH IGE REF $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE IGE REF $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SALT BUSH IGE $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EUCALYPTUS IGE(REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG (WHOLE) IGE(REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS IGE(REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR IGE (REF) $24.50 $35.00 $12.60–$50.00 6% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER IGE(REF) $25.20 $36.00 $12.96–$51.43 3% below 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BOTRYTIS CINEREA IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BIPOLARIS IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMB'S QUARTERS IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RASPBERRY IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ANCHOVY IGE REF $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BLACK PEPPERCORN IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT POLLEN IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CAULIFLOWER IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRY IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH SILVER IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT IGE $28.70 $41.00 $14.76–$58.57 10% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MACKEREL IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT MEAT $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DUCK MEAT IGE TO MMC $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMB IGE $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY MEAT $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CRANBERRY IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LIME IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CUCUMBER IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 APRICOT IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FLOUNDER IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TROUT IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WALLEYE PIKE PERCH IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GUINEA PIG EPITHELIUM IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HORSE DANDER IGE $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LENTIL IgE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CATFISH IgE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELON IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HORSEFLY IGE REF $29.40 $42.00 $15.12–$60.00 13% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE- ASPERGILLUS FUMIGATUS $30.80 $44.00 $15.84–$62.86 18% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V IGE REF $30.80 $44.00 $15.84–$62.86 18% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G IGE REF $30.80 $44.00 $15.84–$62.86 18% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX-SPECIFIC IGE(REF) $33.60 $48.00 $17.28–$68.57 29% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS NIGER IGE(REF) $33.60 $48.00 $17.28–$68.57 29% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BASS BLACK IGE $34.30 $49.00 $17.64–$70.00 32% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CARMINE RED DYE IGE $34.30 $49.00 $17.64–$70.00 32% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PARROT FEATHERS IGE (REF) $35.00 $50.00 $18.00–$71.43 35% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 VENISON IGE $35.70 $51.00 $18.36–$72.86 37% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE-EGG WHITE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE-EGG YOLK $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER,IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASH WHITE IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH GERMAN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE/BOX ELDER IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN HICKORY TREE (T22) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN SMUT IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PENCILLIUM CHRYSOGENUM $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH MARSHELDER REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HONEYBEE IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HORNET WHT FACE IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BUMLEBEE IGE (REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HORNET YELLOW IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN, CULTIVATED IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM PURPURASRENS IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AUREOBASISI PULLULANS IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FIRE ANT IGE (REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET POTATO IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CINNAMON IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GOAT EPITHELIUM IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LIMA BEAN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 OLIVE BLACK & GREEN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALBICANS IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 KIDNEY BEAN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICK PEA IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GREEN BEAN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALFALFA IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM PROLIFERATUM IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA BETAE IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SETOMELANOMMA ROSTRATA IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM PURPUR IGE IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COFFEE IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BING CHERRY IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEPPER IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GELATIN IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MUSHROOM IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MOSQUITO IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN/SQUASH IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HALIBUT IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RYE IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RICE IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 YEAST IGE BAKER'S & BREWER'S (REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SALMON IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS CHARTARUM/ATRA IgE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 POTATO WHT IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PINEAPPLE IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ONION IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MUSSEL IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MELON IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LEMON IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 KIWI FRUIT/ IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEA IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CELERY IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CARROT IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BUCKWHEAT IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PEAR IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 APPLE IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COD FISH IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS IGE $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK IGE(REF) $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE IGE REF $37.10 $53.00 $19.08–$75.71 43% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED COMMON IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM IGE REF $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RED CEDAR IGE (REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MULBERRY / WHITE / IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN IGE REF $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE RED IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 KENTUCKY BLUE GRASS / IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM IGE REF $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH AMERICAN IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY, WHITE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASSOC CHG PENICILLIUM NOTATUM IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 NETTLE IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BOX-ELDER TREE (MAPLE) IGE (REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 VANILLA IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 MALT IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST MITE(D. FARINAE) IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE OAK IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 AMERICAN ELM IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE-PARAKETTE FEATHERS $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET CHESTNUT IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE- ALTERNARIA ALTERNATE (MOLD)(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE-MILK $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES FARINAE IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CEDAR-MOUNTAIN IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN All. Spec. IgE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED SHORT IGE (W1) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT, CULTIVATED IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAYFISH FRESH WATER IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER SEED IGE $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM BOTRYOSUM IGE(REF) $39.20 $56.00 $20.16–$80.00 51% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 _ALLERGEN SPECIFIC IGE EACH ALLERGEN $47.60 $68.00 $24.48–$97.14 83% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CANARY PERCIPITATING AB IGE MMC $56.00 $80.00 $28.80–$114.29 115% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKATIEL FEATHERS IGE(MMC) $56.00 $80.00 $28.80–$114.29 115% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 LOVEBIRD FEATHERS IGE(MMC) $56.00 $80.00 $28.80–$114.29 115% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 EUROPEAN HORNET IGE REF $68.60 $98.00 $35.28–$140.00 164% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PARROT DROPPINGS MMC $71.40 $102.00 $36.72–$145.71 175% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 FEATHER MIX IGE $77.00 $110.00 $39.60–$157.14 196% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE- FOR CATS $91.70 $131.00 $47.16–$187.14 253% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASSOC CHG PEANUT REFLEX REF $164.50 $235.00 $84.60–$335.71 533% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKATIEL DROPPINGS MMC $172.90 $247.00 $88.92–$352.86 565% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE WITH COMPONENT REFLEX REF $196.70 $281.00 $101.16–$401.43 657% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, REGIONAL ZONE10 $484.40 $692.00 $249.12–$988.57 1763% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 CHILDHOOD ALLERGY PANEL-DR BASS $487.20 $696.00 $250.56–$994.29 1774% above 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG (WHOLE) IGE(REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ACACIA IGE(REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE IGE REF $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH IGE REF $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 QUEEN PALM IGE(REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR IGE (REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS IGE(REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALT BUSH IGE $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OLIVE TREE IGE(REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUCALYPTUS IGE(REF) $24.50 $35.00 $21.77–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER IGE(REF) $25.20 $36.00 $22.39–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUGWORT IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT POLLEN IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOTRYTIS CINEREA IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB'S QUARTERS IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ANCHOVY IGE REF $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEBERRY IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH SILVER IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK PEPPERCORN IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RASPBERRY IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIPOLARIS IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAULIFLOWER IGE $28.70 $41.00 $25.50–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY MEAT $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACKEREL IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELON IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LENTIL IgE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APRICOT IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CUCUMBER IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRANBERRY IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB IGE $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK MEAT IGE TO MMC $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT MEAT $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSEFLY IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIME IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE DANDER IGE $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUINEA PIG EPITHELIUM IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CATFISH IgE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALLEYE PIKE PERCH IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TROUT IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FLOUNDER IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT IGE REF $29.40 $42.00 $26.12–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN V IGE REF $30.80 $44.00 $27.37–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN G IGE REF $30.80 $44.00 $27.37–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE- ASPERGILLUS FUMIGATUS $30.80 $44.00 $27.37–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS NIGER IGE(REF) $33.60 $48.00 $29.86–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX-SPECIFIC IGE(REF) $33.60 $48.00 $29.86–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BASS BLACK IGE $34.30 $49.00 $30.48–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARMINE RED DYE IGE $34.30 $49.00 $30.48–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARROT FEATHERS IGE (REF) $35.00 $50.00 $31.10–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 VENISON IGE $35.70 $51.00 $31.72–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COFFEE IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN SMUT IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STACHYBOTRYS CHARTARUM/ATRA IgE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM PURPURASRENS IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AUREOBASISI PULLULANS IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET POTATO IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CINNAMON IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOAT EPITHELIUM IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIRE ANT IGE (REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIMA BEAN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OLIVE BLACK & GREEN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANDIDA ALBICANS IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIDNEY BEAN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE BEAN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICK PEA IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN BEAN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALFALFA IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM PROLIFERATUM IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHOMA BETAE IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SETOMELANOMMA ROSTRATA IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM PURPUR IGE IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BING CHERRY IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEPPER IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GELATIN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSHROOM IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOSQUITO IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN/SQUASH IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HALIBUT IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST IGE BAKER'S & BREWER'S (REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE BEAN IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO WHT IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINEAPPLE IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSSEL IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELON IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI FRUIT/ IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEA IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GARLIC IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUCKWHEAT IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN, CULTIVATED IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORNET YELLOW IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUMLEBEE IGE (REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORNET WHT FACE IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEYBEE IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ROUGH MARSHELDER REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENCILLIUM CHRYSOGENUM $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN HICKORY TREE (T22) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE/BOX ELDER IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH GERMAN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASH WHITE IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COD FISH IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK IGE(REF) $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHOCOLATE IGE REF $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE-EGG WHITE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE-EGG YOLK $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER,IGE $37.10 $53.00 $32.97–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASSOC CHG PENICILLIUM NOTATUM IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CEDAR-MOUNTAIN IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN IGE REF $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE RED IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH AMERICAN IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM IGE REF $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM IGE REF $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN All. Spec. IgE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET CHESTNUT IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MALT IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 VANILLA IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER SEED IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAYFISH FRESH WATER IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST MITE(D. FARINAE) IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT, CULTIVATED IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOX-ELDER TREE (MAPLE) IGE (REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE OAK IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMERICAN ELM IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE- ALTERNARIA ALTERNATE (MOLD)(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE-MILK $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED SHORT IGE (W1) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE-PARAKETTE FEATHERS $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PIGWEED COMMON IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NETTLE IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES FARINAE IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD IGE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED CEDAR IGE (REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MULBERRY / WHITE / IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KENTUCKY BLUE GRASS / IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STEMPHYLIUM BOTRYOSUM IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HICKORY, WHITE $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN IGE(REF) $39.20 $56.00 $34.83–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 _ALLERGEN SPECIFIC IGE EACH ALLERGEN $47.60 $68.00 $42.30–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOVEBIRD FEATHERS IGE(MMC) $56.00 $80.00 $49.76–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKATIEL FEATHERS IGE(MMC) $56.00 $80.00 $49.76–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANARY PERCIPITATING AB IGE MMC $56.00 $80.00 $49.76–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUROPEAN HORNET IGE REF $68.60 $98.00 $60.96–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARROT DROPPINGS MMC $71.40 $102.00 $63.44–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FEATHER MIX IGE $77.00 $110.00 $68.42–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE- FOR CATS $91.70 $131.00 $81.48–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASSOC CHG PEANUT REFLEX REF $164.50 $235.00 $146.17–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKATIEL DROPPINGS MMC $172.90 $247.00 $153.63–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE WITH COMPONENT REFLEX REF $196.70 $281.00 $174.78–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, REGIONAL ZONE10 $484.40 $692.00 $430.42–$3,396.04 — 30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILDHOOD ALLERGY PANEL-DR BASS $487.20 $696.00 $432.91–$3,396.04 — 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP3-AFP $40.60 $58.00 $20.88–$82.86 64% below 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETAL PROTEIN SERUM(REF) $221.20 $316.00 $113.76–$451.43 96% above 30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP3-AFP $40.60 $58.00 $36.08–$3,396.04 — 30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETAL PROTEIN SERUM(REF) $221.20 $316.00 $196.55–$3,396.04 — 30%
Ammonia blood test CPT 82140 AMMONIA REF $123.20 $176.00 $63.36–$251.43 16% above 30%
Ammonia blood test CPT 82140 URINE 24 HOUR AMMONIA(REF) $144.90 $207.00 $74.52–$295.71 36% above 30%
Ammonia blood test CPT 82140 AMMONIA $151.90 $217.00 $78.12–$310.00 43% above 30%
Ammonia blood test inpatient CPT 82140 AMMONIA REF $123.20 $176.00 $109.47–$3,396.04 — 30%
Ammonia blood test inpatient CPT 82140 URINE 24 HOUR AMMONIA(REF) $144.90 $207.00 $128.75–$3,396.04 — 30%
Ammonia blood test inpatient CPT 82140 AMMONIA $151.90 $217.00 $134.97–$3,396.04 — 30%
Amylase blood test CPT 82150 AMYLASE BODY FLUID $123.20 $176.00 $63.36–$251.43 50% above 30%
Amylase blood test CPT 82150 AMYLASE $123.20 $176.00 $63.36–$251.43 50% above 30%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID $123.20 $176.00 $109.47–$3,396.04 — 30%
Amylase blood test inpatient CPT 82150 AMYLASE $123.20 $176.00 $109.47–$3,396.04 — 30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CITRULLINE AB IGG/IGA (CCP)(REF) $114.80 $164.00 $59.04–$234.29 37% above 30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CITRULLINE AB IGG/IGA (CCP)(REF) $114.80 $164.00 $102.01–$3,396.04 — 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 LA-ANA $28.70 $41.00 $14.76–$58.57 68% below 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (REF) $93.80 $134.00 $48.24–$191.43 4% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA $93.80 $134.00 $48.24–$191.43 4% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W REFLEX $93.80 $134.00 $48.24–$191.43 4% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA REFLEX 11 BIOMARKER MULTIPLE $100.80 $144.00 $51.84–$205.71 12% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA $119.00 $170.00 $61.20–$242.86 32% above 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LA-ANA $28.70 $41.00 $25.50–$3,396.04 — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W REFLEX $93.80 $134.00 $83.35–$3,396.04 — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (REF) $93.80 $134.00 $83.35–$3,396.04 — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA $93.80 $134.00 $83.35–$3,396.04 — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA REFLEX 11 BIOMARKER MULTIPLE $100.80 $144.00 $89.57–$3,396.04 — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA $119.00 $170.00 $105.74–$3,396.04 — 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP $205.10 $293.00 $105.48–$418.57 9% above 30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP $205.10 $293.00 $182.25–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NOSE CULTURE $60.90 $87.00 $31.32–$124.29 32% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 OTHER ROUTINE CULTURE $76.30 $109.00 $39.24–$155.71 15% below 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE MRSA (NARES/ THROAT/ RECTUM) $104.30 $149.00 $53.64–$212.86 16% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TEST BORDETELLA PERTUSSIS-NASOPHAR $128.10 $183.00 $65.88–$261.43 42% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BORDETELLA PERTUSSIS-NASOPHARYNGEAL CUL $128.10 $183.00 $65.88–$261.43 42% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NOSE $138.60 $198.00 $71.28–$282.86 54% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT $138.60 $198.00 $71.28–$282.86 54% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ENVIRONMENTAL $149.80 $214.00 $77.04–$305.71 66% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TISSUE $149.80 $214.00 $77.04–$305.71 66% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC $149.80 $214.00 $77.04–$305.71 66% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GC SCREEN $149.80 $214.00 $77.04–$305.71 66% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID $158.20 $226.00 $81.36–$322.86 76% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NOSE CULTURE $60.90 $87.00 $54.11–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 OTHER ROUTINE CULTURE $76.30 $109.00 $67.80–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE MRSA (NARES/ THROAT/ RECTUM) $104.30 $149.00 $92.68–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BORDETELLA PERTUSSIS-NASOPHARYNGEAL CUL $128.10 $183.00 $113.83–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TEST BORDETELLA PERTUSSIS-NASOPHAR $128.10 $183.00 $113.83–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NOSE $138.60 $198.00 $123.16–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT $138.60 $198.00 $123.16–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GC SCREEN $149.80 $214.00 $133.11–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TISSUE $149.80 $214.00 $133.11–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC $149.80 $214.00 $133.11–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ENVIRONMENTAL $149.80 $214.00 $133.11–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL $158.20 $226.00 $140.57–$3,396.04 — 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ROUTINE $158.20 $226.00 $140.57–$3,396.04 — 30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $153.30 $219.00 $78.84–$312.86 20% above 30%
Basic metabolic panel (blood test) CPT 80048 DAILY BASIC METABOLIC PANEL $153.30 $219.00 $78.84–$312.86 20% above 30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $153.30 $219.00 $136.22–$3,396.04 — 30%
Basic metabolic panel (blood test) inpatient CPT 80048 DAILY BASIC METABOLIC PANEL $153.30 $219.00 $136.22–$3,396.04 — 30%
Bilirubin blood test, total CPT 82247 ASSOC CHG TOTAL BILI $55.30 $79.00 $28.44–$112.86 10% below 30%
Bilirubin blood test, total CPT 82247 BILIRUBIN INDIRECT $74.20 $106.00 $38.16–$151.43 21% above 30%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL $74.20 $106.00 $38.16–$151.43 21% above 30%
Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN NEOBILI $74.20 $106.00 $38.16–$151.43 21% above 30%
Bilirubin blood test, total CPT 82247 TOTAL BILI BODY FLUID $74.20 $106.00 $38.16–$151.43 21% above 30%
Bilirubin blood test, total inpatient CPT 82247 ASSOC CHG TOTAL BILI $55.30 $79.00 $49.14–$3,396.04 — 30%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN NEOBILI $74.20 $106.00 $65.93–$3,396.04 — 30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN INDIRECT $74.20 $106.00 $65.93–$3,396.04 — 30%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILI BODY FLUID $74.20 $106.00 $65.93–$3,396.04 — 30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL $74.20 $106.00 $65.93–$3,396.04 — 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Lvl Iv-Surg Path Gross&mcrscp Xm $39.90 $57.00 $20.52–$81.43 83% below 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW PARTICLE SECTION(REF) $174.30 $249.00 $89.64–$355.71 27% below 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY - CATEGORY 4B - TECH FEE $213.50 $305.00 $109.80–$435.71 11% below 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY - CATEGORY 4 - TECH FEE $270.20 $386.00 $138.96–$551.43 13% above 30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Lvl Iv-Surg Path Gross&mcrscp Xm $121.10 $173.00 $107.61–$3,396.04 — 30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW PARTICLE SECTION(REF) $174.30 $249.00 $154.88–$3,396.04 — 30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATHOLOGY - CATEGORY 4B - TECH FEE $213.50 $305.00 $189.71–$3,396.04 — 30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATHOLOGY - CATEGORY 4 - TECH FEE $270.20 $386.00 $240.09–$3,396.04 — 30%
Blood culture for bacteria CPT 87040 CULTURE FUNGUS BLOOD $60.90 $87.00 $31.32–$124.29 60% below 30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD $191.80 $274.00 $98.64–$391.43 25% above 30%
Blood culture for bacteria inpatient CPT 87040 CULTURE FUNGUS BLOOD $60.90 $87.00 $54.11–$3,396.04 — 30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD $191.80 $274.00 $170.43–$3,396.04 — 30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE $17.50 $25.00 $9.00–$35.71 26% below 30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LEAD VENIPUNCTURE COLLECT SPECIMEN/BLOOD $18.90 $27.00 $9.72–$38.57 20% below 30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE $17.50 $25.00 $15.55–$3,396.04 — 30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LEAD VENIPUNCTURE COLLECT SPECIMEN/BLOOD $18.90 $27.00 $16.79–$3,396.04 — 30%
Blood glucose (sugar) test CPT 82947 GLUCOSE $74.90 $107.00 $38.52–$152.86 65% above 30%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR PP $74.90 $107.00 $38.52–$152.86 65% above 30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE $74.90 $107.00 $66.55–$3,396.04 — 30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR PP $74.90 $107.00 $66.55–$3,396.04 — 30%
Blood lead test CPT 83655 LEAD LEVEL BY FINGERSTICK (PEDIATRIC) $46.20 $66.00 $23.76–$94.29 18% below 30%
Blood lead test CPT 83655 LEAD BLOOD (PEDIATRIC)(REF) $67.20 $96.00 $34.56–$137.14 20% above 30%
Blood lead test CPT 83655 LEAD BLOOD (ADULT)(REF) $67.20 $96.00 $34.56–$137.14 20% above 30%
Blood lead test CPT 83655 LEAD TO STATE $70.00 $100.00 $36.00–$142.86 25% above 30%
Blood lead test inpatient CPT 83655 LEAD LEVEL BY FINGERSTICK (PEDIATRIC) $46.20 $66.00 $41.05–$3,396.04 — 30%
Blood lead test inpatient CPT 83655 LEAD BLOOD (PEDIATRIC)(REF) $67.20 $96.00 $59.71–$3,396.04 — 30%
Blood lead test inpatient CPT 83655 LEAD BLOOD (ADULT)(REF) $67.20 $96.00 $59.71–$3,396.04 — 30%
Blood lead test inpatient CPT 83655 LEAD TO STATE $70.00 $100.00 $62.20–$3,396.04 — 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST AUTOMATED $19.60 $28.00 $10.08–$40.00 78% below 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM $126.00 $180.00 $64.80–$257.14 38% above 30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST AUTOMATED $19.60 $28.00 $17.42–$3,396.04 — 30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM $126.00 $180.00 $111.96–$3,396.04 — 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPE, GEL $48.30 $69.00 $24.84–$98.57 43% below 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO GROUP $77.00 $110.00 $39.60–$157.14 9% below 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB RETYPE ABO TYPE $79.10 $113.00 $40.68–$161.43 6% below 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 CICBC ABO GROUP $79.10 $113.00 $40.68–$161.43 6% below 30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPE, GEL $48.30 $69.00 $42.92–$3,396.04 — 30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO GROUP $77.00 $110.00 $68.42–$3,396.04 — 30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 CICBC ABO GROUP $79.10 $113.00 $70.29–$3,396.04 — 30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB RETYPE ABO TYPE $79.10 $113.00 $70.29–$3,396.04 — 30%
