Fort Worth Surgicare Partners
Listed in its price file as “Fort Worth Surgicare Partners, LTD.”.
Fort Worth Surgicare Partners in Fort Worth, TX publishes cash prices for 306 common procedures listed here, from its own machine-readable price file updated Apr 14, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 241 of 305 procedures and above it for 64. By typical cash price it ranks #42 of 240 Texas hospitals and #5 of 81 hospitals in the Dallas, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.
1800 Park Pl Ave, Fort Worth, TX 76110 Collected Sep 27, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Bilateral 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | — | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 BCE XR Ankle, complete min 3 views 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | 31% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Left 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | 31% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Right 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | 31% below | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Bilateral 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 BCE XR Ankle, complete min 3 views 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Right 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Left 73610 | $246.60 | $411.00 | $193.17–$8,427.00 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Lmt bl physiologic of U/LE art 93922 | $357.00 | $595.00 | $279.65–$8,427.00 | 49% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 BCE US Lmt bl physiologic of U/LE art 93922 | $357.00 | $595.00 | $279.65–$8,427.00 | 49% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 BCE US Lmt bl physiologic of U/LE art 93922 | $357.00 | $595.00 | $279.65–$8,427.00 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Lmt bl physiologic of U/LE art 93922 | $357.00 | $595.00 | $279.65–$8,427.00 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BCE XR Esophagus 74220 | $403.80 | $673.00 | $316.31–$8,427.00 | 19% below | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus 74220 | $403.80 | $673.00 | $316.31–$8,427.00 | 19% below | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BCE XR Esophagus 74220 | $403.80 | $673.00 | $316.31–$8,427.00 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus 74220 | $403.80 | $673.00 | $316.31–$8,427.00 | — | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 BCE US Breast, Unilateral; Complete 76641 | $153.00 | $255.00 | $119.85–$8,427.00 | 65% below | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 BCE US Breast, Unilateral; Complete 76641 | $153.00 | $255.00 | $119.85–$8,427.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast, unilateral; Limited 76642 | $153.00 | $255.00 | $119.85–$8,427.00 | 56% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast, unilateral; Limited 76642 | $153.00 | $255.00 | $119.85–$8,427.00 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | 48% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 BCE CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | 48% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 BCE CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Renal Stone Protocol 74176 | $2,735.40 | $4,559.00 | $2,142.73–$8,427.00 | 18% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 BCE CT Abd & Pelvis, w/o contrast 74176 | $2,735.40 | $4,559.00 | $2,142.73–$8,427.00 | 18% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd and Pelvis w/o Contrast 74176 | $2,735.40 | $4,559.00 | $2,142.73–$8,427.00 | 18% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 BCE CT Abd & Pelvis, w/o contrast 74176 | $2,735.40 | $4,559.00 | $2,142.73–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd and Pelvis w/o Contrast 74176 | $2,735.40 | $4,559.00 | $2,142.73–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Renal Stone Protocol 74176 | $2,735.40 | $4,559.00 | $2,142.73–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 BCE CT Abd & Pelvis, w/contrast 74177 | $3,394.20 | $5,657.00 | $2,658.79–$8,427.00 | 13% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast 74177 | $3,394.20 | $5,657.00 | $2,658.79–$8,427.00 | 13% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 BCE CT Abd & Pelvis, w/contrast 74177 | $3,394.20 | $5,657.00 | $2,658.79–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast 74177 | $3,394.20 | $5,657.00 | $2,658.79–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd and Pelvis w/ + w/o Con 74178 | $3,568.20 | $5,947.00 | $2,795.09–$8,427.00 | 14% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 BCE CT Abd & Pelvis, w & w/o contrast 74178 | $3,568.20 | $5,947.00 | $2,795.09–$8,427.00 | 14% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd and Pelvis w/ + w/o Con 74178 | $3,568.20 | $5,947.00 | $2,795.09–$8,427.00 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 BCE CT Abd & Pelvis, w & w/o contrast 74178 | $3,568.20 | $5,947.00 | $2,795.09–$8,427.00 | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $1,369.11–$8,427.00 | 35% below | 40% |
| CT scan of the abdomen with contrast CPT 74160 BCE CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $1,369.11–$8,427.00 | 35% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $1,369.11–$8,427.00 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 BCE CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $1,369.11–$8,427.00 | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast 74150 | $1,385.40 | $2,309.00 | $1,085.23–$8,427.00 | 35% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 BCE CT Abdomen, w/o contrast 74150 | $1,385.40 | $2,309.00 | $1,085.23–$8,427.00 | 35% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast 74150 | $1,385.40 | $2,309.00 | $1,085.23–$8,427.00 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 BCE CT Abdomen, w/o contrast 74150 | $1,385.40 | $2,309.00 | $1,085.23–$8,427.00 | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 BCE CT Maxillofacial area w/o contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | 33% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 zzCT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | 33% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | 33% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | 33% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | 33% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 zzCT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 BCE CT Maxillofacial area w/o contrast 70486 | $1,130.40 | $1,884.00 | $885.48–$8,427.00 | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 BCE CT, Head or brain; w/o contrast 70450 | $1,330.80 | $2,218.00 | $1,042.46–$8,427.00 | 32% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast 70450 | $1,330.80 | $2,218.00 | $1,042.46–$8,427.00 | 32% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 BCE CT, Head or brain; w/o contrast 70450 | $1,330.80 | $2,218.00 | $1,042.46–$8,427.00 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast 70450 | $1,330.80 | $2,218.00 | $1,042.46–$8,427.00 | — | 40% |
| CT scan of the head with contrast CPT 70460 BCE CT head or brain w/contrast 70460 | $1,466.40 | $2,444.00 | $1,148.68–$8,427.00 | 27% below | 40% |
| CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast 70460 | $1,466.40 | $2,444.00 | $1,148.68–$8,427.00 | 27% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast 70460 | $1,466.40 | $2,444.00 | $1,148.68–$8,427.00 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 BCE CT head or brain w/contrast 70460 | $1,466.40 | $2,444.00 | $1,148.68–$8,427.00 | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast 70470 | $1,780.80 | $2,968.00 | $1,394.96–$8,427.00 | 23% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Contrast 70470 | $1,780.80 | $2,968.00 | $1,394.96–$8,427.00 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 BCE CT Lumbar Spine w/o contrast 72131 | $1,524.60 | $2,541.00 | $1,194.27–$8,427.00 | 32% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast 72131 | $1,524.60 | $2,541.00 | $1,194.27–$8,427.00 | 32% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast 72131 | $1,524.60 | $2,541.00 | $1,194.27–$8,427.00 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 BCE CT Lumbar Spine w/o contrast 72131 | $1,524.60 | $2,541.00 | $1,194.27–$8,427.00 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 BCE CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $1,064.08–$8,427.00 | 36% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $1,064.08–$8,427.00 | 36% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $1,064.08–$8,427.00 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 BCE CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $1,064.08–$8,427.00 | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast 72193 | $1,646.40 | $2,744.00 | $1,289.68–$8,427.00 | 27% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 BCE CT Pelvis s/contrast 72193 | $1,646.40 | $2,744.00 | $1,289.68–$8,427.00 | 27% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast 72193 | $1,646.40 | $2,744.00 | $1,289.68–$8,427.00 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 BCE CT Pelvis s/contrast 72193 | $1,646.40 | $2,744.00 | $1,289.68–$8,427.00 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Duplex Carotid 93880 | $370.80 | $618.00 | $290.46–$8,427.00 | 74% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US Duplex Carotid 93880 | $370.80 | $618.00 | $290.46–$8,427.00 | — | 40% |
| Chest X-ray, 2 views CPT 71046 BCE Radiologic examination, chest; 2 views 71046 | $171.00 | $285.00 | $133.95–$8,427.00 | 59% below | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views 71046 | $171.00 | $285.00 | $133.95–$8,427.00 | 59% below | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 View (Frontal & Lat) 71046 | $171.00 | $285.00 | $133.95–$8,427.00 | 59% below | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $171.00 | $285.00 | $133.95–$8,427.00 | 59% below | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $171.00 | $285.00 | $133.95–$8,427.00 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 BCE Radiologic examination, chest; 2 views 71046 | $171.00 | $285.00 | $133.95–$8,427.00 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 View (Frontal & Lat) 71046 | $171.00 | $285.00 | $133.95–$8,427.00 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views 71046 | $171.00 | $285.00 | $133.95–$8,427.00 | — | 40% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal 71045 | $127.20 | $212.00 | $99.64–$8,427.00 | 63% below | 40% |
| Chest X-ray, single view CPT 71045 BCE Radiologic examination, chest; single view 71045 | $127.20 | $212.00 | $99.64–$8,427.00 | 63% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal 71045 | $127.20 | $212.00 | $99.64–$8,427.00 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 BCE Radiologic examination, chest; single view 71045 | $127.20 | $212.00 | $99.64–$8,427.00 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete 76770 | $421.20 | $702.00 | $329.94–$8,427.00 | 43% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Aorta Renal 76770 | $421.20 | $702.00 | $329.94–$8,427.00 | 43% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 BCE US retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76770 | $421.20 | $702.00 | $329.94–$8,427.00 | 43% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 BCE US retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76770 | $421.20 | $702.00 | $329.94–$8,427.00 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete 76770 | $421.20 | $702.00 | $329.94–$8,427.00 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Aorta Renal 76770 | $421.20 | $702.00 | $329.94–$8,427.00 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w/ Detail 76811 | $398.40 | $664.00 | $312.08–$8,427.00 | 53% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w/ Detail 76811 | $398.40 | $664.00 | $312.08–$8,427.00 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast 71250 | $1,437.00 | $2,395.00 | $1,125.65–$8,427.00 | 27% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 BCE CT Thorax, w/o contrast 71250 | $1,437.00 | $2,395.00 | $1,125.65–$8,427.00 | 27% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 BCE CT Thorax, w/o contrast 71250 | $1,437.00 | $2,395.00 | $1,125.65–$8,427.00 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast 71250 | $1,437.00 | $2,395.00 | $1,125.65–$8,427.00 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 BCE CT Thorax w/contrast 71260 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | 24% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast 71260 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | 24% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 BCE CT Thorax w/contrast 71260 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast 71260 | $1,713.60 | $2,856.00 | $1,342.32–$8,427.00 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 BCE US DUPLEX SCAN, ARTERIAL, LOWER EXTREMITY, BILATERAL 93925 | $816.00 | $1,360.00 | $639.20–$8,427.00 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US Duplex Arterial LE Bl 93925 | $816.00 | $1,360.00 | $639.20–$8,427.00 | 64% below | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 BCE US DUPLEX SCAN, ARTERIAL, LOWER EXTREMITY, BILATERAL 93925 | $816.00 | $1,360.00 | $639.20–$8,427.00 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Duplex Arterial LE Bl 93925 | $816.00 | $1,360.00 | $639.20–$8,427.00 | — | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 BCE US Venous Doppler Extremity Bl 93970 | $763.20 | $1,272.00 | $597.84–$8,427.00 | 63% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Doppler Extremity Bl 93970 | $793.80 | $1,323.00 | $621.81–$8,427.00 | 62% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 BCE BCE US Venous Doppler Extremity Bl 93970 | $793.80 | $1,323.00 | $621.81–$8,427.00 | 62% below | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BCE US Venous Doppler Extremity Bl 93970 | $763.20 | $1,272.00 | $597.84–$8,427.00 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BCE BCE US Venous Doppler Extremity Bl 93970 | $793.80 | $1,323.00 | $621.81–$8,427.00 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Venous Doppler Extremity Bl 93970 | $793.80 | $1,323.00 | $621.81–$8,427.00 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echocardiogram w/ Color flow 93306 | $1,159.20 | $1,932.00 | $908.04–$8,427.00 | 55% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 BCE US Echocardiography w/Color Flow 93306 | $1,173.60 | $1,956.00 | $919.32–$8,427.00 | 55% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echocardiogram w/ Color flow 93306 | $1,159.20 | $1,932.00 | $908.04–$8,427.00 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 BCE US Echocardiography w/Color Flow 93306 | $1,173.60 | $1,956.00 | $919.32–$8,427.00 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY; AGE 6 YEARS OR OLDER, SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS 95811 | $3,420.00 | $5,700.00 | $3,591.00–$8,427.00 | 29% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY; AGE 6 YEARS OR OLDER, SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS 95811 | $3,420.00 | $5,700.00 | $3,591.00–$8,427.00 | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | — | 40% |
