Hospital Sierra Vista-Douglas, AZ

Copper Queen Community Hospital

Copper Queen Community Hospital in Bisbee, AZ publishes cash prices for 372 common procedures listed here, from its own machine-readable price file updated Oct 7, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Arizona median for 270 of 364 procedures and below it for 90. By typical cash price it ranks #41 of 53 Arizona hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

101 Cole Avenue, Bisbee, AZ 85603 Collected Oct 14, 2026 Source price file Check a bill from this hospital (520) 432-6401

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 031312 · CMS hospital register NPI 1518968767

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Copper Queen Community Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast	$3,290.40	$4,113.00	$271.40–$3,701.70	118% above	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast	$3,290.40	$4,113.00	$3,701.70	—	20%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views	$324.00	$405.00	$34.76–$364.50	51% above	20%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views	$324.00	$405.00	$364.50	—	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Right	$368.00	$460.00	$34.44–$414.00	147% above	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Left	$369.60	$462.00	$34.44–$415.80	148% above	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Right	$368.00	$460.00	$414.00	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Left	$369.60	$462.00	$415.80	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES	$333.60	$417.00	$66.05–$375.30	11% below	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES	$333.60	$417.00	$375.30	—	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Right	$1,881.60	$2,352.00	$372.56–$2,116.80	117% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Left	$1,936.00	$2,420.00	$383.33–$2,178.00	123% above	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Right	$1,881.60	$2,352.00	$2,116.80	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Left	$1,936.00	$2,420.00	$2,178.00	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Left Complete	$676.00	$845.00	$133.85–$760.50	189% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Right Complete	$676.00	$845.00	$133.85–$760.50	189% above	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Right Complete	$676.00	$845.00	$760.50	—	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Left Complete	$676.00	$845.00	$760.50	—	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Right Limited	$571.20	$714.00	$113.10–$642.60	179% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Left Limited	$571.20	$714.00	$113.10–$642.60	179% above	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Right Limited	$571.20	$714.00	$642.60	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Left Limited	$571.20	$714.00	$642.60	—	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angiography Abdomen/Pelvis	$4,699.20	$5,874.00	$539.81–$5,286.60	182% above	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angiography Abdomen/Pelvis	$4,699.20	$5,874.00	$5,286.60	—	20%
CT angiography (CTA) of the head CPT 70496 CT Angiography Head w/ Contrast	$3,306.40	$4,133.00	$271.40–$3,719.70	189% above	20%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angiography Head w/ Contrast	$3,306.40	$4,133.00	$3,719.70	—	20%
CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck w/ Contrast	$3,300.80	$4,126.00	$271.40–$3,713.40	186% above	20%
CT angiography (CTA) of the neck CPT 70498 CQCH CT Angiography Neck w/ Contrast	$3,458.40	$4,323.00	$271.40–$3,890.70	200% above	20%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angiography Neck w/ Contrast	$3,300.80	$4,126.00	$3,713.40	—	20%
CT angiography (CTA) of the neck inpatient CPT 70498 CQCH CT Angiography Neck w/ Contrast	$3,458.40	$4,323.00	$3,890.70	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/ Contrast	$3,340.00	$4,175.00	$271.40–$3,757.50	170% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest w/ Contrast	$3,340.00	$4,175.00	$3,757.50	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis w/o Contrast	$3,628.00	$4,535.00	$369.18–$4,081.50	177% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis w/o Contrast	$3,628.00	$4,535.00	$4,081.50	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w/ Contrast	$3,668.00	$4,585.00	$539.81–$4,126.50	81% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w/ Contrast	$3,668.00	$4,585.00	$4,126.50	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis w + w/o Contrast	$4,139.20	$5,174.00	$539.81–$4,656.60	76% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen/Pelvis w + w/o Contrast	$4,139.20	$5,174.00	$4,656.60	—	20%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$2,901.60	$3,627.00	$271.40–$3,264.30	134% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$2,901.60	$3,627.00	$3,264.30	—	20%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast	$1,916.00	$2,395.00	$161.76–$2,155.50	118% above	20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast	$1,916.00	$2,395.00	$2,155.50	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast Read	$1,570.40	$1,963.00	$161.76–$1,766.70	97% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$1,652.80	$2,066.00	$161.76–$1,859.40	107% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast Read	$1,570.40	$1,963.00	$1,766.70	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$1,652.80	$2,066.00	$1,859.40	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 CLIENT CT HEAD WO CONTR	$241.79	$302.24	$47.87–$272.02	72% below	20%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast	$1,430.52	$1,788.15	$161.76–$1,609.34	65% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CLIENT CT HEAD WO CONTR	$241.79	$302.24	$272.02	—	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast	$1,430.52	$1,788.15	$1,609.34	—	20%
CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast	$1,677.60	$2,097.00	$271.40–$1,887.30	46% above	20%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast	$1,677.60	$2,097.00	$1,887.30	—	20%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast	$2,059.20	$2,574.00	$271.40–$2,316.60	56% above	20%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Contrast	$2,059.20	$2,574.00	$2,316.60	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$1,774.98	$2,218.72	$161.76–$1,996.85	66% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$1,774.98	$2,218.72	$1,996.85	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$2,359.20	$2,949.00	$161.76–$2,654.10	121% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$2,359.20	$2,949.00	$2,654.10	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$2,924.00	$3,655.00	$271.40–$3,289.50	167% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$2,924.00	$3,655.00	$3,289.50	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Bilateral	$1,259.20	$1,574.00	$249.32–$1,416.60	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Doppler Bilateral	$1,259.20	$1,574.00	$1,416.60	—	20%
Chest CT scan without and with contrast CPT 71270 CT Chest W/WO Contrast	$2,336.00	$2,920.00	$271.40–$2,628.00	70% above	20%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest W/WO Contrast	$2,336.00	$2,920.00	$2,628.00	—	20%
Chest X-ray, 2 views CPT 71046 CLIENT CHEST TWO VIEW	$57.60	$72.00	$11.40–$134.65	67% below	20%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$363.20	$454.00	$31.86–$408.60	108% above	20%
Chest X-ray, 2 views inpatient CPT 71046 CLIENT CHEST TWO VIEW	$57.60	$72.00	$64.80	—	20%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$363.20	$454.00	$408.60	—	20%
Chest X-ray, single view CPT 71045 XR Chest 1 View	$267.20	$334.00	$24.14–$300.60	138% above	20%
Chest X-ray, single view CPT 71045 XR Chest 1 View Special	$267.20	$334.00	$24.14–$300.60	138% above	20%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$267.20	$334.00	$300.60	—	20%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Special	$267.20	$334.00	$300.60	—	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left	$385.60	$482.00	$30.90–$433.80	117% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right	$385.60	$482.00	$30.90–$433.80	117% above	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right	$385.60	$482.00	$433.80	—	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left	$385.60	$482.00	$433.80	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Aorta Duplex Complete	$662.40	$828.00	$131.16–$745.20	57% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal	$662.40	$828.00	$131.16–$745.20	57% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Aorta Duplex Complete	$662.40	$828.00	$745.20	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal	$662.40	$828.00	$745.20	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Study	$591.20	$739.00	$36.65–$665.10	107% above	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Study	$591.20	$739.00	$665.10	—	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Dexa Appendicular	$95.20	$119.00	$18.85–$134.65	54% below	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Dexa Appendicular	$95.20	$119.00	$107.10	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest W/O Contrast	$1,560.00	$1,950.00	$161.76–$1,755.00	76% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest W/O Contrast	$1,560.00	$1,950.00	$1,755.00	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W/Contrast	$1,908.00	$2,385.00	$271.40–$2,146.50	60% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W/Contrast	$1,908.00	$2,385.00	$2,146.50	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Diagnostic Bilateral.	$855.20	$1,069.00	$169.33–$962.10	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Diagnostic Bilateral.	$855.20	$1,069.00	$962.10	—	20%
Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Diagnostic Right.	$688.80	$861.00	$136.38–$774.90	190% above	20%
Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Diagnostic Left.	$724.80	$906.00	$143.51–$815.40	205% above	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Diagnostic Right.	$688.80	$861.00	$774.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Diagnostic Left.	$724.80	$906.00	$815.40	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral	$1,637.60	$2,047.00	$324.24–$1,842.30	—	20%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral	$1,637.60	$2,047.00	$1,842.30	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral	$1,212.80	$1,516.00	$240.13–$1,364.40	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$1,382.40	$1,728.00	$273.72–$1,555.20	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral	$1,212.80	$1,516.00	$1,364.40	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$1,382.40	$1,728.00	$1,555.20	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO Complete	$1,988.80	$2,486.00	$393.78–$2,237.40	98% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO Complete	$1,988.80	$2,486.00	$2,237.40	—	20%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right	$290.40	$363.00	$27.68–$326.70	54% above	20%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left	$290.40	$363.00	$27.68–$326.70	54% above	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right	$290.40	$363.00	$326.70	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left	$290.40	$363.00	$326.70	—	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Right	$444.00	$555.00	$31.22–$499.50	227% above	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Left	$444.00	$555.00	$31.22–$499.50	227% above	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Right	$444.00	$555.00	$499.50	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Left	$444.00	$555.00	$499.50	—	20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella etc. w/o Contrast	$1,943.20	$2,429.00	$161.76–$2,186.10	136% above	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit Sella etc. w/o Contrast	$1,943.20	$2,429.00	$2,186.10	—	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches	$544.00	$680.00	$43.34–$612.00	121% above	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views	$680.00	$850.00	$43.34–$765.00	176% above	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches	$544.00	$680.00	$612.00	—	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Minimum 3 Views	$680.00	$850.00	$765.00	—	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right	$371.20	$464.00	$27.68–$417.60	126% above	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left	$371.20	$464.00	$27.68–$417.60	126% above	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left	$371.20	$464.00	$417.60	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right	$371.20	$464.00	$417.60	—	20%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right	$371.20	$464.00	$29.93–$417.60	230% above	20%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left	$371.20	$464.00	$29.93–$417.60	230% above	20%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right	$371.20	$464.00	$417.60	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left	$371.20	$464.00	$417.60	—	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Left	$371.20	$464.00	$27.04–$417.60	218% above	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Right	$371.20	$464.00	$27.04–$417.60	218% above	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right	$390.40	$488.00	$27.04–$439.20	234% above	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left	$390.40	$488.00	$27.04–$439.20	234% above	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Left	$371.20	$464.00	$417.60	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Right	$371.20	$464.00	$417.60	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right	$390.40	$488.00	$439.20	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left	$390.40	$488.00	$439.20	—	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete Left	$488.04	$610.05	$44.74–$549.04	78% above	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete Right	$488.82	$611.03	$44.74–$549.93	78% above	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete Left	$488.04	$610.05	$549.04	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete Right	$488.82	$611.03	$549.93	—	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Left	$1,534.40	$1,918.00	$303.81–$1,726.20	44% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Right	$1,615.20	$2,019.00	$319.81–$1,817.10	51% above	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Left	$1,534.40	$1,918.00	$1,726.20	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Right	$1,615.20	$2,019.00	$1,817.10	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$553.60	$692.00	$109.61–$622.80	42% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$553.60	$692.00	$622.80	—	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Left	$429.60	$537.00	$29.93–$483.30	240% above	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Right	$429.60	$537.00	$29.93–$483.30	240% above	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Left	$429.60	$537.00	$483.30	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Right	$429.60	$537.00	$483.30	—	20%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o Contrast 70544	$1,512.80	$1,891.00	$299.53–$1,701.90	32% above	20%
MR angiography (MRA) of the head without contrast CPT 70544 MRV Head w/o Contrast	$2,468.00	$3,085.00	$369.18–$2,776.50	115% above	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/o Contrast 70544	$1,512.80	$1,891.00	$1,701.90	—	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Head w/o Contrast	$2,468.00	$3,085.00	$2,776.50	—	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Left	$2,464.80	$3,081.00	$488.03–$2,772.90	65% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Right	$2,464.80	$3,081.00	$488.03–$2,772.90	65% above	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Left	$2,464.80	$3,081.00	$2,772.90	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Right	$2,464.80	$3,081.00	$2,772.90	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE Joint w/ + w/o Contrast Left	$4,892.00	$6,115.00	$968.62–$5,503.50	141% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE Joint w/ + w/o Contrast Right	$4,892.00	$6,115.00	$968.62–$5,503.50	141% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE Joint w/ + w/o Contrast Right	$4,892.00	$6,115.00	$5,503.50	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE Joint w/ + w/o Contrast Left	$4,892.00	$6,115.00	$5,503.50	—	20%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$2,332.80	$2,916.00	$369.18–$2,624.40	106% above	20%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$2,332.80	$2,916.00	$2,624.40	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$4,068.80	$5,086.00	$539.81–$4,577.40	95% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$4,068.80	$5,086.00	$4,577.40	—	20%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$2,609.58	$3,261.98	$369.18–$2,935.78	98% above	20%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$2,609.58	$3,261.98	$2,935.78	—	20%
