Tug Valley Arh Regional Medical Center
Listed in its price file as “Appalachian Regional Healthcare, Inc.”.
Tug Valley Arh Regional Medical Center in South Williamson, KY publishes cash prices for 209 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 Kentucky median for 121 of 207 procedures and above it for 72. By typical cash price it ranks #24 of 59 Kentucky hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
260 Hospital Drive South Williamson KY 41503 Collected Sep 27, 2026 Source price file (606) 237-1700
Acute care hospital Emergency department CMS star rating 2 of 5 CCN 180069 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Kentucky | Off list |
|---|---|---|---|---|---|
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED BIL | $518.40 | $864.00 | $50.91–$777.60 | 59% above | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED BIL | $518.40 | $864.00 | $50.91–$777.60 | 59% above | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIM LT | $76.20 | $127.00 | $24.44–$67.64 | 77% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED BIL | $518.40 | $864.00 | $50.91–$777.60 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIM LT | $76.20 | $127.00 | $24.44–$67.64 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD+PELVIS WO CONTRAST | $215.40 | $359.00 | $61.51–$189.00 | 90% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD+PELVIS WO CONTRAST | $215.40 | $359.00 | $61.51–$189.00 | — | 40% |
| Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW | $22.20 | $37.00 | $6.44–$15.09 | 88% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW | $22.20 | $37.00 | $6.44–$15.09 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST | $136.80 | $228.00 | $38.35–$209.42 | 87% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST | $136.80 | $228.00 | $38.35–$209.42 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $647.40 | $1,079.00 | $98.30–$971.10 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $647.40 | $1,079.00 | $98.30–$971.10 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI | $647.40 | $1,079.00 | $98.30–$971.10 | — | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE AP/LAT/1 OBL BIL | $46.20 | $77.00 | $6.69–$24.47 | 87% below | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE AP/LAT/1 OBL BIL | $46.20 | $77.00 | $6.69–$24.47 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LDCT FOR LUNG CA SCREENING | $2,073.00 | $3,455.00 | $61.48–$3,109.50 | 284% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LDCT FOR LUNG CA SCREENING | $2,073.00 | $3,455.00 | $61.48–$3,109.50 | 284% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LDCT FOR LUNG CA SCREENING | $2,073.00 | $3,455.00 | $61.48–$3,109.50 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR BREAST BILAT W/WO CONTRAST | $5,028.00 | $8,380.00 | $760.00–$7,542.00 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR BREAST BILAT W/WO CONTRAST | $5,028.00 | $8,380.00 | $760.00–$7,542.00 | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MR BREAST BILAT W/WO CONTRAST | $5,028.00 | $8,380.00 | $760.00–$7,542.00 | — | 40% |
| Screening mammogram, both breasts CPT 77067 MM MAMMGM SPCL SCRN INCL CAD | $30.00 | $50.00 | $7.65–$120.00 | 83% below | 40% |
| Screening mammogram, both breasts CPT 77067 MM MAMMGM SPCL SCRN INCL CAD | $30.00 | $50.00 | $7.65–$120.00 | 83% below | 40% |
| Screening mammogram, both breasts CPT 77067 MM MAMMOGRAM SCRN BIL INCL CAD | $259.80 | $433.00 | $66.25–$389.70 | 46% above | 40% |
| Screening mammogram, both breasts CPT 77067 MM MAMMOGRAM SCRN BIL INCL CAD | $259.80 | $433.00 | $66.25–$389.70 | 46% above | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MM MAMMGM SPCL SCRN INCL CAD | $30.00 | $50.00 | $7.65–$120.00 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MM MAMMOGRAM SCRN BIL INCL CAD | $259.80 | $433.00 | $66.25–$389.70 | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 EC ECHO STRESS TRANSTHORACIC | $169.20 | $282.00 | $60.48–$195.46 | 90% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 EC ECHO STRESS TRANSTHORACIC | $169.20 | $282.00 | $60.48–$195.46 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK | $68.40 | $114.00 | $20.08–$89.69 | 88% below | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMP MIN 3 VIEWS BIL | $46.20 | $77.00 | $5.92–$21.79 | 86% below | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMP MIN 3 VIEWS BIL | $46.20 | $77.00 | $5.92–$21.79 | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE 1-2 VIEWS BIL | $43.80 | $73.00 | $5.92–$21.25 | 84% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE 1-2 VIEWS BIL | $43.80 | $73.00 | $5.92–$21.25 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Kentucky | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT | $88.80 | $148.00 | $4.50–$133.20 | 34% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT | $88.80 | $148.00 | $4.50–$133.20 | 34% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT | $88.80 | $148.00 | $4.50–$133.20 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT | $88.80 | $148.00 | $4.40–$133.20 | 34% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT | $88.80 | $148.00 | $4.40–$133.20 | 34% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT | $88.80 | $148.00 | $4.40–$133.20 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL | $346.80 | $578.00 | $40.48–$520.20 | 12% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL | $346.80 | $578.00 | $40.48–$520.20 | 12% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL | $346.80 | $578.00 | $40.48–$520.