Blood urea nitrogen (BUN) test CPT 84520 BUN SERUM $88.90 $127.00 $45.72–$181.43 71% above 30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN SERUM $88.90 $127.00 $78.99–$3,396.04 — 30%
C-peptide blood test CPT 84681 C-PEPTID $63.00 $90.00 $32.40–$128.57 39% below 30%
C-peptide blood test CPT 84681 C-PEPTIDE 24 HR URINE(REF) $136.50 $195.00 $70.20–$278.57 32% above 30%
C-peptide blood test CPT 84681 C-PEPTIDE(REF) $188.30 $269.00 $96.84–$384.29 82% above 30%
C-peptide blood test inpatient CPT 84681 C-PEPTID $63.00 $90.00 $55.98–$3,396.04 — 30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE 24 HR URINE(REF) $136.50 $195.00 $121.29–$3,396.04 — 30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE(REF) $188.30 $269.00 $167.32–$3,396.04 — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 IBD ASSOCIATED CHARGE $21.00 $30.00 $10.80–$42.86 71% below 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN $27.30 $39.00 $14.04–$55.71 63% below 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 ASSOC CHG IBD PROFILE CRP $59.50 $85.00 $30.60–$121.43 19% below 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP NON SPECIFIC $121.80 $174.00 $62.64–$248.57 66% above 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 DAILY CRP NON SPECIFIC $121.80 $174.00 $62.64–$248.57 66% above 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 IBD ASSOCIATED CHARGE $21.00 $30.00 $18.66–$3,396.04 — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN $27.30 $39.00 $24.26–$3,396.04 — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 ASSOC CHG IBD PROFILE CRP $59.50 $85.00 $52.87–$3,396.04 — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP NON SPECIFIC $121.80 $174.00 $108.23–$3,396.04 — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 DAILY CRP NON SPECIFIC $121.80 $174.00 $108.23–$3,396.04 — 30%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN/EPI STOOL PCR CEPHEID $220.50 $315.00 $113.40–$450.00 20% above 30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN/EPI STOOL PCR CEPHEID $220.50 $315.00 $195.93–$3,396.04 — 30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 REF $102.90 $147.00 $52.92–$210.00 7% below 30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 REF $102.90 $147.00 $91.43–$3,396.04 — 30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 REF $169.40 $242.00 $87.12–$345.71 5% above 30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125 REF $169.40 $242.00 $150.52–$3,396.04 — 30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV2 PCR $143.50 $205.00 $73.80–$292.86 24% above 30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COV2 PCR $143.50 $205.00 $127.51–$3,396.04 — 30%
Calcium blood test, total CPT 82310 CALICUM REF $42.70 $61.00 $21.96–$87.14 6% below 30%
Calcium blood test, total CPT 82310 CALCIUM $94.50 $135.00 $48.60–$192.86 108% above 30%
Calcium blood test, total inpatient CPT 82310 CALICUM REF $42.70 $61.00 $37.94–$3,396.04 — 30%
Calcium blood test, total inpatient CPT 82310 CALCIUM $94.50 $135.00 $83.97–$3,396.04 — 30%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA REF $179.20 $256.00 $92.16–$365.71 27% above 30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA REF $179.20 $256.00 $159.23–$3,396.04 — 30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA BY IFA $30.80 $44.00 $15.84–$62.86 59% below 30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM (QUANT) $31.50 $45.00 $16.20–$64.29 58% below 30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG $86.10 $123.00 $44.28–$175.71 16% above 30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA BY IFA $30.80 $44.00 $27.37–$3,396.04 — 30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM (QUANT) $31.50 $45.00 $27.99–$3,396.04 — 30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG $86.10 $123.00 $76.51–$3,396.04 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ASSOC CHG CHLAMYDIA NAA PHARYNGEAL $98.70 $141.00 $50.76–$201.43 20% below 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ASSOC CT genital swab/urine PCR CEPHEID $159.60 $228.00 $82.08–$325.71 29% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA-NAA GEN OR URINE (REF) $159.60 $228.00 $82.08–$325.71 29% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ASSOC CHG CHLAMYDIA NAA PHARYNGEAL $98.70 $141.00 $87.70–$3,396.04 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ASSOC CT genital swab/urine PCR CEPHEID $159.60 $228.00 $141.82–$3,396.04 — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA-NAA GEN OR URINE (REF) $159.60 $228.00 $141.82–$3,396.04 — 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 ASSOC CHG LIPID PANEL REF $56.70 $81.00 $29.16–$115.71 56% below 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $145.60 $208.00 $74.88–$297.14 13% above 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 ASSOC CHG LIPID PANEL REF $56.70 $81.00 $50.38–$3,396.04 — 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $145.60 $208.00 $129.38–$3,396.04 — 30%
Complete blood count (CBC) with differential CPT 85025 ASSOC CHG GHP & CBC/AUTO DIFF REF $58.80 $84.00 $30.24–$120.00 25% below 30%
Complete blood count (CBC) with differential CPT 85025 CBC, W/AUTO DIFF $123.90 $177.00 $63.72–$252.86 58% above 30%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF CHARGE ONLY $123.90 $177.00 $63.72–$252.86 58% above 30%
Complete blood count (CBC) with differential CPT 85025 GHP in-house CBC W/DIFF $130.20 $186.00 $66.96–$265.71 66% above 30%
Complete blood count (CBC) with differential inpatient CPT 85025 ASSOC CHG GHP & CBC/AUTO DIFF REF $58.80 $84.00 $52.25–$3,396.04 — 30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC, W/AUTO DIFF $123.90 $177.00 $110.09–$3,396.04 — 30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF CHARGE ONLY $123.90 $177.00 $110.09–$3,396.04 — 30%
Complete blood count (CBC) with differential inpatient CPT 85025 GHP in-house CBC W/DIFF $130.20 $186.00 $115.69–$3,396.04 — 30%
Complete blood count (CBC), no differential CPT 85027 DAILY CBC W/O DIFF $108.50 $155.00 $55.80–$221.43 67% above 30%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM CHARGE ONLY $108.50 $155.00 $55.80–$221.43 67% above 30%
Complete blood count (CBC), no differential CPT 85027 .CBC NO DIFF CHG ONLY $108.50 $155.00 $55.80–$221.43 67% above 30%
Complete blood count (CBC), no differential CPT 85027 GHP in-house CBC W/O DIFF $108.50 $155.00 $55.80–$221.43 67% above 30%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF $108.50 $155.00 $55.80–$221.43 67% above 30%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM CHARGE ONLY $108.50 $155.00 $96.41–$3,396.04 — 30%
Complete blood count (CBC), no differential inpatient CPT 85027 DAILY CBC W/O DIFF $108.50 $155.00 $96.41–$3,396.04 — 30%
Complete blood count (CBC), no differential inpatient CPT 85027 GHP in-house CBC W/O DIFF $108.50 $155.00 $96.41–$3,396.04 — 30%
Complete blood count (CBC), no differential inpatient CPT 85027 .CBC NO DIFF CHG ONLY $108.50 $155.00 $96.41–$3,396.04 — 30%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF $108.50 $155.00 $96.41–$3,396.04 — 30%
Comprehensive metabolic panel (blood test) CPT 80053 ASSOC CHG GHP & CMP REF $58.80 $84.00 $30.24–$120.00 63% below 30%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $174.30 $249.00 $89.64–$355.71 9% above 30%
Comprehensive metabolic panel (blood test) CPT 80053 GHP in-house CMP $179.90 $257.00 $92.52–$367.14 13% above 30%
Comprehensive metabolic panel (blood test) CPT 80053 DAILY COMPREHENSIVE METABOLIC PANEL $209.30 $299.00 $107.64–$427.14 31% above 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 ASSOC CHG GHP & CMP REF $58.80 $84.00 $52.25–$3,396.04 — 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL $174.30 $249.00 $154.88–$3,396.04 — 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 GHP in-house CMP $179.90 $257.00 $159.85–$3,396.04 — 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 DAILY COMPREHENSIVE METABOLIC PANEL $209.30 $299.00 $185.98–$3,396.04 — 30%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL MS $83.30 $119.00 $42.84–$170.00 24% below 30%
Cortisol blood test, total CPT 82533 CORTISOL / DEXAMETHASONE SUPPRESSION $91.70 $131.00 $47.16–$187.14 17% below 30%
Cortisol blood test, total CPT 82533 CORTISOL AM REF $117.60 $168.00 $60.48–$240.00 7% above 30%
Cortisol blood test, total CPT 82533 CORTISOL PM REF $117.60 $168.00 $60.48–$240.00 7% above 30%
Cortisol blood test, total CPT 82533 CORTISOL $156.10 $223.00 $80.28–$318.57 42% above 30%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL 1 SPECIMEN REF $156.10 $223.00 $80.28–$318.57 42% above 30%
Cortisol blood test, total CPT 82533 ASSOC CHG ACTH STIMULATION CORTISOL REF $156.10 $223.00 $80.28–$318.57 42% above 30%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL MS $83.30 $119.00 $74.02–$3,396.04 — 30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL / DEXAMETHASONE SUPPRESSION $91.70 $131.00 $81.48–$3,396.04 — 30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PM REF $117.60 $168.00 $104.50–$3,396.04 — 30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL AM REF $117.60 $168.00 $104.50–$3,396.04 — 30%
Cortisol blood test, total inpatient CPT 82533 ASSOC CHG ACTH STIMULATION CORTISOL REF $156.10 $223.00 $138.71–$3,396.04 — 30%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL 1 SPECIMEN REF $156.10 $223.00 $138.71–$3,396.04 — 30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL $156.10 $223.00 $138.71–$3,396.04 — 30%
Creatine kinase (CK) blood test, total CPT 82550 DAILY CPK $123.20 $176.00 $63.36–$251.43 100% above 30%
Creatine kinase (CK) blood test, total CPT 82550 CPK $123.20 $176.00 $63.36–$251.43 100% above 30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 DAILY CPK $123.20 $176.00 $109.47–$3,396.04 — 30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK $123.20 $176.00 $109.47–$3,396.04 — 30%
Creatinine blood test CPT 82565 CREATININE $86.80 $124.00 $44.64–$177.14 73% above 30%
Creatinine blood test inpatient CPT 82565 CREATININE $86.80 $124.00 $77.13–$3,396.04 — 30%
Cytomegalovirus (CMV) antibody test CPT 86644 CICBC CMV ANTIBODY SCREEN MICROPLATE $53.20 $76.00 $27.36–$108.57 37% below 30%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGG REF $109.20 $156.00 $56.16–$222.86 28% above 30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CICBC CMV ANTIBODY SCREEN MICROPLATE $53.20 $76.00 $47.27–$3,396.04 — 30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGG REF $109.20 $156.00 $97.03–$3,396.04 — 30%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER (REF) $191.10 $273.00 $98.28–$390.00 58% above 30%
D-dimer blood test (blood clot marker) CPT 85379 DO NOT ORDER D-DIMER (QUAL) $194.60 $278.00 $100.08–$397.14 61% above 30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (TRIAGE) $194.60 $278.00 $100.08–$397.14 61% above 30%
D-dimer blood test (blood clot marker) CPT 85379 DAILY D DIMER $200.90 $287.00 $103.32–$410.00 66% above 30%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER $200.90 $287.00 $103.32–$410.00 66% above 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER (REF) $191.10 $273.00 $169.81–$3,396.04 — 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DO NOT ORDER D-DIMER (QUAL) $194.60 $278.00 $172.92–$3,396.04 — 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (TRIAGE) $194.60 $278.00 $172.92–$3,396.04 — 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER $200.90 $287.00 $178.51–$3,396.04 — 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DAILY D DIMER $200.90 $287.00 $178.51–$3,396.04 — 30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S04 $99.40 $142.00 $51.12–$202.86 8% below 30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S04 $99.40 $142.00 $88.32–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ASSOC CHARGE DRUG SCREEN 5 PANEL $22.40 $32.00 $11.52–$45.71 77% below 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN CLASS B (ASSOC CHG ONLY) $64.40 $92.00 $33.12–$131.43 34% below 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN ASSOC CHARGE ONLY $64.40 $92.00 $33.12–$131.43 34% below 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE METABOLITE SCREEN URINE(REF) $74.20 $106.00 $38.16–$151.43 24% below 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NON-DOT UDS(ONLY FOR EMPLOYMENT) $75.60 $108.00 $38.88–$154.29 22% below 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GHB $154.70 $221.00 $79.56–$315.71 59% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL-10 DRUGS SERUM $185.50 $265.00 $95.40–$378.57 90% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MEDICAL PROFESSIONAL 15 $241.50 $345.00 $124.20–$492.86 148% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 16 & ETOH WHOLE BLD/CONFIRM $294.00 $420.00 $151.20–$600.00 202% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ToxAssure COMPREHENSIVE PROFILE UDS (26) $420.70 $601.00 $216.36–$858.57 331% above 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ASSOC CHARGE DRUG SCREEN 5 PANEL $22.40 $32.00 $19.90–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN CLASS B (ASSOC CHG ONLY) $64.40 $92.00 $57.22–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN ASSOC CHARGE ONLY $64.40 $92.00 $57.22–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE METABOLITE SCREEN URINE(REF) $74.20 $106.00 $65.93–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NON-DOT UDS(ONLY FOR EMPLOYMENT) $75.60 $108.00 $67.18–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GHB $154.70 $221.00 $137.46–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL-10 DRUGS SERUM $185.50 $265.00 $164.83–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEDICAL PROFESSIONAL 15 $241.50 $345.00 $214.59–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 16 & ETOH WHOLE BLD/CONFIRM $294.00 $420.00 $261.24–$3,396.04 — 30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ToxAssure COMPREHENSIVE PROFILE UDS (26) $420.70 $601.00 $373.82–$3,396.04 — 30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL $150.50 $215.00 $77.40–$307.14 55% above 30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL $150.50 $215.00 $133.73–$3,396.04 — 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VIRUS/VCA IGG $75.60 $108.00 $38.88–$154.29 30% below 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VIRUS/VCA IGM $75.60 $108.00 $38.88–$154.29 30% below 30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VIRUS/VCA IGG $75.60 $108.00 $67.18–$3,396.04 — 30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VIRUS/VCA IGM $75.60 $108.00 $67.18–$3,396.04 — 30%
Estradiol blood test CPT 82670 ASSOC CHG ESTRADIOL-TOTAL(REF) $56.70 $81.00 $29.16–$115.71 47% below 30%
Estradiol blood test CPT 82670 ESTRADIOL $179.90 $257.00 $92.52–$367.14 70% above 30%
Estradiol blood test CPT 82670 ESTRADIOL-SENSITIVE BY LC/MS $220.50 $315.00 $113.40–$450.00 108% above 30%
Estradiol blood test inpatient CPT 82670 ASSOC CHG ESTRADIOL-TOTAL(REF) $56.70 $81.00 $50.38–$3,396.04 — 30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL $179.90 $257.00 $159.85–$3,396.04 — 30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL-SENSITIVE BY LC/MS $220.50 $315.00 $195.93–$3,396.04 — 30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $172.90 $247.00 $88.92–$352.86 46% above 30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH PEDIATRIC $184.10 $263.00 $94.68–$375.71 56% above 30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $172.90 $247.00 $153.63–$3,396.04 — 30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH PEDIATRIC $184.10 $263.00 $163.59–$3,396.04 — 30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL REF $464.10 $663.00 $238.68–$947.14 167% above 30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL REF $464.10 $663.00 $412.39–$3,396.04 — 30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $203.00 $290.00 $104.40–$414.29 53% above 30%
Ferritin blood test (iron stores) CPT 82728 DAILY FERRITIN $203.00 $290.00 $104.40–$414.29 53% above 30%
Ferritin blood test (iron stores) inpatient CPT 82728 DAILY FERRITIN $203.00 $290.00 $180.38–$3,396.04 — 30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN $203.00 $290.00 $180.38–$3,396.04 — 30%