MRI of the brain, with and without contrast dye CPT 70553 MRA Brain w/o + w/ Contrast 70553	$1,890.40	$2,363.00	$374.30–$2,126.70	at median	20%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$3,826.40	$4,783.00	$539.81–$4,304.70	103% above	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRA Brain w/o + w/ Contrast 70553	$1,890.40	$2,363.00	$2,126.70	—	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$3,826.40	$4,783.00	$4,304.70	—	20%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$2,558.58	$3,198.23	$369.18–$2,878.41	46% above	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$2,558.58	$3,198.23	$2,878.41	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$3,671.20	$4,589.00	$539.81–$4,130.10	51% above	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$3,671.20	$4,589.00	$4,130.10	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$2,386.40	$2,983.00	$369.18–$2,684.70	33% above	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$2,386.40	$2,983.00	$2,684.70	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$3,682.40	$4,603.00	$539.81–$4,142.70	68% above	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$3,682.40	$4,603.00	$4,142.70	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$2,388.80	$2,986.00	$369.18–$2,687.40	66% above	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$2,388.80	$2,986.00	$2,687.40	—	20%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$4,045.60	$5,057.00	$539.81–$4,551.30	106% above	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$4,045.60	$5,057.00	$4,551.30	—	20%
MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum w/o Contrast	$2,144.00	$2,680.00	$369.18–$2,412.00	70% above	20%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$2,768.80	$3,461.00	$369.18–$3,114.90	119% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum w/o Contrast	$2,144.00	$2,680.00	$2,412.00	—	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$2,768.80	$3,461.00	$3,114.90	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE Joint w/o Contrast Left	$2,468.00	$3,085.00	$488.66–$2,776.50	70% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE Joint w/o Contrast Right	$2,468.00	$3,085.00	$488.66–$2,776.50	70% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE Joint w/o Contrast Right	$2,468.00	$3,085.00	$2,776.50	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE Joint w/o Contrast Left	$2,468.00	$3,085.00	$2,776.50	—	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views	$886.40	$1,108.00	$50.53–$997.20	221% above	20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views	$886.40	$1,108.00	$997.20	—	20%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w/ Contrast	$2,142.40	$2,678.00	$271.40–$2,410.20	98% above	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck w/ Contrast	$2,142.40	$2,678.00	$2,410.20	—	20%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck w/o Contrast	$1,881.60	$2,352.00	$161.76–$2,116.80	122% above	20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck w/o Contrast	$1,881.60	$2,352.00	$2,116.80	—	20%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue	$136.00	$170.00	$26.93–$153.00	23% below	20%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue	$136.00	$170.00	$153.00	—	20%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,562.40	$1,953.00	$161.76–$1,757.70	54% above	20%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,562.40	$1,953.00	$1,757.70	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited	$314.40	$393.00	$62.25–$353.70	2% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non-OB Limited	$314.40	$393.00	$353.70	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete	$1,032.80	$1,291.00	$161.76–$1,161.90	154% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Complete	$1,032.80	$1,291.00	$1,161.90	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Complete	$1,179.20	$1,474.00	$161.76–$1,326.60	181% above	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Complete	$1,179.20	$1,474.00	$1,326.60	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Transvaginal < 14 Wks Single Gest	$828.80	$1,036.00	$161.76–$932.40	145% above	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Transvaginal < 14 Wks Single Gest	$828.80	$1,036.00	$932.40	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Detailed Multi	$329.60	$412.00	$65.26–$370.80	4% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Fetal Eval Complete	$652.80	$816.00	$129.25–$734.40	105% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Detailed Multi	$329.60	$412.00	$370.80	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Fetal Eval Complete	$652.80	$816.00	$734.40	—	20%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 3 Views Left	$371.20	$464.00	$33.46–$417.60	161% above	20%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 3 Views Right	$390.40	$488.00	$33.46–$439.20	175% above	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 3 Views Left	$371.20	$464.00	$417.60	—	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 3 Views Right	$390.40	$488.00	$439.20	—	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Left	$371.20	$464.00	$38.88–$417.60	30% above	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Right	$390.40	$488.00	$38.88–$439.20	37% above	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Left	$371.20	$464.00	$417.60	—	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Right	$390.40	$488.00	$439.20	—	20%
Screening mammogram, both breasts both sides CPT 77067 MA Mammogram Routine Screening Bilat.	$662.40	$828.00	$122.92–$745.20	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MA Mammogram Routine Screening Bilat.	$662.40	$828.00	$745.20	—	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Right	$444.00	$555.00	$33.15–$499.50	188% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Left	$444.00	$555.00	$33.15–$499.50	188% above	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Left	$444.00	$555.00	$499.50	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Right	$444.00	$555.00	$499.50	—	20%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete	$738.40	$923.00	$35.05–$830.70	334% above	20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete	$738.40	$923.00	$830.70	—	20%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views	$371.20	$464.00	$33.14–$417.60	67% above	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views	$371.20	$464.00	$417.60	—	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left	$336.80	$421.00	$33.80–$378.90	86% above	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right	$336.80	$421.00	$33.80–$378.90	86% above	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right	$336.80	$421.00	$378.90	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left	$336.80	$421.00	$378.90	—	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast	$1,536.80	$1,921.00	$161.76–$1,728.90	44% above	20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast	$1,536.80	$1,921.00	$1,728.90	—	20%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$771.20	$964.00	$152.70–$867.60	108% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$771.20	$964.00	$867.60	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$572.80	$716.00	$113.41–$644.40	70% above	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$572.80	$716.00	$644.40	—	20%
Ultrasound of the abdomen, complete CPT 76700 US Pancreas	$420.00	$525.00	$83.16–$472.50	15% below	20%
Ultrasound of the abdomen, complete CPT 76700 US Spleen	$696.00	$870.00	$137.81–$783.00	41% above	20%
Ultrasound of the abdomen, complete CPT 76700 US Liver	$928.80	$1,161.00	$161.76–$1,044.90	88% above	20%
Ultrasound of the abdomen, complete CPT 76700 US Gallbladder	$985.60	$1,232.00	$161.76–$1,108.80	99% above	20%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$1,177.60	$1,472.00	$161.76–$1,324.80	138% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Pancreas	$420.00	$525.00	$472.50	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Spleen	$696.00	$870.00	$783.00	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Liver	$928.80	$1,161.00	$1,044.90	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Gallbladder	$985.60	$1,232.00	$1,108.80	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,177.60	$1,472.00	$1,324.80	—	20%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents)	$808.80	$1,011.00	$160.14–$909.90	124% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents)	$808.80	$1,011.00	$909.90	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$750.40	$938.00	$148.58–$844.20	128% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$1,032.80	$1,291.00	$161.76–$1,161.90	214% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$750.40	$938.00	$844.20	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$1,032.80	$1,291.00	$1,161.90	—	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left	$371.20	$464.00	$30.26–$417.60	76% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right	$390.40	$488.00	$30.26–$439.20	85% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus 1 View Left	$390.40	$488.00	$30.26–$439.20	85% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus 1 View Right	$390.40	$488.00	$30.26–$439.20	85% above	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left	$371.20	$464.00	$417.60	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus 1 View Left	$390.40	$488.00	$439.20	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right	$390.40	$488.00	$439.20	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus 1 View Right	$390.40	$488.00	$439.20	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$689.60	$862.00	$136.54–$775.80	66% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$689.60	$862.00	$136.54–$775.80	66% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Radiology Misc	$689.60	$862.00	$136.54–$775.80	66% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$883.20	$1,104.00	$161.76–$993.60	113% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$945.02	$1,181.28	$161.76–$1,063.15	128% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Radiology Misc	$689.60	$862.00	$775.80	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$689.60	$862.00	$775.80	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$689.60	$862.00	$775.80	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$883.20	$1,104.00	$993.60	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$945.02	$1,181.28	$1,063.15	—	20%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right	$371.20	$464.00	$32.18–$417.60	141% above	20%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left	$371.20	$464.00	$32.18–$417.60	141% above	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right	$371.20	$464.00	$417.60	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left	$371.20	$464.00	$417.60	—	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Left	$444.00	$555.00	$38.94–$499.50	127% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Right	$444.00	$555.00	$38.94–$499.50	127% above	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Left	$444.00	$555.00	$499.50	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Right	$444.00	$555.00	$499.50	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis	$461.60	$577.00	$45.06–$519.30	92% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis	$461.60	$577.00	$45.06–$519.30	92% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis	$461.60	$577.00	$519.30	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis	$461.60	$577.00	$519.30	—	20%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View	$282.40	$353.00	$28.65–$317.70	46% above	20%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View w/Decub	$356.00	$445.00	$28.65–$400.50	84% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View	$282.40	$353.00	$317.70	—	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View w/Decub	$356.00	$445.00	$400.50	—	20%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left	$371.20	$464.00	$30.57–$417.60	172% above	20%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right	$371.20	$464.00	$30.57–$417.60	172% above	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left	$371.20	$464.00	$417.60	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right	$371.20	$464.00	$417.60	—	20%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left	$371.20	$464.00	$27.04–$417.60	304% above	20%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right	$371.20	$464.00	$27.04–$417.60	304% above	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left	$371.20	$464.00	$417.60	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right	$371.20	$464.00	$417.60	—	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Right	$369.60	$462.00	$32.51–$415.80	216% above	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Left	$371.20	$464.00	$32.51–$417.60	217% above	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Right	$369.60	$462.00	$415.80	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Left	$371.20	$464.00	$417.60	—	20%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Right	$369.60	$462.00	$35.08–$415.80	93% above	20%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Left	$371.20	$464.00	$35.08–$417.60	93% above	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Right	$369.60	$462.00	$415.80	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Left	$371.20	$464.00	$417.60	—	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee One or Two Views Right	$429.60	$537.00	$32.51–$483.30	177% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee One or Two Views Left	$429.60	$537.00	$32.51–$483.30	177% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLIENT KNEE LIMITED RT	$430.40	$538.00	$32.51–$484.20	177% above	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee One or Two Views Left	$429.60	$537.00	$483.30	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee One or Two Views Right	$429.60	$537.00	$483.30	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLIENT KNEE LIMITED RT	$430.40	$538.00	$484.20	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$734.40	$918.00	$37.66–$826.20	287% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$734.40	$918.00	$826.20	—	20%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views	$674.40	$843.00	$49.25–$758.70	111% above	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 Views	$674.40	$843.00	$758.70	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views	$444.00	$555.00	$34.74–$499.50	298% above	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views	$444.00	$555.00	$499.50	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views	$440.80	$551.00	$37.33–$495.90	102% above	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views	$440.80	$551.00	$495.90	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 View	$271.20	$339.00	$26.39–$305.10	43% above	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 View	$271.20	$339.00	$305.10	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum and Coccyx	$371.20	$464.00	$30.90–$417.60	189% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum and Coccyx	$371.20	$464.00	$417.60	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
ACTH blood test CPT 82024 ACTH, Plasma LC	$366.40	$458.00	$56.00–$412.20	332% above	20%
ACTH blood test inpatient CPT 82024 ACTH, Plasma LC	$366.40	$458.00	$412.20	—	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$99.20	$124.00	$7.68–$111.60	318% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$99.20	$124.00	$111.60	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$99.20	$124.00	$7.51–$111.60	270% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$99.20	$124.00	$111.60	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) LC	$915.20	$1,144.00	$69.06–$1,029.60	981% above	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis LC	$1,335.20	$1,669.00	$69.06–$1,502.10	1478% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) LC	$915.20	$1,144.00	$1,029.60	—	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis LC	$1,335.20	$1,669.00	$1,502.10	—	20%
Albumin blood test CPT 82040 Albumin Level	$49.60	$62.00	$7.18–$55.80	238% above	20%
Albumin blood test inpatient CPT 82040 Albumin Level	$49.60	$62.00	$55.80	—	20%
Aldosterone blood test CPT 82088 Aldosterone LCMS, Serum LC	$386.40	$483.00	$59.09–$434.70	356% above	20%
Aldosterone blood test CPT 82088 Aldosterone/Renin Ratio LC	$386.40	$483.00	$59.09–$434.70	356% above	20%
Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS, Serum LC	$386.40	$483.00	$434.70	—	20%