| Knee X-ray, 3 views CPT 73562 BCE XR Knee 3 Views 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | 24% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | 24% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | 24% below | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 BCE XR Knee 3 Views 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left 73562 | $265.80 | $443.00 | $208.21–$8,427.00 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 BCE US Abdominal, limited 76705 | $445.80 | $743.00 | $349.21–$8,427.00 | 34% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited 76705 | $445.80 | $743.00 | $349.21–$8,427.00 | 34% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited 76705 | $445.80 | $743.00 | $349.21–$8,427.00 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 BCE US Abdominal, limited 76705 | $445.80 | $743.00 | $349.21–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Ankle w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Knee w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 BCE MRI w/o contrast lower extremity 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | 5% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Knee w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hip w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Ankle w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 BCE MRI w/o contrast lower extremity 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $1,600.35–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Ankle w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Knee w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Hip w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Hip w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Ankle w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Knee w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $1,491.78–$8,427.00 | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast 74181 | $1,737.60 | $2,896.00 | $1,361.12–$8,427.00 | 24% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast 74181 | $1,737.60 | $2,896.00 | $1,361.12–$8,427.00 | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 BCE MRI, abdomen; w/o contrast & w/contrast 74183 | $2,400.00 | $4,000.00 | $1,880.00–$8,427.00 | 26% below | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast 74183 | $2,400.00 | $4,000.00 | $1,880.00–$8,427.00 | 26% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast 74183 | $2,400.00 | $4,000.00 | $1,880.00–$8,427.00 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 BCE MRI, abdomen; w/o contrast & w/contrast 74183 | $2,400.00 | $4,000.00 | $1,880.00–$8,427.00 | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 BCE MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $1,423.16–$8,427.00 | 17% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $1,423.16–$8,427.00 | 17% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $1,423.16–$8,427.00 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 BCE MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $1,423.16–$8,427.00 | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast 70553 | $2,571.00 | $4,285.00 | $2,013.95–$8,427.00 | 15% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 BCE MRI Brain, w/o & w/contrast 70553 | $2,571.00 | $4,285.00 | $2,013.95–$8,427.00 | 15% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BCE MRI Brain, w/o & w/contrast 70553 | $2,571.00 | $4,285.00 | $2,013.95–$8,427.00 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast 70553 | $2,571.00 | $4,285.00 | $2,013.95–$8,427.00 | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 BCE MRI Spine Lumbar w/o contrast 72148 | $1,788.00 | $2,980.00 | $1,400.60–$8,427.00 | 22% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast 72148 | $1,788.00 | $2,980.00 | $1,400.60–$8,427.00 | 22% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 BCE MRI Spine Lumbar w/o contrast 72148 | $1,788.00 | $2,980.00 | $1,400.60–$8,427.00 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast 72148 | $1,788.00 | $2,980.00 | $1,400.60–$8,427.00 | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 BCE MRI Spine Lumbar w/ & w/o contrast 72158 | $2,608.80 | $4,348.00 | $2,043.56–$8,427.00 | 18% below | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast 72158 | $2,608.80 | $4,348.00 | $2,043.56–$8,427.00 | 18% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 BCE MRI Spine Lumbar w/ & w/o contrast 72158 | $2,608.80 | $4,348.00 | $2,043.56–$8,427.00 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast 72158 | $2,608.80 | $4,348.00 | $2,043.56–$8,427.00 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $1,300.49–$8,427.00 | 23% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 BCE MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $1,300.49–$8,427.00 | 23% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 BCE MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $1,300.49–$8,427.00 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $1,300.49–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Cont 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 BCE MRI Spinal canal w/o & w/contrast, cervical 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast one side CPT 72156 MRI Brachial Plexus w/+w/o Left 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast one side CPT 72156 MRI Brachial Plexus w/+w/o Right 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 BCE MRI Spinal canal w/o & w/contrast, cervical 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Cont 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient one side CPT 72156 MRI Brachial Plexus w/+w/o Right 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient one side CPT 72156 MRI Brachial Plexus w/+w/o Left 72156 | $2,533.80 | $4,223.00 | $1,984.81–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | 23% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 BCE MRI Spine Cervical 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | 23% below | 40% |
| MRI of the neck (cervical spine), no contrast dye one side CPT 72141 MRI Brachial Plexus wo/Contrast Lt 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | 23% below | 40% |
| MRI of the neck (cervical spine), no contrast dye one side CPT 72141 MRI Brachial Plexus wo/Contrast Rt 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | 23% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 BCE MRI Spine Cervical 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient one side CPT 72141 MRI Brachial Plexus wo/Contrast Lt 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient one side CPT 72141 MRI Brachial Plexus wo/Contrast Rt 72141 | $1,849.80 | $3,083.00 | $1,449.01–$8,427.00 | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 BCE MRI Pelvis w/o Contrast + w Contrast 72197 | $2,047.80 | $3,413.00 | $1,604.11–$8,427.00 | 40% below | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast 72197 | $2,047.80 | $3,413.00 | $1,604.11–$8,427.00 | 40% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 BCE MRI Pelvis w/o Contrast + w Contrast 72197 | $2,047.80 | $3,413.00 | $1,604.11–$8,427.00 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast 72197 | $2,047.80 | $3,413.00 | $1,604.11–$8,427.00 | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $1,189.10–$8,427.00 | 39% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 BCE MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $1,189.10–$8,427.00 | 39% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum/Coccyx w/o Contrast 72195 | $1,518.00 | $2,530.00 | $1,189.10–$8,427.00 | 39% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum/Coccyx w/o Contrast 72195 | $1,518.00 | $2,530.00 | $1,189.10–$8,427.00 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 BCE MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $1,189.10–$8,427.00 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $1,189.10–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Elbow w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Wrist w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 BCE MRI UE Joint 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Shoulder w/o Contrast Bl 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Elbow w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Wrist w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 BCE MRI UE Joint 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Shoulder w/o Contrast Bl 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $1,555.23–$8,427.00 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 BCE US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $323.36–$8,427.00 | 20% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $323.36–$8,427.00 | 20% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 BCE US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $323.36–$8,427.00 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $323.36–$8,427.00 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic/Trans (Non-OB) 76856/76830 | $487.24 | $812.06 | $381.66–$8,427.00 | 43% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete 76856 | $527.40 | $879.00 | $397.64–$8,427.00 | 39% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 CPT Price | $602.40 | $1,004.00 | $397.64–$8,427.00 | 30% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic/Trans (Non-OB) 76856/76830 | $487.24 | $812.06 | $381.66–$8,427.00 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Complete 76856 | $527.40 | $879.00 | $397.64–$8,427.00 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 CPT Price | $602.40 | $1,004.00 | $397.64–$8,427.00 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester 76805 | $289.80 | $483.00 | $227.01–$8,427.00 | 56% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester 76805 | $289.80 | $483.00 | $227.01–$8,427.00 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester 76801 | $364.80 | $608.00 | $285.76–$8,427.00 | 45% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester 76801 | $364.80 | $608.00 | $285.76–$8,427.00 | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete Bilateral 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR Shoulder Comp Min 2 View BL 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | 17% below | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 BCE XR Shoulder Complete 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | 17% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Comp Min 2 View Left 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | 17% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Comp Min 2 View Right 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | 17% below | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete Bilateral 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR Shoulder Comp Min 2 View BL 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 BCE XR Shoulder Complete 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Comp Min 2 View Right 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Comp Min 2 View Left 73030 | $255.00 | $425.00 | $199.75–$8,427.00 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Video 74230 | $440.40 | $734.00 | $344.98–$8,427.00 | 27% below | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BCE Swallowing function, w/cineradiography74230 | $440.40 | $734.00 | $344.98–$8,427.00 | 27% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BCE Swallowing function, w/cineradiography74230 | $440.40 | $734.00 | $344.98–$8,427.00 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Video 74230 | $440.40 | $734.00 | $344.98–$8,427.00 | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 BCE US Transvaginal 76830 | $427.20 | $712.00 | $334.64–$8,427.00 | 35% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal 76830 | $427.20 | $712.00 | $334.64–$8,427.00 | 35% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $427.20 | $712.00 | $334.64–$8,427.00 | 35% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal 76830 | $427.20 | $712.00 | $334.64–$8,427.00 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $427.20 | $712.00 | $334.64–$8,427.00 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 BCE US Transvaginal 76830 | $427.20 | $712.00 | $334.64–$8,427.00 | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal 76817 | $206.40 | $344.00 | $161.68–$8,427.00 | 65% below | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal 76817 | $206.40 | $344.00 | $161.68–$8,427.00 | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 