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE PEANUT W/COMPONENT REFELX | $4.80 | $8.00 | $1.84–$7.20 | 61% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE PEANUT W/COMPONENT REFELX | $4.80 | $8.00 | $1.84–$7.20 | 61% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE MUSSEL | $10.20 | $17.00 | $3.91–$15.30 | 18% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE EACH | $10.20 | $17.00 | $3.45–$15.30 | 18% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE EACH | $10.20 | $17.00 | $3.45–$15.30 | 18% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE MUSSEL | $10.20 | $17.00 | $3.91–$15.30 | 18% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRASSES | $37.20 | $62.00 | $4.43–$55.80 | 200% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRASSES | $37.20 | $62.00 | $4.43–$55.80 | 200% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD IGE II | $39.60 | $66.00 | $4.43–$59.40 | 219% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD IGE II | $39.60 | $66.00 | $4.43–$59.40 | 219% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE PEANUT W/COMPONENT REFELX | $4.80 | $8.00 | $1.84–$7.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE EACH | $10.20 | $17.00 | $3.45–$15.30 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE MUSSEL | $10.20 | $17.00 | $3.91–$15.30 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRASSES | $37.20 | $62.00 | $4.43–$55.80 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD IGE II | $39.60 | $66.00 | $4.43–$59.40 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS | $82.80 | $138.00 | $11.00–$124.20 | 6% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS | $82.80 | $138.00 | $11.00–$124.20 | 6% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS REF | $90.60 | $151.00 | $11.00–$135.90 | 3% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS REF | $90.60 | $151.00 | $11.00–$135.90 | 3% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ABS | $82.80 | $138.00 | $11.00–$124.20 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ABS REF | $90.60 | $151.00 | $11.00–$135.90 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES REF | $82.80 | $138.00 | $10.27–$124.20 | at median | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES REF | $82.80 | $138.00 | $10.27–$124.20 | at median | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $82.80 | $138.00 | $10.27–$124.20 | at median | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $82.80 | $138.00 | $10.27–$124.20 | at median | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES | $82.80 | $138.00 | $10.27–$124.20 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES REF | $82.80 | $138.00 | $10.27–$124.20 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $209.40 | $349.00 | $28.85–$314.10 | 6% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $209.40 | $349.00 | $28.85–$314.10 | 6% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP | $209.40 | $349.00 | $28.85–$314.10 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $134.40 | $224.00 | $5.69–$201.60 | 25% above | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $134.40 | $224.00 | $5.69–$201.60 | 25% above | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $134.40 | $224.00 | $5.69–$201.60 | — | 40% |
| Blood culture for bacteria CPT 87040 CULT BLOOD | $187.80 | $313.00 | $8.77–$281.70 | 46% above | 40% |
| Blood culture for bacteria CPT 87040 CULT BLOOD | $187.80 | $313.00 | $8.77–$281.70 | 46% above | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD | $187.80 | $313.00 | $8.77–$281.70 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $12.00 | $20.00 | $4.60–$28.80 | 31% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $19.20 | $32.00 | $4.60–$28.80 | 10% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $19.20 | $32.00 | $4.60–$28.80 | — | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD | $67.20 | $112.00 | $3.34–$100.80 | 10% above | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD | $67.20 | $112.00 | $3.34–$100.80 | 10% above | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD | $67.20 | $112.00 | $3.34–$100.80 | — | 40% |
| Blood lead test CPT 83655 LEAD | $72.00 | $120.00 | $10.29–$108.00 | 21% below | 40% |
| Blood lead test CPT 83655 LEAD | $72.00 | $120.00 | $10.29–$108.00 | 21% below | 40% |