Aldosterone blood test inpatient CPT 82088 Aldosterone/Renin Ratio LC	$386.40	$483.00	$434.70	—	20%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$84.80	$106.00	$7.51–$95.40	409% above	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$84.80	$106.00	$95.40	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill 602931 Mimosa/acacia	$31.20	$39.00	$6.18–$35.10	164% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill 602503 Johnson Grass	$31.20	$39.00	$6.18–$35.10	164% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill 602872 Rye Grass	$31.20	$39.00	$6.18–$35.10	164% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, EAC	$32.80	$41.00	$6.49–$36.90	177% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC	$38.40	$48.00	$7.57–$43.20	225% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 F044-IgE Strawberry LC	$46.40	$58.00	$7.57–$52.20	293% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC	$48.00	$60.00	$7.57–$54.00	306% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(14) LC	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Basic Food LC	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHOC	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FISH/SHELL MIX	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PORK	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Allergens(14)	$49.60	$62.00	$7.57–$55.80	320% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 M005-IgE Candida albicans LC	$51.20	$64.00	$7.57–$57.60	333% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MILK	$52.00	$65.00	$7.57–$58.50	340% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGN PNUT	$52.00	$65.00	$7.57–$58.50	340% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens w/Total IgE Area 12 LC	$52.00	$65.00	$7.57–$58.50	340% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Alder Tree	$59.20	$74.00	$7.57–$66.60	401% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill Ige Dog dander	$60.80	$76.00	$7.57–$68.40	414% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill Allergen Test	$116.00	$145.00	$7.57–$130.50	881% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Profile LC	$849.60	$1,062.00	$7.57–$955.80	7088% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens w/Total IgE 11 LC	$944.00	$1,180.00	$7.57–$1,062.00	7886% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Zone 16 LC	$1,400.00	$1,750.00	$7.57–$1,575.00	11744% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill 602931 Mimosa/acacia	$31.20	$39.00	$35.10	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill 602872 Rye Grass	$31.20	$39.00	$35.10	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill 602503 Johnson Grass	$31.20	$39.00	$35.10	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, EAC	$32.80	$41.00	$36.90	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC	$38.40	$48.00	$43.20	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F044-IgE Strawberry LC	$46.40	$58.00	$52.20	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC	$48.00	$60.00	$54.00	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(14) LC	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FISH/SHELL MIX	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PORK	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Basic Food LC	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Allergens(14)	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHOC	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN	$49.60	$62.00	$55.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M005-IgE Candida albicans LC	$51.20	$64.00	$57.60	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK	$52.00	$65.00	$58.50	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens w/Total IgE Area 12 LC	$52.00	$65.00	$58.50	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGN PNUT	$52.00	$65.00	$58.50	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alder Tree	$59.20	$74.00	$66.60	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill Ige Dog dander	$60.80	$76.00	$68.40	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill Allergen Test	$116.00	$145.00	$130.50	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Allergy Profile LC	$849.60	$1,062.00	$955.80	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens w/Total IgE 11 LC	$944.00	$1,180.00	$1,062.00	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Zone 16 LC	$1,400.00	$1,750.00	$1,575.00	—	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 General Lab	$160.80	$201.00	$24.32–$180.90	332% above	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Serum, Tumor Marker LC	$355.20	$444.00	$24.32–$399.60	854% above	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 General Lab	$160.80	$201.00	$180.90	—	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Tumor Marker LC	$355.20	$444.00	$399.60	—	20%
Ammonia blood test CPT 82140 Ammonia Level	$136.80	$171.00	$21.13–$153.90	109% above	20%
Ammonia blood test CPT 82140 82140 - Litholink 24-Hour Urine, KS LC	$136.80	$171.00	$21.13–$153.90	109% above	20%
Ammonia blood test CPT 82140 AMMONIA	$152.00	$190.00	$21.13–$171.00	132% above	20%
Ammonia blood test inpatient CPT 82140 82140 - Litholink 24-Hour Urine, KS LC	$136.80	$171.00	$153.90	—	20%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$136.80	$171.00	$153.90	—	20%
Ammonia blood test inpatient CPT 82140 AMMONIA	$152.00	$190.00	$171.00	—	20%
Amylase blood test CPT 82150 CLIENT AMYLASE	$16.00	$20.00	$3.17–$18.00	23% above	20%
Amylase blood test CPT 82150 Amylase Level	$209.60	$262.00	$9.40–$235.80	1509% above	20%
Amylase blood test inpatient CPT 82150 CLIENT AMYLASE	$16.00	$20.00	$18.00	—	20%
Amylase blood test inpatient CPT 82150 Amylase Level	$209.60	$262.00	$235.80	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC	$412.00	$515.00	$18.78–$463.50	1380% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC	$412.00	$515.00	$463.50	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Direct LC	$121.60	$152.00	$17.53–$136.80	344% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies, IFA LC	$121.60	$152.00	$17.53–$136.80	344% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Ab Reflex Cascade LC	$121.60	$152.00	$17.53–$136.80	344% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive LC	$128.00	$160.00	$17.53–$144.00	367% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex LC	$162.40	$203.00	$17.53–$182.70	493% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Direct LC	$121.60	$152.00	$136.80	—	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies, IFA LC	$121.60	$152.00	$136.80	—	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Ab Reflex Cascade LC	$121.60	$152.00	$136.80	—	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive LC	$128.00	$160.00	$144.00	—	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex LC	$162.40	$203.00	$182.70	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 proBNP LC	$99.20	$124.00	$19.64–$111.60	29% above	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide (BNP)	$383.20	$479.00	$56.93–$431.10	396% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 proBNP LC	$99.20	$124.00	$111.60	—	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Brain Natriuretic Peptide (BNP)	$383.20	$479.00	$431.10	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF Culture	$92.80	$116.00	$12.50–$104.40	52% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 C CSF	$92.80	$116.00	$12.50–$104.40	52% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$131.20	$164.00	$12.50–$147.60	115% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture	$138.40	$173.00	$12.50–$155.70	127% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 B Pertussis, Nasophar Culture	$169.60	$212.00	$12.50–$190.80	178% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture	$189.60	$237.00	$12.50–$213.30	211% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture	$248.80	$311.00	$12.50–$279.90	308% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture	$333.60	$417.00	$12.50–$375.30	447% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 C CSF	$92.80	$116.00	$104.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF Culture	$92.80	$116.00	$104.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$131.20	$164.00	$147.60	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture	$138.40	$173.00	$155.70	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 B Pertussis, Nasophar Culture	$169.60	$212.00	$190.80	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture	$189.60	$237.00	$213.30	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture	$248.80	$311.00	$279.90	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture	$333.60	$417.00	$375.30	—	20%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$89.60	$112.00	$7.28–$100.80	344% above	20%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$89.60	$112.00	$100.80	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LVL 4 GROSS EXAM	$964.80	$1,206.00	$51.06–$1,085.40	1022% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LVL 4 GROSS EXAM	$964.80	$1,206.00	$1,085.40	—	20%
Blood culture for bacteria CPT 87040 Blood Culture	$126.40	$158.00	$14.96–$142.20	at median	20%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$126.40	$158.00	$142.20	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLIENT BLOOD COLLECT LC	$9.60	$12.00	$1.90–$13.54	52% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLIENT BLOOD COLLECTION	$9.60	$12.00	$1.90–$13.54	52% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLIENT BLOOD COLLECT SQ	$10.40	$13.00	$2.06–$13.54	48% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venous Draw Charge	$28.80	$36.00	$5.70–$32.40	43% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of Venous Blood by venipuncture	$31.20	$39.00	$6.18–$35.10	55% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$31.20	$39.00	$6.18–$35.10	55% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Venous Draw	$32.80	$41.00	$6.49–$36.90	63% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CLIENT BLOOD COLLECTION	$9.60	$12.00	$10.80	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CLIENT BLOOD COLLECT LC	$9.60	$12.00	$10.80	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CLIENT BLOOD COLLECT SQ	$10.40	$13.00	$11.70	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venous Draw Charge	$28.80	$36.00	$32.40	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection of Venous Blood by venipuncture	$31.20	$39.00	$35.10	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$31.20	$39.00	$35.10	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Venous Draw	$32.80	$41.00	$36.90	—	20%
Blood glucose (sugar) test CPT 82947 Glucose Fasting	$62.40	$78.00	$5.70–$70.20	38% above	20%
Blood glucose (sugar) test CPT 82947 Glucose Level	$65.60	$82.00	$5.70–$73.80	45% above	20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting	$62.40	$78.00	$70.20	—	20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$65.60	$82.00	$73.80	—	20%
Blood lead test CPT 83655 Lead, Blood (Pediatric) LC	$214.40	$268.00	$17.56–$241.20	829% above	20%
Blood lead test CPT 83655 Lead, Blood (Adult) LC	$216.00	$270.00	$17.56–$243.00	836% above	20%
Blood lead test CPT 83655 LEAD ADULT	$236.80	$296.00	$17.56–$266.40	926% above	20%
Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric) LC	$214.40	$268.00	$241.20	—	20%
Blood lead test inpatient CPT 83655 Lead, Blood (Adult) LC	$216.00	$270.00	$243.00	—	20%
Blood lead test inpatient CPT 83655 LEAD ADULT	$236.80	$296.00	$266.40	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum 1	$12.00	$15.00	$2.38–$13.50	82% below	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qual w/ Reflex to Beta hCG	$12.80	$16.00	$2.53–$14.40	81% below	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum 1	$12.00	$15.00	$13.50	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG Qual w/ Reflex to Beta hCG	$12.80	$16.00	$14.40	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO/RH/AB SCREEN	$68.00	$85.00	$4.34–$76.50	16% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 AFC GENERIC ADD-ON	$68.00	$85.00	$4.34–$76.50	16% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh	$71.20	$89.00	$4.34–$80.10	12% below	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO/RH/AB SCREEN	$68.00	$85.00	$76.50	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 AFC GENERIC ADD-ON	$68.00	$85.00	$76.50	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh	$71.20	$89.00	$80.10	—	20%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$48.80	$61.00	$5.73–$54.90	200% above	20%
Blood urea nitrogen (BUN) test CPT 84520 BUN/Creat Ratio	$51.20	$64.00	$5.73–$57.60	215% above	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$48.80	$61.00	$54.90	—	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN/Creat Ratio	$51.20	$64.00	$57.60	—	20%
C-peptide blood test CPT 84681 C-Peptide, Serum LC	$463.20	$579.00	$30.17–$521.10	711% above	20%
C-peptide blood test inpatient CPT 84681 C-Peptide, Serum LC	$463.20	$579.00	$521.10	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein, Quant LC	$92.80	$116.00	$7.51–$104.40	93% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein, Quant LC	$92.80	$116.00	$104.40	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 PNT 1007757 C Diff Toxin Gene NAA DPT	$216.00	$270.00	$42.77–$243.00	196% above	20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE	$225.60	$282.00	$44.67–$253.80	209% above	20%
C. difficile toxin gene test (stool PCR) CPT 87493 C. difficile Toxin Gene NAA LC	$352.80	$441.00	$54.04–$396.90	384% above	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 PNT 1007757 C Diff Toxin Gene NAA DPT	$216.00	$270.00	$243.00	—	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOX GENE	$225.60	$282.00	$253.80	—	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. difficile Toxin Gene NAA LC	$352.80	$441.00	$396.90	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 LC	$196.00	$245.00	$30.17–$220.50	680% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Antigen 19-9 LC	$196.00	$245.00	$220.50	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 Human Epididymis Protein 4 LC	$286.40	$358.00	$30.17–$322.20	323% above	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC	$519.20	$649.00	$30.17–$584.10	667% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Human Epididymis Protein 4 LC	$286.40	$358.00	$322.20	—	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC	$519.20	$649.00	$584.10	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)	$83.20	$104.00	$16.47–$93.60	32% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Novel Coronavirus (CoVID-19), NAA LC	$160.00	$200.00	$31.68–$180.00	154% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)	$83.20	$104.00	$93.60	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Novel Coronavirus (CoVID-19), NAA LC	$160.00	$200.00	$180.00	—	20%
Calcium blood test, total CPT 82310 Calcium Level Total	$59.20	$74.00	$7.48–$66.60	294% above	20%
Calcium blood test, total CPT 82310 Ca+PTH Intact LC	$62.40	$78.00	$7.48–$70.20	315% above	20%
Calcium blood test, total inpatient CPT 82310 Calcium Level Total	$59.20	$74.00	$66.60	—	20%
Calcium blood test, total inpatient CPT 82310 Ca+PTH Intact LC	$62.40	$78.00	$70.20	—	20%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA LC	$188.80	$236.00	$27.49–$212.40	229% above	20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LC	$188.80	$236.00	$212.40	—	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster IgM Ab LC	$220.80	$276.00	$18.68–$248.40	968% above	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG LC	$232.00	$290.00	$18.68–$261.00	1022% above	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster IgM Ab LC	$220.80	$276.00	$248.40	—	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG LC	$232.00	$290.00	$261.00	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC	$310.40	$388.00	$50.88–$349.20	401% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/GC Amplification LC	$316.00	$395.00	$50.88–$355.50	410% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis, NAA LC	$310.40	$388.00	$349.20	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia/GC Amplification LC	$316.00	$395.00	$355.50	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LipoProfile LC	$173.60	$217.00	$19.42–$195.30	341% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Standard	$211.20	$264.00	$19.42–$237.60	437% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LipoProfile LC	$173.60	$217.00	$195.30	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel Standard	$211.20	$264.00	$237.60	—	20%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count/Hemogram Standard	$190.40	$238.00	$11.27–$214.20	216% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count/Hemogram Standard	$190.40	$238.00	$214.20	—	20%
Complete blood count (CBC), no differential CPT 85027 Hemogram Standard	$109.60	$137.00	$9.38–$123.30	125% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram Standard	$109.60	$137.00	$123.30	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel Standard	$312.00	$390.00	$15.31–$351.00	137% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel Standard	$312.00	$390.00	$351.00	—	20%
Cortisol blood test, total CPT 82533 Cortisol LC	$153.60	$192.00	$23.64–$172.80	274% above	20%
Cortisol blood test, total CPT 82533 Cortisol, Urinary Free LC	$205.60	$257.00	$23.64–$231.30	401% above	20%
Cortisol blood test, total CPT 82533 CBG With Free Cortisol LC	$216.80	$271.00	$23.64–$243.90	429% above	20%
Cortisol blood test, total inpatient CPT 82533 Cortisol LC	$153.60	$192.00	$172.80	—	20%
Cortisol blood test, total inpatient CPT 82533 Cortisol, Urinary Free LC	$205.60	$257.00	$231.30	—	20%