BCE US Abdomen Complete 76700 | $619.20 | $1,032.00 | $397.64–$8,427.00 | 28% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete 76700 | $619.20 | $1,032.00 | $397.64–$8,427.00 | 28% below | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 BCE US Abdomen Complete 76700 | $619.20 | $1,032.00 | $397.64–$8,427.00 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete 76700 | $619.20 | $1,032.00 | $397.64–$8,427.00 | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) 76870 | $398.40 | $664.00 | $312.08–$8,427.00 | 47% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 BCE US, Scrotum and contents 76870 | $398.40 | $664.00 | $312.08–$8,427.00 | 47% below | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 BCE US, Scrotum and contents 76870 | $398.40 | $664.00 | $312.08–$8,427.00 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) 76870 | $398.40 | $664.00 | $312.08–$8,427.00 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 BCE US Soft Tissue of head & neck 76536 | $420.60 | $701.00 | $329.47–$8,427.00 | 35% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue of Head and Neck 76536 | $420.60 | $701.00 | $329.47–$8,427.00 | 35% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue of Head and Neck 76536 | $420.60 | $701.00 | $329.47–$8,427.00 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 BCE US Soft Tissue of head & neck 76536 | $420.60 | $701.00 | $329.47–$8,427.00 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI without KUB 74240 | $462.60 | $771.00 | $362.37–$8,427.00 | 37% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 BCE XR Upper GI Without KUB 74240 | $462.60 | $771.00 | $362.37–$8,427.00 | 37% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI without KUB 74240 | $462.60 | $771.00 | $362.37–$8,427.00 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 BCE XR Upper GI Without KUB 74240 | $462.60 | $771.00 | $362.37–$8,427.00 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 BCE US Venous Doppler Extremity Unilat 93971 | $640.20 | $1,067.00 | $397.64–$8,427.00 | 20% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Extremity Unilat 93971 | $640.20 | $1,067.00 | $397.64–$8,427.00 | 20% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ED US Duplex Scan Extremity Veins, Unilat 93971 | $659.40 | $1,099.00 | $397.64–$8,427.00 | 18% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 BCE US Venous Doppler Extremity Unilat 93971 | $640.20 | $1,067.00 | $397.64–$8,427.00 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Extremity Unilat 93971 | $640.20 | $1,067.00 | $397.64–$8,427.00 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 ED US Duplex Scan Extremity Veins, Unilat 93971 | $659.40 | $1,099.00 | $397.64–$8,427.00 | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Bilateral 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 BCE XR Wrist, complete min of 3 views 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | 28% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Left 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | 28% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Right 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | 28% below | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Bilateral 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 BCE XR Wrist, complete min of 3 views 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Right 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Left 73110 | $258.00 | $430.00 | $202.10–$8,427.00 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Left 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | 53% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | 53% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Right 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | 53% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | 53% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 BCE XR Hip, Unilateral, w Pelvis 2-3 Views 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | 53% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Left 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 BCE XR Hip, Unilateral, w Pelvis 2-3 Views 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Right 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left 73502 | $189.00 | $315.00 | $148.05–$8,427.00 | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View 74018 | $160.20 | $267.00 | $125.49–$8,427.00 | 53% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 BCE Radiologic examination, abdomen; 1 view 74018 | $160.20 | $267.00 | $125.49–$8,427.00 | 53% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR abdomen 1 view 74018 | $160.20 | $267.00 | $125.49–$8,427.00 | 53% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 BCE Radiologic examination, abdomen; 1 view 74018 | $160.20 | $267.00 | $125.49–$8,427.00 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR abdomen 1 view 74018 | $160.20 | $267.00 | $125.49–$8,427.00 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View 74018 | $160.20 | $267.00 | $125.49–$8,427.00 | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 BCE XR Ankle 2 Views 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | 37% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | 37% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | 37% below | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 BCE XR Ankle 2 Views 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left 73600 | $181.20 | $302.00 | $141.94–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 BCE XR Finger, min 2 views 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 BCE XR Finger, min 2 views 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Right 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Left 73140 | $180.60 | $301.00 | $141.47–$8,427.00 | — | 40% |
| X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | — | 40% |
| X-ray of the foot, 2 views CPT 73620 BCE XR Foot Complete 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | 25% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | 25% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | 25% below | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 BCE XR Foot Complete 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left 73620 | $250.80 | $418.00 | $196.46–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Bilateral 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 BCE XR Foot, complete, min 3 views 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Left 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete min 3 views Left 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete min 3 views Rt 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Right 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Bilateral 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 BCE XR Foot, complete, min 3 views 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete min 3 views Rt 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Left 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Right 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete min 3 views Left 73630 | $318.60 | $531.00 | $249.57–$8,427.00 | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Bilateral 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 BCE XR Hand, min 3 views 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | 28% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Right 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | 28% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Left 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | 28% below | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Bilateral 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 BCE XR Hand, min 3 views 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Right 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Left 73130 | $277.20 | $462.00 | $217.14–$8,427.00 | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 BCE XR Knee, 1 or 2 views 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | 18% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | 18% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | 18% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 BCE XR Knee, 1 or 2 views 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left 73560 | $228.00 | $380.00 | $178.60–$8,427.00 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 BCE XR Spine, lumbosacral, 2 or 3 views 72100 | $265.20 | $442.00 | $207.74–$8,427.00 | 44% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views 72100 | $265.20 | $442.00 | $207.74–$8,427.00 | 44% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views 72100 | $265.20 | $442.00 | $207.74–$8,427.00 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 BCE XR Spine, lumbosacral, 2 or 3 views 72100 | $265.20 | $442.00 | $207.74–$8,427.00 | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V 72110 | $355.80 | $593.00 | $278.71–$8,427.00 | 45% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 BCE XR Spine Lumbosacral Min 4 views 72110 | $355.80 | $593.00 | $278.71–$8,427.00 | 45% below | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 BCE XR Spine Lumbosacral Min 4 views 72110 | $355.80 | $593.00 | $278.71–$8,427.00 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V 72110 | $355.80 | $593.00 | $278.71–$8,427.00 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 BCE XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $183.30–$8,427.00 | 42% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $183.30–$8,427.00 | 42% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 BCE XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $183.30–$8,427.00 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $183.30–$8,427.00 | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views 70160 | $184.80 | $308.00 | $144.76–$8,427.00 | 37% below | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views 70160 | $184.80 | $308.00 | $144.76–$8,427.00 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 BCE XR Spine, cervical; 2 or 3 views 72040 | $254.40 | $424.00 | $199.28–$8,427.00 | 32% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views 72040 | $254.40 | $424.00 | $199.28–$8,427.00 | 32% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views 72040 | $254.40 | $424.00 | $199.28–$8,427.00 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 BCE XR Spine, cervical; 2 or 3 views 72040 | $254.40 | $424.00 | $199.28–$8,427.00 | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 BCE XR Pelvis, 1 or 2 views 72170 | $223.80 | $373.00 | $175.31–$8,427.00 | 40% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views 72170 | $223.80 | $373.00 | $175.31–$8,427.00 | 40% below | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 BCE XR Pelvis, 1 or 2 views 72170 | $223.80 | $373.00 | $175.31–$8,427.00 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views 72170 | $223.80 | $373.00 | $175.31–$8,427.00 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Minimum 2 Views 72220 | $227.40 | $379.00 | $178.13–$8,427.00 | 31% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx Minimum 2 Views 72220 | $227.40 | $379.00 | $178.13–$8,427.00 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $91.20 | $152.00 | $0.47–$8,427.00 | 55% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $91.20 | $152.00 | $0.47–$8,427.00 | 55% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP ACUTE PROF | $236.40 | $394.00 | $0.47–$8,427.00 | 39% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP ACUTE PROF | $236.40 | $394.00 | $0.47–$8,427.00 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, eac | $16.20 | $27.00 | $0.47–$8,427.00 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen specific IgE; quantitative or semiquantitative, eac | $16.20 | $27.00 | $0.47–$8,427.00 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide | $65.40 | $109.00 | $0.47–$8,427.00 | 27% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide | $65.40 | $109.00 | $0.47–$8,427.00 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen | $60.60 | $101.00 | $0.47–$8,427.00 | 41% below | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody Screen | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide | $142.20 | $237.00 | $0.47–$8,427.00 | 28% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Brain Natriuretic Peptide | $142.20 | $237.00 | $0.47–$8,427.00 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $226.80 | $378.00 | $0.47–$8,427.00 | 11% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $226.80 | $378.00 | $0.47–$8,427.00 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Pathology Level IV 88305 | $321.60 | $536.00 | $0.47–$8,427.00 | 4% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Pathology Level IV 88305 | $321.60 | $536.00 | $0.47–$8,427.00 | — | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture | $138.00 | $230.00 | $0.47–$8,427.00 | 42% below | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture. | $138.00 | $230.00 | $0.47–$8,427.00 | 42% below | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture. | $138.00 | $230.00 | $0.47–$8,427.00 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $138.00 | $230.00 | $0.47–$8,427.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $21.60 | $36.00 | $13.23–$8,427.00 | 5% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Charge | $21.60 | $36.00 | $13.23–$8,427.00 | 5% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Charge | $21.60 | $36.00 | $13.23–$8,427.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture | $21.60 | $36.00 | $13.23–$8,427.00 | — | 40% |
