SelfPayRates
Hospital Sierra Vista-Douglas, AZ

Copper Queen Community Hospital

Copper Queen Community Hospital in Bisbee, AZ publishes cash prices for 217 common procedures listed here, from its own machine-readable price file updated Feb 4, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Arizona median for 165 of 211 procedures and below it for 45. By typical cash price it ranks #40 of 53 Arizona hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

101 Cole Avenue, Bisbee, AZ 85603 Collected Sep 27, 2026 Source price file (520) 432-6401

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

Scans and imaging

ProcedureCash price List priceInsurers payvs ArizonaOff list
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Right Complete $676.00 $845.00 $135.20–$760.50 98% above 20%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Left Complete $676.00 $845.00 $135.20–$760.50 98% above 20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Left Complete $676.00 $845.00 $219.70–$760.50 — 20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Right Complete $676.00 $845.00 $219.70–$760.50 — 20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Left Limited $571.20 $714.00 $114.24–$642.60 142% above 20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Right Limited $571.20 $714.00 $114.24–$642.60 142% above 20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Left Limited $571.20 $714.00 $185.64–$642.60 — 20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Right Limited $571.20 $714.00 $185.64–$642.60 — 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 $668.00–$3,757.50 140% 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 $1,085.50–$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 $725.60–$4,081.50 176% 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 $1,179.10–$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 $733.60–$4,126.50 98% 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 $1,192.10–$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 $827.84–$4,656.60 79% 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 $1,345.24–$4,656.60 — 20%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast $2,901.60 $3,627.00 $580.32–$3,264.30 124% above 20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast $2,901.60 $3,627.00 $943.02–$3,264.30 — 20%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast $1,916.00 $2,395.00 $383.20–$2,155.50 111% above 20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast $1,916.00 $2,395.00 $622.70–$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 $314.08–$1,766.70 92% 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 $330.56–$1,859.40 102% 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 $510.38–$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 $537.16–$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 $48.36–$272.02 73% below 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast $1,325.60 $1,657.00 $265.12–$1,491.30 50% above 20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CLIENT CT HEAD WO CONTR $241.79 $302.24 $78.58–$272.02 — 20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast $1,325.60 $1,657.00 $430.82–$1,491.30 — 20%
CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast $1,677.60 $2,097.00 $335.52–$1,887.30 48% above 20%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast $1,677.60 $2,097.00 $545.22–$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 $411.84–$2,316.60 44% 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 $669.24–$2,316.60 — 20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast $1,584.80 $1,981.00 $316.96–$1,782.90 35% above 20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast $1,584.80 $1,981.00 $515.06–$1,782.90 — 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 $471.84–$2,654.10 111% 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 $766.74–$2,654.10 — 20%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast $2,924.00 $3,655.00 $584.80–$3,289.50 148% above 20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast $2,924.00 $3,655.00 $950.30–$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 $166.84–$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 $409.24–$1,416.60 — 20%
Chest X-ray, 2 views CPT 71046 CLIENT CHEST TWO VIEW $57.60 $72.00 $11.52–$64.80 70% below 20%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views $363.20 $454.00 $72.64–$408.60 89% above 20%
Chest X-ray, 2 views inpatient CPT 71046 CLIENT CHEST TWO VIEW $57.60 $72.00 $18.72–$64.80 — 20%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views $363.20 $454.00 $118.04–$408.60 — 20%
Chest X-ray, single view CPT 71045 XR Chest 1 View $267.20 $334.00 $53.44–$300.60 150% above 20%
Chest X-ray, single view CPT 71045 XR Chest 1 View Special $267.20 $334.00 $53.44–$300.60 150% above 20%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View $267.20 $334.00 $86.84–$300.60 — 20%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Special $267.20 $334.00 $86.84–$300.60 — 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Aorta Duplex Complete $662.40 $828.00 $132.48–$745.20 66% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal $662.40 $828.00 $132.48–$745.20 66% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal $662.40 $828.00 $215.28–$745.20 — 20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Aorta Duplex Complete $662.40 $828.00 $215.28–$745.20 — 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Study $591.20 $739.00 $79.00–$665.10 94% above 20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Study $591.20 $739.00 $192.14–$665.10 — 20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Dexa Appendicular $95.20 $119.00 $19.04–$107.10 54% below 20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Dexa Appendicular $95.20 $119.00 $30.94–$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 $312.00–$1,755.00 90% 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 $507.00–$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 $381.60–$2,146.50 51% above 20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W/Contrast $1,908.00 $2,385.00 $620.10–$2,146.50 — 20%
Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Diagnostic Bilateral. $855.20 $1,069.00 $171.04–$962.10 — 20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Diagnostic Bilateral. $855.20 $1,069.00 $277.94–$962.10 — 20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral $1,637.60 $2,047.00 $166.84–$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 $532.22–$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 $166.84–$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 $166.84–$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 $394.16–$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 $449.28–$1,555.20 — 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO Complete $1,988.80 $2,486.00 $350.10–$2,237.40 97% above 20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO Complete $1,988.80 $2,486.00 $646.36–$2,237.40 — 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited $553.60 $692.00 $110.72–$622.80 25% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited $553.60 $692.00 $179.92–$622.80 — 20%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast $2,332.80 $2,916.00 $466.56–$2,624.40 109% above 20%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast $2,332.80 $2,916.00 $758.16–$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 $813.76–$4,577.40 94% 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 $1,322.36–$4,577.40 — 20%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast $2,421.60 $3,027.00 $484.32–$2,724.30 92% above 20%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast $2,421.60 $3,027.00 $787.02–$2,724.30 — 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 $378.08–$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 $765.28–$4,304.70 102% 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 $614.38–$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 $1,243.58–$4,304.70 — 20%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast $2,391.20 $2,989.00 $478.24–$2,690.10 53% above 20%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast $2,391.20 $2,989.00 $777.14–$2,690.10 — 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 $734.24–$4,130.10 54% 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 $1,193.14–$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 $477.28–$2,684.70 58% 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 $775.58–$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 $736.48–$4,142.70 54% 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 $1,196.78–$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 $477.76–$2,687.40 76% 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 $776.36–$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 $809.12–$4,551.30 99% 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 $1,314.82–$4,551.30 — 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum w/o Contrast $2,144.00 $2,680.00 $428.80–$2,412.00 73% above 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast $2,768.80 $3,461.00 $553.76–$3,114.90 123% above 20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum w/o Contrast $2,144.00 $2,680.00 $696.80–$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 $899.86–$3,114.90 — 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited $314.40 $393.00 $62.88–$353.70 7% above 20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non-OB Limited $314.40 $393.00 $102.18–$353.70 — 20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete $1,032.80 $1,291.00 $206.56–$1,161.90 141% above 20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Complete $1,032.80 $1,291.00 $335.66–$1,161.90 — 20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Complete $1,179.20 $1,474.00 $79.00–$1,326.60 202% above 20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Complete $1,179.20 $1,474.00 $383.24–$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 $79.00–$932.40 191% 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 $269.36–$932.40 — 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Detailed Multi $329.60 $412.00 $65.92–$370.80 7% above 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Fetal Eval Complete $652.80 $816.00 $79.00–$734.40 112% above 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Detailed Multi $329.60 $412.00 $107.12–$370.80 — 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Fetal Eval Complete $652.80 $816.00 $212.16–$734.40 — 20%