Cortisol blood test, total inpatient CPT 82533 CBG With Free Cortisol LC	$216.80	$271.00	$243.90	—	20%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$62.40	$78.00	$9.44–$70.20	345% above	20%
Creatine kinase (CK) blood test, total CPT 82550 CK, Total+Isoenzymes, Serum LC	$62.40	$78.00	$9.44–$70.20	345% above	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$62.40	$78.00	$70.20	—	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK, Total+Isoenzymes, Serum LC	$62.40	$78.00	$70.20	—	20%
Creatinine blood test CPT 82565 Creatinine	$60.80	$76.00	$7.42–$68.40	304% above	20%
Creatinine blood test CPT 82565 CREATININE S	$64.00	$80.00	$7.42–$72.00	326% above	20%
Creatinine blood test inpatient CPT 82565 Creatinine	$60.80	$76.00	$68.40	—	20%
Creatinine blood test inpatient CPT 82565 CREATININE S	$64.00	$80.00	$72.00	—	20%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC	$175.20	$219.00	$20.87–$197.10	468% above	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC	$175.20	$219.00	$197.10	—	20%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$236.00	$295.00	$14.76–$265.50	137% above	20%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer 2	$248.80	$311.00	$14.76–$279.90	149% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$236.00	$295.00	$265.50	—	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer 2	$248.80	$311.00	$279.90	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate LC	$367.20	$459.00	$32.23–$413.10	592% above	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate LC	$367.20	$459.00	$413.10	—	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Screen Only, Whole Blood LC	$214.40	$268.00	$42.45–$241.20	154% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Analysis Profile, Comprehensive, Urine LC	$224.80	$281.00	$44.51–$252.90	166% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PM BARBITURATES	$224.80	$281.00	$44.51–$252.90	166% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PNT 1002836 Drug Screen 10 w/ confirmation	$225.60	$282.00	$44.67–$253.80	167% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Confirmation Tests THC	$225.60	$282.00	$44.67–$253.80	167% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 80307 - Drug test(s), presumptive, any number of drug classe	$225.60	$282.00	$44.67–$253.80	167% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates	$236.80	$296.00	$46.89–$266.40	181% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen Standard	$304.00	$380.00	$60.19–$342.00	260% above	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Screen Only, Whole Blood LC	$214.40	$268.00	$241.20	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PM BARBITURATES	$224.80	$281.00	$252.90	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Analysis Profile, Comprehensive, Urine LC	$224.80	$281.00	$252.90	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307 - Drug test(s), presumptive, any number of drug classe	$225.60	$282.00	$253.80	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PNT 1002836 Drug Screen 10 w/ confirmation	$225.60	$282.00	$253.80	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Confirmation Tests THC	$225.60	$282.00	$253.80	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates	$236.80	$296.00	$266.40	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screen Standard	$304.00	$380.00	$342.00	—	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel Standard	$80.80	$101.00	$10.16–$90.90	43% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel Standard	$80.80	$101.00	$90.90	—	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBv ab VCA, IGG	$118.40	$148.00	$23.44–$133.20	448% above	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBv ab VCA, IGG	$118.40	$148.00	$133.20	—	20%
Estradiol blood test CPT 82670 Estradiol, Sensitive, LC	$264.80	$331.00	$40.51–$297.90	316% above	20%
Estradiol blood test CPT 82670 Estradiol LC	$264.80	$331.00	$40.51–$297.90	316% above	20%
Estradiol blood test inpatient CPT 82670 Estradiol LC	$264.80	$331.00	$297.90	—	20%
Estradiol blood test inpatient CPT 82670 Estradiol, Sensitive, LC	$264.80	$331.00	$297.90	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum LC	$335.20	$419.00	$26.94–$377.10	473% above	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH and LH LC	$335.20	$419.00	$26.94–$377.10	473% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Serum LC	$335.20	$419.00	$377.10	—	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH and LH LC	$335.20	$419.00	$377.10	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal LC	$393.60	$492.00	$28.46–$442.80	692% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Fecal LC	$393.60	$492.00	$442.80	—	20%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$192.80	$241.00	$19.76–$216.90	146% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$192.80	$241.00	$216.90	—	20%
Fibrinogen blood test CPT 85384 Fibrinogen	$111.20	$139.00	$14.09–$125.10	129% above	20%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$111.20	$139.00	$125.10	—	20%
Folate (folic acid) blood test CPT 82746 Folic Acid(FOLATE)	$144.80	$181.00	$21.32–$162.90	70% above	20%
Folate (folic acid) blood test CPT 82746 Folate Level	$190.40	$238.00	$21.32–$214.20	124% above	20%
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid(FOLATE)	$144.80	$181.00	$162.90	—	20%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$190.40	$238.00	$214.20	—	20%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine,Free,Serum LC	$360.80	$451.00	$24.56–$405.90	798% above	20%
Free T3 thyroid hormone test CPT 84481 .T3Free LC	$380.00	$475.00	$24.56–$427.50	846% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine,Free,Serum LC	$360.80	$451.00	$405.90	—	20%
Free T3 thyroid hormone test inpatient CPT 84481 .T3Free LC	$380.00	$475.00	$427.50	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4	$284.00	$355.00	$13.08–$319.50	427% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free, Direct, LC	$299.20	$374.00	$13.08–$336.60	456% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 .Thyroxine (T4) Free, Direct H LC	$299.20	$374.00	$13.08–$336.60	456% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4	$284.00	$355.00	$319.50	—	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .Thyroxine (T4) Free, Direct H LC	$299.20	$374.00	$336.60	—	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free, Direct, LC	$299.20	$374.00	$336.60	—	20%
Free testosterone test CPT 84402 Testosterone, Free, Direct LC	$241.60	$302.00	$36.93–$271.80	445% above	20%
Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC	$241.60	$302.00	$271.80	—	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$126.40	$158.00	$10.44–$142.20	340% above	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT LC	$132.80	$166.00	$10.44–$149.40	362% above	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HCV FibroSure LC	$160.00	$200.00	$10.44–$180.00	457% above	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$126.40	$158.00	$142.20	—	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT LC	$132.80	$166.00	$149.40	—	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HCV FibroSure LC	$160.00	$200.00	$180.00	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Post Prandial	$66.40	$83.00	$6.89–$74.70	25% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 2Hr Post Prandial	$66.40	$83.00	$6.89–$74.70	25% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 HR PP	$66.40	$83.00	$6.89–$74.70	25% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 HR PP	$66.40	$83.00	$74.70	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 2Hr Post Prandial	$66.40	$83.00	$74.70	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Post Prandial	$66.40	$83.00	$74.70	—	20%
Glucose tolerance test, 3 samples CPT 82951 GTT 3-Hour	$227.20	$284.00	$18.66–$255.60	125% above	20%
Glucose tolerance test, 3 samples CPT 82951 .GTT-2 Hr	$227.20	$284.00	$18.66–$255.60	125% above	20%
Glucose tolerance test, 3 samples CPT 82951 GTT OB 3 Hour	$238.40	$298.00	$18.66–$268.20	136% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT-2 Hr	$227.20	$284.00	$255.60	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3-Hour	$227.20	$284.00	$255.60	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT OB 3 Hour	$238.40	$298.00	$268.20	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMPLIFICTN	$320.00	$400.00	$50.88–$360.00	429% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae NAA LC	$329.60	$412.00	$50.88–$370.80	445% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMPLIFICTN	$320.00	$400.00	$360.00	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae NAA LC	$329.60	$412.00	$370.80	—	20%
H. pylori antibody blood test CPT 86677 H Pylori Rapid Urease	$160.80	$201.00	$24.43–$180.90	307% above	20%
H. pylori antibody blood test CPT 86677 H. pylori IgG, Abs LC	$169.60	$212.00	$24.43–$190.80	329% above	20%
H. pylori antibody blood test CPT 86677 Helicobacter pylori, IgA LC	$169.60	$212.00	$24.43–$190.80	329% above	20%
H. pylori antibody blood test CPT 86677 H Pylori AB IgM LC	$172.80	$216.00	$24.43–$194.40	337% above	20%
H. pylori antibody blood test inpatient CPT 86677 H Pylori Rapid Urease	$160.80	$201.00	$180.90	—	20%
H. pylori antibody blood test inpatient CPT 86677 H. pylori IgG, Abs LC	$169.60	$212.00	$190.80	—	20%
H. pylori antibody blood test inpatient CPT 86677 Helicobacter pylori, IgA LC	$169.60	$212.00	$190.80	—	20%
H. pylori antibody blood test inpatient CPT 86677 H Pylori AB IgM LC	$172.80	$216.00	$194.40	—	20%
H. pylori stool antigen test CPT 87338 H. pylori Stool Ag, EIA LC	$418.40	$523.00	$20.85–$470.70	867% above	20%
H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag, EIA LC	$418.40	$523.00	$470.70	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Bill HIV-1 RNA	$522.40	$653.00	$103.44–$587.70	329% above	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA, PCR (Graph) rfx/Geno LC	$804.00	$1,005.00	$123.39–$904.50	561% above	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV Quant, LC	$804.00	$1,005.00	$123.39–$904.50	561% above	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Real Time PCR (Non-Graph) LC	$846.40	$1,058.00	$123.39–$952.20	595% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Bill HIV-1 RNA	$522.40	$653.00	$587.70	—	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV Quant, LC	$804.00	$1,005.00	$904.50	—	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA, PCR (Graph) rfx/Geno LC	$804.00	$1,005.00	$904.50	—	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Real Time PCR (Non-Graph) LC	$846.40	$1,058.00	$952.20	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4th Gen Screen w Reflex LC	$240.00	$300.00	$34.92–$270.00	486% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4th Gen Screen w Reflex LC	$240.00	$300.00	$270.00	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 IGP,Aptima HPV,CtNg Age Gdln LC	$139.20	$174.00	$27.56–$156.60	154% above	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Genotypes 16/18,45 LC	$146.68	$183.35	$29.04–$165.01	168% above	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 IGP,Aptima HPV,CtNg Age Gdln LC	$139.20	$174.00	$156.60	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Genotypes 16/18,45 LC	$146.68	$183.35	$165.01	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C	$111.20	$139.00	$14.08–$125.10	129% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin POC	$116.80	$146.00	$14.08–$131.40	141% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Standard	$149.60	$187.00	$14.08–$168.30	209% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C	$111.20	$139.00	$125.10	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin POC	$116.80	$146.00	$131.40	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c Standard	$149.60	$187.00	$168.30	—	20%
Hemoglobin blood test CPT 85018 Hemoglobin	$37.60	$47.00	$3.44–$42.30	55% above	20%
Hemoglobin blood test CPT 85018 Hemoglobin - POC	$37.60	$47.00	$3.44–$42.30	55% above	20%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin - POC	$37.60	$47.00	$42.30	—	20%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$37.60	$47.00	$42.30	—	20%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab, Tot LC	$185.60	$232.00	$17.47–$208.80	580% above	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot LC	$185.60	$232.00	$208.80	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab LC	$90.40	$113.00	$15.57–$101.70	210% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surf Ab Quant LC	$307.20	$384.00	$15.57–$345.60	954% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab LC	$90.40	$113.00	$101.70	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surf Ab Quant LC	$307.20	$384.00	$345.60	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 .HBsAg Confirmation LC	$234.40	$293.00	$14.98–$263.70	962% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen LC	$316.00	$395.00	$14.98–$355.50	1331% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 .HBsAg Confirmation LC	$234.40	$293.00	$263.70	—	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen LC	$316.00	$395.00	$355.50	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody LC	$404.80	$506.00	$20.69–$455.40	961% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody LC	$404.80	$506.00	$455.40	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 RNA, PCR (NonGraph) rfx/Geno LC	$575.20	$719.00	$62.12–$647.10	547% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV RNA IU LC	$599.20	$749.00	$62.12–$674.10	574% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA, PCR, Quant (Reflex to Genotyping LC	$720.80	$901.00	$62.12–$810.90	711% above	20%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC	$597.60	$747.00	$62.12–$672.30	573% above	20%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Graph) LC	$599.20	$749.00	$62.12–$674.10	574% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 RNA, PCR (NonGraph) rfx/Geno LC	$575.20	$719.00	$647.10	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HCV RNA IU LC	$599.20	$749.00	$674.10	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA, PCR, Quant (Reflex to Genotyping LC	$720.80	$901.00	$810.90	—	20%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC	$597.60	$747.00	$672.30	—	20%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Graph) LC	$599.20	$749.00	$674.10	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 and 2-Specific Ab, IgG LC	$124.00	$155.00	$19.13–$139.50	303% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1-Specific Ab, IgG LC	$130.40	$163.00	$19.13–$146.70	324% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 and 2-Specific Ab, IgG LC	$124.00	$155.00	$139.50	—	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1-Specific Ab, IgG LC	$130.40	$163.00	$146.70	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2-Specific Ab, IgG LC	$183.20	$229.00	$28.06–$206.10	452% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG	$192.80	$241.00	$28.06–$216.90	481% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2-Specific Ab, IgG LC	$183.20	$229.00	$206.10	—	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG	$192.80	$241.00	$216.90	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein	$125.60	$157.00	$18.78–$141.30	127% above	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Cardiac LC	$132.00	$165.00	$18.78–$148.50	138% above	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACT PROT CARDIAC	$138.40	$173.00	$18.78–$155.70	150% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein	$125.60	$157.00	$141.30	—	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, Cardiac LC	$132.00	$165.00	$148.50	—	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACT PROT CARDIAC	$138.40	$173.00	$155.70	—	20%
Homocysteine blood test CPT 83090 Homocyst(e)ine, Plasma LC	$388.00	$485.00	$25.98–$436.50	180% above	20%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine, Plasma LC	$388.00	$485.00	$436.50	—	20%
Insulin blood test CPT 83525 Insulin LC	$146.40	$183.00	$16.57–$164.70	436% above	20%
Insulin blood test CPT 83525 INSULIN TOTL	$154.40	$193.00	$16.57–$173.70	465% above	20%
Insulin blood test inpatient CPT 83525 Insulin LC	$146.40	$183.00	$164.70	—	20%
Insulin blood test inpatient CPT 83525 INSULIN TOTL	$154.40	$193.00	$173.70	—	20%
Iron blood test (serum iron) CPT 83540 Iron	$65.60	$82.00	$9.38–$73.80	74% above	20%
Iron blood test (serum iron) CPT 83540 Iron Level	$80.80	$101.00	$9.38–$90.90	114% above	20%
Iron blood test (serum iron) CPT 83540 Iron Profile Standard	$88.00	$110.00	$9.38–$99.00	133% above	20%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$65.60	$82.00	$73.80	—	20%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$80.80	$101.00	$90.90	—	20%
Iron blood test (serum iron) inpatient CPT 83540 Iron Profile Standard	$88.00	$110.00	$99.00	—	20%
Iron-binding capacity (TIBC) test CPT 83550 CLIENT .IRON BINDING CAPACITY	$271.20	$339.00	$12.67–$305.10	235% above	20%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$357.60	$447.00	$12.67–$402.30	341% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 CLIENT .IRON BINDING CAPACITY	$271.20	$339.00	$305.10	—	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$357.60	$447.00	$402.30	—	20%