| Blood glucose (sugar) test CPT 82947 Blood Glucose, Capillary | $29.40 | $49.00 | $0.47–$8,427.00 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose Random | $39.60 | $66.00 | $0.47–$8,427.00 | 20% below | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Blood Glucose, Capillary | $29.40 | $49.00 | $0.47–$8,427.00 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Random | $39.60 | $66.00 | $0.47–$8,427.00 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Human Chorionic Gonadotropin Qualitative | $109.20 | $182.00 | $0.47–$8,427.00 | 39% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta Human Chorionic Gonadotropin Qualitative | $109.20 | $182.00 | $0.47–$8,427.00 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Group by Blood Center 86900 | $78.00 | $130.00 | $0.47–$8,427.00 | 12% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Group by Blood Center 86900 | $78.00 | $130.00 | $0.47–$8,427.00 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $81.00 | $135.00 | $0.47–$8,427.00 | 39% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $81.00 | $135.00 | $0.47–$8,427.00 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $60.60 | $101.00 | $0.47–$8,427.00 | 62% below | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid COVID-19, RNA | $119.40 | $199.00 | $0.47–$8,427.00 | 44% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid SARS Coronavirus 2 RdRp gene | $119.40 | $199.00 | $0.47–$8,427.00 | 44% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID-19 Ql RT-PCR | $204.60 | $341.00 | $0.47–$8,427.00 | 147% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid COVID-19, RNA | $119.40 | $199.00 | $0.47–$8,427.00 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid SARS Coronavirus 2 RdRp gene | $119.40 | $199.00 | $0.47–$8,427.00 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 COVID-19 Ql RT-PCR | $204.60 | $341.00 | $0.47–$8,427.00 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Wet Prep | $151.80 | $253.00 | $0.47–$8,427.00 | 22% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Rapid DNA | $152.40 | $254.00 | $0.47–$8,427.00 | 23% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Wet Prep | $151.80 | $253.00 | $0.47–$8,427.00 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis Rapid DNA | $152.40 | $254.00 | $0.47–$8,427.00 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $171.60 | $286.00 | $0.47–$8,427.00 | 30% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $171.60 | $286.00 | $0.47–$8,427.00 | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Auto Diff | $91.20 | $152.00 | $0.47–$8,427.00 | 3% below | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Auto Diff | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC Auto No Diff | $60.60 | $101.00 | $0.47–$8,427.00 | 42% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC Auto No Diff | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $324.60 | $541.00 | $0.47–$8,427.00 | 10% below | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $324.60 | $541.00 | $0.47–$8,427.00 | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $211.80 | $353.00 | $0.47–$8,427.00 | 15% above | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $211.80 | $353.00 | $0.47–$8,427.00 | — | 40% |
| Estradiol blood test CPT 82670 Estradiol | $234.00 | $390.00 | $0.47–$8,427.00 | 54% above | 40% |
| Estradiol blood test inpatient CPT 82670 Estradiol | $234.00 | $390.00 | $0.47–$8,427.00 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone | $81.00 | $135.00 | $0.47–$8,427.00 | 49% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone | $81.00 | $135.00 | $0.47–$8,427.00 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $99.60 | $166.00 | $0.47–$8,427.00 | 3% below | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $99.60 | $166.00 | $0.47–$8,427.00 | — | 40% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $99.60 | $166.00 | $0.47–$8,427.00 | 20% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $99.60 | $166.00 | $0.47–$8,427.00 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $53.40 | $89.00 | $0.47–$8,427.00 | 65% below | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 Free | $53.40 | $89.00 | $0.47–$8,427.00 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Throxine Free | $171.60 | $286.00 | $0.47–$8,427.00 | 67% above | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $171.60 | $286.00 | $0.47–$8,427.00 | 67% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Throxine Free | $171.60 | $286.00 | $0.47–$8,427.00 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free | $171.60 | $286.00 | $0.47–$8,427.00 | — | 40% |
| Free testosterone test CPT 84402 Testosterone Free | $37.80 | $63.00 | $0.47–$8,427.00 | 66% below | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Free | $37.80 | $63.00 | $0.47–$8,427.00 | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL 80050 | $226.80 | $378.00 | $0.47–$8,427.00 | 52% below | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL 80050 | $226.80 | $378.00 | $0.47–$8,427.00 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950 | $24.60 | $41.00 | $0.47–$8,427.00 | 78% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950 | $24.60 | $41.00 | $0.47–$8,427.00 | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS 82951 | $33.60 | $56.00 | $0.47–$8,427.00 | 79% below | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS 82951 | $33.60 | $56.00 | $0.47–$8,427.00 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae 87591 | $97.80 | $163.00 | $0.47–$8,427.00 | 31% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea RNA by TMA | $97.80 | $163.00 | $0.47–$8,427.00 | 31% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea RNA by TMA | $97.80 | $163.00 | $0.47–$8,427.00 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae 87591 | $97.80 | $163.00 | $0.47–$8,427.00 | — | 40% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody | $256.80 | $428.00 | $0.47–$8,427.00 | 97% above | 40% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Antibody | $256.80 | $428.00 | $0.47–$8,427.00 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 and HIV-2 87389 | $146.40 | $244.00 | $0.47–$8,427.00 | 1% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 and HIV-2 87389 | $146.40 | $244.00 | $0.47–$8,427.00 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $120.00 | $200.00 | $0.47–$8,427.00 | 30% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c | $120.00 | $200.00 | $0.47–$8,427.00 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $142.20 | $237.00 | $0.47–$8,427.00 | 123% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody | $142.20 | $237.00 | $0.47–$8,427.00 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $37.20 | $62.00 | $0.47–$8,427.00 | 53% below | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen | $37.20 | $62.00 | $0.47–$8,427.00 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody IgM + IgG | $142.20 | $237.00 | $0.47–$8,427.00 | 63% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody IgM + IgG | $142.20 | $237.00 | $0.47–$8,427.00 | — | 40% |
| Homocysteine blood test CPT 83090 Homocystine Total | $21.60 | $36.00 | $0.47–$8,427.00 | 86% below | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocystine Total | $21.60 | $36.00 | $0.47–$8,427.00 | — | 40% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $60.60 | $101.00 | $0.47–$8,427.00 | 32% below | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total | $60.60 | $101.00 | $0.47–$8,427.00 | 38% below | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Total | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $31.20 | $52.00 | $0.47–$8,427.00 | 91% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $31.20 | $52.00 | $0.47–$8,427.00 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $88.80 | $148.00 | $0.47–$8,427.00 | 41% below | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone | $88.80 | $148.00 | $0.47–$8,427.00 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $91.20 | $152.00 | $0.47–$8,427.00 | 7% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $171.60 | $286.00 | $0.47–$8,427.00 | 40% below | 40% |
| Liver function blood test panel CPT 80076 LIVER | $189.60 | $316.00 | $0.47–$8,427.00 | 34% below | 40% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $171.60 | $286.00 | $0.47–$8,427.00 | — | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER | $189.60 | $316.00 | $0.47–$8,427.00 | — | 40% |
| Lyme disease antibody test CPT 86618 LYMES | $60.60 | $101.00 | $0.47–$8,427.00 | 27% below | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYMES | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| Magnesium blood test CPT 83735 Serum Magnesium | $81.00 | $135.00 | $0.47–$8,427.00 | 76% above | 40% |
| Magnesium blood test inpatient CPT 83735 Serum Magnesium | $81.00 | $135.00 | $0.47–$8,427.00 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening 86308 | $100.80 | $168.00 | $0.47–$8,427.00 | 5% above | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile antibodies; screening 86308 | $100.80 | $168.00 | $0.47–$8,427.00 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen | $142.20 | $237.00 | $0.47–$8,427.00 | 71% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen | $142.20 | $237.00 | $0.47–$8,427.00 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 iPTH | $55.20 | $92.00 | $0.47–$8,427.00 | 75% below | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 iPTH | $55.20 | $92.00 | $0.47–$8,427.00 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $91.20 | $152.00 | $0.47–$8,427.00 | 71% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| Progesterone blood test CPT 84144 Progesterone 84144 | $81.00 | $135.00 | $0.47–$8,427.00 | 33% below | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone 84144 | $81.00 | $135.00 | $0.47–$8,427.00 | — | 40% |
| Prolactin blood test CPT 84146 Prolactin Level | $171.60 | $286.00 | $0.47–$8,427.00 | 42% above | 40% |
| Prolactin blood test inpatient CPT 84146 Prolactin Level | $171.60 | $286.00 | $0.47–$8,427.00 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $91.20 | $152.00 | $0.47–$8,427.00 | 93% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test any number of drug classes read direct optical observation 80305 | $108.60 | $181.00 | $0.47–$8,427.00 | 28% below | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug test any number of drug classes read direct optical observation 80305 | $108.60 | $181.00 | $0.47–$8,427.00 | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Flu | $133.80 | $223.00 | $0.47–$8,427.00 | 18% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Flu | $133.80 | $223.00 | $0.47–$8,427.00 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Test | $81.00 | $135.00 | $0.47–$8,427.00 | 25% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep Test | $81.00 | $135.00 | $0.47–$8,427.00 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $78.60 | $131.00 | $0.47–$8,427.00 | 42% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor | $78.60 | $131.00 | $0.47–$8,427.00 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 MMR Titer | $32.40 | $54.00 | $0.47–$8,427.00 | 17% below | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 MMR Titer | $32.40 | $54.00 | $0.47–$8,427.00 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR | $21.60 | $36.00 | $0.47–$8,427.00 | 68% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR | $21.60 | $36.00 | $0.47–$8,427.00 | — | 40% |
| Stool ova and parasites exam CPT 87177 Ova and Parasites Exam | $120.00 | $200.00 | $0.47–$8,427.00 | 17% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Ova and Parasites Exam | $120.00 | $200.00 | $0.47–$8,427.00 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool | $68.40 | $114.00 | $0.47–$8,427.00 | 53% above | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool | $68.40 | $114.00 | $0.47–$8,427.00 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FIT FECAL OCCULT 82274 | $58.80 | $98.00 | $0.47–$8,427.00 | 24% below | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FIT FECAL OCCULT 82274 | $58.80 | $98.00 | $0.47–$8,427.00 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Test | $53.40 | $89.00 | $0.47–$8,427.00 | 5% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Test | $53.40 | $89.00 | $0.47–$8,427.00 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon-TB Gold | $124.20 | $207.00 | $0.47–$8,427.00 | 44% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon-TB Gold | $124.20 | $207.00 | $0.47–$8,427.00 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testost Total | $37.80 | $63.00 | $0.47–$8,427.00 | 70% below | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testost Total | $37.80 | $63.00 | $0.47–$8,427.00 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $171.60 | $286.00 | $0.47–$8,427.00 | 32% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Rflx Free T4 | $189.60 | $316.00 | $0.47–$8,427.00 | 45% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $171.60 | $286.00 | $0.47–$8,427.00 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Rflx Free T4 | $189.60 | $316.00 | $0.47–$8,427.00 | — | 40% |
