Cape Fear Valley - Hoke Hospital
Cape Fear Valley - Hoke Hospital in Raeford, NC publishes cash prices for 327 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the North Carolina median for 178 of 325 procedures and above it for 91. By typical cash price it ranks #21 of 59 North Carolina hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
210 Medical Pavilion Dr,Raeford,NC,28376 Collected Sep 27, 2026 Source price file (910) 904-8000
Acute care hospital Emergency department CMS star rating 4 of 5 CCN 340188 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Cape Fear Valley - Hoke Hospital in Raeford, NC:
- Feb 13, 2026 Warning notice
- May 15, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE | $298.80 | $498.00 | $86.22–$215.55 | 9% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES | $357.00 | $595.00 | $131.81–$329.52 | at median | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST | $438.00 | $730.00 | $173.77–$434.43 | 3% above | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY | $1,114.20 | $1,857.00 | $396.07–$990.17 | 20% below | 40% |
| Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE | $219.60 | $366.00 | $103.58–$258.95 | 58% below | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $168.00 | $280.00 | $86.22–$215.55 | 52% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST | $2,010.60 | $3,351.00 | $173.77–$434.42 | 4% below | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT SCAN OF BLOOD VESSELS AND GRAFTS OF HEART WITH CONTRAST | $532.80 | $888.00 | $345.64–$864.10 | 70% below | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM | $259.20 | $432.00 | $86.22–$215.55 | 9% above | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST | $2,807.40 | $4,679.00 | $236.39–$590.98 | 2% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST | $3,610.20 | $6,017.00 | $345.64–$864.10 | at median | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST | $3,865.20 | $6,442.00 | $345.64–$864.10 | at median | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST | $2,179.20 | $3,632.00 | $173.77–$434.42 | 1% above | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST | $1,894.80 | $3,158.00 | $103.58–$258.95 | 6% above | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST | $1,357.80 | $2,263.00 | $103.58–$258.95 | 3% above | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST | $1,314.00 | $2,190.00 | $103.58–$258.95 | 4% above | 40% |
| CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST | $1,641.60 | $2,736.00 | $173.77–$434.42 | 2% above | 40% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST | $1,864.80 | $3,108.00 | $173.77–$434.42 | 4% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST | $1,559.40 | $2,599.00 | $103.58–$258.95 | at median | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST | $1,486.80 | $2,478.00 | $103.58–$258.95 | 2% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST | $1,751.40 | $2,919.00 | $173.77–$434.42 | at median | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW | $789.00 | $1,315.00 | $236.39–$590.98 | at median | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS | $196.20 | $327.00 | $86.22–$215.55 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW | $162.60 | $271.00 | $86.22–$215.55 | 13% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY | $706.80 | $1,178.00 | $103.58–$258.95 | 28% above | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $451.20 | $752.00 | $103.58–$258.95 | 9% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $864.00 | $1,440.00 | $236.39–$590.98 | 56% above | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST | $1,332.60 | $2,221.00 | $103.58–$258.95 | 1% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST | $1,714.80 | $2,858.00 | $173.77–$434.42 | at median | 40% |
| Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS | $276.60 | $461.00 | $44.92–$112.30 | 57% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI | $217.20 | $362.00 | $36.49–$91.22 | 10% below | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS | $493.20 | $822.00 | $236.39–$590.97 | at median | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $737.40 | $1,229.00 | $236.39–$590.98 | at median | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION | $1,659.00 | $2,765.00 | $541.34–$1,353.35 | 1% below | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $1,383.60 | $2,306.00 | $396.07–$990.17 | 4% below | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT | $228.60 | $381.00 | $213.92–$534.80 | 43% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER) | $2,461.20 | $4,102.00 | $850.78–$2,126.95 | 34% below | 40% |
| Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3 | $298.80 | $498.00 | $86.22–$215.55 | 8% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN | $579.60 | $966.00 | $103.58–$258.95 | 2% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING | $127.80 | $213.00 | $103.58–$258.95 | 62% below | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI | $1,347.75 | $2,246.25 | $102.52–$256.30 | — | 40% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI SCAN OF BOTH BREASTS | $1,227.75 | $2,046.25 | $102.52–$256.30 | 74% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $2,135.40 | $3,559.00 | $236.39–$590.98 | 11% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $2,925.00 | $4,875.00 | $345.64–$864.10 | at median | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST | $2,372.40 | $3,954.00 | $236.39–$590.98 | 4% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST | $5,437.80 | $9,063.00 | $345.64–$864.10 | 75% above | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST | $3,276.60 | $5,461.00 | $236.39–$590.98 | 44% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST | $4,130.40 | $6,884.00 | $345.64–$864.10 | 41% above | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST | $3,072.00 | $5,120.00 | $236.39–$590.98 | 36% above | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST | $4,239.00 | $7,065.00 | $345.64–$864.10 | 44% above | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST | $3,234.00 | $5,390.00 | $236.39–$590.98 | 53% above | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST | $4,092.60 | $6,821.00 | $345.64–$864.10 | 38% above | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST | $3,091.80 | $5,153.00 | $236.39–$590.98 | 36% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST | $4,187.40 | $6,979.00 | $345.64–$864.10 | 20% above | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST | $3,033.00 | $5,055.00 | $236.39–$590.98 | 73% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $2,233.20 | $3,722.00 | $236.39–$590.97 | 15% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT | $4,107.60 | $6,846.00 | $1,282.64–$3,206.60 | 11% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH | $3,952.20 | $6,587.00 | $1,416.69–$3,541.72 | 1% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS | $314.40 | $524.00 | $103.58–$258.95 | 11% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS | $631.20 | $1,052.00 | $103.58–$258.95 | 2% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS | $642.00 | $1,070.00 | $103.58–$258.95 | 16% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS | $642.00 | $1,070.00 | $103.58–$258.95 | 38% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS | $318.60 | $531.00 | $103.58–$258.95 | at median | 40% |
| Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY | $228.60 | $381.00 | $33.99–$84.98 | at median | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER | $327.00 | $545.00 | $86.22–$215.55 | 17% above | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) | $2,374.80 | $3,958.00 | $850.78–$2,126.95 | 25% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE | $942.60 | $1,571.00 | $541.34–$1,353.35 | 27% below | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+ | $391.20 | $652.00 | $173.77–$434.42 | 3% above | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA | $544.20 | $907.00 | $103.58–$258.95 | at median | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS | $642.00 | $1,070.00 | $103.58–$258.95 | 42% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN | $805.20 | $1,342.00 | $103.58–$258.95 | 16% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM | $543.60 | $906.00 | $103.58–$258.95 | at median | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE | $582.60 | $971.00 | $103.58–$258.95 | at median | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST | $545.40 | $909.00 | $173.77–$434.42 | 5% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $558.60 | $931.00 | $103.58–$258.95 | at median | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST | $236.40 | $394.00 | $86.22–$215.55 | at median | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $231.60 | $386.00 | $86.22–$215.55 | at median | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW | $234.00 | $390.00 | $86.22–$215.55 | 4% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE | $232.20 | $387.00 | $86.22–$215.55 | 1% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $198.00 | $330.00 | $86.22–$215.55 | 6% above | 40% |
| X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT | $242.40 | $404.00 | $86.22–$215.55 | 20% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT | $299.40 | $499.00 | $86.22–$215.55 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND | $279.00 | $465.00 | $86.22–$215.55 | 5% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $253.20 | $422.00 | $86.22–$215.55 | 13% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS | $310.80 | $518.00 | $103.58–$258.95 | at median | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS | $459.60 | $766.00 | $103.58–$258.95 | at median | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS | $312.00 | $520.00 | $103.58–$258.95 | 5% above | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS | $257.40 | $429.00 | $86.22–$215.55 | 28% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS | $527.40 | $879.00 | $86.22–$215.55 | 69% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS | $267.00 | $445.00 | $103.58–$258.95 | at median | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS | $200.40 | $334.00 | $86.22–$215.55 | 27% below | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $8.84 | $14.73 | $5.30–$68.00 | 80% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $54.00 | $90.00 | $5.30–$68.00 | 21% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $54.00 | $90.00 | $5.18–$68.00 | 24% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $79.40 | $132.33 | $47.63–$119.08 | 77% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $8.70 | $14.50 | $5.22–$68.00 | 54% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH | $1,320.00 | $2,200.00 | $5.22–$68.00 | 6847% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT | $20.40 | $34.00 | $12.95–$68.00 | 73% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $21.59 | $35.98 | $12.95–$68.00 | 72% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $20.15 | $33.58 | $12.09–$68.00 | 60% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER | $20.40 | $34.00 | $12.09–$68.00 | 60% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $108.00 | $180.00 | $39.26–$98.15 | 11% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $14.10 | $23.50 | $8.46–$68.00 | 91% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $121.80 | $203.00 | $8.46–$68.00 | 22% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $178.80 | $298.00 | $51.63–$129.07 | at median | 40% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $544.80 | $908.00 | $10.32–$68.00 | 263% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $4.50 | $7.50 | $9.34–$68.00 | 52% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $23.40 | $39.00 | $9.34–$68.00 | 150% above | 40% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $6.56 | $10.93 | $3.93–$68.00 | 83% below | 40% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $54.00 | $90.00 | $3.93–$68.00 | 41% above | 40% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $20.18 | $33.63 | $12.11–$68.00 | 45% below | 40% |
| Blood lead test CPT 83655 LEAD LEVEL | $24.60 | $41.00 | $12.11–$68.00 | 33% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) | $169.20 | $282.00 | $68.00–$329.52 | 208% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $56.40 | $94.00 | $5.18–$68.00 | 7% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE | $38.40 | $64.00 | $37.27–$93.18 | 71% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $34.70 | $57.83 | $20.81–$68.00 | 60% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 | $46.80 | $78.00 | $20.81–$68.00 | 46% below | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $34.70 | $57.83 | $20.81–$68.00 | 59% below | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 | $46.80 | $78.00 | $20.81–$68.00 | 44% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN | $34.20 | $57.00 | $51.31–$128.28 | 60% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $84.60 | $141.00 | $51.31–$128.27 | 1% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $139.80 | $233.00 | $35.09–$87.72 | 18% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $84.00 | $140.00 | $13.39–$68.00 | 7% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $202.80 | $338.00 | $7.77–$68.00 | 97% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $10.77 | $17.95 | $6.47–$68.00 | 83% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $65.40 | $109.00 | $6.47–$68.00 | 1% above | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $162.00 | $270.00 | $10.56–$68.00 | at median | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $59.40 | $99.00 | $10.18–$68.00 | 59% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL | $34.20 | $57.00 | $22.23–$68.00 | 67% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $37.07 | $61.78 | $22.23–$68.00 | 64% below | 40% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $46.56 | $77.60 | $27.94–$69.85 | 65% below | 40% |
| Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) | $193.20 | $322.00 | $27.94–$69.85 | 44% above | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL | $70.80 | $118.00 | $18.58–$68.00 | 24% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $32.72 | $54.53 | $19.63–$68.00 | 80% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL | $171.60 | $286.00 | $19.63–$68.00 | 3% above | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $153.60 | $256.00 | $13.63–$68.00 | 69% above | 40% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $24.51 | $40.85 | $14.70–$68.00 | 74% below | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $169.80 | $283.00 | $14.70–$68.00 | 82% above | 40% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $84.60 | $141.00 | $16.94–$68.00 | at median | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $15.03 | $25.05 | $9.02–$68.00 | 79% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $91.80 | $153.00 | $9.02–$68.00 | 28% above | 40% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $42.45 | $70.75 | $25.47–$68.00 | 42% below | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE | $48.60 | $81.00 | $25.47–$68.00 | 33% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE | $66.00 | $110.00 | $4.75–$68.00 | 78% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $21.45 | $35.75 | $12.87–$68.00 | 80% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $139.80 | $233.00 | $35.09–$87.72 | 24% above | 40% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY | $25.28 | $42.13 | $16.85–$68.00 | 80% below | 40% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA | $23.97 | $39.95 | $14.38–$68.00 | 79% below | 40% |