| Blood lead test inpatient CPT 83655 LEAD | $72.00 | $120.00 | $10.29–$108.00 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM QUAL | $118.20 | $197.00 | $6.38–$177.30 | 27% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM QUAL | $118.20 | $197.00 | $6.38–$177.30 | 27% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM QUAL | $118.20 | $197.00 | $6.38–$177.30 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE | $57.60 | $96.00 | $2.54–$86.40 | 5% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE | $57.60 | $96.00 | $2.54–$86.40 | 5% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPE | $57.60 | $96.00 | $2.54–$86.40 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $101.40 | $169.00 | $3.25–$152.10 | 53% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $101.40 | $169.00 | $3.25–$152.10 | 53% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP | $101.40 | $169.00 | $3.25–$152.10 | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 EPI STRAIN | $54.60 | $91.00 | $20.93–$81.90 | 47% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 EPI STRAIN | $54.60 | $91.00 | $20.93–$81.90 | 47% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF AMPLIFIED PROBE | $82.80 | $138.00 | $29.83–$124.20 | 20% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF AMPLIFIED PROBE | $82.80 | $138.00 | $29.83–$124.20 | 20% below | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 EPI STRAIN | $54.60 | $91.00 | $20.93–$81.90 | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDIFF AMPLIFIED PROBE | $82.80 | $138.00 | $29.83–$124.20 | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CANCER AG 19-9 | $291.00 | $485.00 | $17.69–$436.50 | 85% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CANCER AG 19-9 | $291.00 | $485.00 | $17.69–$436.50 | 85% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER AG 19-9 | $291.00 | $485.00 | $17.69–$436.50 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 (FLUID) | $210.60 | $351.00 | $17.69–$315.90 | 22% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 (FLUID) | $210.60 | $351.00 | $17.69–$315.90 | 22% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 (FLUID) | $210.60 | $351.00 | $17.69–$315.90 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $221.40 | $369.00 | $9.68–$332.10 | 54% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $221.40 | $369.00 | $9.68–$332.10 | 54% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $221.40 | $369.00 | $9.68–$332.10 | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED W/DIFF | $75.60 | $126.00 | $6.61–$113.40 | 16% above | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED W/DIFF | $75.60 | $126.00 | $6.61–$113.40 | 16% above | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTOMATED W/DIFF | $75.60 | $126.00 | $6.61–$113.40 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED | $57.60 | $96.00 | $5.50–$86.40 | 9% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED | $57.60 | $96.00 | $5.50–$86.40 | 9% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTOMATED | $57.60 | $96.00 | $5.50–$86.40 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $158.40 | $264.00 | $7.15–$237.60 | 9% above | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $158.40 | $264.00 | $7.15–$237.60 | 9% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $158.40 | $264.00 | $7.15–$237.60 | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE | $281.40 | $469.00 | $18.89–$422.10 | 79% above | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE | $281.40 | $469.00 | $18.89–$422.10 | 79% above | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE | $281.40 | $469.00 | $18.89–$422.10 | — | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL | $135.60 | $226.00 | $23.75–$203.40 | 12% below | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL | $135.60 | $226.00 | $23.75–$203.40 | 12% below | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $135.60 | $226.00 | $23.75–$203.40 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $279.00 | $465.00 | $15.79–$418.50 | 14% above | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $279.00 | $465.00 | $15.79–$418.50 | 14% above | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $279.00 | $465.00 | $15.79–$418.50 | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $498.60 | $831.00 | $16.68–$747.90 | 102% above | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $498.60 | $831.00 | $16.68–$747.90 | 102% above | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL | $498.60 | $831.00 | $16.68–$747.90 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $240.60 | $401.00 | $11.58–$360.90 | 60% above | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $240.60 | $401.00 | $11.58–$360.90 | 60% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $240.60 | $401.00 | $11.58–$360.90 | — | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $266.40 | $444.00 | $0.92–$399.60 | 91% above | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $266.40 | $444.00 | $0.92–$399.60 | 91% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $266.40 | $444.00 | $0.92–$399.60 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE WO TOTAL