Screening mammogram, both breasts both sides CPT 77067 MA Mammogram Routine Screening Bilat. $662.40 $828.00 $132.48–$745.20 — 20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MA Mammogram Routine Screening Bilat. $662.40 $828.00 $215.28–$745.20 — 20%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal $771.20 $964.00 $79.00–$867.60 115% above 20%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal $771.20 $964.00 $250.64–$867.60 — 20%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal $572.80 $716.00 $79.00–$644.40 75% above 20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal $572.80 $716.00 $186.16–$644.40 — 20%
Ultrasound of the abdomen, complete CPT 76700 US Pancreas $420.00 $525.00 $84.00–$472.50 18% below 20%
Ultrasound of the abdomen, complete CPT 76700 US Spleen $696.00 $870.00 $139.20–$783.00 35% above 20%
Ultrasound of the abdomen, complete CPT 76700 US Liver $928.80 $1,161.00 $185.76–$1,044.90 80% above 20%
Ultrasound of the abdomen, complete CPT 76700 US Gallbladder $985.60 $1,232.00 $197.12–$1,108.80 91% above 20%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete $1,177.60 $1,472.00 $235.52–$1,324.80 129% above 20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Pancreas $420.00 $525.00 $136.50–$472.50 — 20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Spleen $696.00 $870.00 $226.20–$783.00 — 20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Liver $928.80 $1,161.00 $301.86–$1,044.90 — 20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Gallbladder $985.60 $1,232.00 $320.32–$1,108.80 — 20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete $1,177.60 $1,472.00 $382.72–$1,324.80 — 20%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) $808.80 $1,011.00 $161.76–$909.90 104% above 20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) $808.80 $1,011.00 $262.86–$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 $79.00–$844.20 125% 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 $79.00–$1,161.90 209% 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 $243.88–$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 $335.66–$1,161.90 — 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 $79.00–$775.80 56% above 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right $689.60 $862.00 $79.00–$775.80 56% above 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 $79.00–$775.80 56% 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 $79.00–$993.60 100% above 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 $224.12–$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 $224.12–$775.80 — 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right $689.60 $862.00 $224.12–$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 $287.04–$993.60 — 20%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View $282.40 $353.00 $56.48–$317.70 63% above 20%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View w/Decub $356.00 $445.00 $71.20–$400.50 106% above 20%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View $282.40 $353.00 $91.78–$317.70 — 20%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View w/Decub $356.00 $445.00 $115.70–$400.50 — 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 $146.88–$826.20 328% 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 $238.68–$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 $134.88–$758.70 95% 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 $219.18–$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 $88.80–$499.50 315% 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 $144.30–$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 $88.16–$495.90 97% 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 $143.26–$495.90 — 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 View $271.20 $339.00 $54.24–$305.10 47% above 20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 View $271.20 $339.00 $88.14–$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 $74.24–$417.60 244% 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 $120.64–$417.60 — 20%

Lab tests

ProcedureCash price List priceInsurers payvs ArizonaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase $99.20 $124.00 $19.84–$111.60 171% above 20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase $99.20 $124.00 $32.24–$111.60 — 20%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase $99.20 $124.00 $19.84–$111.60 178% above 20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase $99.20 $124.00 $32.24–$111.60 — 20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) LC $915.20 $1,144.00 $183.04–$1,029.60 564% above 20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis LC $1,335.20 $1,669.00 $267.04–$1,502.10 868% above 20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) LC $915.20 $1,144.00 $297.44–$1,029.60 — 20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis LC $1,335.20 $1,669.00 $433.94–$1,502.10 — 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill 602931 Mimosa/acacia $31.20 $39.00 $6.24–$35.10 147% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill 602503 Johnson Grass $31.20 $39.00 $6.24–$35.10 147% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill 602872 Rye Grass $31.20 $39.00 $6.24–$35.10 147% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, EAC $32.80 $41.00 $6.56–$36.90 159% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC $38.40 $48.00 $7.68–$43.20 204% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F044-IgE Strawberry LC $46.40 $58.00 $9.28–$52.20 267% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC $48.00 $60.00 $9.60–$54.00 279% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FISH/SHELL MIX $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(14) LC $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Basic Food LC $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PORK $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHOC $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Allergens(14) $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG $49.60 $62.00 $9.92–$55.80 292% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 M005-IgE Candida albicans LC $51.20 $64.00 $10.24–$57.60 305% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGN PNUT $52.00 $65.00 $10.40–$58.50 311% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens w/Total IgE Area 12 LC $52.00 $65.00 $10.40–$58.50 311% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MILK $52.00 $65.00 $10.40–$58.50 311% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Alder Tree $59.20 $74.00 $11.84–$66.60 368% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill Ige Dog dander $60.80 $76.00 $12.16–$68.40 381% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill Allergen Test $116.00 $145.00 $23.20–$130.50 817% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Profile LC $849.60 $1,062.00 $169.92–$955.80 6616% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens w/Total IgE 11 LC $944.00 $1,180.00 $188.80–$1,062.00 7362% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Zone 16 LC $1,400.00 $1,750.00 $280.00–$1,575.00 10967% above 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill 602503 Johnson Grass $31.20 $39.00 $10.14–$35.10 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill 602931 Mimosa/acacia $31.20 $39.00 $10.14–$35.10 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill 602872 Rye Grass $31.20 $39.00 $10.14–$35.10 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, EAC $32.80 $41.00 $10.66–$36.90 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC $38.40 $48.00 $12.48–$43.20 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F044-IgE Strawberry LC $46.40 $58.00 $15.08–$52.20 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC $48.00 $60.00 $15.60–$54.00 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHOC $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PORK $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Allergens(14) $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Basic Food LC $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(14) LC $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FISH/SHELL MIX $49.60 $62.00 $16.12–$55.