Kidney function blood test panel CPT 80069 Renal Function Panel Standard	$120.80	$151.00	$12.59–$135.90	43% above	20%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel Standard	$120.80	$151.00	$135.90	—	20%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH), S LC	$393.60	$492.00	$26.85–$442.80	556% above	20%
LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORMONE)	$415.20	$519.00	$26.85–$467.10	592% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone(LH), S LC	$393.60	$492.00	$442.80	—	20%
LH (luteinizing hormone) test inpatient CPT 83002 LH (LUTEINIZING HORMONE)	$415.20	$519.00	$467.10	—	20%
Lactate (lactic acid) blood test CPT 83605 Lactate	$194.40	$243.00	$16.78–$218.70	584% above	20%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate	$194.40	$243.00	$218.70	—	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$55.20	$69.00	$8.76–$62.10	71% above	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$55.20	$69.00	$62.10	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$193.60	$242.00	$9.99–$217.80	614% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$193.60	$242.00	$217.80	—	20%
Liver function blood test panel CPT 80076 Hepatic Function Panel Standard	$229.60	$287.00	$11.85–$258.30	185% above	20%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel Standard	$229.60	$287.00	$258.30	—	20%
Lyme disease antibody test CPT 86618 Lyme AB Total w Reflex LC	$161.60	$202.00	$24.69–$181.80	362% above	20%
Lyme disease antibody test CPT 86618 Lyme, Western Blot, Serum LC	$266.40	$333.00	$24.69–$299.70	662% above	20%
Lyme disease antibody test CPT 86618 Lyme, IgM, Early Test/Reflex LC	$267.20	$334.00	$24.69–$300.60	664% above	20%
Lyme disease antibody test CPT 86618 LYME AB IGM	$281.60	$352.00	$24.69–$316.80	705% above	20%
Lyme disease antibody test CPT 86618 Lyme Ab, Total/IgM Responses LC	$301.60	$377.00	$24.69–$339.30	762% above	20%
Lyme disease antibody test inpatient CPT 86618 Lyme AB Total w Reflex LC	$161.60	$202.00	$181.80	—	20%
Lyme disease antibody test inpatient CPT 86618 Lyme, Western Blot, Serum LC	$266.40	$333.00	$299.70	—	20%
Lyme disease antibody test inpatient CPT 86618 Lyme, IgM, Early Test/Reflex LC	$267.20	$334.00	$300.60	—	20%
Lyme disease antibody test inpatient CPT 86618 LYME AB IGM	$281.60	$352.00	$316.80	—	20%
Lyme disease antibody test inpatient CPT 86618 Lyme Ab, Total/IgM Responses LC	$301.60	$377.00	$339.30	—	20%
Magnesium blood test CPT 83735 Magnesium Level	$64.00	$80.00	$9.71–$72.00	363% above	20%
Magnesium blood test CPT 83735 83735 - Litholink 24-Hour Urine, KS LC	$64.00	$80.00	$9.71–$72.00	363% above	20%
Magnesium blood test CPT 83735 83735 LC#LC	$67.20	$84.00	$9.71–$75.60	386% above	20%
Magnesium blood test CPT 83735 Magnesium, RBC LC	$137.60	$172.00	$9.71–$154.80	896% above	20%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$64.00	$80.00	$72.00	—	20%
Magnesium blood test inpatient CPT 83735 83735 - Litholink 24-Hour Urine, KS LC	$64.00	$80.00	$72.00	—	20%
Magnesium blood test inpatient CPT 83735 83735 LC#LC	$67.20	$84.00	$75.60	—	20%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC LC	$137.60	$172.00	$154.80	—	20%
Measles (rubeola) antibody test CPT 86765 Acute Measles Panel, IgM Antibody and PCR LC	$60.80	$76.00	$12.04–$68.40	265% above	20%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgG LC	$175.20	$219.00	$18.68–$197.10	950% above	20%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$184.00	$230.00	$18.68–$207.00	1003% above	20%
Measles (rubeola) antibody test CPT 86765 Rubeola IgM LC	$193.60	$242.00	$18.68–$217.80	1061% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 Acute Measles Panel, IgM Antibody and PCR LC	$60.80	$76.00	$68.40	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies, IgG LC	$175.20	$219.00	$197.10	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG	$184.00	$230.00	$207.00	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgM LC	$193.60	$242.00	$217.80	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$103.20	$129.00	$7.51–$116.10	39% above	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$103.20	$129.00	$116.10	—	20%
Mumps immunity blood test CPT 86735 Mumps Antibodies, IgM LC	$132.00	$165.00	$18.92–$148.50	346% above	20%
Mumps immunity blood test CPT 86735 Measles/Mumps/Rubella Immunity LC	$132.00	$165.00	$18.92–$148.50	346% above	20%
Mumps immunity blood test CPT 86735 Mumps Antibodies, IgG LC	$139.20	$174.00	$18.92–$156.60	371% above	20%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgM LC	$132.00	$165.00	$148.50	—	20%
Mumps immunity blood test inpatient CPT 86735 Measles/Mumps/Rubella Immunity LC	$132.00	$165.00	$148.50	—	20%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgG LC	$139.20	$174.00	$156.60	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Total+% Free (Serial) LC	$205.60	$257.00	$26.67–$231.30	275% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Total+% Free (Serial) LC	$205.60	$257.00	$231.30	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic.	$179.20	$224.00	$26.67–$201.60	204% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultra. W/Serial Monitor LC	$200.00	$250.00	$26.67–$225.00	239% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic.	$179.20	$224.00	$201.60	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Ultra. W/Serial Monitor LC	$200.00	$250.00	$225.00	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopathology, cervical or vaginal (any reporting system), c	$100.80	$126.00	$19.96–$113.40	153% above	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopathology, cervical or vaginal (any reporting system), c	$100.80	$126.00	$113.40	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH	$267.20	$334.00	$52.91–$300.60	210% above	20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC	$565.60	$707.00	$59.86–$636.30	557% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH	$267.20	$334.00	$300.60	—	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact LC	$565.60	$707.00	$636.30	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$37.60	$47.00	$7.44–$42.30	99% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$108.00	$135.00	$8.71–$121.50	471% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$112.80	$141.00	$8.71–$126.90	497% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 .PT (Thromborel-S) LC	$112.80	$141.00	$8.71–$126.90	497% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT DED	$118.40	$148.00	$8.71–$133.20	526% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$37.60	$47.00	$42.30	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$108.00	$135.00	$121.50	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$112.80	$141.00	$126.90	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 .PT (Thromborel-S) LC	$112.80	$141.00	$126.90	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT DED	$118.40	$148.00	$133.20	—	20%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level	$92.80	$116.00	$6.87–$104.40	311% above	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level	$92.80	$116.00	$104.40	—	20%
Potassium blood test CPT 84132 Potassium Level	$56.80	$71.00	$6.90–$63.90	122% above	20%
Potassium blood test inpatient CPT 84132 Potassium Level	$56.80	$71.00	$63.90	—	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 informaSeq(SM) Prenatal Test LC	$185.60	$232.00	$36.75–$1,100.62	89% below	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 informaSeq(SM) Prenatal Test LC	$185.60	$232.00	$208.80	—	20%
Progesterone blood test CPT 84144 Progesterone LC	$435.20	$544.00	$30.25–$489.60	432% above	20%
Progesterone blood test inpatient CPT 84144 Progesterone LC	$435.20	$544.00	$489.60	—	20%
Prolactin blood test CPT 84146 Prolactin LC	$192.00	$240.00	$28.10–$216.00	269% above	20%
Prolactin blood test inpatient CPT 84146 Prolactin LC	$192.00	$240.00	$216.00	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$56.80	$71.00	$6.22–$63.90	201% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin/INR POC	$56.80	$71.00	$6.22–$63.90	201% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 Protime/PTT	$56.80	$71.00	$6.22–$63.90	201% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$76.00	$95.00	$6.22–$85.50	303% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin/INR POC	$56.80	$71.00	$63.90	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime/PTT	$56.80	$71.00	$63.90	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$56.80	$71.00	$63.90	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$76.00	$95.00	$85.50	—	20%
Rapid flu test (influenza antigen) CPT 87804 CLIENT INFLUENZA A SCREEN (RAPID)	$104.00	$130.00	$20.59–$117.00	340% above	20%
Rapid flu test (influenza antigen) CPT 87804 INFLU B SCN	$140.00	$175.00	$24.00–$157.50	492% above	20%
Rapid flu test (influenza antigen) CPT 87804 Influenza AB Rapid	$140.00	$175.00	$24.00–$157.50	492% above	20%
Rapid flu test (influenza antigen) CPT 87804 87804 SARS-CoV-2 (COVID-19) Ag/ Flu A andB (Influenza A)	$156.00	$195.00	$24.00–$175.50	560% above	20%
Rapid flu test (influenza antigen) CPT 87804 87804 SARS-CoV-2 (COVID-19) Ag/ Flu A andB (Influenza B)	$164.00	$205.00	$24.00–$184.50	593% above	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 CLIENT INFLUENZA A SCREEN (RAPID)	$104.00	$130.00	$117.00	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLU B SCN	$140.00	$175.00	$157.50	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza AB Rapid	$140.00	$175.00	$157.50	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 SARS-CoV-2 (COVID-19) Ag/ Flu A andB (Influenza A)	$156.00	$195.00	$175.50	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 SARS-CoV-2 (COVID-19) Ag/ Flu A andB (Influenza B)	$164.00	$205.00	$184.50	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep POC	$26.40	$33.00	$5.23–$29.70	13% below	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Rapid Screen	$140.00	$175.00	$23.97–$157.50	359% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep POC	$26.40	$33.00	$29.70	—	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Rapid Screen	$140.00	$175.00	$157.50	—	20%
Renin blood test CPT 84244 Renin Activity, Plasma LC	$220.00	$275.00	$31.89–$247.50	267% above	20%
Renin blood test inpatient CPT 84244 Renin Activity, Plasma LC	$220.00	$275.00	$247.50	—	20%
Rh blood typing CPT 86901 Rh	$79.20	$99.00	$4.34–$89.10	83% above	20%
Rh blood typing CPT 86901 AFC GENERIC ADD-ON	$79.20	$99.00	$4.34–$89.10	83% above	20%
Rh blood typing inpatient CPT 86901 Rh	$79.20	$99.00	$89.10	—	20%
Rh blood typing inpatient CPT 86901 AFC GENERIC ADD-ON	$79.20	$99.00	$89.10	—	20%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC	$137.60	$172.00	$20.87–$154.80	405% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$144.80	$181.00	$20.87–$162.90	431% above	20%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, IgM LC	$144.80	$181.00	$20.87–$162.90	431% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC	$137.60	$172.00	$154.80	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody, IgM LC	$144.80	$181.00	$162.90	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$144.80	$181.00	$162.90	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate	$24.00	$30.00	$3.92–$27.00	60% below	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate	$24.00	$30.00	$27.00	—	20%
Sodium blood test CPT 84295 Sodium Level	$52.80	$66.00	$6.97–$59.40	171% above	20%
Sodium blood test inpatient CPT 84295 Sodium Level	$52.80	$66.00	$59.40	—	20%
Stool ova and parasites exam CPT 87177 .Ova + Parasite Exam Result	$161.60	$202.00	$12.90–$181.80	473% above	20%
Stool ova and parasites exam CPT 87177 Ova + Parasite Exam LC	$216.80	$271.00	$12.90–$243.90	669% above	20%
Stool ova and parasites exam inpatient CPT 87177 .Ova + Parasite Exam Result	$161.60	$202.00	$181.80	—	20%
Stool ova and parasites exam inpatient CPT 87177 Ova + Parasite Exam LC	$216.80	$271.00	$243.90	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool 1-3	$71.20	$89.00	$6.35–$80.10	177% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool 1-3	$71.20	$89.00	$80.10	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Bill BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMM	$79.20	$99.00	$15.68–$89.10	333% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Bill BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMM	$79.20	$99.00	$89.10	—	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Ab (FTA-Ab) LC	$156.00	$195.00	$19.20–$175.50	502% above	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Ab (FTA-Ab) LC	$156.00	$195.00	$175.50	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, Rfx Qn RPR/Confirm TP LC	$51.20	$64.00	$6.19–$57.60	294% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .RPR Qn+TP Abs LC	$52.00	$65.00	$6.19–$58.50	300% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR LC	$71.20	$89.00	$6.19–$80.10	448% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, Rfx Qn RPR/Confirm TP LC	$51.20	$64.00	$57.60	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 .RPR Qn+TP Abs LC	$52.00	$65.00	$58.50	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR LC	$71.20	$89.00	$80.10	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold (In Tube) LC	$115.20	$144.00	$22.81–$129.60	59% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERONÂ®-TB Gold Plus (Client Incubated) LC	$120.00	$150.00	$23.76–$135.00	65% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON Client Incubated LC	$585.60	$732.00	$89.87–$658.80	707% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON TB Gold (In Tube) LC	$115.20	$144.00	$129.60	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERONÂ®-TB Gold Plus (Client Incubated) LC	$120.00	$150.00	$135.00	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON Client Incubated LC	$585.60	$732.00	$658.80	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum LC	$355.20	$444.00	$37.42–$399.60	928% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Serum LC	$355.20	$444.00	$399.60	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC	$137.60	$172.00	$21.10–$154.80	506% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 .Thyroid Peroxidase (TPO) Ab LC	$195.20	$244.00	$21.10–$219.60	760% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROX	$195.20	$244.00	$21.10–$219.60	760% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC	$249.60	$312.00	$21.10–$280.80	1000% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC	$137.60	$172.00	$154.80	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 .Thyroid Peroxidase (TPO) Ab LC	$195.20	$244.00	$219.60	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROX	$195.20	$244.00	$219.60	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC	$249.60	$312.00	$280.80	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Cascade Profile LC	$160.00	$200.00	$24.36–$180.00	160% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$258.40	$323.00	$24.36–$290.70	319% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Reflex to FT4	$268.00	$335.00	$24.36–$301.50	335% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile LC	$160.00	$200.00	$180.00	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$258.40	$323.00	$290.70	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Reflex to FT4	$268.00	$335.00	$301.50	—	20%
Total IgE blood test CPT 82785 Allergens w/Total IgE Area 12 LC	$104.80	$131.00	$20.75–$117.90	284% above	20%
Total IgE blood test CPT 82785 Immunoglobulin E, Total LC	$156.80	$196.00	$23.87–$176.40	475% above	20%
Total IgE blood test CPT 82785 IMMUNOGLOB E	$164.80	$206.00	$23.87–$185.40	505% above	20%
Total IgE blood test inpatient CPT 82785 Allergens w/Total IgE Area 12 LC	$104.80	$131.00	$117.90	—	20%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Total LC	$156.80	$196.00	$176.40	—	20%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOB E	$164.80	$206.00	$185.40	—	20%
Total cholesterol blood test CPT 82465 Cholesterol Total	$60.80	$76.00	$6.31–$68.40	190% above	20%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total	$60.80	$76.00	$68.40	—	20%
Total thyroxine (T4) blood test CPT 84436 T4, Total	$92.80	$116.00	$9.96–$104.40	195% above	20%
Total thyroxine (T4) blood test inpatient CPT 84436 T4, Total	$92.80	$116.00	$104.40	—	20%
Total triiodothyronine (T3) blood test CPT 84480 T3, Total	$196.00	$245.00	$20.56–$220.50	92% above	20%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC	$206.40	$258.00	$20.56–$232.20	102% above	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3, Total	$196.00	$245.00	$220.50	—	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC	$206.40	$258.00	$232.20	—	20%
Transferrin blood test CPT 84466 Transferrin LC	$151.20	$189.00	$18.50–$170.10	149% above	20%
Transferrin blood test inpatient CPT 84466 Transferrin LC	$151.20	$189.00	$170.10	—	20%
Triglycerides blood test CPT 84478 VAP Cholesterol Profile LC	$87.20	$109.00	$8.32–$98.10	397% above	20%
Triglycerides blood test CPT 84478 Triglycerides	$103.20	$129.00	$8.32–$116.10	489% above	20%