Fibrinogen blood test CPT 85384 FIBRINOGEN $79.80 $114.00 $41.04–$162.86 8% below 30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN $79.80 $114.00 $70.91–$3,396.04 — 30%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM $178.50 $255.00 $91.80–$364.29 59% above 30%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM $178.50 $255.00 $158.61–$3,396.04 — 30%
Free T3 thyroid hormone test CPT 84481 ASSOC CHG FREE T3 REF $185.50 $265.00 $95.40–$378.57 55% above 30%
Free T3 thyroid hormone test CPT 84481 FREE T3 $316.40 $452.00 $162.72–$645.71 165% above 30%
Free T3 thyroid hormone test inpatient CPT 84481 ASSOC CHG FREE T3 REF $185.50 $265.00 $164.83–$3,396.04 — 30%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 $316.40 $452.00 $281.14–$3,396.04 — 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSOC CHG FREE T4 REF $98.70 $141.00 $50.76–$201.43 15% below 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE $116.20 $166.00 $59.76–$237.14 at median 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 DIALYSIS/MS FT4(REF) $335.30 $479.00 $172.44–$684.29 188% above 30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSOC CHG FREE T4 REF $98.70 $141.00 $87.70–$3,396.04 — 30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE $116.20 $166.00 $103.25–$3,396.04 — 30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 DIALYSIS/MS FT4(REF) $335.30 $479.00 $297.94–$3,396.04 — 30%
Free testosterone test CPT 84402 TESTOSTERONE FREE & TOTAL $110.60 $158.00 $56.88–$225.71 10% below 30%
Free testosterone test CPT 84402 TESTOSTERONE FREE $110.60 $158.00 $56.88–$225.71 10% below 30%
Free testosterone test CPT 84402 ASSOC CHG FREE TESTOSTERONE EQUILBRIUM $174.30 $249.00 $89.64–$355.71 42% above 30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE & TOTAL $110.60 $158.00 $98.28–$3,396.04 — 30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE $110.60 $158.00 $98.28–$3,396.04 — 30%
Free testosterone test inpatient CPT 84402 ASSOC CHG FREE TESTOSTERONE EQUILBRIUM $174.30 $249.00 $154.88–$3,396.04 — 30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSOC CHG GGT $81.20 $116.00 $41.76–$165.71 39% above 30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT $107.80 $154.00 $55.44–$220.00 85% above 30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSOC CHG GGT $81.20 $116.00 $72.15–$3,396.04 — 30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT $107.80 $154.00 $95.79–$3,396.04 — 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 HR GESTATIONAL GLUCOSE SCREEN $129.50 $185.00 $66.60–$264.29 128% above 30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 1 HR GESTATIONAL GLUCOSE SCREEN $129.50 $185.00 $115.07–$3,396.04 — 30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 5HR $151.20 $216.00 $77.76–$308.57 12% above 30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 4HR $151.20 $216.00 $77.76–$308.57 12% above 30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3HR $156.10 $223.00 $80.28–$318.57 16% above 30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 2HR $156.10 $223.00 $80.28–$318.57 16% above 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 5HR $151.20 $216.00 $134.35–$3,396.04 — 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 4HR $151.20 $216.00 $134.35–$3,396.04 — 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3HR $156.10 $223.00 $138.71–$3,396.04 — 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 2HR $156.10 $223.00 $138.71–$3,396.04 — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ASSOC CHG GC NAA PHARYNGEAL $98.70 $141.00 $50.76–$201.43 20% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ASSOC NG genital swab/urine PCR CEPHEID $159.60 $228.00 $82.08–$325.71 30% above 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC-NAA GEN OR URINE $159.60 $228.00 $82.08–$325.71 30% above 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ASSOC CHG GC NAA PHARYNGEAL $98.70 $141.00 $87.70–$3,396.04 — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ASSOC NG genital swab/urine PCR CEPHEID $159.60 $228.00 $141.82–$3,396.04 — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC-NAA GEN OR URINE $159.60 $228.00 $141.82–$3,396.04 — 30%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL ANTIGEN $191.80 $274.00 $98.64–$391.43 65% above 30%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL ANTIGEN $191.80 $274.00 $170.43–$3,396.04 — 30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD $335.30 $479.00 $172.44–$684.29 1% below 30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD $335.30 $479.00 $297.94–$3,396.04 — 30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN REFLEX TO CONFIRMATION REF $129.50 $185.00 $66.60–$264.29 15% above 30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN REFLEX TO CONFIRMATION REF $129.50 $185.00 $115.07–$3,396.04 — 30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 ASSOC CHG HPV/APTIMA REFLEX $140.00 $200.00 $72.00–$285.71 4% below 30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 ASSOC CHG HPV/APTIMA THIN PREP REF $200.20 $286.00 $102.96–$408.57 37% above 30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 ASSOC CHG HPV/APTIMA REFLEX $140.00 $200.00 $124.40–$3,396.04 — 30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 ASSOC CHG HPV/APTIMA THIN PREP REF $200.20 $286.00 $177.89–$3,396.04 — 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C -GLYCOHEMOGLOBIN $113.40 $162.00 $58.32–$231.43 27% above 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C WITH eAG $113.40 $162.00 $58.32–$231.43 27% above 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C -GLYCOHEMOGLOBIN $113.40 $162.00 $100.76–$3,396.04 — 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C WITH eAG $113.40 $162.00 $100.76–$3,396.04 — 30%
Hemoglobin blood test CPT 85018 HGB $18.90 $27.00 $9.72–$38.57 40% below 30%
Hemoglobin blood test CPT 85018 Bld# Hgb $20.30 $29.00 $10.44–$41.43 36% below 30%
Hemoglobin blood test CPT 85018 HEMOGLOBIN TOT COLORIMETRIC $39.20 $56.00 $20.16–$80.00 24% above 30%
Hemoglobin blood test CPT 85018 HEMOGLOBIN $49.70 $71.00 $25.56–$101.43 58% above 30%
Hemoglobin blood test inpatient CPT 85018 HGB $18.90 $27.00 $16.79–$3,396.04 — 30%
Hemoglobin blood test inpatient CPT 85018 Bld# Hgb $20.30 $29.00 $18.04–$3,396.04 — 30%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN TOT COLORIMETRIC $39.20 $56.00 $34.83–$3,396.04 — 30%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN $49.70 $71.00 $44.16–$3,396.04 — 30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY (HBcAb)TOTAL $108.50 $155.00 $55.80–$221.43 39% above 30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY (HBcAb)TOTAL $108.50 $155.00 $96.41–$3,396.04 — 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE Ab (HBsAb) $81.20 $116.00 $41.76–$165.71 13% below 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY $123.20 $176.00 $63.36–$251.43 31% above 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE Ab (HBsAb) $81.20 $116.00 $72.15–$3,396.04 — 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY $123.20 $176.00 $109.47–$3,396.04 — 30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG $125.30 $179.00 $64.44–$255.71 41% above 30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG $125.30 $179.00 $111.34–$3,396.04 — 30%
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB WITH REFLEX TO QUANT PCR $171.50 $245.00 $88.20–$350.00 53% above 30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB WITH REFLEX TO QUANT PCR $171.50 $245.00 $152.39–$3,396.04 — 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA NAA for diagnosis $394.10 $563.00 $202.68–$804.29 49% above 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 ASSOC CHG REFLEX HCV QUANT PCR $394.10 $563.00 $202.68–$804.29 49% above 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 ASSOC CHG HEPATITIS C RNA QUANT PCR $522.20 $746.00 $268.56–$1,065.71 97% above 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT PCR $522.20 $746.00 $268.56–$1,065.71 97% above 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 ASSOC CHG REFLEX HCV QUANT PCR $394.10 $563.00 $350.19–$3,396.04 — 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA NAA for diagnosis $394.10 $563.00 $350.19–$3,396.04 — 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 ASSOC CHG HEPATITIS C RNA QUANT PCR $522.20 $746.00 $464.01–$3,396.04 — 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT PCR $522.20 $746.00 $464.01–$3,396.04 — 30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV-1 IGG $91.00 $130.00 $46.80–$185.71 40% above 30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV-1 IGG $91.00 $130.00 $80.86–$3,396.04 — 30%
Herpes blood test, HSV-2 antibody CPT 86696 ASSOC CHG HSV-2 IGM $46.20 $66.00 $23.76–$94.29 42% below 30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG $131.60 $188.00 $67.68–$268.57 64% above 30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ASSOC CHG HSV-2 IGM $46.20 $66.00 $41.05–$3,396.04 — 30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG $131.60 $188.00 $116.94–$3,396.04 — 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP - CARDIAC(LABCORP) $128.80 $184.00 $66.24–$262.86 39% above 30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP - CARDIAC(LABCORP) $128.80 $184.00 $114.45–$3,396.04 — 30%
Homocysteine blood test CPT 83090 HOMOCYSTINE (COAG) $41.30 $59.00 $21.24–$84.29 66% below 30%
Homocysteine blood test CPT 83090 HOMOCYSTEINE PLASMA $110.60 $158.00 $56.88–$225.71 8% below 30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE (COAG) $41.30 $59.00 $36.70–$3,396.04 — 30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE PLASMA $110.60 $158.00 $98.28–$3,396.04 — 30%
Insulin blood test CPT 83525 INSULIN TOTAL $120.40 $172.00 $61.92–$245.71 65% above 30%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL $120.40 $172.00 $106.98–$3,396.04 — 30%
Iron blood test (serum iron) CPT 83540 IRON $111.30 $159.00 $57.24–$227.14 41% above 30%
Iron blood test (serum iron) inpatient CPT 83540 IRON $111.30 $159.00 $98.90–$3,396.04 — 30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAP $153.30 $219.00 $78.84–$312.86 104% above 30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAP $153.30 $219.00 $136.22–$3,396.04 — 30%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $159.60 $228.00 $82.08–$325.71 8% above 30%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $159.60 $228.00 $141.82–$3,396.04 — 30%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE PEDIATRIC $160.30 $229.00 $82.44–$327.14 40% above 30%
LH (luteinizing hormone) test CPT 83002 LH LUTEINIZING HORMONE $160.30 $229.00 $82.44–$327.14 40% above 30%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE PEDIATRIC $160.30 $229.00 $142.44–$3,396.04 — 30%
LH (luteinizing hormone) test inpatient CPT 83002 LH LUTEINIZING HORMONE $160.30 $229.00 $142.44–$3,396.04 — 30%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID $64.40 $92.00 $33.12–$131.43 28% below 30%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BACKUP NOVA $118.30 $169.00 $60.84–$241.43 32% above 30%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID $64.40 $92.00 $57.22–$3,396.04 — 30%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID BACKUP NOVA $118.30 $169.00 $105.12–$3,396.04 — 30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH / BODY FLUID $40.60 $58.00 $20.88–$82.86 29% below 30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH $89.60 $128.00 $46.08–$182.86 56% above 30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH / BODY FLUID $40.60 $58.00 $36.08–$3,396.04 — 30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH $89.60 $128.00 $79.62–$3,396.04 — 30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $133.70 $191.00 $68.76–$272.86 43% above 30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $133.70 $191.00 $118.80–$3,396.04 — 30%
Liver function blood test panel CPT 80076 LIVER PROFILE $235.20 $336.00 $120.96–$480.00 70% above 30%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE $235.20 $336.00 $208.99–$3,396.04 — 30%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB TEST WITH REFLEX $121.80 $174.00 $62.64–$248.57 68% above 30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB TEST WITH REFLEX $121.80 $174.00 $108.23–$3,396.04 — 30%
Magnesium blood test CPT 83735 URINE MAGNESIUM RANDOM $16.10 $23.00 $8.28–$32.86 77% below 30%
Magnesium blood test CPT 83735 24HR URINE MAGNESIUM $73.50 $105.00 $37.80–$150.00 5% above 30%
Magnesium blood test CPT 83735 MAGNESIUM RBC (REF) $105.00 $150.00 $54.00–$214.29 50% above 30%
Magnesium blood test CPT 83735 URINE 24 HR MAGNESIUM (REF) $123.20 $176.00 $63.36–$251.43 76% above 30%
Magnesium blood test CPT 83735 IONIZED MAGNESIUM NOVA WHOLE BLOOD $123.20 $176.00 $63.36–$251.43 76% above 30%
Magnesium blood test CPT 83735 MAGNESIUM $123.20 $176.00 $63.36–$251.43 76% above 30%
Magnesium blood test CPT 83735 ASSOC CHG MG FECAL CATHARTIC LAX PANEL $239.40 $342.00 $123.12–$488.57 242% above 30%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM RANDOM $16.10 $23.00 $14.31–$3,396.04 — 30%
Magnesium blood test inpatient CPT 83735 24HR URINE MAGNESIUM $73.50 $105.00 $65.31–$3,396.04 — 30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC (REF) $105.00 $150.00 $93.30–$3,396.04 — 30%
Magnesium blood test inpatient CPT 83735 IONIZED MAGNESIUM NOVA WHOLE BLOOD $123.20 $176.00 $109.47–$3,396.04 — 30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM $123.20 $176.00 $109.47–$3,396.04 — 30%
Magnesium blood test inpatient CPT 83735 URINE 24 HR MAGNESIUM (REF) $123.20 $176.00 $109.47–$3,396.04 — 30%
Magnesium blood test inpatient CPT 83735 ASSOC CHG MG FECAL CATHARTIC LAX PANEL $239.40 $342.00 $212.72–$3,396.04 — 30%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY IGM $75.60 $108.00 $38.88–$154.29 4% above 30%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY IGG $114.10 $163.00 $58.68–$232.86 57% above 30%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY IGM $75.60 $108.00 $67.18–$3,396.04 — 30%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY IGG $114.10 $163.00 $101.39–$3,396.04 — 30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST $118.30 $169.00 $60.84–$241.43 46% above 30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST $118.30 $169.00 $105.12–$3,396.04 — 30%
Mumps immunity blood test CPT 86735 MUMPS TITER, IGM(REF) $46.20 $66.00 $23.76–$94.29 36% below 30%
Mumps immunity blood test CPT 86735 MUMPS TITER IGG(REF) $91.00 $130.00 $46.80–$185.71 26% above 30%
Mumps immunity blood test inpatient CPT 86735 MUMPS TITER, IGM(REF) $46.20 $66.00 $41.05–$3,396.04 — 30%
Mumps immunity blood test inpatient CPT 86735 MUMPS TITER IGG(REF) $91.00 $130.00 $80.86–$3,396.04 — 30%
Obstetric blood test panel CPT 80055 OB PANEL $574.70 $821.00 $295.56–$1,172.86 173% above 30%
Obstetric blood test panel inpatient CPT 80055 OB PANEL $574.70 $821.00 $510.66–$3,396.04 — 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSOC CHG FREE PSA $54.60 $78.00 $28.08–$111.43 41% below 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSOC CHG FREE PSA % $88.90 $127.00 $45.72–$181.43 4% below 30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSOC CHG FREE PSA $54.60 $78.00 $48.52–$3,396.04 — 30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSOC CHG FREE PSA % $88.90 $127.00 $78.99–$3,396.04 — 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-DIAGNOSTIC $166.60 $238.00 $85.68–$340.00 47% above 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA-DIAGNOSTIC $166.60 $238.00 $148.04–$3,396.04 — 30%
Pap test (liquid-based, automated screening with review) CPT 88175 ASSOC CHG PAP LIQ BASE PREP IG REF $88.90 $127.00 $45.72–$181.43 35% below 30%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP GYNE AGE BASED IMAGE GUIDED REF $125.30 $179.00 $64.44–$255.71 8% below 30%
Pap test (liquid-based, automated screening with review) CPT 88175 ASSOC CHG HPV/ REFLEX 16 18 45 $140.00 $200.00 $72.00–$285.71 2% above 30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 ASSOC CHG PAP LIQ BASE PREP IG REF $88.90 $127.00 $78.99–$3,396.04 — 30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP GYNE AGE BASED IMAGE GUIDED REF $125.30 $179.00 $111.34–$3,396.04 — 30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 ASSOC CHG HPV/ REFLEX 16 18 45 $140.00 $200.00 $124.40–$3,396.04 — 30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 ASSOC CHG PAP GYNE LIQ BASED $103.60 $148.00 $53.28–$211.43 6% below 30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 ASSOC CHG PAP GYNE LIQ BASED $103.60 $148.00 $92.06–$3,396.04 — 30%