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M005-IgE Candida albicans LC $51.20 $64.00 $16.64–$57.60 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGN PNUT $52.00 $65.00 $16.90–$58.50 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens w/Total IgE Area 12 LC $52.00 $65.00 $16.90–$58.50 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK $52.00 $65.00 $16.90–$58.50 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alder Tree $59.20 $74.00 $19.24–$66.60 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill Ige Dog dander $60.80 $76.00 $19.76–$68.40 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill Allergen Test $116.00 $145.00 $37.70–$130.50 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Allergy Profile LC $849.60 $1,062.00 $276.12–$955.80 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens w/Total IgE 11 LC $944.00 $1,180.00 $306.80–$1,062.00 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Zone 16 LC $1,400.00 $1,750.00 $455.00–$1,575.00 — 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC $297.60 $372.00 $59.52–$334.80 794% above 20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC $297.60 $372.00 $96.72–$334.80 — 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Ab Reflex Cascade LC $121.60 $152.00 $24.32–$136.80 292% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Direct LC $121.60 $152.00 $24.32–$136.80 292% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies, IFA LC $121.60 $152.00 $24.32–$136.80 292% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex LC $121.60 $152.00 $24.32–$136.80 292% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive LC $128.00 $160.00 $25.60–$144.00 312% above 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Ab Reflex Cascade LC $121.60 $152.00 $39.52–$136.80 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex LC $121.60 $152.00 $39.52–$136.80 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Direct LC $121.60 $152.00 $39.52–$136.80 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies, IFA LC $121.60 $152.00 $39.52–$136.80 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive LC $128.00 $160.00 $41.60–$144.00 — 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 proBNP LC $99.20 $124.00 $19.84–$111.60 15% above 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide (BNP) $388.00 $485.00 $77.60–$436.50 351% above 20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 proBNP LC $99.20 $124.00 $32.24–$111.60 — 20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Brain Natriuretic Peptide (BNP) $388.00 $485.00 $126.10–$436.50 — 20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LVL 4 GROSS EXAM $964.80 $1,206.00 $192.96–$1,085.40 602% above 20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LVL 4 GROSS EXAM $964.80 $1,206.00 $313.56–$1,085.40 — 20%
Blood culture for bacteria CPT 87040 Blood Culture $126.40 $158.00 $25.28–$142.20 13% below 20%
Blood culture for bacteria inpatient CPT 87040 Blood Culture $126.40 $158.00 $41.08–$142.20 — 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLIENT BLOOD COLLECTION $9.60 $12.00 $1.92–$10.80 51% below 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLIENT BLOOD COLLECT LC $9.60 $12.00 $1.92–$10.80 51% below 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLIENT BLOOD COLLECT SQ $10.40 $13.00 $2.08–$11.70 47% below 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venous Draw Charge $28.80 $36.00 $5.76–$32.40 47% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of Venous Blood by venipuncture $31.20 $39.00 $6.24–$35.10 59% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw $31.20 $39.00 $6.24–$35.10 59% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Venous Draw $32.80 $41.00 $6.56–$36.90 67% above 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CLIENT BLOOD COLLECTION $9.60 $12.00 $3.12–$10.80 — 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CLIENT BLOOD COLLECT LC $9.60 $12.00 $3.12–$10.80 — 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CLIENT BLOOD COLLECT SQ $10.40 $13.00 $3.38–$11.70 — 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venous Draw Charge $28.80 $36.00 $9.36–$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 $10.14–$35.10 — 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw $31.20 $39.00 $10.14–$35.10 — 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Venous Draw $32.80 $41.00 $10.66–$36.90 — 20%
Blood glucose (sugar) test CPT 82947 Glucose Fasting $62.40 $78.00 $12.48–$70.20 35% above 20%
Blood glucose (sugar) test CPT 82947 Glucose Level $65.60 $82.00 $13.12–$73.80 42% above 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting $62.40 $78.00 $20.28–$70.20 — 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level $65.60 $82.00 $21.32–$73.80 — 20%
Blood lead test CPT 83655 Lead, Blood (Pediatric) LC $214.40 $268.00 $42.88–$241.20 803% above 20%
Blood lead test CPT 83655 Lead, Blood (Adult) LC $216.00 $270.00 $43.20–$243.00 809% above 20%
Blood lead test CPT 83655 LEAD ADULT $236.80 $296.00 $47.36–$266.40 897% above 20%
Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric) LC $214.40 $268.00 $69.68–$241.20 — 20%
Blood lead test inpatient CPT 83655 Lead, Blood (Adult) LC $216.00 $270.00 $70.20–$243.00 — 20%
Blood lead test inpatient CPT 83655 LEAD ADULT $236.80 $296.00 $76.96–$266.40 — 20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum 1 $12.00 $15.00 $2.40–$13.50 84% below 20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qual w/ Reflex to Beta hCG $12.80 $16.00 $2.56–$14.40 83% below 20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum 1 $12.00 $15.00 $3.90–$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 $4.16–$14.40 — 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 AFC GENERIC ADD-ON $68.00 $85.00 $13.60–$76.50 20% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO/RH/AB SCREEN $68.00 $85.00 $13.60–$76.50 20% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh $71.20 $89.00 $14.24–$80.10 16% below 20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 AFC GENERIC ADD-ON $68.00 $85.00 $22.10–$76.50 — 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 $22.10–$76.50 — 20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh $71.20 $89.00 $23.14–$80.10 — 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein, Quant LC $92.80 $116.00 $18.56–$104.40 153% above 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein, Quant LC $92.80 $116.00 $30.16–$104.40 — 20%
C. difficile toxin gene test (stool PCR) CPT 87493 PNT 1007757 C Diff Toxin Gene NAA DPT $216.00 $270.00 $43.20–$243.00 193% above 20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE $225.60 $282.00 $45.12–$253.80 206% above 20%
C. difficile toxin gene test (stool PCR) CPT 87493 C. difficile Toxin Gene NAA LC $352.80 $441.00 $70.56–$396.90 378% above 20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 PNT 1007757 C Diff Toxin Gene NAA DPT $216.00 $270.00 $70.20–$243.00 — 20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOX GENE $225.60 $282.00 $73.32–$253.80 — 20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. difficile Toxin Gene NAA LC $352.80 $441.00 $114.66–$396.90 — 20%
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 LC $196.00 $245.00 $39.20–$220.50 458% above 20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Antigen 19-9 LC $196.00 $245.00 $63.70–$220.50 — 20%
CA-125 blood test (ovarian cancer marker) CPT 86304 Human Epididymis Protein 4 LC $286.40 $358.00 $57.28–$322.20 241% above 20%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC $519.20 $649.00 $103.84–$584.10 518% above 20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Human Epididymis Protein 4 LC $286.40 $358.00 $93.08–$322.20 — 20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC $519.20 $649.00 $168.74–$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 $16.64–$93.60 46% above 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Novel Coronavirus (CoVID-19), NAA LC $160.00 $200.00 $32.00–$180.00 180% 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 $27.04–$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 $52.00–$180.00 — 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC $329.60 $412.00 $65.92–$370.80 455% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/GC Amplification LC $329.60 $412.00 $65.92–$370.80 455% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis, NAA LC $329.60 $412.00 $107.12–$370.80 — 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia/GC Amplification LC $329.60 $412.00 $107.12–$370.80 — 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Standard $157.60 $197.00 $31.52–$177.30 213% above 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LipoProfile LC $173.60 $217.00 $34.72–$195.30 245% above 20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel Standard $157.60 $197.00 $51.22–$177.30 — 20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LipoProfile LC $173.60 $217.00 $56.42–$195.30 — 20%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count/Hemogram Standard $136.00 $170.00 $27.20–$153.00 73% above 20%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count/Hemogram Standard $136.00 $170.00 $44.20–$153.00 — 20%
Complete blood count (CBC), no differential CPT 85027 Hemogram Standard $77.60 $97.00 $15.52–$87.30 40% above 20%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram Standard $77.60 $97.00 $25.22–$87.30 — 20%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel Standard $312.00 $390.00 $62.40–$351.00 102% above 20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel Standard $312.00 $390.00 $101.40–$351.00 — 20%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer $236.00 $295.00 $47.20–$265.50 125% above 20%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer 2 $248.80 $311.00 $49.76–$279.90 137% above 20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer $236.00 $295.00 $76.70–$265.50 — 20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer 2 $248.80 $311.00 $80.86–$279.90 — 20%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate LC $367.20 $459.00 $73.44–$413.10 483% above 20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate LC $367.20 $459.00 $119.34–$413.10 — 20%
Estradiol blood test CPT 82670 Estradiol LC $264.80 $331.00 $52.96–$297.90 238% above 20%
Estradiol blood test CPT 82670 Estradiol, Sensitive, LC $264.80 $331.00 $52.96–$297.90 238% above 20%