Triglycerides blood test inpatient CPT 84478 VAP Cholesterol Profile LC	$87.20	$109.00	$98.10	—	20%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$103.20	$129.00	$116.10	—	20%
Troponin test, quantitative CPT 84484 Troponin I	$236.00	$295.00	$18.08–$265.50	387% above	20%
Troponin test, quantitative CPT 84484 Cardiac Panel 2	$236.00	$295.00	$18.08–$265.50	387% above	20%
Troponin test, quantitative CPT 84484 Cardiac Panel Standard	$248.80	$311.00	$18.08–$279.90	413% above	20%
Troponin test, quantitative CPT 84484 Troponin	$248.80	$311.00	$18.08–$279.90	413% above	20%
Troponin test, quantitative inpatient CPT 84484 Cardiac Panel 2	$236.00	$295.00	$265.50	—	20%
Troponin test, quantitative inpatient CPT 84484 Troponin I	$236.00	$295.00	$265.50	—	20%
Troponin test, quantitative inpatient CPT 84484 Troponin	$248.80	$311.00	$279.90	—	20%
Troponin test, quantitative inpatient CPT 84484 Cardiac Panel Standard	$248.80	$311.00	$279.90	—	20%
Uric acid blood test CPT 84550 .Uric Acid, Please Note LC	$67.20	$84.00	$6.55–$75.60	5% below	20%
Uric acid blood test CPT 84550 Uric Acid	$88.00	$110.00	$6.55–$99.00	25% above	20%
Uric acid blood test inpatient CPT 84550 .Uric Acid, Please Note LC	$67.20	$84.00	$75.60	—	20%
Uric acid blood test inpatient CPT 84550 Uric Acid	$88.00	$110.00	$99.00	—	20%
Urinalysis with microscope exam, automated CPT 81001 Bill Observed Chain of Custody	$37.60	$47.00	$4.60–$42.30	2% below	20%
Urinalysis with microscope exam, automated CPT 81001 CLIENT URINALYSIS (W/ MICRO)	$60.80	$76.00	$4.60–$68.40	58% above	20%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture, if indicated Standard	$60.80	$76.00	$4.60–$68.40	58% above	20%
Urinalysis with microscope exam, automated CPT 81001 UA/M w/rflx Culture, Routine LC	$67.20	$84.00	$4.60–$75.60	75% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 Bill Observed Chain of Custody	$37.60	$47.00	$42.30	—	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 CLIENT URINALYSIS (W/ MICRO)	$60.80	$76.00	$68.40	—	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture, if indicated Standard	$60.80	$76.00	$68.40	—	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA/M w/rflx Culture, Routine LC	$67.20	$84.00	$75.60	—	20%
Urinalysis without microscope exam, automated CPT 81003 Kidney Stone Urine/Saturation LC	$44.00	$55.00	$3.26–$49.50	128% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 Kidney Stone Urine/Saturation LC	$44.00	$55.00	$49.50	—	20%
Urinalysis without microscope exam, manual CPT 81002 QUICK CARE URINALYSIS DIPSTICK	$21.60	$27.00	$4.28–$24.30	233% above	20%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK	$21.60	$27.00	$4.28–$24.30	233% above	20%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC	$24.00	$30.00	$4.75–$27.00	270% above	20%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick	$32.80	$41.00	$5.05–$36.90	405% above	20%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis with Microscopic, if indicated Standard	$34.40	$43.00	$5.05–$38.70	430% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK	$21.60	$27.00	$24.30	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 QUICK CARE URINALYSIS DIPSTICK	$21.60	$27.00	$24.30	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC	$24.00	$30.00	$27.00	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick	$32.80	$41.00	$36.90	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis with Microscopic, if indicated Standard	$34.40	$43.00	$38.70	—	20%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture, Urology Extended Workup LC	$131.20	$164.00	$11.70–$147.60	144% above	20%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$184.80	$231.00	$11.70–$207.90	243% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture, Urology Extended Workup LC	$131.20	$164.00	$147.60	—	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$184.80	$231.00	$207.90	—	20%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN 24 HOUR URINE + TOTAL VOLUME	$99.20	$124.00	$8.38–$111.60	291% above	20%
Urine microalbumin (albumin) test CPT 82043 U24 Microalbumin/Creat	$109.60	$137.00	$8.38–$123.30	332% above	20%
Urine microalbumin (albumin) test CPT 82043 Microalb/Creat Ratio	$252.00	$315.00	$8.38–$283.50	894% above	20%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN 24 HOUR URINE + TOTAL VOLUME	$99.20	$124.00	$111.60	—	20%
Urine microalbumin (albumin) test inpatient CPT 82043 U24 Microalbumin/Creat	$109.60	$137.00	$123.30	—	20%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalb/Creat Ratio	$252.00	$315.00	$283.50	—	20%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine 1	$169.60	$212.00	$12.48–$190.80	244% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test Urine 1	$169.60	$212.00	$190.80	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$143.20	$179.00	$21.87–$161.10	133% above	20%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12/Folate Panel	$144.00	$180.00	$21.87–$162.00	134% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$143.20	$179.00	$161.10	—	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12/Folate Panel	$144.00	$180.00	$162.00	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy LC	$233.60	$292.00	$42.92–$262.80	239% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level	$281.60	$352.00	$42.92–$316.80	309% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC	$412.00	$515.00	$42.92–$463.50	498% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy LC	$233.60	$292.00	$262.80	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level	$281.60	$352.00	$316.80	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC	$412.00	$515.00	$463.50	—	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol(1,25 di-OH Vit D) LC	$432.00	$540.00	$55.83–$486.00	419% above	20%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol(1,25 di-OH Vit D) LC	$432.00	$540.00	$486.00	—	20%
Zinc blood test CPT 84630 Zinc, Whole Blood LC	$113.60	$142.00	$16.52–$127.80	367% above	20%
Zinc blood test CPT 84630 Zinc, Plasma or Serum LC	$289.60	$362.00	$16.52–$325.80	1092% above	20%
Zinc blood test inpatient CPT 84630 Zinc, Whole Blood LC	$113.60	$142.00	$127.80	—	20%
Zinc blood test inpatient CPT 84630 Zinc, Plasma or Serum LC	$289.60	$362.00	$325.80	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Quantitative	$163.20	$204.00	$21.82–$183.60	510% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Subunit, Qnt, Serum LC	$165.60	$207.00	$21.82–$186.30	519% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFC GENERIC ADD-ON	$172.00	$215.00	$21.82–$193.50	543% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 FIRST TRIMESTER SCREEN	$172.00	$215.00	$21.82–$193.50	543% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Quantitative	$163.20	$204.00	$183.60	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG,Beta Subunit, Qnt, Serum LC	$165.60	$207.00	$186.30	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFC GENERIC ADD-ON	$172.00	$215.00	$193.50	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 FIRST TRIMESTER SCREEN	$172.00	$215.00	$193.50	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 CLSD TX FX DIS FIB WO/MA	$860.80	$1,076.00	$28.24–$968.40	33% below	20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 CLSD TX FX DIS FIB WO/MA	$860.80	$1,076.00	$968.40	—	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28475 Closed tx of metatarsal fx, with manipulation each	$414.40	$518.00	$12.90–$466.20	68% below	20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28475 Closed tx of metatarsal fx, with manipulation each	$414.40	$518.00	$466.20	—	20%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY	$2,014.40	$2,518.00	$360.17–$5,062.66	84% below	20%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY	$2,014.40	$2,518.00	$2,266.20	—	20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 54161-REMOVAL OF FORESKIN (OLDER THAN 28 DAYS)	$831.20	$1,039.00	$164.58–$4,169.00	68% below	20%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 54161-REMOVAL OF FORESKIN (OLDER THAN 28 DAYS)	$831.20	$1,039.00	$935.10	—	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision, Using Clamp or Other Device; Newborn Charge	$326.40	$408.00	$64.63–$3,234.38	29% above	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision, Using Clamp or Other Device; Newborn Charge	$326.40	$408.00	$367.20	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 CLSD TX FX DIS RAD W/OMA	$788.80	$986.00	$14.64–$887.40	50% below	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600 CLSD TX FX DIS RAD W/OMA	$788.80	$986.00	$887.40	—	20%
Colonoscopy with polyp removal CPT 45385 45385 COLONSCOPY W/LESION REMOVAL BY SNARE	$909.60	$1,137.00	$180.10–$1,851.53	69% below	20%
Colonoscopy with polyp removal inpatient CPT 45385 45385 COLONSCOPY W/LESION REMOVAL BY SNARE	$909.60	$1,137.00	$1,023.30	—	20%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY BX	$3,916.87	$4,896.09	$233.26–$4,406.48	28% above	20%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY BX	$3,916.87	$4,896.09	$4,406.48	—	20%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$1,691.20	$2,114.00	$158.29–$3,596.00	26% below	20%
Colonoscopy, diagnostic CPT 45378 Colonoscopy	$2,947.20	$3,684.00	$158.29–$3,596.00	30% above	20%
Colonoscopy, diagnostic CPT 45378 45378 PROF DIAGNOSTIC COLONSCOP	$2,947.20	$3,684.00	$158.29–$3,596.00	30% above	20%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$1,691.20	$2,114.00	$1,902.60	—	20%
Colonoscopy, diagnostic inpatient CPT 45378 45378 PROF DIAGNOSTIC COLONSCOP	$2,947.20	$3,684.00	$3,315.60	—	20%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy	$2,947.20	$3,684.00	$3,315.60	—	20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy of the cervix incuding upper/adjacent vagina with	$988.80	$1,236.00	$35.56–$2,671.00	77% below	20%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colposcopy of the cervix incuding upper/adjacent vagina with	$988.80	$1,236.00	$1,112.40	—	20%
Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$641.60	$802.00	$127.04–$5,454.10	91% below	20%
Cystoscopy with ureteral stent placement inpatient CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$641.60	$802.00	$721.80	—	20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,539.81	$1,924.76	$142.60–$3,098.00	10% above	20%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,539.81	$1,924.76	$1,732.28	—	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction Benign/Premalig Lesion Charge	$172.80	$216.00	$13.25–$310.43	10% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruction Benign/Premalig Lesion Charge	$172.80	$216.00	$194.40	—	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Irrigation w/ impaction	$76.00	$95.00	$15.05–$91.28	79% below	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ear Irrigation w/ impaction	$76.00	$95.00	$85.50	—	20%
Earwax removal with instruments, one ear CPT 69210 69210 REMOVE IMPACTED CERUMEN	$184.00	$230.00	$16.45–$207.00	54% below	20%
Earwax removal with instruments, one ear CPT 69210 Ear Irrigation POC	$188.00	$235.00	$16.45–$211.50	53% below	20%
Earwax removal with instruments, one ear inpatient CPT 69210 69210 REMOVE IMPACTED CERUMEN	$184.00	$230.00	$207.00	—	20%
Earwax removal with instruments, one ear inpatient CPT 69210 Ear Irrigation POC	$188.00	$235.00	$211.50	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Edometrial Sampling (biopsy) w/ or w/o Endo	$148.80	$186.00	$28.47–$2,671.00	89% below	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy Endometrial Charge	$404.80	$506.00	$38.01–$455.40	71% below	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Edometrial Sampling (biopsy) w/ or w/o Endo	$148.80	$186.00	$167.40	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Biopsy Endometrial Charge	$404.80	$506.00	$455.40	—	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$303.20	$379.00	$60.03–$3,098.00	88% below	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY	$303.20	$379.00	$341.10	—	20%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE (EG INTERPHALANGEAL FUSION PARTIAL OR TOTAL	$1,480.80	$1,851.00	$148.19–$5,062.66	88% below	20%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE (EG INTERPHALANGEAL FUSION PARTIAL OR TOTAL	$1,480.80	$1,851.00	$1,665.90	—	20%
Hysteroscopy with endometrial ablation CPT 58563 Endometrial Ablation hysteroscopic	$1,020.00	$1,275.00	$201.96–$7,740.14	87% below	20%
Hysteroscopy with endometrial ablation CPT 58563 NOVASURE KIT, NS-2007	$3,056.00	$3,820.00	$605.09–$7,740.14	62% below	20%
Hysteroscopy with endometrial ablation inpatient CPT 58563 Endometrial Ablation hysteroscopic	$1,020.00	$1,275.00	$1,147.50	—	20%
Hysteroscopy with endometrial ablation inpatient CPT 58563 NOVASURE KIT, NS-2007	$3,056.00	$3,820.00	$3,438.00	—	20%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$528.80	$661.00	$58.93–$2,671.00	88% below	20%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)	$528.80	$661.00	$594.90	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess, Simple/Single Charge	$324.00	$405.00	$21.46–$364.50	22% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 I D ABSCESS	$466.40	$583.00	$21.46–$524.70	12% above	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess, Simple/Single Charge	$324.00	$405.00	$364.50	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 I D ABSCESS	$466.40	$583.00	$524.70	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTIONS OF TENDON SHEATH, LIGAMENT, OR MUSCLE MEMBRANE	$125.60	$157.00	$18.18–$2,671.00	67% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJ TENDON ETC	$180.80	$226.00	$19.52–$474.93	53% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTIONS OF TENDON SHEATH, LIGAMENT, OR MUSCLE MEMBR	$212.80	$266.00	$19.52–$474.93	45% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTIONS OF TENDON SHEATH, LIGAMENT, OR MUSCLE MEMBRANE	$125.60	$157.00	$141.30	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJ TENDON ETC	$180.80	$226.00	$203.40	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJECTIONS OF TENDON SHEATH, LIGAMENT, OR MUSCLE MEMBR	$212.80	$266.00	$239.40	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, Asp, Inj - Large	$251.20	$314.00	$20.57–$474.93	58% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ASP / INJECTIONS JOINT MAJOR	$360.00	$450.00	$20.57–$474.93	39% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrocentesis, Asp, Inj - Large	$251.20	$314.00	$282.60	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 ASP / INJECTIONS JOINT MAJOR	$360.00	$450.00	$405.00	—	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Non-biodegradable drug delivery implant	$415.20	$519.00	$38.71–$467.10	197% above	20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion Non-biodegradable drug delivery implant	$415.20	$519.00	$467.10	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, Asp, Inj - Intermediate	$193.60	$242.00	$18.82–$474.93	53% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ASP / INJECTIONS JOINT INTERMEDIATE	$293.60	$367.00	$18.82–$474.93	29% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 Arthrocentesis, Asp, Inj - Intermediate	$193.60	$242.00	$217.80	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 ASP / INJECTIONS JOINT INTERMEDIATE	$293.60	$367.00	$330.30	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Cha	$191.20	$239.00	$18.83–$474.93	47% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ASP / INJECTIONS JOINT SMALL	$206.40	$258.00	$18.83–$474.93	43% below	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Cha	$191.20	$239.00	$215.10	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 ASP / INJECTIONS JOINT SMALL	$206.40	$258.00	$232.20	—	20%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LA	$2,356.00	$2,945.00	$466.49–$5,062.66	71% below	20%
Knee arthroscopy with meniscus trim CPT 29881 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL	$2,360.80	$2,951.00	$467.44–$5,062.66	71% below	20%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LA	$2,356.00	$2,945.00	$2,650.50	—	20%
Knee arthroscopy with meniscus trim inpatient CPT 29881 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL	$2,360.80	$2,951.00	$2,655.90	—	20%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND L	$2,444.80	$3,056.00	$484.07–$5,062.66	66% below	20%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND L	$2,444.80	$3,056.00	$2,750.40	—	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY, SURGICAL; REPAIR INITIAL INGUINAL HERNIA	$2,350.40	$2,938.00	$465.38–$9,354.07	85% below	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY, SURGICAL; REPAIR INITIAL INGUINAL HERNIA	$2,350.40	$2,938.00	$2,644.20	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude Hands and	$232.80	$291.00	$46.09–$629.00	76% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 REPAIR INTMD WND 2.5CM OR LESS	$1,194.40	$1,493.00	$117.30–$1,343.70	22% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude Hands and	$232.80	$291.00	$261.90	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 REPAIR INTMD WND 2.5CM OR LESS	$1,194.40	$1,493.00	$1,343.70	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Remove Lesion, Trunk/Arm/Leg <.5 cm Charge	$281.60	$352.00	$46.13–$1,095.68	64% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Remove Lesion, Trunk/Arm/Leg <.5 cm Charge	$281.60	$352.00	$316.80	—	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Remove Lesion, Face/Lid/Ear/Nose/Lip <.5 cm Charge	$323.20	$404.00	$37.91–$1,095.68	59% below	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Remove Lesion, Face/Lid/Ear/Nose/Lip <.5 cm Charge	$323.20	$404.00	$363.60	—	20%