Parathyroid hormone (PTH) blood test CPT 83970 PTH $283.50 $405.00 $145.80–$578.57 30% above 30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH $283.50 $405.00 $251.91–$3,396.04 — 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT-LA (REF) $81.20 $116.00 $41.76–$165.71 17% above 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $99.40 $142.00 $51.12–$202.86 43% above 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 DAILY PTT $99.40 $142.00 $51.12–$202.86 43% above 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 ASSOC CHG PTT (REF) $99.40 $142.00 $51.12–$202.86 43% above 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT-LA (REF) $81.20 $116.00 $72.15–$3,396.04 — 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $99.40 $142.00 $88.32–$3,396.04 — 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ASSOC CHG PTT (REF) $99.40 $142.00 $88.32–$3,396.04 — 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 DAILY PTT $99.40 $142.00 $88.32–$3,396.04 — 30%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS $91.70 $131.00 $47.16–$187.14 47% above 30%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS $91.70 $131.00 $81.48–$3,396.04 — 30%
Potassium blood test CPT 84132 POTASSIUM $72.10 $103.00 $37.08–$147.14 61% above 30%
Potassium blood test inpatient CPT 84132 POTASSIUM $72.10 $103.00 $64.07–$3,396.04 — 30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNIT21 + CORE (CHR. 21 18 13 SEX REF $637.70 $911.00 $327.96–$1,301.43 28% below 30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNIT21 + CORE (CHR. 21 18 13 SEX REF $637.70 $911.00 $566.64–$3,396.04 — 30%
Progesterone blood test CPT 84144 PROGESTERONE $126.00 $180.00 $64.80–$257.14 7% below 30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE $126.00 $180.00 $111.96–$3,396.04 — 30%
Prolactin blood test CPT 84146 MONOMERIC PROLACTIN REF $108.50 $155.00 $55.80–$221.43 14% below 30%
Prolactin blood test CPT 84146 PROLACTIN $182.00 $260.00 $93.60–$371.43 44% above 30%
Prolactin blood test inpatient CPT 84146 MONOMERIC PROLACTIN REF $108.50 $155.00 $96.41–$3,396.04 — 30%
Prolactin blood test inpatient CPT 84146 PROLACTIN $182.00 $260.00 $161.72–$3,396.04 — 30%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Tm $38.50 $55.00 $19.80–$78.57 at median 30%
Prothrombin time (PT/INR) clotting test CPT 85610 PT (COAG PROFILE) $65.10 $93.00 $33.48–$132.86 69% above 30%
Prothrombin time (PT/INR) clotting test CPT 85610 ASSOC CHG PT (REF) $66.50 $95.00 $34.20–$135.71 73% above 30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME $68.60 $98.00 $35.28–$140.00 78% above 30%
Prothrombin time (PT/INR) clotting test CPT 85610 DAILY PROTIME $68.60 $98.00 $35.28–$140.00 78% above 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Tm $38.50 $55.00 $34.21–$3,396.04 — 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT (COAG PROFILE) $65.10 $93.00 $57.85–$3,396.04 — 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ASSOC CHG PT (REF) $66.50 $95.00 $59.09–$3,396.04 — 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 DAILY PROTIME $68.60 $98.00 $60.96–$3,396.04 — 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME $68.60 $98.00 $60.96–$3,396.04 — 30%
Rapid flu test (influenza antigen) CPT 87804 Iaadiadoo Inf RHC $79.10 $113.00 $40.68–$161.43 at median 30%
Rapid flu test (influenza antigen) CPT 87804 ASSOC CHG CRYPTOCOCCUS AG TITER $98.70 $141.00 $50.76–$201.43 25% above 30%
Rapid flu test (influenza antigen) CPT 87804 ASSOC CHG FLU A EIA REF $131.60 $188.00 $67.68–$268.57 66% above 30%
Rapid flu test (influenza antigen) CPT 87804 ASSOC FLU B EIA REF $131.60 $188.00 $67.68–$268.57 66% above 30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A RAPID $150.50 $215.00 $77.40–$307.14 90% above 30%
Rapid flu test (influenza antigen) inpatient CPT 87804 Iaadiadoo Inf RHC $79.10 $113.00 $70.29–$3,396.04 — 30%
Rapid flu test (influenza antigen) inpatient CPT 87804 ASSOC CHG CRYPTOCOCCUS AG TITER $98.70 $141.00 $87.70–$3,396.04 — 30%
Rapid flu test (influenza antigen) inpatient CPT 87804 ASSOC CHG FLU A EIA REF $131.60 $188.00 $116.94–$3,396.04 — 30%
Rapid flu test (influenza antigen) inpatient CPT 87804 ASSOC FLU B EIA REF $131.60 $188.00 $116.94–$3,396.04 — 30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A RAPID $150.50 $215.00 $133.73–$3,396.04 — 30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN $104.30 $149.00 $53.64–$212.86 71% above 30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN $104.30 $149.00 $92.68–$3,396.04 — 30%
Renin blood test CPT 84244 RENIN $101.50 $145.00 $52.20–$207.14 10% below 30%
Renin blood test inpatient CPT 84244 RENIN $101.50 $145.00 $90.19–$3,396.04 — 30%
Rh blood typing CPT 86901 CICBC RH TYPE $30.80 $44.00 $15.84–$62.86 55% below 30%
Rh blood typing CPT 86901 BB RH TYPE $67.90 $97.00 $34.92–$138.57 1% below 30%
Rh blood typing inpatient CPT 86901 CICBC RH TYPE $30.80 $44.00 $27.37–$3,396.04 — 30%
Rh blood typing inpatient CPT 86901 BB RH TYPE $67.90 $97.00 $60.33–$3,396.04 — 30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ARTHRITIS (RA) FACTOR REF $64.40 $92.00 $33.12–$131.43 2% above 30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR BY TURBIDITY RDL $64.40 $92.00 $33.12–$131.43 2% above 30%
Rheumatoid factor (RF) test CPT 86431 ASSOC CHG RF FACTOR ISOTOPES IgM $74.20 $106.00 $38.16–$151.43 17% above 30%
Rheumatoid factor (RF) test CPT 86431 ASSOC CHG RF FACTOR ISOTOPES IgG $74.20 $106.00 $38.16–$151.43 17% above 30%
Rheumatoid factor (RF) test CPT 86431 ASSOC CHG RF FACTOR ISOTOPES IgA $74.20 $106.00 $38.16–$151.43 17% above 30%
Rheumatoid factor (RF) test CPT 86431 RA TEST QUANT $128.10 $183.00 $65.88–$261.43 102% above 30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID ARTHRITIS (RA) FACTOR REF $64.40 $92.00 $57.22–$3,396.04 — 30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR BY TURBIDITY RDL $64.40 $92.00 $57.22–$3,396.04 — 30%
Rheumatoid factor (RF) test inpatient CPT 86431 ASSOC CHG RF FACTOR ISOTOPES IgA $74.20 $106.00 $65.93–$3,396.04 — 30%
Rheumatoid factor (RF) test inpatient CPT 86431 ASSOC CHG RF FACTOR ISOTOPES IgM $74.20 $106.00 $65.93–$3,396.04 — 30%
Rheumatoid factor (RF) test inpatient CPT 86431 ASSOC CHG RF FACTOR ISOTOPES IgG $74.20 $106.00 $65.93–$3,396.04 — 30%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TEST QUANT $128.10 $183.00 $113.83–$3,396.04 — 30%
Rubella antibody test (immunity check) CPT 86762 MEASLES GERMAN IGG $79.80 $114.00 $41.04–$162.86 5% above 30%
Rubella antibody test (immunity check) CPT 86762 MEASLES GERMAN IGM $116.20 $166.00 $59.76–$237.14 52% above 30%
Rubella antibody test (immunity check) inpatient CPT 86762 MEASLES GERMAN IGG $79.80 $114.00 $70.91–$3,396.04 — 30%
Rubella antibody test (immunity check) inpatient CPT 86762 MEASLES GERMAN IGM $116.20 $166.00 $103.25–$3,396.04 — 30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE, AUTOMATED (CHARGE) $37.80 $54.00 $19.44–$77.14 18% below 30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE $67.20 $96.00 $34.56–$137.14 46% above 30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE, AUTOMATED (CHARGE) $37.80 $54.00 $33.59–$3,396.04 — 30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE $67.20 $96.00 $59.71–$3,396.04 — 30%
Sodium blood test CPT 84295 SODIUM $70.00 $100.00 $36.00–$142.86 43% above 30%
Sodium blood test inpatient CPT 84295 SODIUM $70.00 $100.00 $62.20–$3,396.04 — 30%
Stool ova and parasites exam CPT 87177 O & P STOOL $95.90 $137.00 $49.32–$195.71 28% above 30%
Stool ova and parasites exam CPT 87177 ..TEST O & P STOOL $119.00 $170.00 $61.20–$242.86 59% above 30%
Stool ova and parasites exam inpatient CPT 87177 O & P STOOL $119.00 $170.00 $105.74–$3,396.04 — 30%
Stool ova and parasites exam inpatient CPT 87177 ..TEST O & P STOOL $119.00 $170.00 $105.74–$3,396.04 — 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Bld Oclt Proxidase Actv Qual Feces 1 Det $14.00 $20.00 $7.20–$28.57 51% below 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD $17.50 $25.00 $9.00–$35.71 39% below 30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Bld Oclt Proxidase Actv Qual Feces 1 Det $14.00 $20.00 $12.44–$3,396.04 — 30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD $17.50 $25.00 $15.55–$3,396.04 — 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA ABS rfx RPR & QUANT $98.70 $141.00 $50.76–$201.43 46% above 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 ASSOC CHG TPPA $100.80 $144.00 $51.84–$205.71 49% above 30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA ABS rfx RPR & QUANT $98.70 $141.00 $87.70–$3,396.04 — 30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ASSOC CHG TPPA $100.80 $144.00 $89.57–$3,396.04 — 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR $74.90 $107.00 $38.52–$152.86 47% above 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR rflx QUANT RPR/ TREPONEMA ABS $74.90 $107.00 $38.52–$152.86 47% above 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF $77.70 $111.00 $39.96–$158.57 52% above 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR rflx QUANT RPR/ TREPONEMA ABS $74.90 $107.00 $66.55–$3,396.04 — 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR $74.90 $107.00 $66.55–$3,396.04 — 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF $77.70 $111.00 $69.04–$3,396.04 — 30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD SINGLE TUBE $257.60 $368.00 $132.48–$525.71 17% above 30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON GOLD SINGLE TUBE $257.60 $368.00 $228.90–$3,396.04 — 30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE LC/MS, TOTAL $125.30 $179.00 $64.44–$255.71 at median 30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE $198.80 $284.00 $102.24–$405.71 59% above 30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE LC/MS, TOTAL $125.30 $179.00 $111.34–$3,396.04 — 30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE $198.80 $284.00 $176.65–$3,396.04 — 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL ANTIBODIES $114.10 $163.00 $58.68–$232.86 43% above 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI TPO (MICROSOMAL ABG) $114.80 $164.00 $59.04–$234.29 44% above 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibodies Ea $123.20 $176.00 $63.36–$251.43 54% above 30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL ANTIBODIES $114.10 $163.00 $101.39–$3,396.04 — 30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI TPO (MICROSOMAL ABG) $114.80 $164.00 $102.01–$3,396.04 — 30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibodies Ea $123.20 $176.00 $109.47–$3,396.04 — 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSOC CHG GHP & TSH REF $58.80 $84.00 $30.24–$120.00 54% below 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE PROFILE REF $91.70 $131.00 $47.16–$187.14 28% below 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 GHP in-house TSH $140.00 $200.00 $72.00–$285.71 10% above 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $140.00 $200.00 $72.00–$285.71 10% above 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSOC CHG GHP & TSH REF $58.80 $84.00 $52.25–$3,396.04 — 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADE PROFILE REF $91.70 $131.00 $81.48–$3,396.04 — 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $140.00 $200.00 $124.40–$3,396.04 — 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 GHP in-house TSH $140.00 $200.00 $124.40–$3,396.04 — 30%
Total IgE blood test CPT 82785 IGE TOTAL $128.10 $183.00 $65.88–$261.43 51% above 30%
Total IgE blood test inpatient CPT 82785 IGE TOTAL $128.10 $183.00 $113.83–$3,396.04 — 30%
Total cholesterol blood test CPT 82465 CHOLESTEROL $70.00 $100.00 $36.00–$142.86 57% above 30%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL $70.00 $100.00 $62.20–$3,396.04 — 30%
Total thyroxine (T4) blood test CPT 84436 T7-TT4 $67.90 $97.00 $34.92–$138.57 17% below 30%
Total thyroxine (T4) blood test CPT 84436 T4 (TOTAL) REF $71.40 $102.00 $36.72–$145.71 13% below 30%
Total thyroxine (T4) blood test CPT 84436 ASSOC CHG TOTAL T4 REF $81.20 $116.00 $41.76–$165.71 1% below 30%
Total thyroxine (T4) blood test inpatient CPT 84436 T7-TT4 $67.90 $97.00 $60.33–$3,396.04 — 30%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 (TOTAL) REF $71.40 $102.00 $63.44–$3,396.04 — 30%
Total thyroxine (T4) blood test inpatient CPT 84436 ASSOC CHG TOTAL T4 REF $81.20 $116.00 $72.15–$3,396.04 — 30%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T-3 (REF) $209.30 $299.00 $107.64–$427.14 114% above 30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T-3 (REF) $209.30 $299.00 $185.98–$3,396.04 — 30%
Transferrin blood test CPT 84466 TRANSFERRIN $182.70 $261.00 $93.96–$372.86 89% above 30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN $182.70 $261.00 $162.34–$3,396.04 — 30%
Trichomonas test (NAAT) CPT 87661 ASSOC CHG TRICH-NAA GEN/URINE $110.60 $158.00 $56.88–$225.71 11% below 30%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS-NAA GEN/URINE $133.70 $191.00 $68.76–$272.86 7% above 30%
Trichomonas test (NAAT) CPT 87661 TV Trich genital swab/urine PCR CEPHEID $133.70 $191.00 $68.76–$272.86 7% above 30%
Trichomonas test (NAAT) inpatient CPT 87661 ASSOC CHG TRICH-NAA GEN/URINE $110.60 $158.00 $98.28–$3,396.04 — 30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS-NAA GEN/URINE $133.70 $191.00 $118.80–$3,396.04 — 30%
Trichomonas test (NAAT) inpatient CPT 87661 TV Trich genital swab/urine PCR CEPHEID $133.70 $191.00 $118.80–$3,396.04 — 30%
Triglycerides blood test CPT 84478 TRIGLYCERIDES $26.60 $38.00 $13.68–$54.29 43% below 30%
Triglycerides blood test CPT 84478 TRIGLYCERIDES BODY FLUID $104.30 $149.00 $53.64–$212.86 123% above 30%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES $96.60 $138.00 $85.84–$3,396.04 — 30%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BODY FLUID $104.30 $149.00 $92.68–$3,396.04 — 30%
Troponin test, quantitative CPT 84484 TROPONIN I $128.10 $183.00 $65.88–$261.43 19% below 30%
Troponin test, quantitative CPT 84484 TRIAGE TROPONIN I $180.60 $258.00 $92.88–$368.57 15% above 30%
Troponin test, quantitative CPT 84484 TROPONIN LEVEL $214.20 $306.00 $110.16–$437.14 36% above 30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I $128.10 $183.00 $113.83–$3,396.04 — 30%
Troponin test, quantitative inpatient CPT 84484 TRIAGE TROPONIN I $180.60 $258.00 $160.48–$3,396.04 — 30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN LEVEL $214.20 $306.00 $190.33–$3,396.04 — 30%
Uric acid blood test CPT 84550 URINE URIC ACID 24 HOUR OR RANDOM $23.10 $33.00 $11.88–$47.14 68% below 30%
Uric acid blood test CPT 84550 URIC ACID $76.30 $109.00 $39.24–$155.71 5% above 30%
Uric acid blood test inpatient CPT 84550 URINE URIC ACID 24 HOUR OR RANDOM $23.10 $33.00 $20.53–$3,396.04 — 30%
Uric acid blood test inpatient CPT 84550 URIC ACID $76.30 $109.00 $67.80–$3,396.04 — 30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS w/ REFLEX to Microscopy $71.40 $102.00 $36.72–$145.71 11% above 30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS w/Microscopy/C&S if indicated $71.40 $102.00 $36.72–$145.71 11% above 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS w/Microscopy/C&S if indicated $71.40 $102.00 $63.44–$3,396.04 — 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS w/ REFLEX to Microscopy $71.40 $102.00 $63.44–$3,396.04 — 30%
Urinalysis with microscope exam, manual CPT 81000 URINE FOR EOSINOPHILS $14.00 $20.00 $7.20–$28.57 44% below 30%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS DIPSTICK AUTO READ $49.70 $71.00 $25.56–$101.43 99% above 30%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINE FOR EOSINOPHILS $14.00 $20.00 $12.44–$3,396.04 — 30%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS DIPSTICK AUTO READ $49.70 $71.00 $44.16–$3,396.04 — 30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP AUTOMATED $49.70 $71.00 $25.56–$101.43 99% above 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP AUTOMATED $49.70 $71.00 $44.16–$3,396.04 — 30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIP NON-AUTOMATED $21.00 $30.00 $10.80–$42.86 16% below 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIP NON-AUTOMATED $21.00 $30.00 $18.66–$3,396.04 — 30%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE $109.20 $156.00 $56.16–$222.86 19% above 30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE $109.20 $156.00 $97.03–$3,396.04 — 30%