Estradiol blood test inpatient CPT 82670 Estradiol LC $264.80 $331.00 $86.06–$297.90 — 20%
Estradiol blood test inpatient CPT 82670 Estradiol, Sensitive, LC $264.80 $331.00 $86.06–$297.90 — 20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum LC $335.20 $419.00 $67.04–$377.10 132% above 20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH and LH LC $335.20 $419.00 $67.04–$377.10 132% above 20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Serum LC $335.20 $419.00 $108.94–$377.10 — 20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH and LH LC $335.20 $419.00 $108.94–$377.10 — 20%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal LC $284.00 $355.00 $56.80–$319.50 489% above 20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Fecal LC $284.00 $355.00 $92.30–$319.50 — 20%
Ferritin blood test (iron stores) CPT 82728 Ferritin $143.20 $179.00 $28.64–$161.10 55% above 20%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $143.20 $179.00 $46.54–$161.10 — 20%
Folate (folic acid) blood test CPT 82746 Folate Level $137.60 $172.00 $27.52–$154.80 29% above 20%
Folate (folic acid) blood test CPT 82746 Folic Acid(FOLATE) $144.80 $181.00 $28.96–$162.90 36% above 20%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level $137.60 $172.00 $44.72–$154.80 — 20%
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid(FOLATE) $144.80 $181.00 $47.06–$162.90 — 20%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine,Free,Serum LC $360.80 $451.00 $72.16–$405.90 675% above 20%
Free T3 thyroid hormone test CPT 84481 .T3Free LC $380.00 $475.00 $76.00–$427.50 716% above 20%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine,Free,Serum LC $360.80 $451.00 $117.26–$405.90 — 20%
Free T3 thyroid hormone test inpatient CPT 84481 .T3Free LC $380.00 $475.00 $123.50–$427.50 — 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 $284.00 $355.00 $56.80–$319.50 359% above 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 .Thyroxine (T4) Free, Direct H LC $299.20 $374.00 $59.84–$336.60 384% above 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free, Direct, LC $299.20 $374.00 $59.84–$336.60 384% above 20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 $284.00 $355.00 $92.30–$319.50 — 20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .Thyroxine (T4) Free, Direct H LC $299.20 $374.00 $97.24–$336.60 — 20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free, Direct, LC $299.20 $374.00 $97.24–$336.60 — 20%
Free testosterone test CPT 84402 Testosterone, Free, Direct LC $241.60 $302.00 $48.32–$271.80 221% above 20%
Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC $241.60 $302.00 $78.52–$271.80 — 20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 HR PP $66.40 $83.00 $13.28–$74.70 27% below 20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 2Hr Post Prandial $66.40 $83.00 $13.28–$74.70 27% below 20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Post Prandial $66.40 $83.00 $13.28–$74.70 27% below 20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 HR PP $66.40 $83.00 $21.58–$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 $21.58–$74.70 — 20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 2Hr Post Prandial $66.40 $83.00 $21.58–$74.70 — 20%
Glucose tolerance test, 3 samples CPT 82951 GTT 3-Hour $227.20 $284.00 $45.44–$255.60 76% above 20%
Glucose tolerance test, 3 samples CPT 82951 .GTT-2 Hr $227.20 $284.00 $45.44–$255.60 76% above 20%
Glucose tolerance test, 3 samples CPT 82951 GTT OB 3 Hour $238.40 $298.00 $47.68–$268.20 85% above 20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3-Hour $227.20 $284.00 $73.84–$255.60 — 20%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT-2 Hr $227.20 $284.00 $73.84–$255.60 — 20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT OB 3 Hour $238.40 $298.00 $77.48–$268.20 — 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMPLIFICTN $320.00 $400.00 $64.00–$360.00 518% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae NAA LC $329.60 $412.00 $65.92–$370.80 537% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMPLIFICTN $320.00 $400.00 $104.00–$360.00 — 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae NAA LC $329.60 $412.00 $107.12–$370.80 — 20%
H. pylori antibody blood test CPT 86677 H Pylori Rapid Urease $160.80 $201.00 $32.16–$180.90 294% above 20%
H. pylori antibody blood test CPT 86677 H. pylori IgG, Abs LC $169.60 $212.00 $33.92–$190.80 316% above 20%
H. pylori antibody blood test CPT 86677 Helicobacter pylori, IgA LC $169.60 $212.00 $33.92–$190.80 316% above 20%
H. pylori antibody blood test CPT 86677 H Pylori AB IgM LC $172.80 $216.00 $34.56–$194.40 324% above 20%
H. pylori antibody blood test inpatient CPT 86677 H Pylori Rapid Urease $160.80 $201.00 $52.26–$180.90 — 20%
H. pylori antibody blood test inpatient CPT 86677 H. pylori IgG, Abs LC $169.60 $212.00 $55.12–$190.80 — 20%
H. pylori antibody blood test inpatient CPT 86677 Helicobacter pylori, IgA LC $169.60 $212.00 $55.12–$190.80 — 20%
H. pylori antibody blood test inpatient CPT 86677 H Pylori AB IgM LC $172.80 $216.00 $56.16–$194.40 — 20%
H. pylori stool antigen test CPT 87338 H. pylori Stool Ag, EIA LC $325.60 $407.00 $65.12–$366.30 635% above 20%
H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag, EIA LC $325.60 $407.00 $105.82–$366.30 — 20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Bill HIV-1 RNA $522.40 $653.00 $104.48–$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 $160.80–$904.50 561% above 20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV Quant, LC $804.00 $1,005.00 $160.80–$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 $169.28–$952.20 595% above 20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Bill HIV-1 RNA $522.40 $653.00 $169.78–$587.70 — 20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA, PCR (Graph) rfx/Geno LC $804.00 $1,005.00 $261.30–$904.50 — 20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV Quant, LC $804.00 $1,005.00 $261.30–$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 $275.08–$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 $48.00–$270.00 467% 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 $78.00–$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 $27.84–$156.60 152% 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 $45.24–$156.60 — 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C $111.20 $139.00 $22.24–$125.10 107% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin POC $116.80 $146.00 $23.36–$131.40 118% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Standard $149.60 $187.00 $29.92–$168.30 179% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C $111.20 $139.00 $36.14–$125.10 — 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin POC $116.80 $146.00 $37.96–$131.40 — 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c Standard $149.60 $187.00 $48.62–$168.30 — 20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab LC $106.40 $133.00 $21.28–$119.70 104% above 20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surf Ab Quant LC $307.20 $384.00 $61.44–$345.60 489% above 20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab LC $106.40 $133.00 $34.58–$119.70 — 20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surf Ab Quant LC $307.20 $384.00 $99.84–$345.60 — 20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 .HBsAg Confirmation LC $234.40 $293.00 $46.88–$263.70 342% above 20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen LC $316.00 $395.00 $63.20–$355.50 496% above 20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 .HBsAg Confirmation LC $234.40 $293.00 $76.18–$263.70 — 20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen LC $316.00 $395.00 $102.70–$355.50 — 20%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody LC $301.60 $377.00 $60.32–$339.30 499% above 20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody LC $301.60 $377.00 $98.02–$339.30 — 20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA, PCR, Quant (Reflex to Genotyping LC $520.80 $651.00 $104.16–$585.90 567% above 20%
Hepatitis C viral load (HCV RNA) test CPT 87522 RNA, PCR (NonGraph) rfx/Geno LC $575.20 $719.00 $115.04–$647.10 637% above 20%
Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV RNA IU LC $599.20 $749.00 $119.84–$674.10 667% above 20%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC $597.60 $747.00 $119.52–$672.30 665% above 20%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Graph) LC $599.20 $749.00 $119.84–$674.10 667% above 20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA, PCR, Quant (Reflex to Genotyping LC $520.80 $651.00 $169.26–$585.90 — 20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 RNA, PCR (NonGraph) rfx/Geno LC $575.20 $719.00 $186.94–$647.10 — 20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HCV RNA IU LC $599.20 $749.00 $194.74–$674.10 — 20%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC $597.60 $747.00 $194.22–$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 $194.74–$674.10 — 20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 and 2-Specific Ab, IgG LC $124.00 $155.00 $24.80–$139.50 292% above 20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1-Specific Ab, IgG LC $130.40 $163.00 $26.08–$146.70 312% above 20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 and 2-Specific Ab, IgG LC $124.00 $155.00 $40.30–$139.50 — 20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1-Specific Ab, IgG LC $130.40 $163.00 $42.38–$146.70 — 20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2-Specific Ab, IgG LC $183.20 $229.00 $36.64–$206.10 452% above 20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG $192.80 $241.00 $38.56–$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 $59.54–$206.10 — 20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG $192.80 $241.00 $62.66–$216.90 — 20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein $125.60 $157.00 $25.12–$141.30 86% above 20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Cardiac LC $132.00 $165.00 $26.40–$148.50 95% above 20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACT PROT CARDIAC $138.40 $173.00 $27.68–$155.70 105% above 20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein $125.60 $157.00 $40.82–$141.30 — 20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, Cardiac LC $132.00 $165.00 $42.90–$148.50 — 20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACT PROT CARDIAC $138.40 $173.00 $44.98–$155.70 — 20%