Nail removal (partial or complete), one nail CPT 11730 Avulsion of Nail Plate, Partial or Complete, Simple; Single Charge	$240.80	$301.00	$47.68–$310.43	1% below	20%
Nail removal (partial or complete), one nail CPT 11730 11730 AVULS NAIL SIMPLE SGL	$270.40	$338.00	$53.54–$310.43	11% above	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of Nail Plate, Partial or Complete, Simple; Single Charge	$240.80	$301.00	$270.90	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 AVULS NAIL SIMPLE SGL	$270.40	$338.00	$304.20	—	20%
Occipital nerve block (injection for headaches) CPT 64405 64405 Injection, Anesthetic agent; Facial Nerve	$439.20	$549.00	$23.02–$494.10	19% above	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 Injection, Anesthetic agent; Facial Nerve	$439.20	$549.00	$494.10	—	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excise of Nail matrix, Part. or Complete, for Permanent Removal Charge	$480.00	$600.00	$61.87–$629.00	23% below	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excise of Nail matrix, Part. or Complete, for Permanent Removal Charge	$480.00	$600.00	$540.00	—	20%
Prostate removal (prostatectomy), laparoscopic CPT 55866 55866 LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICA	$4,988.00	$6,235.00	$987.62–$16,447.22	74% below	20%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 55866 LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICA	$4,988.00	$6,235.00	$5,611.50	—	20%
Removal of a foreign object under the skin, simple CPT 10120 Incision Removal of Foreign Body, Subcutaneous Tissues; Simple Charge	$308.00	$385.00	$48.99–$629.00	46% below	20%
Removal of a foreign object under the skin, simple CPT 10120 10120 INCS REM FOB SUB CUT S	$465.60	$582.00	$48.99–$629.00	18% below	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision Removal of Foreign Body, Subcutaneous Tissues; Simple Charge	$308.00	$385.00	$346.50	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 INCS REM FOB SUB CUT S	$465.60	$582.00	$523.80	—	20%
Short arm splint (forearm and hand) CPT 29125 29125 APL SPLINT SHORT ARM	$243.20	$304.00	$28.94–$273.60	69% below	20%
Short arm splint (forearm and hand) inpatient CPT 29125 29125 APL SPLINT SHORT ARM	$243.20	$304.00	$273.60	—	20%
Short leg splint (calf to foot) CPT 29515 29515 APPL SPLINT SHRT LEG	$242.40	$303.00	$25.11–$272.70	31% below	20%
Short leg splint (calf to foot) inpatient CPT 29515 29515 APPL SPLINT SHRT LEG	$242.40	$303.00	$272.70	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Simple Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.5 cm >	$351.20	$439.00	$52.21–$395.10	56% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 REPAIR SMPLE WND 2.5CM OR LESS	$476.00	$595.00	$52.21–$535.50	112% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Simple Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.5 cm >	$351.20	$439.00	$395.10	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 REPAIR SMPLE WND 2.5CM OR LESS	$476.00	$595.00	$535.50	—	20%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY, FIRST SKIN GROWTH	$202.40	$253.00	$40.08–$2,671.00	60% below	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY, FIRST SKIN GROWTH	$202.40	$253.00	$227.70	—	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.5 cm or Le	$364.80	$456.00	$72.23–$1,095.68	58% below	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.5 cm or Le	$364.80	$456.00	$410.40	—	20%
Skin tag removal, up to 15 tags CPT 11200 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to w/15 Lesions C	$240.00	$300.00	$16.81–$310.43	at median	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to w/15 Lesions C	$240.00	$300.00	$270.00	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 LUMBAR SPINAL TAP	$560.00	$700.00	$83.33–$1,092.18	10% below	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 LUMBAR SPINAL TAP	$560.00	$700.00	$630.00	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Simple Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.6 cm t	$431.20	$539.00	$58.65–$485.10	36% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 REPAIR SMPLE WND 2.6CM -7.5CM	$618.40	$773.00	$58.65–$695.70	96% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair Simple Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.6 cm t	$431.20	$539.00	$485.10	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 REPAIR SMPLE WND 2.6CM -7.5CM	$618.40	$773.00	$695.70	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 2.5 cm >	$410.40	$513.00	$60.08–$461.70	70% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SPL FACE MUC MEMB 2.5	$582.40	$728.00	$60.08–$655.20	58% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 2.5 cm >	$410.40	$513.00	$461.70	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 SPL FACE MUC MEMB 2.5	$582.40	$728.00	$655.20	—	20%
TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THRO	$3,049.60	$3,812.00	$603.82–$8,296.15	61% below	20%
TURP (transurethral resection of the prostate) inpatient CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THRO	$3,049.60	$3,812.00	$3,430.80	—	20%
Trigger finger release surgery CPT 26055 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER).	$1,264.00	$1,580.00	$250.27–$3,596.00	71% below	20%
Trigger finger release surgery inpatient CPT 26055 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER).	$1,264.00	$1,580.00	$1,422.00	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD DILATION	$5,077.60	$6,347.00	$617.94–$5,712.30	37% above	20%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD DILATION	$5,077.60	$6,347.00	$5,712.30	—	20%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SGL/MULTI ADD ON CHARGE	$2,046.40	$2,558.00	$236.04–$3,596.00	15% below	20%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF THE ESOPHAGUS, STOMACH, AND/OR UPPER SMALL BOWEL U	$2,660.00	$3,325.00	$236.04–$3,596.00	11% above	20%
Upper endoscopy (EGD) with biopsy CPT 43239 43239 BIOPSY OF THE ESOPHAGUS, STOMACH, AND/OR UPPER SMALL B	$2,660.00	$3,325.00	$236.04–$3,596.00	11% above	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SGL/MULTI ADD ON CHARGE	$2,046.40	$2,558.00	$2,302.20	—	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 BIOPSY OF THE ESOPHAGUS, STOMACH, AND/OR UPPER SMALL B	$2,660.00	$3,325.00	$2,992.50	—	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 BIOPSY OF THE ESOPHAGUS, STOMACH, AND/OR UPPER SMALL BOWEL U	$2,660.00	$3,325.00	$2,992.50	—	20%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD With PEG	$1,188.00	$1,485.00	$166.32–$3,596.00	45% below	20%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$1,564.80	$1,956.00	$166.32–$3,596.00	28% below	20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD With PEG	$1,188.00	$1,485.00	$1,336.50	—	20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$1,564.80	$1,956.00	$1,760.40	—	20%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE Tech	$1,620.80	$2,026.00	$320.92–$8,296.15	84% below	20%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE Tech	$1,620.80	$2,026.00	$1,823.40	—	20%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN	$1,719.20	$2,149.00	$340.40–$8,296.15	86% below	20%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN	$1,719.20	$2,149.00	$1,934.10	—	20%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INC	$971.20	$1,214.00	$102.86–$4,169.00	—	20%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$388.80	$486.00	$76.98–$3,234.38	95% below	20%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INC	$971.20	$1,214.00	$1,092.60	—	20%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$388.80	$486.00	$437.40	—	20%
Wart removal, up to 14 warts CPT 17110 Destruction (eg, laser/electro/cryo/chemosurgery/curettement), of warts; up to 1	$212.80	$266.00	$42.13–$310.43	14% below	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY,	$253.60	$317.00	$47.20–$2,671.00	3% above	20%
Wart removal, up to 14 warts CPT 17110 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSU	$351.20	$439.00	$47.20–$395.10	43% above	20%
Wart removal, up to 14 warts inpatient CPT 17110 Destruction (eg, laser/electro/cryo/chemosurgery/curettement), of warts; up to 1	$212.80	$266.00	$239.40	—	20%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY,	$253.60	$317.00	$285.30	—	20%
Wart removal, up to 14 warts inpatient CPT 17110 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSU	$351.20	$439.00	$395.10	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin/Soft Tissue Charge	$270.40	$338.00	$53.54–$629.00	63% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin/Soft Tissue Charge	$270.40	$338.00	$304.20	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration	$692.80	$866.00	$137.17–$779.40	28% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD PRODUCT TRANSFUSION	$726.40	$908.00	$143.83–$817.20	34% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admininstration	$766.40	$958.00	$151.75–$862.20	42% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration	$692.80	$866.00	$779.40	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD PRODUCT TRANSFUSION	$726.40	$908.00	$817.20	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admininstration	$766.40	$958.00	$862.20	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Airway inhalation treatment	$74.40	$93.00	$14.73–$338.82	71% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mini-Neb Subsequent	$135.83	$169.79	$26.89–$338.82	48% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 Airway inhalation treatment	$74.40	$93.00	$83.70	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mini-Neb Subsequent	$135.83	$169.79	$152.81	—	20%
Critical care, first 30 to 74 minutes CPT 99291 99291 - ED Critical Care	$2,860.80	$3,576.00	$53.55–$3,218.40	3% above	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - ED Critical Care	$2,860.80	$3,576.00	$3,218.40	—	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH	$62.40	$78.00	$12.36–$70.20	43% above	20%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH	$62.40	$78.00	$70.20	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CLIENT EKG (12 LEAD)	$82.40	$103.00	$16.32–$92.70	36% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram	$175.20	$219.00	$34.69–$197.10	35% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG (12 LEAD)	$193.60	$242.00	$38.33–$217.80	49% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CLIENT EKG (12 LEAD)	$82.40	$103.00	$92.70	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram	$175.20	$219.00	$197.10	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG (12 LEAD)	$193.60	$242.00	$217.80	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - ED Level 1	$315.20	$394.00	$32.72–$542.00	27% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - ED Level 1	$315.20	$394.00	$354.60	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - ED Level 2	$624.80	$781.00	$71.10–$744.00	67% above	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - ED Level 2	$624.80	$781.00	$702.90	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - ED Level 3	$1,109.60	$1,387.00	$125.32–$1,248.30	60% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - ED Level 3	$1,109.60	$1,387.00	$1,248.30	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - ED Level 4	$1,761.60	$2,202.00	$221.43–$1,981.80	55% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - ED Level 4	$1,761.60	$2,202.00	$1,981.80	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - ED Level 5	$2,620.00	$3,275.00	$332.40–$2,947.50	57% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - ED Level 5	$2,620.00	$3,275.00	$2,947.50	—	20%
Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy Including Patient 50 Mins	$560.80	$701.00	$0.35–$630.90	283% above	20%
Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psychotherapy Including Patient 50 Mins	$560.80	$701.00	$630.90	—	20%
Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYCHOTHERAPY 50 Mins	$540.00	$675.00	$0.36–$607.50	278% above	20%
Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 FAMILY PSYCHOTHERAPY 50 Mins	$540.00	$675.00	$607.50	—	20%
Group psychotherapy session CPT 90853 90853 Group psychotherapy.	$132.80	$166.00	$3.90–$157.18	at median	20%
Group psychotherapy session inpatient CPT 90853 90853 Group psychotherapy.	$132.80	$166.00	$149.40	—	20%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 HEART RHYTHM TRACING, ANALYSIS, AND INTERPRETATION OF 48-HOU	$180.00	$225.00	$35.64–$202.50	—	20%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 HEART RHYTHM TRACING, ANALYSIS, AND INTERPRETATION OF 48-HOU	$180.00	$225.00	$202.50	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration 1ST Hour Charge	$134.40	$168.00	$26.61–$329.11	28% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION FOR THERAPY	$160.00	$200.00	$31.68–$329.11	15% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$235.84	$294.80	$46.70–$329.11	26% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV FLUID HYDRATION INITAL HOUR	$289.60	$362.00	$57.34–$329.11	55% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration 1ST Hour Charge	$134.40	$168.00	$151.20	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION FOR THERAPY	$160.00	$200.00	$180.00	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$235.84	$294.80	$265.32	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV FLUID HYDRATION INITAL HOUR	$289.60	$362.00	$325.80	—	20%
IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION 1ST HR Charge	$172.80	$216.00	$34.21–$329.11	33% below	20%
IV infusion of a medicine, first hour CPT 96365 96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN	$304.80	$381.00	$60.35–$342.90	18% above	20%
IV infusion of a medicine, first hour CPT 96365 96365 IV DRUG FIRST HOUR	$677.60	$847.00	$134.16–$762.30	162% above	20%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$684.80	$856.00	$135.59–$770.40	165% above	20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION 1ST HR Charge	$172.80	$216.00	$194.40	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN	$304.80	$381.00	$342.90	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV DRUG FIRST HOUR	$677.60	$847.00	$762.30	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$684.80	$856.00	$770.40	—	20%
IV push of a medicine, first drug CPT 96374 INTRAVENOUS ADMINISTRATI	$149.60	$187.00	$29.62–$329.11	9% below	20%
IV push of a medicine, first drug CPT 96374 96374 - IV Injection, single/initial	$214.40	$268.00	$42.45–$329.11	31% above	20%
IV push of a medicine, first drug CPT 96374 96374 INTRAVENOUS PUSH ADMINISTRATI	$289.60	$362.00	$57.34–$329.11	77% above	20%
IV push of a medicine, first drug inpatient CPT 96374 INTRAVENOUS ADMINISTRATI	$149.60	$187.00	$168.30	—	20%
IV push of a medicine, first drug inpatient CPT 96374 96374 - IV Injection, single/initial	$214.40	$268.00	$241.20	—	20%
IV push of a medicine, first drug inpatient CPT 96374 96374 INTRAVENOUS PUSH ADMINISTRATI	$289.60	$362.00	$325.80	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 IM INJ OF ANTIBIOTIC	$33.60	$42.00	$6.65–$111.40	51% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THERAPTIC PROPHALACTIC I	$196.00	$245.00	$38.81–$220.50	183% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$206.40	$258.00	$40.87–$232.20	198% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 IM INJ OF ANTIBIOTIC	$33.60	$42.00	$37.80	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THERAPTIC PROPHALACTIC I	$196.00	$245.00	$220.50	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$206.40	$258.00	$232.20	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Intake Psychiatric diagnostic interview examination	$643.20	$804.00	$25.56–$723.60	212% above	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Intake Psychiatric diagnostic interview examination	$643.20	$804.00	$723.60	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 97112 THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINU	$186.40	$233.00	$36.91–$209.70	11% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINU	$186.40	$233.00	$209.70	—	20%
New patient office visit, about 30 minutes CPT 99203 Office/OP New Visit Level 3 99203	$284.00	$355.00	$21.32–$367.62	56% above	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Office/OP New Visit Level 3 99203	$284.00	$355.00	$319.50	—	20%
New patient office visit, about 45 minutes CPT 99204 Office/OP New Visit Level 4 99204	$367.20	$459.00	$24.43–$413.10	85% above	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Office/OP New Visit Level 4 99204	$367.20	$459.00	$413.10	—	20%