Urine microalbumin (albumin) test CPT 82043 24HR URINE MICROALBUMIN $126.00 $180.00 $64.80–$257.14 96% above 30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN $126.00 $180.00 $64.80–$257.14 96% above 30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN $126.00 $180.00 $111.96–$3,396.04 — 30%
Urine microalbumin (albumin) test inpatient CPT 82043 24HR URINE MICROALBUMIN $126.00 $180.00 $111.96–$3,396.04 — 30%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Tst Vis Color Cmprsn Met $30.80 $44.00 $15.84–$62.86 59% below 30%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE $106.40 $152.00 $54.72–$217.14 43% above 30%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Tst Vis Color Cmprsn Met $32.20 $46.00 $28.61–$3,396.04 — 30%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE $106.40 $152.00 $94.54–$3,396.04 — 30%
Vitamin B12 (cobalamin) blood test CPT 82607 HOMOCYSTEINE VITAMIN PANEL-CYANOCCOBALAM $89.60 $128.00 $46.08–$182.86 31% below 30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 $126.70 $181.00 $65.16–$258.57 2% below 30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HOMOCYSTEINE VITAMIN PANEL-CYANOCCOBALAM $89.60 $128.00 $79.62–$3,396.04 — 30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 $126.70 $181.00 $112.58–$3,396.04 — 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HEMOGLOBIN FETAL QUANT $120.40 $172.00 $61.92–$245.71 34% below 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXY VITAMIN D $212.10 $303.00 $109.08–$432.86 16% above 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2+D3 FRACTIONATED REF $349.30 $499.00 $179.64–$712.86 92% above 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HEMOGLOBIN FETAL QUANT $120.40 $172.00 $106.98–$3,396.04 — 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXY VITAMIN D $212.10 $303.00 $188.47–$3,396.04 — 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2+D3 FRACTIONATED REF $349.30 $499.00 $310.38–$3,396.04 — 30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 1 25 DIHYDROXY VITAMIN D (REF) $224.70 $321.00 $115.56–$458.57 16% above 30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1 25 DIHYDROXY VITAMIN D (REF) $224.70 $321.00 $199.66–$3,396.04 — 30%
Zinc blood test CPT 84630 ZINC PLASMA OR SERUM $98.00 $140.00 $50.40–$200.00 40% above 30%
Zinc blood test CPT 84630 ZINC WHOLE BLOOD $107.80 $154.00 $55.44–$220.00 54% above 30%
Zinc blood test inpatient CPT 84630 ZINC PLASMA OR SERUM $98.00 $140.00 $87.08–$3,396.04 — 30%
Zinc blood test inpatient CPT 84630 ZINC WHOLE BLOOD $107.80 $154.00 $95.79–$3,396.04 — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP3-HCG $24.50 $35.00 $12.60–$50.00 77% below 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG TUMOR MARKER(REF) $193.20 $276.00 $99.36–$394.29 84% above 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG-QUANT $193.20 $276.00 $99.36–$394.29 84% above 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP3-HCG $24.50 $35.00 $21.77–$3,396.04 — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG-QUANT $193.20 $276.00 $171.67–$3,396.04 — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG TUMOR MARKER(REF) $193.20 $276.00 $171.67–$3,396.04 — 30%

Surgery and procedures

ProcedureCash price List priceInsurers payvs IllinoisOff list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION $1,444.10 $2,063.00 $742.68–$2,947.14 26% above 30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION $1,444.10 $2,063.00 $1,100.00–$3,396.04 — 30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY $1,750.00 $2,500.00 $900.00–$3,571.43 44% above 30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY $1,750.00 $2,500.00 $1,100.00–$3,396.04 — 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CRYOSURGERY 1ST LESION $103.60 $148.00 $53.28–$211.43 41% below 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction Premalignant Lesion 1st RHC $107.80 $154.00 $55.44–$220.00 38% below 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 CRYOSURGERY 1ST LESION $103.60 $148.00 $92.06–$3,396.04 — 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruction Premalignant Lesion 1st RHC $107.80 $154.00 $95.79–$3,396.04 — 30%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY $514.50 $735.00 $264.60–$1,050.00 10% below 30%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY $514.50 $735.00 $457.17–$3,396.04 — 30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal impacted cerumen using irr RHC $26.60 $38.00 $13.68–$54.29 77% below 30%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REM IMPACTED CERUMEN, IRRIGATION UNILAT $41.30 $59.00 $21.24–$84.29 64% below 30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal impacted cerumen using irr RHC $26.60 $38.00 $23.64–$3,396.04 — 30%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REM IMPACTED CERUMEN, IRRIGATION UNILAT $41.30 $59.00 $36.70–$3,396.04 — 30%
Earwax removal with instruments, one ear CPT 69210 Rmvl Impacted Cerumen Spx 1/Both Ears $84.70 $121.00 $43.56–$172.86 32% below 30%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN, ONE OR BOTH EA $99.40 $142.00 $51.12–$202.86 20% below 30%
Earwax removal with instruments, one ear inpatient CPT 69210 Rmvl Impacted Cerumen Spx 1/Both Ears $84.70 $121.00 $75.26–$3,396.04 — 30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN, ONE OR BOTH EA $99.40 $142.00 $88.32–$3,396.04 — 30%
Hemorrhoid banding (rubber band ligation) CPT 46221 COLONOSCOPY WITH HEMORRHOID BANDING $3,507.00 $5,010.00 $1,803.60–$7,157.14 284% above 30%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 COLONOSCOPY WITH HEMORRHOID BANDING $3,507.00 $5,010.00 $1,100.00–$5,010.00 — 30%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain pus from under the skin - TC $43.40 $62.00 $22.32–$88.57 89% below 30%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS $215.60 $308.00 $110.88–$440.00 46% below 30%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess RHC $218.40 $312.00 $112.32–$445.71 46% below 30%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SIMPLE $758.80 $1,084.00 $390.24–$1,548.57 89% above 30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain pus from under the skin - TC $43.40 $62.00 $38.56–$3,396.04 — 30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS $215.60 $308.00 $191.58–$3,396.04 — 30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess RHC $218.40 $312.00 $194.06–$3,396.04 — 30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS SIMPLE $758.80 $1,084.00 $674.25–$3,396.04 — 30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection 1 Tendon Sheath/Ligament RHC $102.90 $147.00 $52.92–$210.00 73% below 30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON, LIGAMENT SINGLE $225.40 $322.00 $115.92–$460.00 41% below 30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection 1 Tendon Sheath/Ligament RHC $102.90 $147.00 $91.43–$3,396.04 — 30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON, LIGAMENT SINGLE $225.40 $322.00 $200.28–$3,396.04 — 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Aspir&/Inj Major Jt RHC $115.50 $165.00 $59.40–$235.71 74% below 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS LARGE JOINT OR BURSA $532.70 $761.00 $273.96–$1,087.14 18% above 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Aspir&/Inj Major Jt RHC $115.50 $165.00 $102.63–$3,396.04 — 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS LARGE JOINT OR BURSA $532.70 $761.00 $473.34–$3,396.04 — 30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion, drug-delivery implant $179.90 $257.00 $92.52–$367.14 43% below 30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert drug-delivery implant (Nexplanon) $179.90 $257.00 $92.52–$367.14 43% below 30%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert drug-delivery implant (Nexplanon) $179.90 $257.00 $159.85–$3,396.04 — 30%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion, drug-delivery implant $179.90 $257.00 $159.85–$3,396.04 — 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION INTER/JOINT/BURSA $91.70 $131.00 $47.16–$187.14 76% below 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Aspir&/Inj Interm J RHC $98.70 $141.00 $50.76–$201.43 75% below 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JOINT ASPIRATION/INJ. INTERMEDIATE JOINT $205.10 $293.00 $105.48–$418.57 47% below 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION INTER/JOINT/BURSA $91.70 $131.00 $81.48–$3,396.04 — 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Aspir&/Inj Interm J RHC $98.70 $141.00 $87.70–$3,396.04 — 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JOINT ASPIRATION/INJ. INTERMEDIATE JOINT $205.10 $293.00 $182.25–$3,396.04 — 30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Aspir&/Inj Sm joint RHC $93.80 $134.00 $48.24–$191.43 69% below 30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 JOINT ASPIRATION/INJ. SMALL JOINT/BURSA $205.10 $293.00 $105.48–$418.57 32% below 30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis Aspir&/Inj Sm joint RHC $93.80 $134.00 $83.35–$3,396.04 — 30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 JOINT ASPIRATION/INJ. SMALL JOINT/BURSA $205.10 $293.00 $182.25–$3,396.04 — 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE WOUND SCALP $375.90 $537.00 $193.32–$767.14 36% below 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACER RPR LAYER 2.5 CM OR LESS SCALP, TR $375.90 $537.00 $193.32–$767.14 36% below 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LACER RPR LAYER 2.5 CM OR LESS SCALP, TR $375.90 $537.00 $334.01–$3,396.04 — 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE WOUND SCALP $375.90 $537.00 $334.01–$3,396.04 — 30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc B9 Les Mrgn Xcp Sk Tg T/A/L 0.5 Cm/< $124.60 $178.00 $64.08–$254.29 82% below 30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc B9 Les Mrgn Xcp Sk Tg T/A/L 0.5 Cm/< $221.90 $317.00 $197.17–$3,396.04 — 30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART OR COMPLETE $123.20 $176.00 $63.36–$251.43 56% below 30%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial/Complete Sim $134.40 $192.00 $69.12–$274.29 52% below 30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE PART/COMPLETE $193.90 $277.00 $99.72–$395.71 31% below 30%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL $213.50 $305.00 $109.80–$435.71 24% below 30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART OR COMPLETE $123.20 $176.00 $109.47–$3,396.04 — 30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE PART/COMPLETE $193.90 $277.00 $172.29–$3,396.04 — 30%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Partial/Complete Sim $199.50 $285.00 $177.27–$3,396.04 — 30%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL $213.50 $305.00 $189.71–$3,396.04 — 30%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS OF ABDOMEN $412.30 $589.00 $212.04–$841.43 71% below 30%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS OF ABDOMEN $412.30 $589.00 $366.36–$3,396.04 — 30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc Nail Matrix Permanent Removal RHC $280.00 $400.00 $144.00–$571.43 55% below 30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 MATRIXECTOMY - EXCISON OF NAIL, PERMANEN $346.50 $495.00 $178.20–$707.14 45% below 30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Exc Nail Matrix Permanent Removal RHC $280.00 $400.00 $248.80–$3,396.04 — 30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 MATRIXECTOMY - EXCISON OF NAIL, PERMANEN $346.50 $495.00 $307.89–$3,396.04 — 30%
Removal of a foreign object under the skin, simple CPT 10120 Inc & Rml foreign body, subq; simple TC $51.80 $74.00 $26.64–$105.71 89% below 30%
Removal of a foreign object under the skin, simple CPT 10120 Incision&removal Foreign Body Subq RHC $200.20 $286.00 $102.96–$408.57 57% below 30%
Removal of a foreign object under the skin, simple CPT 10120 INC/RML FOREIGN BODY SIMPLE $270.20 $386.00 $138.96–$551.43 42% below 30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc & Rml foreign body, subq; simple TC $51.80 $74.00 $46.03–$3,396.04 — 30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision&removal Foreign Body Subq RHC $200.20 $286.00 $177.89–$3,396.04 — 30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/RML FOREIGN BODY SIMPLE $270.20 $386.00 $240.09–$3,396.04 — 30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT $108.50 $155.00 $55.80–$221.43 56% below 30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT $421.40 $602.00 $216.72–$860.00 72% above 30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT $108.50 $155.00 $96.41–$3,396.04 — 30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT $421.40 $602.00 $374.44–$3,396.04 — 30%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT $391.30 $559.00 $201.24–$798.57 57% above 30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT $391.30 $559.00 $347.70–$3,396.04 — 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Scalp/Neck/ RHC $130.90 $187.00 $67.32–$267.14 64% below 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACER RPR SIMP 2.5CM OR LESS SCALP, NECK $493.50 $705.00 $253.80–$1,007.14 36% above 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Repair Scalp/Neck/ RHC $130.90 $187.00 $116.31–$3,396.04 — 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACER RPR SIMP 2.5CM OR LESS SCALP, NECK $493.50 $705.00 $438.51–$3,396.04 — 30%
Skin biopsy, punch, one lesion CPT 11104 Punch biopsy of skin (including simple c $43.40 $62.00 $22.32–$88.57 89% below 30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (TC) $850.50 $1,215.00 $437.40–$1,735.71 121% above 30%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch biopsy of skin (including simple c $216.30 $309.00 $192.20–$3,396.04 — 30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (TC) $850.50 $1,215.00 $755.73–$3,396.04 — 30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE ADULT FAC FEE $1,250.90 $1,787.00 $643.32–$2,552.86 39% above 30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE ADULT $1,421.00 $2,030.00 $730.80–$2,900.00 58% above 30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINAL PUNCTURE $1,421.00 $2,030.00 $730.80–$2,900.00 58% above 30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE ADULT FAC FEE $1,250.90 $1,787.00 $1,100.00–$3,396.04 — 30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE ADULT $1,421.00 $2,030.00 $1,100.00–$3,396.04 — 30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR SPINAL PUNCTURE $1,421.00 $2,030.00 $1,100.00–$3,396.04 — 30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LACER RPR SIMP 2.6-7.5CM SCALP, HANDS $511.00 $730.00 $262.80–$1,042.86 24% above 30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LACER RPR SIMP 2.6-7.5CM SCALP, HANDS $511.00 $730.00 $454.06–$3,396.04 — 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Repair F/E/E/N/L/M 2.5cm/ RHC $358.40 $512.00 $184.32–$731.43 11% below 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACER RPR SIMP 2.5 CM OR LESS FACE, EARS $493.50 $705.00 $253.80–$1,007.14 23% above 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Repair F/E/E/N/L/M 2.5cm/ RHC $358.40 $512.00 $318.46–$3,396.04 — 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LACER RPR SIMP 2.5 CM OR LESS FACE, EARS $493.50 $705.00 $438.51–$3,396.04 — 30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SHAVE $174.30 $249.00 $89.64–$355.71 42% below 30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY SHAVE $174.30 $249.00 $154.88–$3,396.04 — 30%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS GUIDED $431.90 $617.00 $222.12–$881.43 64% below 30%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS GUIDED $431.90 $617.00 $383.77–$3,396.04 — 30%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection Single/Mlt Trigr Pt 1/2 RHC $101.50 $145.00 $52.20–$207.14 79% below 30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE OR MULTIPLE TRIGGER PTS 1-2 $120.40 $172.00 $61.92–$245.71 76% below 30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINTS 1 OR 2 MUSCLES $898.10 $1,283.00 $461.88–$1,832.86 82% above 30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection Single/Mlt Trigr Pt 1/2 RHC $101.50 $145.00 $90.19–$3,396.04 — 30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE OR MULTIPLE TRIGGER PTS 1-2 $120.40 $172.00 $106.98–$3,396.04 — 30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINTS 1 OR 2 MUSCLES $898.10 $1,283.00 $798.03–$3,396.04 — 30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BIOPSY 1ST LESION $3,088.40 $4,412.00 $1,588.32–$6,302.86 28% above 30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BIOPSY 1ST LESION $3,088.40 $4,412.00 $1,100.00–$4,412.00 — 30%