| Uric acid blood test CPT 84550 Uric Acid | $68.40 | $114.00 | $0.47–$8,427.00 | 38% below | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $68.40 | $114.00 | $0.47–$8,427.00 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis With Microscopy | $28.80 | $48.00 | $0.47–$8,427.00 | 75% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis With Microscopy | $28.80 | $48.00 | $0.47–$8,427.00 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis | $28.80 | $48.00 | $0.47–$8,427.00 | 47% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick POC | $43.20 | $72.00 | $0.47–$8,427.00 | 20% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick | $60.60 | $101.00 | $0.47–$8,427.00 | 12% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis | $28.80 | $48.00 | $0.47–$8,427.00 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick POC | $43.20 | $72.00 | $0.47–$8,427.00 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick | $60.60 | $101.00 | $0.47–$8,427.00 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine 87086 | $87.60 | $146.00 | $0.47–$8,427.00 | 38% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $91.20 | $152.00 | $0.47–$8,427.00 | 36% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture. | $106.80 | $178.00 | $0.47–$8,427.00 | 25% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Culture, bacterial; quantitative colony count, urine 87086 | $87.60 | $146.00 | $0.47–$8,427.00 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $91.20 | $152.00 | $0.47–$8,427.00 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture. | $106.80 | $178.00 | $0.47–$8,427.00 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test POC | $112.80 | $188.00 | $0.47–$8,427.00 | 25% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test- Point Of Care | $156.60 | $261.00 | $0.47–$8,427.00 | 74% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Beta Human Chorionic Gonadotropin Qualitative Urine | $162.00 | $270.00 | $0.47–$8,427.00 | 80% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test POC | $112.80 | $188.00 | $0.47–$8,427.00 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test- Point Of Care | $156.60 | $261.00 | $0.47–$8,427.00 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Beta Human Chorionic Gonadotropin Qualitative Urine | $162.00 | $270.00 | $0.47–$8,427.00 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $99.60 | $166.00 | $0.47–$8,427.00 | 10% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $99.60 | $166.00 | $0.47–$8,427.00 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $60.00 | $100.00 | $0.47–$8,427.00 | 49% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D HYDROXY | $120.00 | $200.00 | $0.47–$8,427.00 | 2% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level | $60.00 | $100.00 | $0.47–$8,427.00 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D HYDROXY | $120.00 | $200.00 | $0.47–$8,427.00 | — | 40% |
| Zinc blood test CPT 84630 Zinc 84630 | $78.60 | $131.00 | $0.47–$8,427.00 | 14% above | 40% |
| Zinc blood test inpatient CPT 84630 Zinc 84630 | $78.60 | $131.00 | $0.47–$8,427.00 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Human Chorionic Gonadotropin Quantitative | $81.00 | $135.00 | $0.47–$8,427.00 | 28% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Human Chorionic Gonadotropin Quantitative | $81.00 | $135.00 | $0.47–$8,427.00 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY UNDER AGE 12 42830 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 61% below | 40% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY UNDER AGE 12 42830 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRODESIS ANTERIOR INTERBODY CERVICAL BELOW C2 22551 | $2,531.40 | $4,219.00 | $2,320.45–$14,483.00 | 64% below | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRODESIS ANTERIOR INTERBODY CERVICAL BELOW C2 22551 | $2,531.40 | $4,219.00 | $2,320.45–$14,483.00 | — | 40% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPICALLY AIDED KNEE ANTERIOR CRUCIATE LIGAMENT REPAIR/RECONSTRUCTION 29888 | $3,840.00 | $6,400.00 | $3,520.00–$14,275.00 | 47% below | 40% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED KNEE ANTERIOR CRUCIATE LIGAMENT REPAIR/RECONSTRUCTION 29888 | $3,840.00 | $6,400.00 | $3,520.00–$14,275.00 | — | 40% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR 29827 | $3,010.20 | $5,017.00 | $2,759.35–$14,275.00 | 38% below | 40% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR 29827 | $3,010.20 | $5,017.00 | $2,759.35–$14,275.00 | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 NASAL/SINUS ENDOSCOPY W/DILATION OF MAXILLARY SINUS BALLOON 31295 | $1,870.80 | $3,118.00 | $1,714.90–$10,329.00 | 63% below | 40% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NASAL/SINUS ENDOSCOPY W/DILATION OF MAXILLARY SINUS BALLOON 31295 | $1,870.80 | $3,118.00 | $1,714.90–$10,329.00 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT DISTAL FIBULA W/O MANIPULATION 27786 | $543.60 | $906.00 | $498.30–$8,427.00 | 17% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREATMENT DISTAL FIBULA W/O MANIPULATION 27786 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT OF METATARSAL FRACTURE WITHOUT MANIPULATION 28470 | $993.00 | $1,655.00 | $109.00–$8,427.00 | 255% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TREATMENT OF METATARSAL FRACTURE WITHOUT MANIPULATION 28470 | $993.00 | $1,655.00 | $109.00–$8,427.00 | — | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNIONECTOMY; W/SESAMOIDECTOMY; W/DISTAL METATARSAL OSTEOTOMY 28296 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | 54% below | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNIONECTOMY; W/SESAMOIDECTOMY; W/DISTAL METATARSAL OSTEOTOMY 28296 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | — | 40% |
| Bunion correction with removal of part of the big toe joint CPT 28292 BUNIONECTOMY; W/SESAMOIDECTOMY; W/RESEC. PROXIMAL PHALANX BASE 28292 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | 55% below | 40% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 BUNIONECTOMY; W/SESAMOIDECTOMY; W/RESEC. PROXIMAL PHALANX BASE 28292 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION;MEDIAN NERVE AT CARPAL TUNNEL 64721 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 63% below | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION;MEDIAN NERVE AT CARPAL TUNNEL 64721 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Cataract surgery with lens implant CPT 66984 EXTRACAPSULAR CATARACT REMOVAL W/INSERTION OF INTRAOCULAR LENS PROSTHESIS REG. 66984 | $1,894.20 | $3,157.00 | $1,736.35–$9,391.00 | 35% below | 40% |
| Cataract surgery with lens implant inpatient CPT 66984 EXTRACAPSULAR CATARACT REMOVAL W/INSERTION OF INTRAOCULAR LENS PROSTHESIS REG. 66984 | $1,894.20 | $3,157.00 | $1,736.35–$9,391.00 | — | 40% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX 57500 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 27% above | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX 57500 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION-SURGICAL EXCISION-OLDER THAN 28 DAYS 54161 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 38% below | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION-SURGICAL EXCISION-OLDER THAN 28 DAYS 54161 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP OR RING BLOCK 54150 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 18% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP OR RING BLOCK 54150 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED REDUCTION OF DISTAL RADIUS FRACTURE W/O MANIPULATION 25600 | $1,450.80 | $2,418.00 | $109.00–$8,427.00 | 156% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED REDUCTION OF DISTAL RADIUS FRACTURE W/O MANIPULATION 25600 | $1,450.80 | $2,418.00 | $109.00–$8,427.00 | — | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FLEXIBLE; WITH REMOVAL OF TUMOR/POLYP/LESION BY SNARE TECHNIQUE 45385 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 21% above | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FLEXIBLE; WITH REMOVAL OF TUMOR/POLYP/LESION BY SNARE TECHNIQUE 45385 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEXIBLE; WITH BIOPSY; SINGLE OR MULTIPLE 45380 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 21% above | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEXIBLE; WITH BIOPSY; SINGLE OR MULTIPLE 45380 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEXIBLE; DIAGNOSTIC; INCL. COLLECTION OF SPECIMENS 45378 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 1% below | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEXIBLE; DIAGNOSTIC; INCL. COLLECTION OF SPECIMENS 45378 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY OF CERVIX WITH LOOP ELECTRODE BIOPSY 57460 | $3,485.40 | $5,809.00 | $1,887.00–$8,427.00 | 1% below | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY OF CERVIX WITH LOOP ELECTRODE BIOPSY 57460 | $3,485.40 | $5,809.00 | $1,887.00–$8,427.00 | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY URETERAL STENT INSERTION 52332 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | 42% below | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY URETERAL STENT INSERTION 52332 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY 52000 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 31% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY 52000 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE; NON-OBSTETRICAL 58120 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | 75% below | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE; NON-OBSTETRICAL 58120 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESIONS FIRST LESION 17000 | $933.00 | $1,555.00 | $109.00–$8,427.00 | 360% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESIONS FIRST LESION 17000 | $933.00 | $1,555.00 | $109.00–$8,427.00 | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY-GENERAL ANESTHESIA 69436 | $1,870.80 | $3,118.00 | $1,659.00–$8,427.00 | 45% below | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY-GENERAL ANESTHESIA 69436 | $1,870.80 | $3,118.00 | $1,659.00–$8,427.00 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY-LOCAL OR TOPICAL ANESTHESIA 69433 | $543.60 | $906.00 | $498.30–$8,427.00 | 30% below | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY-LOCAL OR TOPICAL ANESTHESIA 69433 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN W/INST. UNILATERAL 69210 | $543.60 | $906.00 | $109.00–$8,427.00 | 216% above | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN W/INST. UNILATERAL 69210 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY 58100 | $966.60 | $1,611.00 | $109.00–$8,427.00 | 163% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY 58100 | $966.60 | $1,611.00 | $109.00–$8,427.00 | — | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 ENDOSCOPY NASAL ETHMOIDECTOMY TOTAL 31255 | $2,531.40 | $4,219.00 | $2,320.45–$9,519.00 | 50% below | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 ENDOSCOPY NASAL ETHMOIDECTOMY TOTAL 31255 | $2,531.40 | $4,219.00 | $2,320.45–$9,519.00 | — | 40% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASAL/SINUS ENDOSCOPY W/FRONTAL SINUS EXPLORATION 31276 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 63% below | 40% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL/SINUS ENDOSCOPY W/FRONTAL SINUS EXPLORATION 31276 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY 31256 | $1,870.80 | $3,118.00 | $1,714.90–$10,356.00 | 45% below | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY 31256 | $1,870.80 | $3,118.00 | $1,714.90–$10,356.00 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL ENDOSCOPY W/MAXILLARY ANTROSTOMY W/REM.OF TISSUE MAXILLARY SINUS 31267 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 62% below | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL ENDOSCOPY W/MAXILLARY ANTROSTOMY W/REM.OF TISSUE MAXILLARY SINUS 31267 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. CERVICAL/THORACIC W/IMAGE 62321 | $580.20 | $967.00 | $531.85–$8,427.00 | 63% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. CERVICAL/THORACIC W/IMAGE 62321 | $580.20 | $967.00 | $531.85–$8,427.00 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAGNOSTIC/THERAPEUTIC AGENT PARAVERTEBRAL FACET JOINT W/ IMAGE GUIDANCE LUMBAR/SACRAL 64493 | $2,127.60 | $3,546.00 | $1,659.00–$8,427.00 | 26% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAGNOSTIC/THERAPEUTIC AGENT PARAVERTEBRAL FACET JOINT W/ IMAGE GUIDANCE LUMBAR/SACRAL 64493 | $2,127.60 | $3,546.00 | $1,659.00–$8,427.00 | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH; 3 CM TO 10 CM 49593 | $2,388.00 | $3,980.00 | $2,189.00–$10,356.00 | 63% below | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH; 3 CM TO 10 CM 49593 | $2,388.00 | $3,980.00 | $2,189.00–$10,356.00 | — | 40% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH GREATER THAN 10 CM 49595 | $2,531.40 | $4,219.00 | $2,320.45–$8,427.00 | 67% below | 40% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH GREATER THAN 10 CM 49595 | $2,531.40 | $4,219.00 | $2,320.45–$8,427.00 | — | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH LESS THAN 3 CM 49591 | $2,388.00 | $3,980.00 | $2,189.00–$9,519.00 | 60% below | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH LESS THAN 3 CM 49591 | $2,388.00 | $3,980.00 | $2,189.00–$9,519.00 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC W/COLLECTION OF SPECIMENS 45330 | $543.60 | $906.00 | $498.30–$8,427.00 | 31% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC W/COLLECTION OF SPECIMENS 45330 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY LAPAROSCOPIC 47562 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | 45% below | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY LAPAROSCOPIC 47562 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | — | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 CHOLECYSTECTOMY CHOLANGIOGRAM LAPRASCOPIC 47563 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | 60% below | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 CHOLECYSTECTOMY CHOLANGIOGRAM LAPRASCOPIC 47563 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | — | 40% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY 47600 | $2,531.40 | $4,219.00 | $1,483.00–$14,275.00 | 21% below | 40% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY 47600 | $2,531.40 | $4,219.00 | $1,483.00–$14,275.00 | — | 40% |
| Hammertoe correction surgery CPT 28285 CORRECTION HAMMER TOE 28285 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 59% below | 40% |
| Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMER TOE 28285 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL-SINGLE COLUMN 46255 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | 49% below | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL-SINGLE COLUMN 46255 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | — | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY W/ OR W/O GRAFT 27132 | $2,921.40 | $4,869.00 | $2,677.95–$18,989.00 | 19% below | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY W/ OR W/O GRAFT 27132 | $2,921.40 | $4,869.00 | $2,677.95–$18,989.00 | — | 40% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY W/ OR W/O REML OF TUBE(S) OR OVARY(S) 58150 | $4,225.80 | $7,043.00 | $1,483.00–$14,275.00 | 1% above | 40% |
| Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY W/ OR W/O REML OF TUBE(S) OR OVARY(S) 58150 | $4,225.80 | $7,043.00 | $1,483.00–$14,275.00 | — | 40% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY WITH ENDOMETRIAL ABLATION 58563 | $2,531.40 | $4,219.00 | $2,320.45–$10,356.00 | 49% below | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY WITH ENDOMETRIAL ABLATION 58563 | $2,531.40 | $4,219.00 | $2,320.45–$10,356.00 | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY WITH BIOPSY 58558 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | 61% below | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY WITH BIOPSY 58558 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | — | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE 58300 | $1,765.20 | $2,942.00 | $109.00–$8,427.00 | 366% above | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE 58300 | $1,765.20 | $2,942.00 | $109.00–$8,427.00 | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ED INCISION AND DRAINAGE SIMPLE 10060 | $51.00 | $85.00 | $46.75–$8,427.00 | 89% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE SURGERY SIMPLE 10060 | $543.60 | $906.00 | $109.00–$8,427.00 | 16% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED INCISION AND DRAINAGE SIMPLE 10060 | $51.00 | $85.00 | $46.75–$8,427.00 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE SURGERY SIMPLE 10060 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INITIAL HERNIA INGUINAL-AGE 5 YEARS OR OLDER-REDUCIBLE 49505 | $2,531.40 | $4,219.00 | $2,320.45–$8,427.00 | 59% below | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INITIAL HERNIA INGUINAL-AGE 5 YEARS OR OLDER-REDUCIBLE 49505 | $2,531.40 | $4,219.00 | $2,320.45–$8,427.00 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ED TRIGGER POINT INJECTION | $51.00 | $85.00 | $46.75–$8,427.00 | 88% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION RECTUS SHEATH 20550 | $543.60 | $906.00 | $498.30–$8,427.00 | 23% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ED TRIGGER POINT INJECTION | $51.00 | $85.00 | $46.75–$8,427.00 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION RECTUS SHEATH 20550 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED ARTHROCENTESIS, ASPIRATION AND/OR INJ, MAJOR JOINT OR BURSA | $195.60 | $326.00 | $179.30–$8,427.00 | 73% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJECTION MAJOR JOINT/BURSA W/O ULTRASOUND GUIDANCE 20610 | $543.60 | $906.00 | $498.30–$8,427.00 | 24% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $1,105.00–$8,427.00 | 196% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 BCE IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $1,105.00–$8,427.00 | 196% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED ARTHROCENTESIS, ASPIRATION AND/OR INJ, MAJOR JOINT OR BURSA | $195.60 | $326.00 | $179.30–$8,427.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJECTION MAJOR JOINT/BURSA W/O ULTRASOUND GUIDANCE 20610 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $1,105.00–$8,427.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 BCE IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $1,105.00–$8,427.00 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT 11981 | $544.20 | $907.00 | $109.00–$18,989.00 | 127% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT 11981 | $544.20 | $907.00 | $109.00–$18,989.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ED ASPIRATE/INJECT INTERMEDIATE JNT, BURSA/GANGLION | $150.60 | $251.00 | $138.05–$8,427.00 | 76% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION INTERMEDIATE JOINT/BURSA W/O ULTRASOUND GUIDANCE 20605 | $543.60 | $906.00 | $498.30–$8,427.00 | 14% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ED ASPIRATE/INJECT INTERMEDIATE JNT, BURSA/GANGLION | $150.60 | $251.00 | $138.05–$8,427.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION INTERMEDIATE JOINT/BURSA W/O ULTRASOUND GUIDANCE 20605 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ED STEROID INJECTION JOINT | $96.60 | $161.00 | $88.55–$8,427.00 | 80% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT OR BURSA; W/O ULTRASOUND GUIDANCE 20600 | $543.60 | $906.00 | $498.30–$8,427.00 | 15% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ED STEROID INJECTION JOINT | $96.60 | $161.00 | $88.55–$8,427.00 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT OR BURSA; W/O ULTRASOUND GUIDANCE 20600 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCAL REPAIR 29882 | $3,010.20 | $5,017.00 | $2,759.35–$14,275.00 | 48% below | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCAL REPAIR 29882 | $3,010.20 | $5,017.00 | $2,759.35–$14,275.00 | — | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCECTOMY 29881 | $3,010.20 | $5,017.00 | $2,759.35–$8,427.00 | 49% below | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCECTOMY 29881 | $3,010.20 | $5,017.00 | $2,759.35–$8,427.00 | — | 40% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY KNEE W/MEDIAL AND LATERAL MENISCECTOMY 29880 | $3,010.20 | $5,017.00 | $2,759.35–$8,427.00 | 47% below | 40% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY KNEE W/MEDIAL AND LATERAL MENISCECTOMY 29880 | $3,010.20 | $5,017.00 | $2,759.35–$8,427.00 | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCOPY KNEE CHONDROPLASTY 29877 | $2,302.20 | $3,837.00 | $2,110.35–$8,427.00 | 49% below | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPY KNEE CHONDROPLASTY 29877 | $2,302.20 | $3,837.00 | $2,110.35–$8,427.00 | — | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 BYPASS GASTRIC LAPAROSCOPIC ROUX-EN-Y 43644 | $4,225.80 | $7,043.00 | $3,873.65–$19,020.00 | 18% below | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 BYPASS GASTRIC LAPAROSCOPIC ROUX-EN-Y 43644 | $4,225.80 | $7,043.00 | $3,873.65–$19,020.00 | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 APPENDECTOMY LAPAROSCOPIC 44970 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | 64% below | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 APPENDECTOMY LAPAROSCOPIC 44970 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | — | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 FUNDOPLICATION LAPAROSCOPIC 43280 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | 77% below | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 FUNDOPLICATION LAPAROSCOPIC 43280 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | — | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 LAPAROSCOPIC TOTAL HYSTERECTOMY 250 G OR LESS 58570 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 77% below | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 LAPAROSCOPIC TOTAL HYSTERECTOMY 250 G OR LESS 58570 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAP.TOTAL HYST.250 G OR LESS W/REMOVALTUBES/OVARY 58571 | $4,225.80 | $7,043.00 | $3,873.65–$14,275.00 | 61% below | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAP.TOTAL HYST.250 G OR LESS W/REMOVALTUBES/OVARY 58571 | $4,225.80 | $7,043.00 | $3,873.65–$14,275.00 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR HERNIA INGUINAL LAPAROSCOPIC-INITIAL 49650 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 85% below | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 REPAIR HERNIA INGUINAL LAPAROSCOPIC-INITIAL 49650 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 REPAIR HERNIA INGUINAL LAPAROSCOPIC-RECURRENT 49651 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 77% below | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 REPAIR HERNIA INGUINAL LAPAROSCOPIC-RECURRENT 49651 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPARASCOPY WITH LYSIS OF ADHESIONS AND REMOVAL OF ADNEXAL STRUCTURES 58661 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | 71% below | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPARASCOPY WITH LYSIS OF ADHESIONS AND REMOVAL OF ADNEXAL STRUCTURES 58661 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | — | 40% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 GASTRECTOMY LAPAROSCOPIC-LONGITUDINAL 43775 | $2,531.40 | $4,219.00 | $2,320.45–$19,020.00 | 73% below | 40% |
| Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 GASTRECTOMY LAPAROSCOPIC-LONGITUDINAL 43775 | $2,531.40 | $4,219.00 | $2,320.45–$19,020.00 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE, TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $96.60 | $161.00 | $88.55–$8,427.00 | 82% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE-TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $543.60 | $906.00 | $109.00–$8,427.00 | at median | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE, TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $96.60 | $161.00 | $88.55–$8,427.00 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE-TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/IMAGE 62323 | $580.20 | $967.00 | $531.85–$8,427.00 | 66% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 BCE INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/IMAGE 62323 | $2,118.00 | $3,530.00 | $1,887.00–$8,427.00 | 25% above | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/IMAGE 62323 | $580.20 | $967.00 | $531.85–$8,427.00 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 BCE INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/IMAGE 62323 | $2,118.00 | $3,530.00 | $1,887.00–$8,427.00 | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/O IMAGE 62322 | $580.20 | $967.00 | $531.85–$8,427.00 | 54% below | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/O IMAGE 62322 | $580.20 | $967.00 | $531.85–$8,427.00 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ.ANESTHETIC AGENT AND/OR STEROID; LUMBAR/SACRAL 64483 | $543.60 | $906.00 | $498.30–$8,427.00 | 62% below | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ.ANESTHETIC AGENT AND/OR STEROID; LUMBAR/SACRAL 64483 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY W/DECOMP.OF NERVE ROOTS W/EXCISION OF HERNIATED DISC/LUMBAR 63030 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | 62% below | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMY W/DECOMP.OF NERVE ROOTS W/EXCISION OF HERNIATED DISC/LUMBAR 63030 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | — | 40% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 LAMINECTOMY FACETECTOMY AND FORAMINOTOMY SINGLE VERTEBRAL SEGMENT;LUMBAR 63047 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | 63% below | 40% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAMINECTOMY FACETECTOMY AND FORAMINOTOMY SINGLE VERTEBRAL SEGMENT;LUMBAR 63047 | $3,310.80 | $5,518.00 | $3,034.90–$14,275.00 | — | 40% |
| Lumbar spinal fusion (posterior), one level CPT 22612 FUSION SPINE LUMBAR POSTERIOR 22612 | $2,531.40 | $4,219.00 | $2,320.45–$14,483.00 | 76% below | 40% |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 FUSION SPINE LUMBAR POSTERIOR 22612 | $2,531.40 | $4,219.00 | $2,320.45–$14,483.00 | — | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL 19301 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | 57% below | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL 19301 | $1,870.80 | $3,118.00 | $1,714.90–$8,427.00 | — | 40% |
| Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE 19303 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 69% below | 40% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE 19303 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISSED ABORTION-SURGICAL-FIRST TRIMESTER 59820 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 60% below | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREATMENT OF MISSED ABORTION-SURGICAL-FIRST TRIMESTER 59820 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESIONTRUNK 0.5CM OR LESS 11400 | $543.60 | $906.00 | $498.30–$8,427.00 | 33% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESIONTRUNK 0.5CM OR LESS 11400 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION FACIAL 0.5CM OR LESS 11440 | $543.60 | $906.00 | $498.30–$8,427.00 | 41% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BENIGN LESION FACIAL 0.5CM OR LESS 11440 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 ED AVULSION OF NAIL PLATE,PARTIAL OR COMPLETE,SIMPLE; SINGLE | $543.60 | $906.00 | $109.00–$8,427.00 | 52% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE 11730 | $543.60 | $906.00 | $109.00–$8,427.00 | 52% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 ED AVULSION OF NAIL PLATE,PARTIAL OR COMPLETE,SIMPLE; SINGLE | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE 11730 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC AGENT/STEROID;GREATER OCCIPITAL NERVE 64405 | $543.60 | $906.00 | $498.30–$8,427.00 | 27% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION ANESTHETIC AGENT/STEROID;GREATER OCCIPITAL NERVE 64405 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGE GUIDANCE 49083 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 11% below | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGE GUIDANCE 49083 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Partial knee replacement (one compartment) CPT 27446 ARTHROPLASTY KNEE CONDYLE AND PLATEA MEDIAL OR LATERAL COMPARTMENT 27446 | $2,531.40 | $4,219.00 | $2,320.45–$18,989.00 | 80% below | 40% |