New patient office visit, about 60 minutes CPT 99205 Office/OP New Visit Level 5 99205	$605.60	$757.00	$28.50–$681.30	168% above	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/OP New Visit Level 5 99205	$605.60	$757.00	$681.30	—	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/OP New Visit Level 2 99202	$222.40	$278.00	$17.72–$367.62	51% above	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/OP New Visit Level 2 99202	$222.40	$278.00	$250.20	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINU	$166.40	$208.00	$32.95–$187.20	3% below	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINU	$166.40	$208.00	$187.20	—	20%
Preventive checkup, new patient aged 18–39 CPT 99385 Preventive Medicine 18-39 years New - 99385	$398.40	$498.00	$31.30–$448.20	249% above	20%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Preventive Medicine 18-39 years New - 99385	$398.40	$498.00	$448.20	—	20%
Preventive checkup, new patient aged 40–64 CPT 99386 Preventive Medicine 40-64 years New - 99386	$473.60	$592.00	$31.01–$532.80	251% above	20%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Preventive Medicine 40-64 years New - 99386	$473.60	$592.00	$532.80	—	20%
Preventive checkup, new patient aged 65 or older CPT 99387 Preventive Medicine 65+ years New - 99387	$500.80	$626.00	$34.82–$563.40	366% above	20%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Preventive Medicine 65+ years New - 99387	$500.80	$626.00	$563.40	—	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 Preventive Medicine 18-39 years Established - 99395	$306.40	$383.00	$26.92–$344.70	329% above	20%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Preventive Medicine 18-39 years Established - 99395	$306.40	$383.00	$344.70	—	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 Preventive Medicine 40-64 years Established - 99396	$397.60	$497.00	$27.21–$447.30	67% above	20%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Preventive Medicine 40-64 years Established - 99396	$397.60	$497.00	$447.30	—	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 Preventive Medicine 65+ years Established - 99397	$420.00	$525.00	$31.30–$472.50	370% above	20%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Preventive Medicine 65+ years Established - 99397	$420.00	$525.00	$472.50	—	20%
Psychiatric evaluation with medical services CPT 90792 90792 Intake Psychiatric diagnostic interview examination	$759.20	$949.00	$25.92–$854.10	236% above	20%
Psychiatric evaluation with medical services inpatient CPT 90792 90792 Intake Psychiatric diagnostic interview examination	$759.20	$949.00	$854.10	—	20%
Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy 30 Mins	$335.20	$419.00	$10.65–$377.10	116% above	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy 30 Mins	$335.20	$419.00	$377.10	—	20%
Psychotherapy session, 45 minutes CPT 90834 90834 Psychotherapy 45 Mins	$446.40	$558.00	$14.20–$502.20	159% above	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Psychotherapy 45 Mins	$446.40	$558.00	$502.20	—	20%
Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy 60 Mins	$670.40	$838.00	$20.95–$754.20	240% above	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy 60 Mins	$670.40	$838.00	$754.20	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION OVER 10 MIN	$43.20	$54.00	$8.55–$57.97	40% above	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION OVER 10 MIN	$43.20	$54.00	$48.60	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/OP Established Visit Level 5 99215	$526.40	$658.00	$26.35–$592.20	139% above	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office/OP Established Visit Level 5 99215	$526.40	$658.00	$592.20	—	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/OP Established Visit Level 3 99213	$247.20	$309.00	$17.97–$367.62	76% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office/OP Established Visit Level 3 99213	$247.20	$309.00	$278.10	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/OP Established Visit Level 4 99214	$318.40	$398.00	$22.28–$367.62	33% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office/OP Established Visit Level 4 99214	$318.40	$398.00	$358.20	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/OP Established Visit Level 2 99212	$193.60	$242.00	$15.33–$367.62	38% above	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/OP Established Visit Level 2 99212	$193.60	$242.00	$217.80	—	20%
Spirometry (breathing test) CPT 94010 INCENTIVE SPIROMTRY	$89.60	$112.00	$17.74–$334.09	54% below	20%
Spirometry (breathing test) CPT 94010 Respiratory Therapy	$616.80	$771.00	$122.13–$693.90	218% above	20%
Spirometry (breathing test) CPT 94010 94010 PFT	$718.40	$898.00	$142.24–$808.20	271% above	20%
Spirometry (breathing test) inpatient CPT 94010 INCENTIVE SPIROMTRY	$89.60	$112.00	$100.80	—	20%
Spirometry (breathing test) inpatient CPT 94010 Respiratory Therapy	$616.80	$771.00	$693.90	—	20%
Spirometry (breathing test) inpatient CPT 94010 94010 PFT	$718.40	$898.00	$808.20	—	20%
Spirometry before and after a bronchodilator CPT 94060 CLIENT PFT PRE/POST	$86.40	$108.00	$17.11–$577.38	72% below	20%
Spirometry before and after a bronchodilator CPT 94060 Respiratory Therapy	$682.40	$853.00	$135.12–$767.70	123% above	20%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test	$718.40	$898.00	$142.24–$808.20	135% above	20%
Spirometry before and after a bronchodilator CPT 94060 PFT Pre Post	$718.40	$898.00	$142.24–$808.20	135% above	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 CLIENT PFT PRE/POST	$86.40	$108.00	$97.20	—	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 Respiratory Therapy	$682.40	$853.00	$767.70	—	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Pre Post	$718.40	$898.00	$808.20	—	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test	$718.40	$898.00	$808.20	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CO	$213.60	$267.00	$42.29–$240.30	8% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CO	$213.60	$267.00	$240.30	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 6	$343.20	$429.00	$67.95–$386.10	27% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy 6	$343.20	$429.00	$386.10	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 91322 Spikevax Medication Charge	$227.20	$284.00	$44.99–$255.60	—	20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 91322 Spikevax Medication Charge	$227.20	$284.00	$255.60	—	20%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Pfizer Comirnaty COVID 19 12 years and older	$134.69	$168.36	$26.67–$151.52	—	20%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Pfizer Comirnaty COVID 19 12 years and older	$134.69	$168.36	$151.52	—	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vaccine POC	$289.60	$362.00	$57.34–$325.80	at median	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vaccine POC	$289.60	$362.00	$325.80	—	20%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine,	$162.40	$203.00	$32.16–$182.70	23% above	20%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine,	$162.40	$203.00	$182.70	—	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 90700 Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), young	$80.00	$100.00	$15.84–$90.00	17% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Immunization Request:DTaP Diphtheria/Pertussis, acellular/Te	$80.00	$100.00	$15.84–$90.00	17% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTaP Diphtheria/Pertussis, acellular/Tetanus Vaccine DTaP Un	$80.00	$100.00	$15.84–$90.00	17% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 90700 Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), young	$80.00	$100.00	$90.00	—	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTaP Diphtheria/Pertussis, acellular/Tetanus Vaccine DTaP Un	$80.00	$100.00	$90.00	—	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Immunization Request:DTaP Diphtheria/Pertussis, acellular/Te	$80.00	$100.00	$90.00	—	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 90723 Diphtheria, tetanus toxoids, acellular pertussis vac, hep B, inactivated p	$180.80	$226.00	$35.80–$203.40	7% below	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Diphth/HepB/Pertussis,Acel/Polio/Tetanus Vaccine POC	$180.80	$226.00	$35.80–$203.40	7% below	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 90723 Diphtheria, tetanus toxoids, acellular pertussis vac, hep B, inactivated p	$180.80	$226.00	$203.40	—	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Diphth/HepB/Pertussis,Acel/Polio/Tetanus Vaccine POC	$180.80	$226.00	$203.40	—	20%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza	$156.00	$195.00	$30.89–$175.50	73% above	20%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza	$156.00	$195.00	$175.50	—	20%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 90697 Vax	$60.00	$75.00	$11.88–$67.50	50% below	20%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 90697 Vax	$60.00	$75.00	$67.50	—	20%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 90673 Flu Vaccine RIV3 NO PRESERV	$67.20	$84.00	$13.31–$75.60	78% below	20%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 90673 Flu Vaccine RIV3 NO PRESERV	$67.20	$84.00	$75.60	—	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV (human papillomavirus vaccine)	$308.00	$385.00	$60.98–$346.50	31% below	20%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV (human papillomavirus vaccine)	$308.00	$385.00	$346.50	—	20%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 CLIENT HEP B IMMUNIZATION	$60.00	$75.00	$11.88–$67.50	62% below	20%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 CLIENT HEP B IMMUNIZATION	$60.00	$75.00	$67.50	—	20%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Adult Vaccine POC	$216.80	$271.00	$42.93–$243.90	98% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Adult Vaccine POC	$216.80	$271.00	$243.90	—	20%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Peds/Adol Vaccine 2 Dose Sched Charge	$112.80	$141.00	$22.33–$126.90	at median	20%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Peds/Adol Vaccine 2 Dose Sched Charge	$112.80	$141.00	$126.90	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg [CQCH]	$38.56	$48.20	$7.63–$43.38	56% below	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 90746 Hepatitis B vaccine, adult dosage (3 dose schedule), for intramuscular use	$228.00	$285.00	$45.14–$256.50	161% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg [CQCH]	$38.56	$48.20	$43.38	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 90746 Hepatitis B vaccine, adult dosage (3 dose schedule), for intramuscular use	$228.00	$285.00	$256.50	—	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for in	$86.40	$108.00	$17.11–$97.20	12% above	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for in	$86.40	$108.00	$97.20	—	20%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Hemophilus Influenza B Vaccine (Hib), PRP-OMP conj. 3-dose IM use POC	$69.60	$87.00	$13.78–$78.30	24% above	20%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Hemophilus Influenza B Vaccine (Hib), PRP-OMP conj. 3-dose IM use POC	$69.60	$87.00	$78.30	—	20%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 90648 Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), f	$86.40	$108.00	$17.11–$97.20	134% above	20%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 90648 Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), f	$86.40	$108.00	$97.20	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use	$168.00	$210.00	$33.26–$189.00	5% below	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR Measles/Mumps/Rubella Virus Vaccine POC	$168.00	$210.00	$33.26–$189.00	5% below	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR Measles/Mumps/Rubella Virus Vaccine POC	$168.00	$210.00	$189.00	—	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use	$168.00	$210.00	$189.00	—	20%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 VFC - 90710 MMRV Vaccine	$470.40	$588.00	$93.14–$529.20	77% above	20%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous us	$470.40	$588.00	$93.14–$529.20	77% above	20%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous us	$470.40	$588.00	$529.20	—	20%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 VFC - 90710 MMRV Vaccine	$470.40	$588.00	$529.20	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for	$314.40	$393.00	$62.25–$353.70	19% below	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for	$314.40	$393.00	$353.70	—	20%
Nasal spray flu vaccine, live (FluMist) CPT 90660 Influenza virus vaccine, live, for intranasal use	$53.60	$67.00	$10.61–$60.30	13% below	20%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 Influenza virus vaccine, live, for intranasal use	$53.60	$67.00	$60.30	—	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal conjugate vaccine, 13 valent, for intramuscular	$236.80	$296.00	$46.89–$266.40	at median	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal conjugate vaccine, 13 valent, for IM use	$333.60	$417.00	$66.05–$375.30	41% above	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13 vaccine Prevnar PFS [CQCH]	$616.53	$770.66	$122.07–$693.59	160% above	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal conjugate vaccine, 13 valent, for intramuscular	$236.80	$296.00	$266.40	—	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal conjugate vaccine, 13 valent, for IM use	$333.60	$417.00	$375.30	—	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13 vaccine Prevnar PFS [CQCH]	$616.53	$770.66	$693.59	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine	$248.00	$310.00	$49.10–$279.00	54% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine	$248.00	$310.00	$279.00	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal 23-Valent Adult Vaccine POC	$68.00	$85.00	$13.46–$76.50	7% below	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23 vaccine Inj [CQCH]	$331.62	$414.52	$65.66–$373.07	353% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal 23-Valent Adult Vaccine POC	$68.00	$85.00	$76.50	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23 vaccine Inj [CQCH]	$331.62	$414.52	$373.07	—	20%
Polio vaccine, inactivated (IPV) CPT 90713 IPV Inactivated Poliovirus Vaccine POC	$86.40	$108.00	$17.11–$97.20	62% above	20%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV Inactivated Poliovirus Vaccine POC	$86.40	$108.00	$97.20	—	20%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 90381 RSV Vaccine 1ML	$416.00	$520.00	$82.37–$468.00	48% below	20%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 90381 RSV 1ML	$480.00	$600.00	$95.04–$540.00	40% below	20%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 90381 RSV Vaccine 1ML	$416.00	$520.00	$468.00	—	20%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 90381 RSV 1ML	$480.00	$600.00	$540.00	—	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 90380 RSV VACCINE 0.5ML	$416.00	$520.00	$82.37–$468.00	48% below	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 90380 RSV 0.5 ML	$480.00	$600.00	$95.04–$540.00	40% below	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 90380 RSV VACCINE 0.5ML	$416.00	$520.00	$468.00	—	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 90380 RSV 0.5 ML	$480.00	$600.00	$540.00	—	20%
Rabies vaccine, one dose CPT 90675 CLIENT RABIES VACCINE INJ (IM)	$387.20	$484.00	$76.67–$481.37	5% above	20%
Rabies vaccine, one dose inpatient CPT 90675 CLIENT RABIES VACCINE INJ (IM)	$387.20	$484.00	$435.60	—	20%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 VFC 90681 Rotavirus vaccine, human, attenuated, 2 dose sched	$247.20	$309.00	$48.95–$278.10	122% above	20%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 90680 Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use	$247.20	$309.00	$48.95–$278.10	122% above	20%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 90680 Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use	$247.20	$309.00	$278.10	—	20%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 VFC 90681 Rotavirus vaccine, human, attenuated, 2 dose sched	$247.20	$309.00	$278.10	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoids (Td)adult IM [CQCH]	$36.35	$45.44	$7.20–$40.90	66% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, for use in indi	$68.00	$85.00	$13.46–$76.50	36% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 Td - TENIVAC (7 yrs older)	$68.00	$85.00	$13.46–$76.50	36% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria toxoids (Td)adult IM [CQCH]	$36.35	$45.44	$40.90	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 90714 Td - TENIVAC (7 yrs older)	$68.00	$85.00	$76.50	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, for use in indi	$68.00	$85.00	$76.50	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, diphtheria toxoids acellular pertussis vaccine (T	$108.00	$135.00	$21.38–$121.50	20% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus, diphtheria toxoids acellular pertussis vaccine (T	$108.00	$135.00	$121.50	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Each additional vaccine	$31.20	$39.00	$6.18–$35.10	12% below	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Each additional vaccine	$31.20	$39.00	$35.10	—	20%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://pricetransparency.healthcare/copper-queen-community-hospital/charges/export