Wart removal, up to 14 warts CPT 17110 DESTRUCT LESION BENIGN UP TO 14 $99.40 $142.00 $51.12–$202.86 57% below 30%
Wart removal, up to 14 warts CPT 17110 Destruction Benign Lesions Up To 14 $219.10 $313.00 $112.68–$447.14 6% below 30%
Wart removal, up to 14 warts CPT 17110 Destruction Benign Lesions Up To 14 RHC $219.10 $313.00 $112.68–$447.14 6% below 30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT LESION BENIGN UP TO 14 $99.40 $142.00 $88.32–$3,396.04 — 30%
Wart removal, up to 14 warts inpatient CPT 17110 Destruction Benign Lesions Up To 14 $219.10 $313.00 $194.69–$3,396.04 — 30%
Wart removal, up to 14 warts inpatient CPT 17110 Destruction Benign Lesions Up To 14 RHC $219.10 $313.00 $194.69–$3,396.04 — 30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCU TISSUE 20 SQ CM OR LES $143.50 $205.00 $73.80–$292.86 78% below 30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN SBQ TISSUE <=20SQ CM $851.20 $1,216.00 $437.76–$1,737.14 28% above 30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCU TISSUE 20 SQ CM OR LES $143.50 $205.00 $127.51–$3,396.04 — 30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN SBQ TISSUE <=20SQ CM $851.20 $1,216.00 $756.35–$3,396.04 — 30%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs IllinoisOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION START $660.80 $944.00 $339.84–$1,348.57 29% below 30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION ADMINISTRATION $931.70 $1,331.00 $479.16–$1,901.43 at median 30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION ADMIN 1 UNIT $931.70 $1,331.00 $479.16–$1,901.43 at median 30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION ADMIN 2 UNIT $1,204.00 $1,720.00 $619.20–$2,457.14 29% above 30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION ADMIN 3 UNIT $1,475.60 $2,108.00 $758.88–$3,011.43 58% above 30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION ADMIN 4 UNIT $1,747.20 $2,496.00 $898.56–$3,565.71 87% above 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION START $660.80 $944.00 $587.17–$3,396.04 — 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION ADMINISTRATION $931.70 $1,331.00 $827.88–$3,396.04 — 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION ADMIN 1 UNIT $931.70 $1,331.00 $827.88–$3,396.04 — 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION ADMIN 2 UNIT $1,204.00 $1,720.00 $1,069.84–$3,396.04 — 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION ADMIN 3 UNIT $1,475.60 $2,108.00 $1,100.00–$3,396.04 — 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION ADMIN 4 UNIT $1,747.20 $2,496.00 $1,100.00–$3,396.04 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT $29.40 $42.00 $15.12–$60.00 84% below 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized/Nonpres Inhalation Tr RHC $33.60 $48.00 $17.28–$68.57 82% below 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EzPAP - HYPERINFLATION THERAPY INITIAL $86.80 $124.00 $44.64–$177.14 54% below 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI (METERED DOSE INHALER) INITIAL $195.30 $279.00 $100.44–$398.57 4% above 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TREATMENT INITIAL $195.30 $279.00 $100.44–$398.57 4% above 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TREATMENT ER INITIAL $195.30 $279.00 $100.44–$398.57 4% above 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT $29.40 $42.00 $26.12–$3,396.04 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pressurized/Nonpres Inhalation Tr RHC $33.60 $48.00 $29.86–$3,396.04 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EzPAP - HYPERINFLATION THERAPY INITIAL $86.80 $124.00 $77.13–$3,396.04 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI (METERED DOSE INHALER) INITIAL $195.30 $279.00 $173.54–$3,396.04 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TREATMENT INITIAL $195.30 $279.00 $173.54–$3,396.04 — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TREATMENT ER INITIAL $195.30 $279.00 $173.54–$3,396.04 — 30%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION UP TO ONE HOUR $515.90 $737.00 $265.32–$1,052.86 18% below 30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION UP TO ONE HOUR $515.90 $737.00 $458.41–$3,396.04 — 30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MINUTES $1,971.20 $2,816.00 $1,013.76–$4,022.86 2% above 30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 MINUTES $1,971.20 $2,816.00 $1,100.00–$3,396.04 — 30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 ELECTROENCEPHALOGRAPHY WAKE/DROWSY 21-40 $397.60 $568.00 $204.48–$811.43 52% below 30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 ELECTROENCEPHALOGRAPHY WAKE/DROWSY 21-40 $397.60 $568.00 $353.30–$3,396.04 — 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG $252.70 $361.00 $129.96–$515.71 9% above 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG $252.70 $361.00 $224.54–$3,396.04 — 30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL ONE $296.10 $423.00 $152.28–$604.29 44% above 30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL ONE $296.10 $423.00 $263.11–$3,396.04 — 30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL TWO $409.50 $585.00 $210.60–$835.71 5% above 30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL TWO $409.50 $585.00 $363.87–$3,396.04 — 30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL THREE $740.60 $1,058.00 $380.88–$1,511.43 7% above 30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL THREE $740.60 $1,058.00 $658.08–$3,396.04 — 30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL FOUR $1,026.90 $1,467.00 $528.12–$2,095.71 9% below 30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL FOUR $1,026.90 $1,467.00 $912.47–$3,396.04 — 30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL FIVE $1,472.80 $2,104.00 $757.44–$3,005.71 12% below 30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL FIVE $1,472.80 $2,104.00 $1,100.00–$3,396.04 — 30%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST $1,180.90 $1,687.00 $607.32–$2,410.00 24% above 30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST $1,180.90 $1,687.00 $1,049.31–$3,396.04 — 30%
Family therapy with the patient, 50 minutes CPT 90847 PSYCH FAMILY W/PATIENT $266.70 $381.00 $137.16–$544.29 49% above 30%
Family therapy with the patient, 50 minutes CPT 90847 Family psychotx WITH patient 50 min $288.40 $412.00 $148.32–$588.57 61% above 30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PSYCH FAMILY W/PATIENT $266.70 $381.00 $236.98–$3,396.04 — 30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family psychotx WITH patient 50 min $288.40 $412.00 $256.26–$3,396.04 — 30%
Family therapy without the patient, 50 minutes CPT 90846 PSYCH FAMILY W/O PATIENT $266.70 $381.00 $137.16–$544.29 41% above 30%
Family therapy without the patient, 50 minutes CPT 90846 Family psychotx W/O patient 50 min $279.30 $399.00 $143.64–$570.00 48% above 30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PSYCH FAMILY W/O PATIENT $266.70 $381.00 $236.98–$3,396.04 — 30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family psychotx W/O patient 50 min $279.30 $399.00 $248.18–$3,396.04 — 30%
Group psychotherapy session CPT 90853 PSYCH GROUP THERAPY $305.90 $437.00 $157.32–$624.29 150% above 30%
Group psychotherapy session inpatient CPT 90853 PSYCH GROUP THERAPY $305.90 $437.00 $271.81–$3,396.04 — 30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF UP TO ONE HOUR, HYDRATION $312.90 $447.00 $160.92–$638.57 10% below 30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION UP TO ONE HOUR $312.90 $447.00 $160.92–$638.57 10% below 30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 31-60 $312.90 $447.00 $160.92–$638.57 10% below 30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION UP TO ONE HOUR $312.90 $447.00 $278.03–$3,396.04 — 30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF UP TO ONE HOUR, HYDRATION $312.90 $447.00 $278.03–$3,396.04 — 30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 31-60 $312.90 $447.00 $278.03–$3,396.04 — 30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION DIAGNOSTIC UP TO ONE HOUR $112.70 $161.00 $57.96–$230.00 73% below 30%
IV infusion of a medicine, first hour CPT 96365 IV INF DX OR THERAPUTIC UP TO ONE HOUR $354.20 $506.00 $182.16–$722.86 16% below 30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION DX/TX 1ST DRUG MIN 16 MINS $354.20 $506.00 $182.16–$722.86 16% below 30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION DIAGNOSTIC UP TO 1 HOUR $354.20 $506.00 $182.16–$722.86 16% below 30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION DIAGNOSTIC UP TO ONE HOUR $112.70 $161.00 $100.14–$3,396.04 — 30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF DX OR THERAPUTIC UP TO ONE HOUR $354.20 $506.00 $314.73–$3,396.04 — 30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION DIAGNOSTIC UP TO 1 HOUR $354.20 $506.00 $314.73–$3,396.04 — 30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION DX/TX 1ST DRUG MIN 16 MINS $354.20 $506.00 $314.73–$3,396.04 — 30%
IV push of a medicine, first drug CPT 96374 INJ INTRAVENOUS INITIAL SUBSTANCE $228.20 $326.00 $117.36–$465.71 6% above 30%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL SUBSTANCE $228.20 $326.00 $117.36–$465.71 6% above 30%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL SUBSTANCE $228.20 $326.00 $202.77–$3,396.04 — 30%
IV push of a medicine, first drug inpatient CPT 96374 INJ INTRAVENOUS INITIAL SUBSTANCE $228.20 $326.00 $202.77–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic Prophylactic/Dx Inj RHC $35.00 $50.00 $18.00–$71.43 68% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION, SUBCUTANEOUS OR IM $39.20 $56.00 $20.16–$80.00 64% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF ANTIBIOTIC IM/SQ $91.00 $130.00 $46.80–$185.71 17% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC OR DIAGNOSTIC $92.40 $132.00 $47.52–$188.57 15% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ OR INTRAMUSCULAR $92.40 $132.00 $47.52–$188.57 15% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBCUTANEOUS OR INTRAMUSCULAR $92.40 $132.00 $47.52–$188.57 15% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPUTIC OR DIAGNOSTIC $92.40 $132.00 $47.52–$188.57 15% below 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapeutic Prophylactic/Dx Inj RHC $35.00 $50.00 $31.10–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION, SUBCUTANEOUS OR IM $39.20 $56.00 $34.83–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION OF ANTIBIOTIC IM/SQ $91.00 $130.00 $80.86–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBQ OR INTRAMUSCULAR $92.40 $132.00 $82.10–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC OR DIAGNOSTIC $92.40 $132.00 $82.10–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBCUTANEOUS OR INTRAMUSCULAR $92.40 $132.00 $82.10–$3,396.04 — 30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPUTIC OR DIAGNOSTIC $92.40 $132.00 $82.10–$3,396.04 — 30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH INITIAL EVALUATION $399.00 $570.00 $205.20–$814.29 58% above 30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH INITIAL EVALUATION $399.00 $570.00 $354.54–$3,396.04 — 30%
New patient office visit, about 30 minutes CPT 99203 NEW PT VISIT 3 LOW MDM -TC $48.30 $69.00 $24.84–$98.57 77% below 30%
New patient office visit, about 30 minutes CPT 99203 NEW PT VISIT LEVEL 3 $350.00 $500.00 $180.00–$714.29 63% above 30%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT VISIT 3 LOW MDM -TC $48.30 $69.00 $42.92–$3,396.04 — 30%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT VISIT LEVEL 3 $350.00 $500.00 $311.00–$3,396.04 — 30%
New patient office visit, about 45 minutes CPT 99204 NEW PT VISIT 4 MODERATE MDM -TC $65.80 $94.00 $33.84–$134.29 78% below 30%
New patient office visit, about 45 minutes CPT 99204 NEW PT VISIT LEVEL 4 $432.60 $618.00 $222.48–$882.86 47% above 30%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT VISIT 4 MODERATE MDM -TC $65.80 $94.00 $58.47–$3,396.04 — 30%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT VISIT LEVEL 4 $432.60 $618.00 $384.40–$3,396.04 — 30%
New patient office visit, about 60 minutes CPT 99205 NEW PT VISIT 5 HIGH MDM -TC $79.10 $113.00 $40.68–$161.43 78% below 30%
New patient office visit, about 60 minutes CPT 99205 NEW PT VISIT 5 HIGH MDM RHC $278.60 $398.00 $143.28–$568.57 24% below 30%
New patient office visit, about 60 minutes CPT 99205 NEW PT VISIT LEVEL 5 $548.80 $784.00 $282.24–$1,120.00 50% above 30%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT VISIT 5 HIGH MDM -TC $79.10 $113.00 $70.29–$3,396.04 — 30%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT VISIT 5 HIGH MDM RHC $278.60 $398.00 $247.56–$3,396.04 — 30%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT VISIT LEVEL 5 $548.80 $784.00 $487.65–$3,396.04 — 30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT VISIT 2 STRAIGHTFORWARD MDM -TC $41.30 $59.00 $21.24–$84.29 74% below 30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT VISIT LEVEL 2 $266.00 $380.00 $136.80–$542.86 70% above 30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT VISIT 2 STRAIGHTFORWARD MDM -TC $41.30 $59.00 $36.70–$3,396.04 — 30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT VISIT LEVEL 2 $266.00 $380.00 $236.36–$3,396.04 — 30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DIETARY CONSULT PER 15 MINUTES FACILITY $26.60 $38.00 $13.68–$54.29 51% below 30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DIETARY CONSULT PER 15 MINUTES $70.00 $100.00 $36.00–$142.86 29% above 30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DIETARY CONSULT PER 15 MINUTES FACILITY $26.60 $38.00 $23.64–$3,396.04 — 30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DIETARY CONSULT PER 15 MINUTES $70.00 $100.00 $62.20–$3,396.04 — 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HEALTH PROMOTION EXERCISE, PER 1/2 HOUR $72.10 $103.00 $37.08–$147.14 40% below 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT-IND THERAPY-ONSITE/15 MIN $120.40 $172.00 $61.92–$245.71 at median 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PHYS THERAPY-IND THERAPY-OFFSITE/15 MIN $128.80 $184.00 $66.24–$262.86 7% above 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HEALTH PROMOTION EXERCISE, PER 1/2 HOUR $72.10 $103.00 $64.07–$3,396.04 — 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT-IND THERAPY-ONSITE/15 MIN $120.40 $172.00 $106.98–$3,396.04 — 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PHYS THERAPY-IND THERAPY-OFFSITE/15 MIN $128.80 $184.00 $114.45–$3,396.04 — 30%
Preventive checkup, new patient aged 65 or older CPT 99387 1st Preventive Medicine New Pt Age RHC $198.10 $283.00 $101.88–$404.29 6% below 30%
Preventive checkup, new patient aged 65 or older CPT 99387 1st Preventive Medicine New Patient Age $198.10 $283.00 $101.88–$404.29 6% below 30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 1st Preventive Medicine New Patient Age $198.10 $283.00 $176.03–$3,396.04 — 30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 1st Preventive Medicine New Pt Age RHC $198.10 $283.00 $176.03–$3,396.04 — 30%
Preventive checkup, returning patient aged 65 or older CPT 99397 Periodic Prev Med Est Patient 65+ $166.60 $238.00 $85.68–$340.00 22% below 30%
Preventive checkup, returning patient aged 65 or older CPT 99397 Periodic Preventive Med Est Patient Age $166.60 $238.00 $85.68–$340.00 22% below 30%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Periodic Prev Med Est Patient 65+ $166.60 $238.00 $148.04–$3,396.04 — 30%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Periodic Preventive Med Est Patient Age $166.60 $238.00 $148.04–$3,396.04 — 30%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SERVICES $399.00 $570.00 $205.20–$814.29 43% above 30%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SERVICES $399.00 $570.00 $354.54–$3,396.04 — 30%