| Partial knee replacement (one compartment) inpatient CPT 27446 ARTHROPLASTY KNEE CONDYLE AND PLATEA MEDIAL OR LATERAL COMPARTMENT 27446 | $2,531.40 | $4,219.00 | $2,320.45–$18,989.00 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL & MATRIX 11750 | $933.00 | $1,555.00 | $855.25–$8,427.00 | 17% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANE | $933.00 | $1,555.00 | $855.25–$8,427.00 | 17% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL & MATRIX 11750 | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANE | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Prostate biopsy CPT 55700 BIOPSY PROSTATE;NEEDLE OR PUNCTURE 55700 | $933.00 | $1,555.00 | $855.25–$8,427.00 | 64% below | 40% |
| Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE;NEEDLE OR PUNCTURE 55700 | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPARASCOPIC PROSTATECTOMY RETROPUBIC RADICAL 55866 | $4,225.80 | $7,043.00 | $3,873.65–$16,185.00 | 60% below | 40% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPARASCOPIC PROSTATECTOMY RETROPUBIC RADICAL 55866 | $4,225.80 | $7,043.00 | $3,873.65–$16,185.00 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION BY NEUROLYTIC AGT PARARVERT FACET JT W/IMAGE LUM/SAC SINGLE JT 64635 | $933.00 | $1,555.00 | $855.25–$8,427.00 | 67% below | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCTION BY NEUROLYTIC AGT PARARVERT FACET JT W/IMAGE LUM/SAC SINGLE JT 64635 | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXCISION LIPOMA BREAST 19120 | $933.00 | $1,555.00 | $855.25–$8,427.00 | 81% below | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION LIPOMA BREAST 19120 | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 ED INCISION AND REMOVAL OF FOREIGN BODY | $51.00 | $85.00 | $46.75–$8,427.00 | 92% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY 10120 | $543.60 | $906.00 | $109.00–$8,427.00 | 15% below | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 ED INCISION AND REMOVAL OF FOREIGN BODY | $51.00 | $85.00 | $46.75–$8,427.00 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY 10120 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMY-UNILATERAL 60220 | $1,870.80 | $3,118.00 | $1,714.90–$8,945.00 | 76% below | 40% |
| Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMY-UNILATERAL 60220 | $1,870.80 | $3,118.00 | $1,714.90–$8,945.00 | — | 40% |
| Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION W/ OR W/O CARTILAGE SCORING-CONTOURING-OR GRAFT 30520 | $933.00 | $1,555.00 | $855.25–$10,356.00 | 74% below | 40% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION W/ OR W/O CARTILAGE SCORING-CONTOURING-OR GRAFT 30520 | $933.00 | $1,555.00 | $855.25–$10,356.00 | — | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY 50590 | $8,242.20 | $13,737.00 | $3,986.00–$14,275.00 | 49% above | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY 50590 | $8,242.20 | $13,737.00 | $3,986.00–$14,275.00 | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 ED, CAST ELBOW TO FINGER (SHORT ARM) 29075 | $31.80 | $53.00 | $29.15–$10,356.00 | 90% below | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGERS 29075 | $33.60 | $56.00 | $30.80–$10,356.00 | 89% below | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 ED, CAST ELBOW TO FINGER (SHORT ARM) 29075 | $31.80 | $53.00 | $29.15–$10,356.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGERS 29075 | $33.60 | $56.00 | $30.80–$10,356.00 | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SPLINT FOREARM TO HAND-STATIC 29125 | $21.60 | $36.00 | $19.80–$14,275.00 | 93% below | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SPLINT FOREARM TO HAND-STATIC 29125 | $21.60 | $36.00 | $19.80–$14,275.00 | — | 40% |
| Short leg splint (calf to foot) CPT 29515 ED APPLICATION SHORT LEG SPLINT-CALF TO FOOT | $27.60 | $46.00 | $25.30–$14,275.00 | 91% below | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT-CALF TO FOOT 29515 | $28.80 | $48.00 | $26.40–$14,275.00 | 91% below | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 ED APPLICATION SHORT LEG SPLINT-CALF TO FOOT | $27.60 | $46.00 | $25.30–$14,275.00 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT-CALF TO FOOT 29515 | $28.80 | $48.00 | $26.40–$14,275.00 | — | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ARTHROSCOPY SHOULDER FOR EXCISION OF DISTAL CLAVICLE 29824 | $2,302.20 | $3,837.00 | $2,110.35–$14,275.00 | 46% below | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHROSCOPY SHOULDER FOR EXCISION OF DISTAL CLAVICLE 29824 | $2,302.20 | $3,837.00 | $2,110.35–$14,275.00 | — | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHOULDER W/SUBACROMIAL DECOMPRESSION/ACROMIOPLASTY 29826 | $2,302.20 | $3,837.00 | $1,105.00–$14,275.00 | 56% below | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY SHOULDER W/SUBACROMIAL DECOMPRESSION/ACROMIOPLASTY 29826 | $2,302.20 | $3,837.00 | $1,105.00–$14,275.00 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED Simple repair, superficial; 2.5 cm or less 12001 | $51.00 | $85.00 | $46.75–$8,427.00 | 88% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GEITALIA-TRUNK-EXT. 2.5CM OR LESS 12001 | $543.60 | $906.00 | $109.00–$8,427.00 | 29% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED Simple repair, superficial; 2.5 cm or less 12001 | $51.00 | $85.00 | $46.75–$8,427.00 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GEITALIA-TRUNK-EXT. 2.5CM OR LESS 12001 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION 11104 | $543.60 | $906.00 | $109.00–$8,427.00 | 19% above | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION 11104 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MALIGNANT LESION INCLUDING MARGIN TRUNK/ARM/LEG 0.5CM OR LESS 11600 | $543.60 | $906.00 | $498.30–$8,427.00 | 55% below | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MALIGNANT LESION INCLUDING MARGIN TRUNK/ARM/LEG 0.5CM OR LESS 11600 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 ED REMOVAL SKIN TAGS,MULTIPLE FIBROCUTANEOUS TAGS,ANY AREA, TO 15 TAGS | $51.00 | $85.00 | $46.75–$8,427.00 | 84% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS MULTIPLE FIBROCUTANEOUS ANY AREA UP TO 15 LESIONS 11200 | $57.60 | $96.00 | $52.80–$8,427.00 | 82% below | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 ED REMOVAL SKIN TAGS,MULTIPLE FIBROCUTANEOUS TAGS,ANY AREA, TO 15 TAGS | $51.00 | $85.00 | $46.75–$8,427.00 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS MULTIPLE FIBROCUTANEOUS ANY AREA UP TO 15 LESIONS 11200 | $57.60 | $96.00 | $52.80–$8,427.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 ED Spinal puncture, lumbar, diagnostic 62270 | $528.60 | $881.00 | $484.55–$8,427.00 | 49% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC 62270 | $543.60 | $906.00 | $498.30–$8,427.00 | 48% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $1,659.00–$8,427.00 | 103% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 BCE IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $1,659.00–$8,427.00 | 103% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED Spinal puncture, lumbar, diagnostic 62270 | $528.60 | $881.00 | $484.55–$8,427.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC 62270 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 BCE IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $1,659.00–$8,427.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $1,659.00–$8,427.00 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED SIMPLE REPAIR WOUNDS SCALP,NECK,AXILLAE,GEITALIA,TRUNK,EXT. 2.6CM-7.5CM 12002 | $528.00 | $880.00 | $109.00–$8,427.00 | 11% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GENITALIA-TRUNK-EXT. 2.6CM TO 7.5CM 12002 | $543.60 | $906.00 | $109.00–$8,427.00 | 15% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED SIMPLE REPAIR WOUNDS SCALP,NECK,AXILLAE,GEITALIA,TRUNK,EXT. 2.6CM-7.5CM 12002 | $528.00 | $880.00 | $109.00–$8,427.00 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GENITALIA-TRUNK-EXT. 2.6CM TO 7.5CM 12002 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED SIMPLE REPAIR OF WOUNDS-FACIAL, EARS, MUCOUS MEMBRANES 2.5CM OR LESS | $51.00 | $85.00 | $46.75–$8,427.00 | 88% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF WOUNDS-FACIAL-EARS-MUCOUS MEMBRANES 2.5CM OR LESS 12011 | $543.60 | $906.00 | $109.00–$8,427.00 | 28% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED SIMPLE REPAIR OF WOUNDS-FACIAL, EARS, MUCOUS MEMBRANES 2.5CM OR LESS | $51.00 | $85.00 | $46.75–$8,427.00 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR OF WOUNDS-FACIAL-EARS-MUCOUS MEMBRANES 2.5CM OR LESS 12011 | $543.60 | $906.00 | $109.00–$8,427.00 | — | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 CYSTOURETHROSCOPY WITH TRANSURETHRAL PROSTATECTOMY 52601 | $5,164.20 | $8,607.00 | $3,986.00–$8,427.00 | 26% below | 40% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 CYSTOURETHROSCOPY WITH TRANSURETHRAL PROSTATECTOMY 52601 | $5,164.20 | $8,607.00 | $3,986.00–$8,427.00 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION 11102 | $543.60 | $906.00 | $109.00–$14,275.00 | 51% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION 11102 | $543.60 | $906.00 | $109.00–$14,275.00 | — | 40% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY AGE 12 OR OVER 42821 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 62% below | 40% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY AGE 12 OR OVER 42821 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY UNDER AGE 12 42820 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 70% below | 40% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY UNDER AGE 12 42820 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY AGE 12 OR OVER 42826 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 67% below | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY AGE 12 OR OVER 42826 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY UNDER AGE 12 42825 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | 68% below | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY UNDER AGE 12 42825 | $1,450.80 | $2,418.00 | $1,329.90–$8,427.00 | — | 40% |
| Total hip replacement CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMORAL PROSTHETIC REPLACEMENT 27130 | $3,310.80 | $5,518.00 | $3,034.90–$18,989.00 | 74% below | 40% |
| Total hip replacement inpatient CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMORAL PROSTHETIC REPLACEMENT 27130 | $3,310.80 | $5,518.00 | $3,034.90–$18,989.00 | — | 40% |
| Total knee replacement CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL AND LATERAL 27447 | $6,033.00 | $10,055.00 | $3,986.00–$18,989.00 | 53% below | 40% |
| Total knee replacement inpatient CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL AND LATERAL 27447 | $6,033.00 | $10,055.00 | $3,986.00–$18,989.00 | — | 40% |
| Total shoulder replacement CPT 23472 TOTAL SHOULDER REPLACEMENT 23472 | $3,310.80 | $5,518.00 | $3,034.90–$18,989.00 | 81% below | 40% |
| Total shoulder replacement inpatient CPT 23472 TOTAL SHOULDER REPLACEMENT 23472 | $3,310.80 | $5,518.00 | $3,034.90–$18,989.00 | — | 40% |
| Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL OR COMPLETE 60240 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | 73% below | 40% |
| Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL OR COMPLETE 60240 | $2,531.40 | $4,219.00 | $2,320.45–$14,275.00 | — | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION (EG. FOR TRIGGER FINGER) 26055 | $543.60 | $906.00 | $498.30–$8,427.00 | 84% below | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG. FOR TRIGGER FINGER) 26055 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 ED INJECTION; SINGLE OR MULTIPLE TRIGGER POINTS, ONE OR TWO MUSCLE GROUPS | $74.40 | $124.00 | $68.20–$8,427.00 | 87% below | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TRIGGER POINT SINGLE 20552 | $543.60 | $906.00 | $498.30–$8,427.00 | 6% below | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED INJECTION; SINGLE OR MULTIPLE TRIGGER POINTS, ONE OR TWO MUSCLE GROUPS | $74.40 | $124.00 | $68.20–$8,427.00 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION TRIGGER POINT SINGLE 20552 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPARASCOPY WITH LYSIS OF ADHESIONS AND FULGURATION OF OVIDUCTS 58670 | $2,531.40 | $4,219.00 | $2,320.45–$9,519.00 | 49% below | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPARASCOPY WITH LYSIS OF ADHESIONS AND FULGURATION OF OVIDUCTS 58670 | $2,531.40 | $4,219.00 | $2,320.45–$9,519.00 | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ESOPHAGOGASTRODUODENOSCOPY W/BIOPSY 43239 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | 7% above | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ESOPHAGOGASTRODUODENOSCOPY W/BIOPSY 43239 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ESOPHAGOGASTRODUODENOSCOPY W/GUIDE WIRE DILATATION 43248 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | 40% above | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ESOPHAGOGASTRODUODENOSCOPY W/GUIDE WIRE DILATATION 43248 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE DIAGNOSTIC 43235 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | 3% below | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE DIAGNOSTIC 43235 | $1,024.80 | $1,708.00 | $939.40–$8,427.00 | — | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETHROSCOPY W/URETEROSCOPY AND/OR PYELOSCOPY W/LITHOTRIPSY 52353 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | 75% below | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETHROSCOPY W/URETEROSCOPY AND/OR PYELOSCOPY W/LITHOTRIPSY 52353 | $1,870.80 | $3,118.00 | $1,714.90–$14,275.00 | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTOURETHROSCOPY W/URETEROSCOPY/PYELOSCOPY INC. LITHOTRIPSY AND STENT INSERTION 52356 | $5,940.60 | $9,901.00 | $3,094.00–$10,329.00 | 12% above | 40% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTOURETHROSCOPY W/URETEROSCOPY/PYELOSCOPY INC. LITHOTRIPSY AND STENT INSERTION 52356 | $5,940.60 | $9,901.00 | $3,094.00–$10,329.00 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY-UNILATERAL OR BILATERAL-INC. POST OP SEMEN EXAMINATION(S) 55250 | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY-UNILATERAL OR BILATERAL-INC. POST OP SEMEN EXAMINATION(S) 55250 | $933.00 | $1,555.00 | $855.25–$8,427.00 | — | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS 17110 | $933.00 | $1,555.00 | $109.00–$8,427.00 | 342% above | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS 17110 | $933.00 | $1,555.00 | $109.00–$8,427.00 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED DEBRIDEMENT SKIN AND SUB-Q TISSUE | $74.40 | $124.00 | $68.20–$8,427.00 | 93% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20CM OR LESS 11042 | $544.20 | $907.00 | $498.85–$8,427.00 | 47% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ED DEBRIDEMENT SKIN AND SUB-Q TISSUE | $74.40 | $124.00 | $68.20–$8,427.00 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20CM OR LESS 11042 | $544.20 | $907.00 | $498.85–$8,427.00 | — | 40% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPEN REDUCTION INTERNAL FIXATION RADIUS EXTRA-ARTICULAR 25607 | $2,531.40 | $4,219.00 | $2,320.45–$10,356.00 | 68% below | 40% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPEN REDUCTION INTERNAL FIXATION RADIUS EXTRA-ARTICULAR 25607 | $2,531.40 | $4,219.00 | $2,320.45–$10,356.00 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 ED TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $522.60 | $871.00 | $479.05–$8,427.00 | 45% below | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $543.60 | $906.00 | $498.30–$8,427.00 | 42% below | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion, blood or blood components 36430 | $543.60 | $906.00 | $498.30–$8,427.00 | 42% below | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $522.60 | $871.00 | $479.05–$8,427.