Homocysteine blood test CPT 83090 Homocyst(e)ine, Plasma LC $388.00 $485.00 $77.60–$436.50 316% above 20%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine, Plasma LC $388.00 $485.00 $126.10–$436.50 — 20%
Insulin blood test CPT 83525 Insulin LC $146.40 $183.00 $29.28–$164.70 389% above 20%
Insulin blood test CPT 83525 INSULIN TOTL $154.40 $193.00 $30.88–$173.70 416% above 20%
Insulin blood test inpatient CPT 83525 Insulin LC $146.40 $183.00 $47.58–$164.70 — 20%
Insulin blood test inpatient CPT 83525 INSULIN TOTL $154.40 $193.00 $50.18–$173.70 — 20%
Iron blood test (serum iron) CPT 83540 Iron Level $62.40 $78.00 $12.48–$70.20 49% above 20%
Iron blood test (serum iron) CPT 83540 Iron Profile Standard $62.40 $78.00 $12.48–$70.20 49% above 20%
Iron blood test (serum iron) CPT 83540 Iron $65.60 $82.00 $13.12–$73.80 56% above 20%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level $62.40 $78.00 $20.28–$70.20 — 20%
Iron blood test (serum iron) inpatient CPT 83540 Iron Profile Standard $62.40 $78.00 $20.28–$70.20 — 20%
Iron blood test (serum iron) inpatient CPT 83540 Iron $65.60 $82.00 $21.32–$73.80 — 20%
Iron-binding capacity (TIBC) test CPT 83550 CLIENT .IRON BINDING CAPACITY $271.20 $339.00 $54.24–$305.10 151% above 20%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity $357.60 $447.00 $71.52–$402.30 231% above 20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 CLIENT .IRON BINDING CAPACITY $271.20 $339.00 $88.14–$305.10 — 20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity $357.60 $447.00 $116.22–$402.30 — 20%
Kidney function blood test panel CPT 80069 Renal Function Panel Standard $120.80 $151.00 $24.16–$135.90 4% above 20%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel Standard $120.80 $151.00 $39.26–$135.90 — 20%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH), S LC $393.60 $492.00 $78.72–$442.80 320% above 20%
LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORMONE) $415.20 $519.00 $83.04–$467.10 343% above 20%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone(LH), S LC $393.60 $492.00 $127.92–$442.80 — 20%
LH (luteinizing hormone) test inpatient CPT 83002 LH (LUTEINIZING HORMONE) $415.20 $519.00 $134.94–$467.10 — 20%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level $140.00 $175.00 $28.00–$157.50 54% above 20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level $140.00 $175.00 $45.50–$157.50 — 20%
Liver function blood test panel CPT 80076 Hepatic Function Panel Standard $158.40 $198.00 $31.68–$178.20 54% above 20%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel Standard $158.40 $198.00 $51.48–$178.20 — 20%
Lyme disease antibody test CPT 86618 Lyme AB Total w Reflex LC $161.60 $202.00 $32.32–$181.80 430% above 20%
Lyme disease antibody test CPT 86618 Lyme, Western Blot, Serum LC $266.40 $333.00 $53.28–$299.70 774% above 20%
Lyme disease antibody test CPT 86618 Lyme, IgM, Early Test/Reflex LC $267.20 $334.00 $53.44–$300.60 777% above 20%
Lyme disease antibody test CPT 86618 LYME AB IGM $281.60 $352.00 $56.32–$316.80 824% above 20%
Lyme disease antibody test CPT 86618 Lyme Ab, Total/IgM Responses LC $301.60 $377.00 $60.32–$339.30 890% above 20%
Lyme disease antibody test inpatient CPT 86618 Lyme AB Total w Reflex LC $161.60 $202.00 $52.52–$181.80 — 20%
Lyme disease antibody test inpatient CPT 86618 Lyme, Western Blot, Serum LC $266.40 $333.00 $86.58–$299.70 — 20%
Lyme disease antibody test inpatient CPT 86618 Lyme, IgM, Early Test/Reflex LC $267.20 $334.00 $86.84–$300.60 — 20%
Lyme disease antibody test inpatient CPT 86618 LYME AB IGM $281.60 $352.00 $91.52–$316.80 — 20%
Lyme disease antibody test inpatient CPT 86618 Lyme Ab, Total/IgM Responses LC $301.60 $377.00 $98.02–$339.30 — 20%
Magnesium blood test CPT 83735 Magnesium Level $64.00 $80.00 $12.80–$72.00 222% above 20%
Magnesium blood test CPT 83735 83735 LC#LC $67.20 $84.00 $13.44–$75.60 238% above 20%
Magnesium blood test CPT 83735 Magnesium, RBC LC $137.60 $172.00 $27.52–$154.80 592% above 20%
Magnesium blood test inpatient CPT 83735 Magnesium Level $64.00 $80.00 $20.80–$72.00 — 20%
Magnesium blood test inpatient CPT 83735 83735 LC#LC $67.20 $84.00 $21.84–$75.60 — 20%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC LC $137.60 $172.00 $44.72–$154.80 — 20%
Measles (rubeola) antibody test CPT 86765 Acute Measles Panel, IgM Antibody and PCR LC $60.80 $76.00 $12.16–$68.40 265% above 20%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgG LC $175.20 $219.00 $35.04–$197.10 950% above 20%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG $184.00 $230.00 $36.80–$207.00 1003% above 20%
Measles (rubeola) antibody test CPT 86765 Rubeola IgM LC $193.60 $242.00 $38.72–$217.80 1061% above 20%
Measles (rubeola) antibody test inpatient CPT 86765 Acute Measles Panel, IgM Antibody and PCR LC $60.80 $76.00 $19.76–$68.40 — 20%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies, IgG LC $175.20 $219.00 $56.94–$197.10 — 20%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG $184.00 $230.00 $59.80–$207.00 — 20%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgM LC $193.60 $242.00 $62.92–$217.80 — 20%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen $103.20 $129.00 $20.64–$116.10 44% above 20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen $103.20 $129.00 $33.54–$116.10 — 20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Total+% Free (Serial) LC $205.60 $257.00 $41.12–$231.30 224% above 20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Total+% Free (Serial) LC $205.60 $257.00 $66.82–$231.30 — 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic. $179.20 $224.00 $35.84–$201.60 131% above 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultra. W/Serial Monitor LC $200.00 $250.00 $40.00–$225.00 158% above 20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic. $179.20 $224.00 $58.24–$201.60 — 20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Ultra. W/Serial Monitor LC $200.00 $250.00 $65.00–$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 $20.16–$113.40 135% 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 $32.76–$113.40 — 20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH $267.20 $334.00 $53.44–$300.60 124% above 20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC $388.00 $485.00 $77.60–$436.50 225% above 20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH $267.20 $334.00 $86.84–$300.60 — 20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact LC $388.00 $485.00 $126.10–$436.50 — 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD $37.60 $47.00 $7.52–$42.30 10% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time $108.00 $135.00 $21.60–$121.50 216% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 .PT (Thromborel-S) LC $112.80 $141.00 $22.56–$126.90 231% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $112.80 $141.00 $22.56–$126.90 231% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT DED $118.40 $148.00 $23.68–$133.20 247% above 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD $37.60 $47.00 $12.22–$42.30 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time $108.00 $135.00 $35.10–$121.50 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $112.80 $141.00 $36.66–$126.90 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 .PT (Thromborel-S) LC $112.80 $141.00 $36.66–$126.90 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT DED $118.40 $148.00 $38.48–$133.20 — 20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 informaSeq(SM) Prenatal Test LC $185.60 $232.00 $37.12–$208.80 79% 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 $60.32–$208.80 — 20%
Progesterone blood test CPT 84144 Progesterone LC $435.20 $544.00 $87.04–$489.60 372% above 20%
Progesterone blood test inpatient CPT 84144 Progesterone LC $435.20 $544.00 $141.44–$489.60 — 20%
Prolactin blood test CPT 84146 Prolactin LC $192.00 $240.00 $38.40–$216.00 141% above 20%
Prolactin blood test inpatient CPT 84146 Prolactin LC $192.00 $240.00 $62.40–$216.00 — 20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $53.60 $67.00 $10.72–$60.30 90% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin/INR POC $56.80 $71.00 $11.36–$63.90 101% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME $56.80 $71.00 $11.36–$63.90 101% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 Protime/PTT $56.80 $71.00 $11.36–$63.90 101% above 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time $53.60 $67.00 $17.42–$60.30 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin/INR POC $56.80 $71.00 $18.46–$63.90 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime/PTT $56.80 $71.00 $18.46–$63.90 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME $56.80 $71.00 $18.46–$63.90 — 20%
Rapid flu test (influenza antigen) CPT 87804 CLIENT INFLUENZA A SCREEN (RAPID) $104.00 $130.00 $20.80–$117.00 288% above 20%
Rapid flu test (influenza antigen) CPT 87804 Influenza AB Rapid $156.00 $195.00 $31.20–$175.50 482% above 20%