| H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL | $32.40 | $54.00 | $14.38–$68.00 | 71% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $141.83 | $236.38 | $68.00–$212.75 | 39% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION | $357.00 | $595.00 | $68.00–$212.75 | 53% above | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY | $22.85 | $38.08 | $13.71–$68.00 | 67% below | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 ANALYSIS FOR ANTIBODY TO HIV-1 AND HIV-2 VIRUS | $73.80 | $123.00 | $13.71–$68.00 | 7% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA | $40.13 | $66.88 | $24.08–$68.00 | 46% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES | $54.60 | $91.00 | $24.08–$68.00 | 27% below | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $58.49 | $97.48 | $35.09–$87.72 | 60% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $16.19 | $26.98 | $9.71–$68.00 | 82% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $54.60 | $91.00 | $9.71–$68.00 | 38% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT | $21.00 | $35.00 | $10.74–$68.00 | 72% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN | $15.00 | $25.00 | $10.33–$68.00 | 83% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT | $22.20 | $37.00 | $14.27–$68.00 | 83% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $23.78 | $39.63 | $14.27–$68.00 | 81% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $71.40 | $119.00 | $42.84–$107.10 | 57% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION | $156.60 | $261.00 | $42.84–$107.10 | 6% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $21.98 | $36.63 | $13.19–$68.00 | 52% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $54.00 | $90.00 | $13.19–$68.00 | 19% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $32.27 | $53.78 | $19.35–$68.00 | 54% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $47.40 | $79.00 | $19.35–$68.00 | 32% below | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY | $75.00 | $125.00 | $12.95–$68.00 | at median | 40% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $28.11 | $46.85 | $17.92–$68.00 | 62% below | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL | $76.80 | $128.00 | $17.92–$68.00 | 4% above | 40% |
| Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL | $18.60 | $31.00 | $11.43–$68.00 | 67% below | 40% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $19.05 | $31.75 | $11.43–$68.00 | 66% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $59.40 | $99.00 | $6.47–$68.00 | 8% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST | $14.57 | $24.28 | $8.74–$68.00 | 77% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $71.40 | $119.00 | $8.74–$68.00 | 14% above | 40% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $143.40 | $239.00 | $8.68–$68.00 | 27% above | 40% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL | $81.00 | $135.00 | $18.52–$68.00 | 17% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $11.48 | $19.13 | $6.89–$68.00 | 90% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $87.60 | $146.00 | $6.89–$68.00 | 23% below | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $13.62 | $22.70 | $8.17–$68.00 | 92% below | 40% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $111.60 | $186.00 | $8.17–$68.00 | 31% below | 40% |
| Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA) | $22.20 | $37.00 | $17.03–$68.00 | 72% below | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $28.38 | $47.30 | $17.03–$68.00 | 65% below | 40% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $11.16 | $18.60 | $6.70–$68.00 | 75% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $65.40 | $109.00 | $6.70–$68.00 | 49% above | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $72.00 | $120.00 | $5.18–$68.00 | 30% below | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $168.00 | $280.00 | $47.81–$119.52 | at median | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE | $30.60 | $51.00 | $18.39–$68.00 | 52% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $110.40 | $184.00 | $18.39–$68.00 | 6% above | 40% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO | $44.16 | $73.60 | $26.61–$86.00 | 56% below | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER | $33.77 | $56.28 | $20.26–$86.00 | 44% below | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST; MANUAL SCREENING | $44.40 | $74.00 | $20.26–$86.00 | 26% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $68.79 | $114.65 | $41.28–$103.20 | 48% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $166.20 | $277.00 | $41.28–$103.20 | 26% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $70.20 | $117.00 | $6.01–$68.00 | 28% above | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY | $1,138.58 | $1,897.63 | $68.00–$1,897.62 | 34% above | 40% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $34.77 | $57.95 | $20.86–$68.00 | 60% below | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL | $39.00 | $65.00 | $20.86–$68.00 | 55% below | 40% |
| Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL | $139.80 | $233.00 | $19.38–$68.00 | at median | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $6.56 | $10.93 | $4.29–$68.00 | 85% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $50.40 | $84.00 | $4.29–$68.00 | 13% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $36.60 | $61.00 | $16.55–$68.00 | 26% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $100.80 | $168.00 | $16.53–$68.00 | 74% above | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $9.45 | $15.75 | $5.67–$68.00 | 78% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL | $19.20 | $32.00 | $5.67–$68.00 | 56% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $23.99 | $39.98 | $14.39–$68.00 | 47% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED | $4.50 | $7.50 | $2.70–$68.00 | 94% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED | $37.20 | $62.00 | $2.70–$68.00 | 51% below | 40% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL VOL/COUNT/MOT | $20.09 | $33.48 | $12.31–$68.00 | 85% below | 40% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $14.84 | $24.73 | $8.90–$68.00 | 62% below | 40% |
| Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES | $18.00 | $30.00 | $8.90–$68.00 | 54% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $6.57 | $10.95 | $4.38–$68.00 | 60% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS | $28.20 | $47.00 | $4.38–$68.00 | 71% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $51.60 | $86.00 | $4.27–$68.00 | 13% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $103.31 | $172.18 | $61.98–$154.95 | 12% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL | $39.00 | $65.00 | $25.81–$68.00 | 56% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $43.02 | $71.70 | $25.81–$68.00 | 52% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $24.26 | $40.43 | $14.55–$68.00 | 48% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT | $87.60 | $146.00 | $14.55–$68.00 | 89% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $28.01 | $46.68 | $16.80–$68.00 | 64% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $303.60 | $506.00 | $16.80–$68.00 | 295% above | 40% |
| Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE | $52.20 | $87.00 | $35.09–$87.72 | 13% below | 40% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $58.49 | $97.48 | $35.09–$87.72 | 3% below | 40% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $59.40 | $99.00 | $4.52–$68.00 | at median | 40% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $60.00 | $100.00 | $3.17–$68.00 | 23% above | 40% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE | $6.03 | $10.05 | $4.02–$68.00 | 85% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $34.80 | $58.00 | $2.25–$68.00 | 29% below | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $5.22 | $8.70 | $3.48–$68.00 | 81% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE | $27.00 | $45.00 | $8.07–$68.00 | 27% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $165.60 | $276.00 | $15.08–$68.00 | 127% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $49.34 | $82.23 | $29.60–$74.00 | 65% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $57.00 | $95.00 | $29.60–$74.00 | 59% below | 40% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $18.98 | $31.63 | $11.39–$68.00 | 48% below | 40% |
| Zinc blood test CPT 84630 ZINC LEVEL | $23.40 | $39.00 | $11.39–$68.00 | 36% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $153.00 | $255.00 | $15.05–$68.00 | at median | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE | $371.40 | $619.00 | $304.10–$760.25 | 1% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC | $1,132.80 | $1,888.00 | $1,636.28–$4,090.70 | 63% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $361.20 | $602.00 | $244.38–$610.95 | 2% below | 40% |
| Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO | $11,145.60 | $18,576.00 | $3,211.87–$8,029.68 | at median | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $995.40 | $1,659.00 | $654.82–$1,637.05 | 4% below | 40% |
| Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB | $27,086.40 | $45,144.00 | $25,895.53–$64,738.82 | 55% below | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER | $2,911.20 | $4,852.00 | $2,071.00–$5,177.50 | at median | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $2,911.20 | $4,852.00 | $2,071.00–$5,177.50 | 654% above | 40% |
| Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE | $921.00 | $1,535.00 | $690.83–$1,727.08 | 15% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO | $361.20 | $602.00 | $244.38–$610.95 | 15% below | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $1,590.60 | $2,651.00 | $1,185.54–$2,963.85 | at median | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL | $1,599.60 | $2,666.00 | $1,185.54–$2,963.85 | 6% below | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $1,599.60 | $2,666.00 | $1,185.54–$2,963.85 | 3% below | 40% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $1,338.00 | $2,230.00 | $921.33–$2,303.32 | 9% below | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP | $163.80 | $273.00 | $3,207.12–$8,017.80 | 11% below | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $87.60 | $146.00 | $301.90–$754.75 | 88% below | 40% |
| Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES | $16,356.60 | $27,261.00 | $11,437.16–$28,592.90 | 37% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $134.40 | $224.00 | $690.83–$1,727.08 | 71% below | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $247.80 | $413.00 | $198.77–$496.92 | 3% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING | $650.40 | $1,084.00 | $534.33–$1,335.82 | at median | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING | $106.20 | $177.00 | $58.44–$146.10 | at median | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $111.00 | $185.00 | $58.44–$146.10 | 29% below | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $69.60 | $116.00 | $200.29–$500.72 | 79% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $844.20 | $1,407.00 | $699.34–$1,748.35 | 43% below | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG | $475.20 | $792.00 | $327.24–$818.10 | 7% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $1,294.20 | $2,157.00 | $876.28–$2,190.70 | at median | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY | $1,217.40 | $2,029.00 | $921.33–$2,303.32 | at median | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY | $220.80 | $368.00 | $49.17–$122.92 | at median | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE | $1,786.80 | $2,978.00 | $3,207.12–$8,017.80 | 41% below | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE | $71.40 | $119.00 | — | 75% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $314.40 | $524.00 | $198.77–$496.93 | 21% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $371.40 | $619.00 | $304.10–$760.25 | 4% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $418.80 | $698.00 | $304.10–$760.25 | at median | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT | $76.20 | $127.00 | $131.81–$329.52 | 42% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $411.00 | $685.00 | $304.10–$760.25 | 9% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $411.00 | $685.00 | $304.10–$760.25 | 13% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $522.60 | $871.00 | $402.75–$1,006.88 | 31% above | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY | $4,213.80 | $7,023.00 | $3,211.87–$8,029.68 | 64% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $844.20 | $1,407.00 | $699.34–$1,748.35 | 32% below | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1 | $1,129.80 | $1,883.00 | $876.28–$2,190.70 | 29% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $67.80 | $113.00 | $701.57–$1,753.92 | 85% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $865.80 | $1,443.00 | $701.57–$1,753.92 | 41% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL | $283.80 | $473.00 | $198.77–$496.92 | 39% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE | $411.00 | $685.00 | $304.10–$760.25 | 29% below | 40% |
| Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT | $16,712.40 | $27,854.00 | $10,355.09–$25,887.72 | 93% above | 40% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $1,288.20 | $2,147.00 | $898.58–$2,246.45 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL | $585.00 | $975.00 | $402.75–$1,006.88 | at median | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $534.60 | $891.00 | $402.75–$1,006.87 | 24% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND | $1,338.00 | $2,230.00 | $921.33–$2,303.32 | at median | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND | $1,217.40 | $2,029.00 | $921.33–$2,303.32 | at median | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE | $5,992.80 | $9,988.00 | $3,492.30–$8,730.75 | 28% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $278.40 | $464.00 | $131.81–$329.52 | 10% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $379.80 | $633.00 | $277.10–$692.75 | 4% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT | $241.20 | $402.00 | $161.00–$402.50 | 9% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $289.20 | $482.00 | $198.77–$496.93 | 22% below | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $249.00 | $415.00 | $402.75–$1,006.88 | 11% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $283.80 | $473.00 | $198.77–$496.92 | at median | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST | $982.80 | $1,638.00 | $699.34–$1,748.35 | 16% 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 OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $318.00 | $530.00 | $198.77–$496.92 | 14% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $318.00 | $530.00 | $198.77–$496.92 | 4% below | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP) | $6,975.00 | $11,625.00 | $5,312.08–$13,280.20 | at median | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $249.00 | $415.00 | $402.75–$1,006.88 | 16% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,029.60 | $1,716.00 | $621.49–$1,553.72 | 22% below | 40% |
| Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $6,598.80 | $10,998.00 | $12,719.65–$31,799.13 | 64% below | 40% |
| Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER | $1,750.80 | $2,918.00 | $1,593.09–$3,982.72 | 53% below | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES | $460.20 | $767.00 | $304.10–$760.25 | at median | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG | $1,324.80 | $2,208.00 | $1,636.28–$4,090.70 | 32% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM | $2,433.60 | $4,056.00 | $1,901.12–$4,752.80 | at median | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $1,324.80 | $2,208.00 | $898.58–$2,246.45 | 19% below | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ | $1,230.00 | $2,050.00 | $898.58–$2,246.45 | 4% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE | $2,433.60 | $4,056.00 | $1,901.12–$4,752.80 | at median | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION | $1,183.20 | $1,972.00 | $898.58–$2,246.45 | at median | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $1,324.80 | $2,208.00 | $898.58–$2,246.45 | 14% below | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD W/TRANSMURAL DRAIN CYST | $3,814.20 | $6,357.00 | $6,014.61–$15,036.52 | at median | 40% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) | $269.40 | $449.00 | $2,071.00–$5,177.50 | 76% below | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN | $4,500.00 | $7,500.00 | $3,128.21–$7,820.52 | 29% above | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $61.80 | $103.00 | $198.77–$496.92 | 60% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $584.40 | $974.00 | $402.75–$1,006.88 | 40% above | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $565.80 | $943.00 | $437.09–$1,092.72 | 23% below | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $604.80 | $1,008.00 | $437.09–$1,092.72 | 18% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $220.20 | $367.00 | $895.63 | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR | $501.00 | $835.00 | $327.24–$818.10 | 29% below | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING TEST | $127.80 | $213.00 | $127.48–$318.70 | 42% below | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES | $2,368.20 | $3,947.00 | $818.37–$2,045.92 | at median | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $657.60 | $1,096.00 | $213.92–$534.80 | 20% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $154.80 | $258.00 | $58.44–$146.10 | 19% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $180.00 | $300.00 | $83.54–$208.85 | 1% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $354.00 | $590.00 | $152.12–$380.30 | at median | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $726.60 | $1,211.00 | $270.45–$676.12 | 19% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $1,231.80 | $2,053.00 | $413.39–$1,033.47 | at median | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $1,882.80 | $3,138.00 | $590.01–$1,475.02 | 12% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) | $1,082.40 | $1,804.00 | $213.92–$534.80 | 2% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $321.00 | $535.00 | $210.73–$543.28 | 3% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $343.80 | $573.00 | $210.73–$526.83 | at median | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $109.80 | $183.00 | $71.33–$178.32 | 7% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES | $355.80 | $593.00 | $369.70–$924.25 | 56% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION | $129.00 | $215.00 | $31.56–$78.90 | 30% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $147.60 | $246.00 | $68.70–$171.75 | 50% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN | $243.60 | $406.00 | $112.53–$281.32 | at median | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN | $295.80 | $493.00 | $153.88–$384.70 | 12% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $130.20 | $217.00 | $39.72–$99.30 | 30% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN | $37.80 | $63.00 | $25.71–$64.28 | 21% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES | $75.60 | $126.00 | $25.71–$64.28 | 57% above | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $143.40 | $239.00 | $97.15–$242.88 | 21% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $292.20 | $487.00 | $94.65–$236.62 | 4% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $146.40 | $244.00 | $94.65–$236.62 | 28% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $216.00 | $360.00 | $94.65–$236.62 | 15% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS | $138.00 | $230.00 | $26.73–$66.82 | 13% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES | $90.00 | $150.00 | $28.02–$70.05 | 4% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES | $21.00 | $35.00 | $37.12–$92.80 | 5% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN | $231.60 | $386.00 | $121.38–$303.45 | 35% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN | $137.40 | $229.00 | $55.63–$139.07 | 55% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN | $178.20 | $297.00 | $81.77–$204.42 | 49% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $114.60 | $191.00 | $29.96–$74.90 | 55% below | 40% |
| Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN | $364.80 | $608.00 | $219.78–$549.45 | 3% above | 40% |
| Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV | $171.60 | $286.00 | $73.86–$184.65 | 3% below | 40% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $231.60 | $386.00 | $213.92–$534.80 | 2% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $523.20 | $872.00 | $369.70–$924.25 | at median | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES | $88.20 | $147.00 | $33.61–$84.03 | 13% below | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $150.00 | $250.00 | $131.81–$329.52 | 33% below | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Spikevax 2025-2026 Formula Ages 12 and up | $470.66 | $784.44 | $404.13 | 84% above | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Comirnaty 2025-2026 Age Over 65 / High Risk 12-64 | $489.75 | $816.25 | $420.93 | 39% below | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ | $249.00 | $415.00 | $575.98 | 23% below | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax | $633.28 | $1,055.47 | $575.98 | 96% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2025-2026 Formula | $23.40 | $39.00 | $58.05 | 63% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2024-2025 Formula PFS | $23.40 | $39.00 | $58.05 | 63% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix 2025-2026 Formula | $23.40 | $39.00 | $58.05 | 63% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 Formula PFS | $23.40 | $39.00 | $58.05 | 63% below | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM | $415.20 | $692.00 | $986.90 | at median | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9 | $897.75 | $1,496.25 | $986.90 | 116% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM | $130.20 | $217.00 | $183.85 | at median | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 Havrix | $289.96 | $483.26 | $183.85 | 123% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $111.00 | $185.00 | $187.88 | 23% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B | $244.89 | $408.15 | $187.88 | 69% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $35.40 | $59.00 | $245.40 | 66% below | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula | $57.00 | $95.00 | $245.40 | 45% below | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC | $144.00 | $240.00 | $292.85 | 34% below | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II | $327.51 | $545.85 | $292.85 | 50% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM | $225.00 | $375.00 | $529.75 | at median | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menveo | $551.09 | $918.49 | $895.63 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Bexsero | $779.12 | $1,298.53 | $895.63 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM | $766.20 | $1,277.00 | $782.25 | at median | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $195.60 | $326.00 | $333.68 | 24% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 | $390.58 | $650.96 | $333.68 | 51% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Abrysvo | $1,005.26 | $1,675.44 | $957.20 | 7% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Arexvy | $9,936.92 | $16,561.53 | $919.05 | 1119% above | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $725.40 | $1,209.00 | $319.75–$799.38 | 49% below | 40% |
| Rabies vaccine, one dose CPT 90675 Imovax Rabies | $1,223.53 | $2,039.22 | $319.75–$799.38 | 14% below | 40% |
| Rabies vaccine, one dose CPT 90675 RabAvert | $1,419.37 | $2,365.61 | $319.75–$799.38 | at median | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM | $288.00 | $480.00 | — | at median | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $51.60 | $86.00 | $97.43 | 53% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac | $147.30 | $245.50 | $97.43 | 35% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $76.20 | $127.00 | $99.23 | 46% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix | $167.96 | $279.93 | $99.23 | 18% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel | $169.43 | $282.38 | $99.23 | 19% above | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM | $178.20 | $297.00 | $415.98 | 26% below | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhim Vi | $509.87 | $849.78 | $895.63 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $72.00 | $120.00 | $71.33–$178.32 | at median | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $90.60 | $151.00 | $71.33–$178.32 | 26% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE | $60.00 | $100.00 | — | at median | 40% |
Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/ce5859a3e1522778c0b0cafe4913c4b9/charges/mrf