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion, blood or blood components 36430 | $543.60 | $906.00 | $498.30–$8,427.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION | $130.20 | $217.00 | $3,986.00–$8,427.00 | 36% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE Pressurized or nonpressurized inhalation treatment for acute airway obstruction 94640 | $376.20 | $627.00 | $3,986.00–$8,427.00 | 85% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 RT Charges - RT -> Pressurized Non-Pressurized Inhalation Treatment | $361.80 | $603.00 | $3,986.00–$8,427.00 | 78% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION | $130.20 | $217.00 | $3,986.00–$8,427.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE Pressurized or nonpressurized inhalation treatment for acute airway obstruction 94640 | $376.20 | $627.00 | $3,986.00–$8,427.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 RT Charges - RT -> Pressurized Non-Pressurized Inhalation Treatment | $361.80 | $603.00 | $3,986.00–$8,427.00 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 BCE EKG, at least 12 leads, tracing only 93005 | $247.20 | $412.00 | $193.64–$8,427.00 | 17% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 93005 | $264.60 | $441.00 | $207.27–$8,427.00 | 11% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG 93005 | $313.80 | $523.00 | $245.81–$8,427.00 | 6% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R 93005 | $571.20 | $952.00 | $447.44–$8,427.00 | 93% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 BCE EKG, at least 12 leads, tracing only 93005 | $247.20 | $412.00 | $193.64–$8,427.00 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 93005 | $264.60 | $441.00 | $207.27–$8,427.00 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG 93005 | $313.80 | $523.00 | $245.81–$8,427.00 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R 93005 | $571.20 | $952.00 | $447.44–$8,427.00 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Visit Level 1 | $291.00 | $485.00 | $202.00–$8,427.00 | 1% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED Visit Level 1 | $291.00 | $485.00 | $202.00–$8,427.00 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Level 2 | $511.20 | $852.00 | $432.00–$8,427.00 | 6% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED Visit Level 2 | $511.20 | $852.00 | $432.00–$8,427.00 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Level 3 | $1,090.20 | $1,817.00 | $917.00–$8,427.00 | 32% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED Visit Level 3 | $1,090.20 | $1,817.00 | $917.00–$8,427.00 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Level 4 | $2,154.00 | $3,590.00 | $1,820.00–$8,427.00 | 58% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED Visit Level 4 | $2,154.00 | $3,590.00 | $1,820.00–$8,427.00 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Level 5 | $4,557.00 | $7,595.00 | $2,457.00–$8,427.00 | 96% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED Visit Level 5 | $4,557.00 | $7,595.00 | $2,457.00–$8,427.00 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 96360 | $236.40 | $394.00 | $3,986.00–$8,427.00 | 52% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED IV INFUSION HYDRATION, INITIAL 31 MINUTES TO 1 HOUR | $246.00 | $410.00 | $3,986.00–$8,427.00 | 50% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 96360 | $236.40 | $394.00 | $3,986.00–$8,427.00 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED IV INFUSION HYDRATION, INITIAL 31 MINUTES TO 1 HOUR | $246.00 | $410.00 | $3,986.00–$8,427.00 | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 96365 | $115.80 | $193.00 | $3,986.00–$8,427.00 | 77% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy/Prophylaxis DX 1st > 1 hour 96365 | $120.60 | $201.00 | $3,986.00–$8,427.00 | 76% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 ED IV INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS ; INITIAL, UP TO 1 | $120.60 | $201.00 | $3,986.00–$8,427.00 | 76% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 INTRAVENOUS INFUSION FOR THERAPY PROPHYLAXIS OR DIAGNOSIS INITIAL UP TO 1 HOUR 96365 | $124.20 | $207.00 | $3,986.00–$8,427.00 | 75% below | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 96365 | $115.80 | $193.00 | $3,986.00–$8,427.00 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy/Prophylaxis DX 1st > 1 hour 96365 | $120.60 | $201.00 | $3,986.00–$8,427.00 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 ED IV INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS ; INITIAL, UP TO 1 | $120.60 | $201.00 | $3,986.00–$8,427.00 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INTRAVENOUS INFUSION FOR THERAPY PROPHYLAXIS OR DIAGNOSIS INITIAL UP TO 1 HOUR 96365 | $124.20 | $207.00 | $3,986.00–$8,427.00 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC OR DIAGNOSTIC INJ. SUCUTANEOUS OR INTRAMUSCULAR 96372 | $114.00 | $190.00 | $3,986.00–$8,427.00 | 32% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR 96372 | $115.80 | $193.00 | $3,986.00–$8,427.00 | 31% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR | $120.60 | $201.00 | $3,986.00–$8,427.00 | 28% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC OR DIAGNOSTIC INJ. SUCUTANEOUS OR INTRAMUSCULAR 96372 | $114.00 | $190.00 | $3,986.00–$8,427.00 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR 96372 | $115.80 | $193.00 | $3,986.00–$8,427.00 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR | $120.60 | $201.00 | $3,986.00–$8,427.00 | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | 47% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | 47% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | 47% below | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Charges - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Complexity -> Low | $73.80 | $123.00 | $3,986.00–$8,427.00 | 72% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 BCE OT Eval, low complexity 97165 | $99.00 | $165.00 | $3,986.00–$8,427.00 | 63% below | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Complexity -> Low | $73.80 | $123.00 | $3,986.00–$8,427.00 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 BCE OT Eval, low complexity 97165 | $99.00 | $165.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Complexity -> High | $80.40 | $134.00 | $3,986.00–$8,427.00 | 74% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 BCE PT Eval, high complexity 97163 | $99.00 | $165.00 | $3,986.00–$8,427.00 | 68% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Complexity -> High | $80.40 | $134.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 BCE PT Eval, high complexity 97163 | $99.00 | $165.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Complexity -> Low | $80.40 | $134.00 | $3,986.00–$8,427.00 | 66% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 BCE PT Eval, low complexity 97161 | $99.00 | $165.00 | $3,986.00–$8,427.00 | 58% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Complexity -> Low | $80.40 | $134.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 BCE PT Eval, low complexity 97161 | $99.00 | $165.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Complexity -> Moderate | $80.40 | $134.00 | $3,986.00–$8,427.00 | 72% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 BCE PT Eval, moderate complexity 97162 | $99.00 | $165.00 | $3,986.00–$8,427.00 | 65% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Complexity -> Moderate | $80.40 | $134.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 BCE PT Eval, moderate complexity 97162 | $99.00 | $165.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charges - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | 46% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charge Units | $60.60 | $101.00 | $3,986.00–$8,427.00 | 46% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units | $60.60 | $101.00 | $3,986.00–$8,427.00 | 46% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charge Units | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charge Units | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charges - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | 51% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | 51% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 BCE OT Therapeutic Exercise 97110 | $60.60 | $101.00 | $3,986.00–$8,427.00 | 51% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | 51% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 BCE OT Therapeutic Exercise 97110 | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Speech therapy session, individual CPT 92507 Speech/Language/Voice/Auditory Charge | $138.00 | $230.00 | $3,986.00–$8,427.00 | 40% below | 40% |
| Speech therapy session, individual inpatient CPT 92507 Speech/Language/Voice/Auditory Charge | $138.00 | $230.00 | $3,986.00–$8,427.00 | — | 40% |
| Spirometry (breathing test) CPT 94010 Spirometry w/graphic record, total/timed vital capacity, expiratory flow rate measurement(s), w +w/o | $295.20 | $492.00 | $3,986.00–$8,427.00 | 25% below | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry w/graphic record, total/timed vital capacity, expiratory flow rate measurement(s), w +w/o | $295.20 | $492.00 | $3,986.00–$8,427.00 | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 RT Charges SV -> PFT w/ Bronchodilator | $235.20 | $392.00 | $3,986.00–$8,427.00 | 63% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Testing w/bronchodilator 94060 | $244.80 | $408.00 | $3,986.00–$8,427.00 | 61% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT Charges SV -> PFT w/ Bronchodilator | $235.20 | $392.00 | $3,986.00–$8,427.00 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Testing w/bronchodilator 94060 | $244.80 | $408.00 | $3,986.00–$8,427.00 | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge | $60.60 | $101.00 | $3,986.00–$8,427.00 | 48% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | 48% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 BCE PT Therapeutic activities, direct 97530 | $60.60 | $101.00 | $3,986.00–$8,427.00 | 48% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | 48% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 BCE OT Therapeutic Activity Charge 97530 | $60.60 | $101.00 | $3,986.00–$8,427.00 | 48% below | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge - PTA | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 BCE PT Therapeutic activities, direct 97530 | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 BCE OT Therapeutic Activity Charge 97530 | $60.60 | $101.00 | $3,986.00–$8,427.00 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza vaccine, inactivated, subunit, adjuvanted, for intramuscular use 90653 | $53.40 | $89.00 | $3,986.00–$8,427.00 | 34% below | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Influenza vaccine, inactivated, subunit, adjuvanted, for intramuscular use 90653 | $53.40 | $89.00 | $3,986.00–$8,427.00 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent 90732 | $147.60 | $246.00 | $3,986.00–$8,427.00 | 44% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent 90732 | $147.60 | $246.00 | $3,986.00–$8,427.00 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETATNUS & DIPHTHERIA TOXIDS, 7 YRS OR OLDER | $69.00 | $115.00 | $3,986.00–$8,427.00 | 48% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETATNUS & DIPHTHERIA TOXIDS, 7 YRS OR OLDER | $69.00 | $115.00 | $3,986.00–$8,427.00 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus/diphtheria/pertuss (Tdap), 7 years or older, intramuscular use 90715 | $22.80 | $38.00 | $3,986.00–$8,427.00 | 86% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus/diphtheria/pertuss (Tdap), 7 years or older, intramuscular use 90715 | $22.80 | $38.00 | $3,986.00–$8,427.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) | $74.40 | $124.00 | $3,986.00–$8,427.00 | 4% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) | $74.40 | $124.00 | $3,986.00–$8,427.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization admin, each add'l vaccine 90472 | $73.20 | $122.00 | $3,986.00–$8,427.00 | 37% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization admin, each add'l vaccine 90472 | $73.20 | $122.00 | $3,986.00–$8,427.00 | — | 40% |
Source file: https://mrfs.hyvehealthcare.com/USPI/752658178_fort-worth-surgicare-partners,-ltd._standardcharges.json