Rapid flu test (influenza antigen) CPT 87804 INFLU B SCN $164.00 $205.00 $32.80–$184.50 512% above 20%
Rapid flu test (influenza antigen) inpatient CPT 87804 CLIENT INFLUENZA A SCREEN (RAPID) $104.00 $130.00 $33.80–$117.00 — 20%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza AB Rapid $156.00 $195.00 $50.70–$175.50 — 20%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLU B SCN $164.00 $205.00 $53.30–$184.50 — 20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Rapid Screen $156.00 $195.00 $31.20–$175.50 346% above 20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Rapid Screen $156.00 $195.00 $50.70–$175.50 — 20%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC $137.60 $172.00 $27.52–$154.80 401% above 20%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, IgM LC $144.80 $181.00 $28.96–$162.90 427% above 20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG $144.80 $181.00 $28.96–$162.90 427% above 20%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC $137.60 $172.00 $44.72–$154.80 — 20%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG $144.80 $181.00 $47.06–$162.90 — 20%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody, IgM LC $144.80 $181.00 $47.06–$162.90 — 20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate $27.20 $34.00 $5.44–$30.60 53% below 20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate $27.20 $34.00 $8.84–$30.60 — 20%
Stool ova and parasites exam CPT 87177 Ova + Parasite Exam LC $157.60 $197.00 $31.52–$177.30 450% above 20%
Stool ova and parasites exam CPT 87177 .Ova + Parasite Exam Result $161.60 $202.00 $32.32–$181.80 464% above 20%
Stool ova and parasites exam inpatient CPT 87177 Ova + Parasite Exam LC $157.60 $197.00 $51.22–$177.30 — 20%
Stool ova and parasites exam inpatient CPT 87177 .Ova + Parasite Exam Result $161.60 $202.00 $52.52–$181.80 — 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool 1-3 $71.20 $89.00 $14.24–$80.10 164% above 20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool 1-3 $71.20 $89.00 $23.14–$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 $15.84–$89.10 310% 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 $25.74–$89.10 — 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR LC $49.60 $62.00 $9.92–$55.80 282% above 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 $10.24–$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 $10.40–$58.50 300% above 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR LC $49.60 $62.00 $16.12–$55.80 — 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 $16.64–$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 $16.90–$58.50 — 20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold (In Tube) LC $115.20 $144.00 $23.04–$129.60 56% above 20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON®-TB Gold Plus (Client Incubated) LC $120.00 $150.00 $24.00–$135.00 62% above 20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON Client Incubated LC $585.60 $732.00 $117.12–$658.80 692% above 20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON TB Gold (In Tube) LC $115.20 $144.00 $37.44–$129.60 — 20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON®-TB Gold Plus (Client Incubated) LC $120.00 $150.00 $39.00–$135.00 — 20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON Client Incubated LC $585.60 $732.00 $190.32–$658.80 — 20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum LC $256.80 $321.00 $51.36–$288.90 621% above 20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Serum LC $256.80 $321.00 $83.46–$288.90 — 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC $137.60 $172.00 $27.52–$154.80 505% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC $185.60 $232.00 $37.12–$208.80 716% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROX $195.20 $244.00 $39.04–$219.60 758% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 .Thyroid Peroxidase (TPO) Ab LC $195.20 $244.00 $39.04–$219.60 758% above 20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC $137.60 $172.00 $44.72–$154.80 — 20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC $185.60 $232.00 $60.32–$208.80 — 20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 .Thyroid Peroxidase (TPO) Ab LC $195.20 $244.00 $63.44–$219.60 — 20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROX $195.20 $244.00 $63.44–$219.60 — 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Cascade Profile LC $160.00 $200.00 $32.00–$180.00 80% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone $184.80 $231.00 $36.96–$207.90 108% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Reflex to FT4 $193.60 $242.00 $38.72–$217.80 118% above 20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile LC $160.00 $200.00 $52.00–$180.00 — 20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone $184.80 $231.00 $60.06–$207.90 — 20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Reflex to FT4 $193.60 $242.00 $62.92–$217.80 — 20%
Uric acid blood test CPT 84550 Uric Acid $60.80 $76.00 $12.16–$68.40 36% above 20%
Uric acid blood test CPT 84550 .Uric Acid, Please Note LC $67.20 $84.00 $13.44–$75.60 50% above 20%
Uric acid blood test inpatient CPT 84550 Uric Acid $60.80 $76.00 $19.76–$68.40 — 20%
Uric acid blood test inpatient CPT 84550 .Uric Acid, Please Note LC $67.20 $84.00 $21.84–$75.60 — 20%
Urinalysis with microscope exam, automated CPT 81001 Bill Observed Chain of Custody $37.60 $47.00 $7.52–$42.30 16% below 20%
Urinalysis with microscope exam, automated CPT 81001 CLIENT URINALYSIS (W/ MICRO) $60.80 $76.00 $12.16–$68.40 36% above 20%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture, if indicated Standard $60.80 $76.00 $12.16–$68.40 36% above 20%
Urinalysis with microscope exam, automated CPT 81001 UA/M w/rflx Culture, Routine LC $67.20 $84.00 $13.44–$75.60 50% above 20%
Urinalysis with microscope exam, automated inpatient CPT 81001 Bill Observed Chain of Custody $37.60 $47.00 $12.22–$42.30 — 20%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture, if indicated Standard $60.80 $76.00 $19.76–$68.40 — 20%
Urinalysis with microscope exam, automated inpatient CPT 81001 CLIENT URINALYSIS (W/ MICRO) $60.80 $76.00 $19.76–$68.40 — 20%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA/M w/rflx Culture, Routine LC $67.20 $84.00 $21.84–$75.60 — 20%
Urinalysis without microscope exam, automated CPT 81003 Kidney Stone Urine/Saturation LC $44.00 $55.00 $8.80–$49.50 69% above 20%
Urinalysis without microscope exam, automated inpatient CPT 81003 Kidney Stone Urine/Saturation LC $44.00 $55.00 $14.30–$49.50 — 20%
Urinalysis without microscope exam, manual CPT 81002 QUICK CARE URINALYSIS DIPSTICK $21.60 $27.00 $4.32–$24.30 236% above 20%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK $21.60 $27.00 $4.32–$24.30 236% above 20%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick $32.80 $41.00 $6.56–$36.90 410% above 20%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis with Microscopic, if indicated Standard $34.40 $43.00 $6.88–$38.70 435% above 20%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK $21.60 $27.00 $7.02–$24.30 — 20%
Urinalysis without microscope exam, manual inpatient CPT 81002 QUICK CARE URINALYSIS DIPSTICK $21.60 $27.00 $7.02–$24.30 — 20%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick $32.80 $41.00 $10.66–$36.90 — 20%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis with Microscopic, if indicated Standard $34.40 $43.00 $11.18–$38.70 — 20%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture $131.20 $164.00 $26.24–$147.60 94% above 20%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture $131.20 $164.00 $42.64–$147.60 — 20%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine 1 $120.80 $151.00 $24.16–$135.90 151% above 20%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test Urine 1 $120.80 $151.00 $39.26–$135.90 — 20%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 $86.40 $108.00 $17.28–$97.20 14% above 20%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level $143.20 $179.00 $28.64–$161.10 89% above 20%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12/Folate Panel $144.00 $180.00 $28.80–$162.00 90% above 20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 $86.40 $108.00 $28.08–$97.20 — 20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level $143.20 $179.00 $46.54–$161.10 — 20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12/Folate Panel $144.00 $180.00 $46.80–$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 $46.72–$262.80 233% 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 $56.32–$316.80 301% 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 $82.40–$463.50 487% 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 $75.92–$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 $91.52–$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 $133.90–$463.50 — 20%
Zinc blood test CPT 84630 Zinc, Whole Blood LC $113.60 $142.00 $22.72–$127.80 367% above 20%
Zinc blood test CPT 84630 Zinc, Plasma or Serum LC $199.20 $249.00 $39.84–$224.10 720% above 20%
Zinc blood test inpatient CPT 84630 Zinc, Whole Blood LC $113.60 $142.00 $36.92–$127.80 — 20%
Zinc blood test inpatient CPT 84630 Zinc, Plasma or Serum LC $199.20 $249.00 $64.74–$224.10 — 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Quantitative $163.20 $204.00 $32.64–$183.60 321% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Subunit, Qnt, Serum LC $165.60 $207.00 $33.12–$186.30 327% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFC GENERIC ADD-ON $172.00 $215.00 $34.40–$193.50 344% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 FIRST TRIMESTER SCREEN $172.00 $215.00 $34.40–$193.50 344% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Quantitative $163.20 $204.00 $53.04–$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 $53.82–$186.30 — 20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFC GENERIC ADD-ON $172.00 $215.00 $55.90–$193.50 — 20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 FIRST TRIMESTER SCREEN $172.00 $215.00 $55.90–$193.50 — 20%