Psychotherapy session, 30 minutes CPT 90832 PSYCH THERAPY INDV 16-37 MIN $249.20 $356.00 $128.16–$508.57 33% above 30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCH THERAPY INDV 16-37 MIN $249.20 $356.00 $221.43–$3,396.04 — 30%
Psychotherapy session, 45 minutes CPT 90834 PSYCH THERAPY INDV 38-52 MIN $278.60 $398.00 $143.28–$568.57 37% above 30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH THERAPY INDV 38-52 MIN $278.60 $398.00 $247.56–$3,396.04 — 30%
Psychotherapy session, 60 minutes CPT 90837 PSYCH THERAPY INDV 60 MIN $441.00 $630.00 $226.80–$900.00 46% above 30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCH THERAPY INDV 60 MIN $441.00 $630.00 $391.86–$3,396.04 — 30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION INTERMEDIATE 3-10 MIN $24.50 $35.00 $12.60–$50.00 28% below 30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Stop smoking or tobacco use 3-10 min $25.20 $36.00 $12.96–$51.43 26% below 30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Stop smoking or tobacco use 3-10 min RHC $25.20 $36.00 $12.96–$51.43 26% below 30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION INTERMEDIATE 3-10 MIN $24.50 $35.00 $21.77–$3,396.04 — 30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Stop smoking or tobacco use 3-10 min $25.20 $36.00 $22.39–$3,396.04 — 30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Stop smoking or tobacco use 3-10 min RHC $25.20 $36.00 $22.39–$3,396.04 — 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT VISIT 5 HIGH MDM -TC $70.70 $101.00 $36.36–$144.29 74% below 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 $267.40 $382.00 $137.52–$545.71 3% below 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT VISIT LEVEL 5 $465.50 $665.00 $239.40–$950.00 68% above 30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PT VISIT 5 HIGH MDM -TC $70.70 $101.00 $62.82–$3,396.04 — 30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT LEVEL 5 $267.40 $382.00 $237.60–$3,396.04 — 30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PT VISIT LEVEL 5 $465.50 $665.00 $413.63–$3,396.04 — 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT VISIT 3 LOW MDM -TC $51.10 $73.00 $26.28–$104.29 66% below 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 $151.90 $217.00 $78.12–$310.00 at median 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT VISIT 3 LOW MDM -GL $269.50 $385.00 $138.60–$550.00 78% above 30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PT VISIT 3 LOW MDM -TC $51.10 $73.00 $45.41–$3,396.04 — 30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT LEVEL 3 $151.90 $217.00 $134.97–$3,396.04 — 30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PT VISIT 3 LOW MDM -GL $269.50 $385.00 $239.47–$3,396.04 — 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT VISIT 4 MODERATE MDM -TC $53.90 $77.00 $27.72–$110.00 70% below 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 $210.00 $300.00 $108.00–$428.57 18% above 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT VISIT LEVEL 4 $350.00 $500.00 $180.00–$714.29 97% above 30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PT VISIT 4 MODERATE MDM -TC $53.90 $77.00 $47.89–$3,396.04 — 30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT LEVEL 4 $210.00 $300.00 $186.60–$3,396.04 — 30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PT VISIT LEVEL 4 $350.00 $500.00 $311.00–$3,396.04 — 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT VISIT 2 STRAIGHTFORWARD MDM -TC $32.20 $46.00 $16.56–$65.71 73% below 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 $113.40 $162.00 $58.32–$231.43 6% below 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT VISIT LEVEL 2 $266.00 $380.00 $136.80–$542.86 122% above 30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PT VISIT 2 STRAIGHTFORWARD MDM -TC $32.20 $46.00 $28.61–$3,396.04 — 30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT LEVEL 2 $113.40 $162.00 $100.76–$3,396.04 — 30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PT VISIT LEVEL 2 $266.00 $380.00 $236.36–$3,396.04 — 30%
Spirometry (breathing test) CPT 94010 PULMONARY SCREENING TEST $81.20 $116.00 $41.76–$165.71 73% below 30%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION SCREEN $104.30 $149.00 $53.64–$212.86 66% below 30%
Spirometry (breathing test) CPT 94010 SPIROMETRY TOTAL & TIMED VITAL CAPACITY $197.40 $282.00 $101.52–$402.86 35% below 30%
Spirometry (breathing test) inpatient CPT 94010 PULMONARY SCREENING TEST $81.20 $116.00 $72.15–$3,396.04 — 30%
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION SCREEN $104.30 $149.00 $92.68–$3,396.04 — 30%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY TOTAL & TIMED VITAL CAPACITY $197.40 $282.00 $175.40–$3,396.04 — 30%
Spirometry before and after a bronchodilator CPT 94060 PULMONARY FUNCTION W/ BRONCHO DIALATOR $263.20 $376.00 $135.36–$537.14 50% below 30%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY W/ BRONCHO DIALATOR $557.20 $796.00 $286.56–$1,137.14 6% above 30%
Spirometry before and after a bronchodilator inpatient CPT 94060 PULMONARY FUNCTION W/ BRONCHO DIALATOR $263.20 $376.00 $233.87–$3,396.04 — 30%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY W/ BRONCHO DIALATOR $557.20 $796.00 $495.11–$3,396.04 — 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES EACH 15 MINUTES $35.00 $50.00 $18.00–$71.43 73% below 30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES EACH 15 MINUTES $35.00 $50.00 $31.10–$3,396.04 — 30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC $189.00 $270.00 $97.20–$385.71 9% below 30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC $189.00 $270.00 $167.94–$3,396.04 — 30%

Vaccines

ProcedureCash price List priceInsurers payvs IllinoisOff list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad RHC $115.99 $165.70 $59.65–$236.71 4% below 30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLUAD (FLU VACCINE HD) 0.5ML 65+ PFS $131.47 $187.82 $67.62–$268.31 9% above 30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Fluad RHC $115.99 $165.70 $103.07–$3,396.04 — 30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLUAD (FLU VACCINE HD) 0.5ML 65+ PFS $131.47 $187.82 $116.82–$3,396.04 — 30%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (VARICELLA - LIVE) 0.5ML SDV $337.40 $482.00 $173.52–$688.57 22% above 30%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (VARICELLA - LIVE) 0.5ML SDV $337.40 $482.00 $299.80–$3,396.04 — 30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (DTaP-IPV) 0.5ML PFS* $140.70 $201.00 $72.36–$287.14 37% above 30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (DTaP-IPV) 0.5ML PFS* $140.70 $201.00 $125.02–$3,396.04 — 30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTaP) 0.5ML PFS* $66.50 $95.00 $34.20–$135.71 4% above 30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTaP) 0.5ML PFS* $66.50 $95.00 $59.09–$3,396.04 — 30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (DTaP-HepB-IPV) 0.5ML PFS*MOB $193.90 $277.00 $99.72–$395.71 22% above 30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (DTaP-HepB-IPV) 0.5ML PFS*MOB $193.90 $277.00 $172.29–$3,396.04 — 30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Alfuria RHC $42.35 $60.50 $21.78–$86.43 23% above 30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AFLURIA (INFLUENZA) VACCINE 0.5ML PFS $48.34 $69.05 $24.86–$98.64 40% above 30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone RHC $51.45 $73.50 $26.46–$105.00 50% above 30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE (INFLUENZA) VACCINE 0.5ML PFS* $53.90 $77.00 $27.72–$110.00 57% above 30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE 10 SYRINGES/BX $185.50 $265.00 $95.40–$378.57 439% above 30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Alfuria RHC $42.35 $60.50 $37.63–$3,396.04 — 30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AFLURIA (INFLUENZA) VACCINE 0.5ML PFS $48.34 $69.05 $42.95–$3,396.04 — 30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone RHC $51.45 $73.50 $45.72–$3,396.04 — 30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE (INFLUENZA) VACCINE 0.5ML PFS* $53.90 $77.00 $47.89–$3,396.04 — 30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE 10 SYRINGES/BX $185.50 $265.00 $164.83–$3,396.04 — 30%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (HPV) 0.5ML PFS* $567.70 $811.00 $291.96–$1,158.57 16% above 30%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (HPV) 0.5ML PFS* $567.70 $811.00 $504.44–$3,396.04 — 30%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (HepA - INACTIVATED) 0.5ML PFS* $88.20 $126.00 $45.36–$180.00 27% below 30%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE(HAVRIX) 1ML* $156.10 $223.00 $80.28–$318.57 30% above 30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (HepA - INACTIVATED) 0.5ML PFS* $88.20 $126.00 $78.37–$3,396.04 — 30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE(HAVRIX) 1ML* $156.10 $223.00 $138.71–$3,396.04 — 30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B ADULT 20MCG/ML PFS $196.00 $280.00 $100.80–$400.00 82% above 30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B ADULT 20MCG/ML PFS $196.00 $280.00 $174.16–$3,396.04 — 30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDS (HEP B) 10MCG/0.5ML PFS $60.20 $86.00 $30.96–$122.86 31% below 30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDS (HEP B) 10MCG/0.5ML PFS $60.20 $86.00 $53.49–$3,396.04 — 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIBERIX (PRP-T) VACCINE (Hib) 0.5ML SDV $43.40 $62.00 $22.32–$88.57 18% below 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 PEDvaxHIB $69.30 $99.00 $35.64–$141.43 31% above 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hemophilus Influenza B Vaccine Prp-T 4 D $70.00 $100.00 $36.00–$142.86 32% above 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIBERIX (PRP-T) VACCINE (Hib) 0.5ML SDV $43.40 $62.00 $38.56–$3,396.04 — 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 PEDvaxHIB $69.30 $99.00 $61.58–$3,396.04 — 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hemophilus Influenza B Vaccine Prp-T 4 D $70.00 $100.00 $62.20–$3,396.04 — 30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Vaccine Splt Prsrv Free Inc An $70.00 $100.00 $36.00–$142.86 9% below 30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUAD (INFLUENZA AD) 0.5ML 65+ PFS* $104.30 $149.00 $53.64–$212.86 35% above 30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH DOSE 0.5ML 65+ PFS* $112.70 $161.00 $57.96–$230.00 46% above 30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Vaccine Splt Prsrv Free Inc An $70.00 $100.00 $62.20–$3,396.04 — 30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUAD (INFLUENZA AD) 0.5ML 65+ PFS* $104.30 $149.00 $92.68–$3,396.04 — 30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH DOSE 0.5ML 65+ PFS* $112.70 $161.00 $100.14–$3,396.04 — 30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II VACCINE 0.5ML SDV $189.00 $270.00 $97.20–$385.71 5% below 30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II VACCINE 0.5ML SDV $189.00 $270.00 $167.94–$3,396.04 — 30%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 ProQuad (MMRV) 0.5ML SDV* $553.00 $790.00 $284.40–$1,128.57 33% above 30%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 ProQuad (MMRV) 0.5ML SDV* $553.00 $790.00 $491.38–$3,396.04 — 30%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MenQuadfi (MenACWY-TT) 0.5ML SDV-MOB $329.00 $470.00 $169.20–$671.43 29% above 30%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MenQuadfi (MenACWY-TT) 0.5ML SDV-MOB $329.00 $470.00 $292.34–$3,396.04 — 30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal Conj Vaccine 13 Valent RHC $227.50 $325.00 $117.00–$464.29 37% below 30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal Conj Vaccine 13 Valent Im $227.50 $325.00 $117.00–$464.29 37% below 30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal Conj Vaccine 13 Valent Im $227.50 $325.00 $202.15–$3,396.04 — 30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal Conj Vaccine 13 Valent RHC $227.50 $325.00 $202.15–$3,396.04 — 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 Vaccine IM RHC $254.80 $364.00 $131.04–$520.00 43% below 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PNEUMOCOCCAL 20) 0.5ML PFS $535.50 $765.00 $275.40–$1,092.86 21% above 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 Vaccine IM RHC $254.80 $364.00 $226.41–$3,396.04 — 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PNEUMOCOCCAL 20) 0.5ML PFS $535.50 $765.00 $475.83–$3,396.04 — 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Polysac Vaccine 23-V 2 Yr + $134.40 $192.00 $69.12–$274.29 27% below 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL (PNEUMOVAX)-23 0.5ML PFS $259.00 $370.00 $133.20–$528.57 41% above 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Polysac Vaccine 23-V 2 Yr + $134.40 $192.00 $119.42–$3,396.04 — 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL (PNEUMOVAX)-23 0.5ML PFS $259.00 $370.00 $230.14–$3,396.04 — 30%
Rabies vaccine, one dose CPT 90675 RABAVERT (RABIES VACCINE) 1ML PFS $840.00 $1,200.00 $432.00–$1,714.29 12% above 30%
Rabies vaccine, one dose CPT 90675 IMOVAX (RABIES VACCINE) 1ML PFS $855.40 $1,222.00 $439.92–$1,745.71 14% above 30%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (RABIES VACCINE) 1ML PFS $840.00 $1,200.00 $746.40–$3,396.04 — 30%
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX (RABIES VACCINE) 1ML PFS $855.40 $1,222.00 $760.08–$3,396.04 — 30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rota Teq (RV5) ORAL LIQUIDR 2ML* $202.30 $289.00 $104.04–$412.86 37% above 30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rota Teq (RV5) ORAL LIQUIDR 2ML* $202.30 $289.00 $179.76–$3,396.04 — 30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Toxoids Adsorbed Prsrv Fr 7 Yr + Im $23.80 $34.00 $12.24–$48.57 69% below 30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIP TOXOID 0.5ML PFS $171.50 $245.00 $88.20–$350.00 123% above 30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Toxoids Adsorbed Prsrv Fr 7 Yr + Im $23.80 $34.00 $21.15–$3,396.04 — 30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIP TOXOID 0.5ML PFS $171.50 $245.00 $152.39–$3,396.04 — 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vaccine 7 Yr + Im RHC $46.20 $66.00 $23.76–$94.29 54% below 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YEARS OR OLDER $119.00 $170.00 $61.20–$242.86 18% above 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETanus/DIP/PERTUSSIS (ADACEL) 0.5ML PFS $233.10 $333.00 $119.88–$475.71 131% above 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vaccine 7 Yr + Im RHC $46.20 $66.00 $41.05–$3,396.04 — 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YEARS OR OLDER $119.00 $170.00 $105.74–$3,396.04 — 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETanus/DIP/PERTUSSIS (ADACEL) 0.5ML PFS $233.10 $333.00 $207.13–$3,396.04 — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION $32.90 $47.00 $16.92–$67.14 43% below 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imadm Prq Id Subq/Im Njxs 1 Vacc $34.30 $49.00 $17.64–$70.00 40% below 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE $76.30 $109.00 $39.24–$155.71 33% above 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION $32.90 $47.00 $29.23–$3,396.04 — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Imadm Prq Id Subq/Im Njxs 1 Vacc $34.30 $49.00 $30.48–$3,396.04 — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE $76.30 $109.00 $67.80–$3,396.04 — 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN EA ADDTL $19.60 $28.00 $10.08–$40.00 50% below 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM VAC EACH ADDITIONAL $24.50 $35.00 $12.60–$50.00 38% below 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imadm Prq Id Subq/Im Njxs Ea Vacc $24.50 $35.00 $12.60–$50.00 38% below 30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN EA ADDTL $19.60 $28.00 $17.42–$3,396.04 — 30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Imadm Prq Id Subq/Im Njxs Ea Vacc $24.50 $35.00 $21.77–$3,396.04 — 30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADM VAC EACH ADDITIONAL $24.50 $35.00 $21.77–$3,396.04 — 30%

Source file: https://hospitalpricetransparencyfiles.com/carlinville-area-hospital-association/370645239_Carlinville-Area-Hospital-Association_standardcharges.csv