Surgery and procedures

ProcedureCash price List priceInsurers payvs ArizonaOff 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 $149.49–$968.40 55% above 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 $279.76–$968.40 — 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 $402.88–$3,914.00 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 $654.68–$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 $166.24–$3,373.00 25% 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 $270.14–$935.10 — 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 $149.49–$887.40 30% above 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 $256.36–$887.40 — 20%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY BX $3,916.87 $4,896.09 $751.80–$4,406.48 38% above 20%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY BX $3,916.87 $4,896.09 $1,272.98–$4,406.48 — 20%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY $1,691.20 $2,114.00 $338.24–$2,909.00 7% below 20%
Colonoscopy, diagnostic CPT 45378 Colonoscopy $2,947.20 $3,684.00 $575.40–$3,315.60 62% above 20%
Colonoscopy, diagnostic CPT 45378 45378 PROF DIAGNOSTIC COLONSCOP $2,947.20 $3,684.00 $575.40–$3,315.60 62% above 20%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY $1,691.20 $2,114.00 $549.64–$1,902.60 — 20%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy $2,947.20 $3,684.00 $957.84–$3,315.60 — 20%
Colonoscopy, diagnostic inpatient CPT 45378 45378 PROF DIAGNOSTIC COLONSCOP $2,947.20 $3,684.00 $957.84–$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 $197.76–$2,161.00 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 $321.36–$1,112.40 — 20%
Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE $641.60 $802.00 $128.32–$3,373.00 85% below 20%
Cystoscopy with ureteral stent placement inpatient CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE $641.60 $802.00 $208.52–$721.80 — 20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY $1,370.40 $1,713.00 $274.08–$2,507.00 4% above 20%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY $1,370.40 $1,713.00 $445.38–$1,541.70 — 20%
Earwax removal with instruments, one ear CPT 69210 69210 REMOVE IMPACTED CERUMEN $184.00 $230.00 $36.80–$207.00 59% above 20%
Earwax removal with instruments, one ear inpatient CPT 69210 69210 REMOVE IMPACTED CERUMEN $184.00 $230.00 $59.80–$207.00 — 20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Edometrial Sampling (biopsy) w/ or w/o Endo $148.80 $186.00 $29.76–$2,161.00 89% 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 $48.36–$167.40 — 20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY $303.20 $379.00 $60.64–$2,507.00 88% below 20%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY $303.20 $379.00 $98.54–$341.10 — 20%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE (EG INTERPHALANGEAL FUSION PARTIAL OR TOTAL $1,480.80 $1,851.00 $296.16–$3,373.00 87% below 20%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE (EG INTERPHALANGEAL FUSION PARTIAL OR TOTAL $1,480.80 $1,851.00 $481.26–$1,665.90 — 20%
Hysteroscopy with endometrial ablation CPT 58563 Endometrial Ablation hysteroscopic $1,020.00 $1,275.00 $204.00–$3,914.00 83% below 20%
Hysteroscopy with endometrial ablation CPT 58563 NOVASURE KIT, NS-2007 $3,056.00 $3,820.00 $611.20–$3,438.00 50% below 20%
Hysteroscopy with endometrial ablation inpatient CPT 58563 Endometrial Ablation hysteroscopic $1,020.00 $1,275.00 $331.50–$1,147.50 — 20%
Hysteroscopy with endometrial ablation inpatient CPT 58563 NOVASURE KIT, NS-2007 $3,056.00 $3,820.00 $993.20–$3,438.00 — 20%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIU $997.60 $1,247.00 $199.52–$1,901.83 82% below 20%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIU $997.60 $1,247.00 $324.22–$1,122.30 — 20%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD) $528.80 $661.00 $105.76–$2,161.00 88% below 20%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD) $528.80 $661.00 $171.86–$594.90 — 20%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 I D ABSCESS $466.40 $583.00 $93.28–$524.70 115% above 20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 I D ABSCESS $466.40 $583.00 $151.58–$524.70 — 20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTIONS OF TENDON SHEATH, LIGAMENT, OR MUSCLE MEMBRANE $152.80 $191.00 $30.56–$2,161.00 83% below 20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJ TENDON ETC $180.80 $226.00 $36.16–$203.40 80% below 20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTIONS OF TENDON SHEATH, LIGAMENT, OR MUSCLE MEMBRANE $152.80 $191.00 $49.66–$171.90 — 20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJ TENDON ETC $180.80 $226.00 $58.76–$203.40 — 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 $72.00–$405.00 60% below 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 $117.00–$405.00 — 20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT $277.40 $346.75 $55.48–$312.07 54% above 20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT $277.40 $346.75 $90.16–$312.07 — 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ASP / INJECTIONS JOINT INTERMEDIATE $293.60 $367.00 $58.72–$330.30 48% below 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 ASP / INJECTIONS JOINT INTERMEDIATE $293.60 $367.00 $95.42–$330.30 — 20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ASP / INJECTIONS JOINT SMALL $206.40 $258.00 $41.28–$232.20 58% below 20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 ASP / INJECTIONS JOINT SMALL $206.40 $258.00 $67.08–$232.20 — 20%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LA $2,356.00 $2,945.00 $471.20–$3,914.00 67% below 20%
Knee arthroscopy with meniscus trim CPT 29881 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL $2,360.80 $2,951.00 $472.16–$3,914.00 67% below 20%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LA $2,356.00 $2,945.00 $765.70–$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 $767.26–$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 $488.96–$2,750.40 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 $794.56–$2,750.40 — 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 $238.88–$1,343.70 170% above 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 $388.18–$1,343.70 — 20%
Nail removal (partial or complete), one nail CPT 11730 11730 AVULS NAIL SIMPLE SGL $270.40 $338.00 $54.08–$304.20 51% above 20%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 AVULS NAIL SIMPLE SGL $270.40 $338.00 $87.88–$304.20 — 20%
Occipital nerve block (injection for headaches) CPT 64405 64405 Injection, Anesthetic agent; Facial Nerve $439.20 $549.00 $87.84–$494.10 243% above 20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 Injection, Anesthetic agent; Facial Nerve $439.20 $549.00 $142.74–$494.10 — 20%
Prostate biopsy CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY A $540.80 $676.00 $108.16–$2,909.00 81% below 20%
Prostate biopsy inpatient CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY A $540.80 $676.00 $175.76–$608.40 — 20%
Prostate removal (prostatectomy), laparoscopic CPT 55866 55866 LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICA $4,988.00 $6,235.00 $997.60–$6,109.00 45% below 20%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 55866 LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICA $4,988.00 $6,235.00 $1,621.10–$5,611.50 — 20%
Removal of a foreign object under the skin, simple CPT 10120 10120 INCS REM FOB SUB CUT S $465.60 $582.00 $93.12–$523.80 81% above 20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 INCS REM FOB SUB CUT S $465.60 $582.00 $151.32–$523.80 — 20%
Short arm splint (forearm and hand) CPT 29125 29125 APL SPLINT SHORT ARM $243.20 $304.00 $48.64–$273.60 49% above 20%
Short arm splint (forearm and hand) inpatient CPT 29125 29125 APL SPLINT SHORT ARM $243.20 $304.00 $79.04–$273.60 — 20%
Short leg splint (calf to foot) CPT 29515 29515 APPL SPLINT SHRT LEG $242.40 $303.00 $48.48–$272.70 89% above 20%
Short leg splint (calf to foot) inpatient CPT 29515 29515 APPL SPLINT SHRT LEG $242.40 $303.00 $78.78–$272.70 — 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 $95.20–$535.50 222% above 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 $154.70–$535.50 — 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 LUMBAR SPINAL TAP $560.00 $700.00 $112.00–$630.00 9% above 20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 LUMBAR SPINAL TAP $560.00 $700.00 $182.00–$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 12002 REPAIR SMPLE WND 2.6CM -7.5CM $618.40 $773.00 $123.68–$695.70 210% 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 12002 REPAIR SMPLE WND 2.6CM -7.5CM $618.40 $773.00 $200.98–$695.70 — 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 $116.48–$655.20 84% above 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 $189.28–$655.20 — 20%
Trigger finger release surgery CPT 26055 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER). $1,264.00 $1,580.00 $252.80–$2,909.00 64% below 20%
Trigger finger release surgery inpatient CPT 26055 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER). $1,264.00 $1,580.00 $410.80–$1,422.00 — 20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD DILATION $5,077.60 $6,347.00 $1,015.52–$5,712.30 85% above 20%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD DILATION $5,077.60 $6,347.00 $1,650.22–$5,712.30 — 20%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SGL/MULTI $1,105.60 $1,382.00 $221.12–$1,243.80 54% below 20%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SGL/MULTI ADD ON CHARGE $2,046.40 $2,558.00 $409.28–$2,909.00 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 $532.00–$2,992.50 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 $532.00–$2,992.50 11% above 20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SGL/MULTI $1,105.60 $1,382.00 $359.32–$1,243.80 — 20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SGL/MULTI ADD ON CHARGE $2,046.40 $2,558.00 $665.08–$2,302.20 — 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 $864.50–$2,992.50 — 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 $864.50–$2,992.50 — 20%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD With PEG $1,188.00 $1,485.00 $237.60–$2,909.00 28% below 20%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD $1,564.80 $1,956.00 $312.96–$2,909.00 5% below 20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD With PEG $1,188.00 $1,485.00 $386.10–$1,336.50 — 20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD $1,564.80 $1,956.00 $508.56–$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 $324.16–$4,540.00 75% 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 $526.76–$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 $343.84–$4,540.00 80% 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 $558.74–$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 $194.24–$3,373.00 — 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 $315.64–$1,092.60 — 20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, $267.20 $334.00 $53.44–$2,161.00 27% above 20%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, $267.20 $334.00 $86.84–$300.60 — 20%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs ArizonaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration $692.80 $866.00 $138.56–$779.40 28% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD PRODUCT TRANSFUSION $726.40 $908.00 $145.28–$817.20 34% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admininstration $766.40 $958.00 $153.28–$862.20 42% above 20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration $692.80 $866.00 $225.16–$779.40 — 20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD PRODUCT TRANSFUSION $726.40 $908.00 $236.08–$817.20 — 20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admininstration $766.40 $958.00 $249.08–$862.20 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mini-Neb Subsequent $120.80 $151.00 $24.16–$136.21 45% below 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mini-Neb Subsequent $120.80 $151.00 $39.26–$135.90 — 20%
Critical care, first 30 to 74 minutes CPT 99291 99291 - ED Critical Care $2,860.80 $3,576.00 $572.16–$3,218.40 36% above 20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - ED Critical Care $2,860.80 $3,576.00 $929.76–$3,218.40 — 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CLIENT EKG (12 LEAD) $82.40 $103.00 $16.48–$92.70 29% below 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram $175.20 $219.00 $25.99–$197.10 51% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG (12 LEAD) $193.60 $242.00 $25.99–$217.80 66% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CLIENT EKG (12 LEAD) $82.40 $103.00 $26.78–$92.70 — 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram $175.20 $219.00 $56.94–$197.10 — 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG (12 LEAD) $193.60 $242.00 $62.92–$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 $63.04–$439.00 32% 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 $102.44–$354.60 — 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - ED Level 2 $624.80 $781.00 $124.96–$702.90 71% above 20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - ED Level 2 $624.80 $781.00 $203.06–$702.90 — 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 EMERGENCY RM- LEVEL 3 ED CHARGE- PROFESSIONAL FEE BCE $839.20 $1,049.00 $167.84–$944.10 36% above 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - ED Level 3 $1,109.60 $1,387.00 $221.92–$1,248.30 79% above 20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 EMERGENCY RM- LEVEL 3 ED CHARGE- PROFESSIONAL FEE BCE $839.20 $1,049.00 $272.74–$944.10 — 20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - ED Level 3 $1,109.60 $1,387.00 $360.62–$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 $352.32–$1,981.80 61% 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 $572.52–$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 $524.00–$2,947.50 73% 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 $851.50–$2,947.50 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION FOR THERAPY $160.00 $200.00 $32.00–$180.00 10% below 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour $214.40 $268.00 $42.88–$241.20 20% 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 $57.92–$325.80 63% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION FOR THERAPY $160.00 $200.00 $52.00–$180.00 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour $214.40 $268.00 $69.68–$241.20 — 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 $94.12–$325.80 — 20%
IV infusion of a medicine, first hour CPT 96365 96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN $304.80 $381.00 $60.96–$342.90 30% above 20%
IV infusion of a medicine, first hour CPT 96365 96365 IV DRUG FIRST HOUR $677.60 $847.00 $135.52–$762.30 190% above 20%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour $684.80 $856.00 $136.96–$770.40 193% above 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 $99.06–$342.90 — 20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV DRUG FIRST HOUR $677.60 $847.00 $220.22–$762.30 — 20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour $684.80 $856.00 $222.56–$770.40 — 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 IM INJ OF ANTIBIOTIC $33.60 $42.00 $6.72–$44.93 50% below 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THERAPTIC PROPHALACTIC I $196.00 $245.00 $39.20–$220.50 191% above 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection $206.40 $258.00 $41.28–$232.20 207% 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 $10.92–$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 $63.70–$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 $67.08–$232.20 — 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION OVER 10 MIN $43.20 $54.00 $8.64–$48.60 40% above 20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION OVER 10 MIN $43.20 $54.00 $14.04–$48.60 — 20%
Spirometry (breathing test) CPT 94010 INCENTIVE SPIROMTRY $89.60 $112.00 $17.92–$100.80 49% below 20%
Spirometry (breathing test) CPT 94010 Respiratory Therapy $616.80 $771.00 $123.36–$693.90 252% above 20%
Spirometry (breathing test) CPT 94010 94010 PFT $718.40 $898.00 $143.68–$808.20 310% above 20%
Spirometry (breathing test) inpatient CPT 94010 INCENTIVE SPIROMTRY $89.60 $112.00 $29.12–$100.80 — 20%
Spirometry (breathing test) inpatient CPT 94010 Respiratory Therapy $616.80 $771.00 $200.46–$693.90 — 20%
Spirometry (breathing test) inpatient CPT 94010 94010 PFT $718.40 $898.00 $233.48–$808.20 — 20%
Spirometry before and after a bronchodilator CPT 94060 CLIENT PFT PRE/POST $86.40 $108.00 $17.28–$191.73 62% below 20%
Spirometry before and after a bronchodilator CPT 94060 Respiratory Therapy $682.40 $853.00 $136.48–$767.70 201% above 20%
Spirometry before and after a bronchodilator CPT 94060 PFT Pre Post $718.40 $898.00 $143.68–$808.20 217% above 20%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test $718.40 $898.00 $143.68–$808.20 217% above 20%
Spirometry before and after a bronchodilator inpatient CPT 94060 CLIENT PFT PRE/POST $86.40 $108.00 $28.08–$97.20 — 20%
Spirometry before and after a bronchodilator inpatient CPT 94060 Respiratory Therapy $682.40 $853.00 $221.78–$767.70 — 20%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test $718.40 $898.00 $233.48–$808.20 — 20%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Pre Post $718.40 $898.00 $233.48–$808.20 — 20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 6 $343.20 $429.00 $68.64–$386.10 45% above 20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy 6 $343.20 $429.00 $111.54–$386.10 — 20%

Vaccines

ProcedureCash price List priceInsurers payvs ArizonaOff list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 91322 Spikevax Medication Charge $227.20 $284.00 $45.44–$255.60 153% above 20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 91322 Spikevax Medication Charge $227.20 $284.00 $73.84–$255.60 — 20%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 CLIENT HEP B IMMUNIZATION $60.00 $75.00 $12.00–$67.50 36% below 20%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 CLIENT HEP B IMMUNIZATION $60.00 $75.00 $19.50–$67.50 — 20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg [CQCH] $38.56 $48.20 $7.71–$43.38 49% below 20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg [CQCH] $38.56 $48.20 $12.53–$43.38 — 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23 vaccine Inj [CQCH] $331.62 $414.52 $66.32–$373.07 342% above 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23 vaccine Inj [CQCH] $331.62 $414.52 $107.78–$373.07 — 20%
Rabies vaccine, one dose CPT 90675 CLIENT RABIES VACCINE INJ (IM) $387.20 $484.00 $77.44–$435.60 5% above 20%
Rabies vaccine, one dose inpatient CPT 90675 CLIENT RABIES VACCINE INJ (IM) $387.20 $484.00 $125.84–$435.60 — 20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoids (Td)adult IM [CQCH] $36.35 $45.44 $7.27–$40.90 62% 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 $11.81–$40.90 — 20%

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