T3 | $346.80 | $578.00 | $14.40–$520.20 | 71% above | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE WO TOTAL T3 | $346.80 | $578.00 | $14.40–$520.20 | 71% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE WO TOTAL T3 | $346.80 | $578.00 | $14.40–$520.20 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE WO TOTAL T4 REF | $39.00 | $65.00 | $7.66–$58.50 | 59% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE WO TOTAL T4 REF | $39.00 | $65.00 | $7.66–$58.50 | 59% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE WO TOTAL T4 | $190.20 | $317.00 | $7.66–$285.30 | 99% above | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE WO TOTAL T4 | $190.20 | $317.00 | $7.66–$285.30 | 99% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE WO TOTAL T4 REF | $39.00 | $65.00 | $7.66–$58.50 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE WO TOTAL T4 | $190.20 | $317.00 | $7.66–$285.30 | — | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $54.00 | $90.00 | $20.70–$81.00 | 34% below | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $54.00 | $90.00 | $20.70–$81.00 | 34% below | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $54.00 | $90.00 | $20.70–$81.00 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE | $26.40 | $44.00 | $4.04–$39.60 | 53% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE | $26.40 | $44.00 | $4.04–$39.60 | 53% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR PP | $124.20 | $207.00 | $4.04–$186.30 | 120% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR PP | $124.20 | $207.00 | $4.04–$186.30 | 120% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE | $26.40 | $44.00 | $4.04–$39.60 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR PP | $124.20 | $207.00 | $4.04–$186.30 | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPEC | $183.60 | $306.00 | $10.94–$275.40 | 21% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPEC | $183.60 | $306.00 | $10.94–$275.40 | 21% above | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPEC | $183.60 | $306.00 | $10.94–$275.40 | — | 40% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTIGEN ST | $189.00 | $315.00 | $12.22–$283.50 | 5% above | 40% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTIGEN ST | $189.00 | $315.00 | $12.22–$283.50 | 5% above | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI ANTIGEN ST | $189.00 | $315.00 | $12.22–$283.50 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA QUANT | $163.80 | $273.00 | $62.79–$245.70 | 37% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA QUANT | $163.80 | $273.00 | $62.79–$245.70 | 37% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA DETECT/QUANT PLASMA | $216.00 | $360.00 | $72.31–$324.00 | 17% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA DETECT/QUANT PLASMA | $216.00 | $360.00 | $72.31–$324.00 | 17% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA QUANT | $163.80 | $273.00 | $62.79–$245.70 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA DETECT/QUANT PLASMA | $216.00 | $360.00 | $72.31–$324.00 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GENERAT SERUM W/REFLX | $252.60 | $421.00 | $20.47–$378.90 | 143% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GENERAT SERUM W/REFLX | $252.60 | $421.00 | $20.47–$378.90 | 143% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GENERAT SERUM W/REFLX | $252.60 | $421.00 | $20.47–$378.90 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV APTIMA HIGH 16/18 45 | $44.40 | $74.00 | $16.76–$66.60 | 57% below | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV APTIMA HIGH 16/18 45 | $44.40 | $74.00 | $16.76–$66.60 | 57% below | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV APTIMA HIGH 16/18 45 | $44.40 | $74.00 | $16.76–$66.60 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C/GLYCOHEMOGLOBIN | $75.00 | $125.00 | $8.25–$112.50 | 2% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C/GLYCOHEMOGLOBIN | $75.00 | $125.00 | $8.25–$112.50 | 2% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C/GLYCOHEMOGLOBIN | $75.00 | $125.00 | $8.25–$112.50 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFAC AB QUAL/QUANT | $42.60 | $71.00 | $9.13–$63.90 | 63% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFAC AB QUAL/QUANT | $42.60 | $71.00 | $9.13–$63.90 | 63% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFAC AB QUAL/QUANT | $42.60 | $71.00 | $9.13–$63.90 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPAT B SURFACE ANTIGEN | $42.60 | $71.00 | $8.78–$63.90 | 58% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPAT B SURFACE ANTIGEN | $42.60 | $71.00 | $8.78–$63.90 | 58% below | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPAT B SURFACE ANTIGEN | $42.60 | $71.00 | $8.78–$63.90 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB | $44.40 | $74.00 | $12.13–$66.60 | 66% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB | $44.40 | $74.00 | $12.13–$66.60 | 66% below | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB | $44.40 | $74.00 | $12.13–$66.60 | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DIAGNOSIS NAA | $174.00 | $290.00 | $36.40–$261.00 | 36% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DIAGNOSIS NAA | $174.00 | $290.00 | $36.40–$261.00 | 36% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DETECT/QUANT S(PCR) | $190.20 | $317.00 | $36.40–$285.30 | 30% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA DETECT/QUANT S(PCR) | $190.20 | $317.00 | $36.40–$285.30 | 30% below | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA DIAGNOSIS NAA | $174.00 | $290.00 | $36.40–$261.00 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA DETECT/QUANT S(PCR) | $190.20 | $317.00 | $36.40–$285.30 | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 | $40.20 | $67.00 | $11.21–$60.30 | 42% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 | $40.20 | $67.00 | $11.21–$60.30 | 42% below | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 | $40.20 | $67.00 | $11.21–$60.30 | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 | $109.80 | $183.00 | $16.45–$164.70 | 37% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 | $109.80 | $183.00 | $16.45–$164.70 | 37% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 | $109.80 | $183.00 | $16.45–$164.70 | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-CARDIAC | $101.40 | $169.00 | $11.00–$152.10 | 6% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-CARDIAC | $101.40 | $169.00 | $11.00–$152.10 | 6% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN-CARDIAC | $101.40 | $169.00 | $11.00–$152.10 | — | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL PLASMA | $121.20 | $202.00 | $14.33–$181.80 | 27% below | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL PLASMA | $121.20 | $202.00 | $14.33–$181.80 | 27% below | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL PLASMA | $121.20 | $202.00 | $14.33–$181.80 | — | 40% |
| Insulin blood test CPT 83525 INSULIN FASTING CONTRACT | $150.60 | $251.00 | $9.71–$225.90 | 36% above | 40% |
| Insulin blood test CPT 83525 INSULIN FASTING CONTRACT | $150.60 | $251.00 | $9.71–$225.90 | 36% above | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN FASTING CONTRACT | $150.60 | $251.00 | $9.71–$225.90 | — | 40% |
| Iron blood test (serum iron) CPT 83540 IRON | $105.60 | $176.00 | $5.51–$158.40 | 46% above | 40% |
| Iron blood test (serum iron) CPT 83540 IRON | $105.60 | $176.00 | $5.51–$158.40 | 46% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $105.60 | $176.00 | $5.51–$158.40 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC DIRECT | $122.40 | $204.00 | $7.43–$183.60 | 23% above | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC DIRECT | $122.40 | $204.00 | $7.43–$183.60 | 23% above | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC DIRECT | $122.40 | $204.00 | $7.43–$183.60 | — | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $208.80 | $348.00 | $5.69–$313.20 | 101% above | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $208.80 | $348.00 | $5.69–$313.20 | 101% above | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $208.80 | $348.00 | $5.69–$313.20 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 LH | $279.00 | $465.00 | $15.74–$418.50 | 38% above | 40% |
| LH (luteinizing hormone) test CPT 83002 LH | $279.00 | $465.00 | $15.74–$418.50 | 38% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH | $279.00 | $465.00 | $15.74–$418.50 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $121.20 | $202.00 | $5.86–$181.80 | 44% above | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $121.20 | $202.00 | $5.86–$181.80 | 44% above | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $121.20 | $202.00 | $5.86–$181.80 | — | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $184.20 | $307.00 | $5.69–$276.30 | 52% above | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $184.20 | $307.00 | $5.69–$276.30 | 52% above | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $184.20 | $307.00 | $5.69–$276.30 | — | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB W RFLX | $24.60 | $41.00 | $9.43–$36.90 | 62% below | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB W RFLX | $24.60 | $41.00 | $9.43–$36.90 | 62% below | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB W RFLX | $24.60 | $41.00 | $9.43–$36.90 | — | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM RANDOM URINE REF | $9.60 | $16.00 | $3.68–$14.40 | 83% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM RANDOM URINE REF | $9.60 | $16.00 | $3.68–$14.40 | 83% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $139.80 | $233.00 | $5.69–$209.70 | 153% above | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $139.80 | $233.00 | $5.69–$209.70 | 153% above | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM RANDOM URINE REF | $9.60 | $16.00 | $3.68–$14.40 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $139.80 | $233.00 | $5.69–$209.70 | — | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM LABCORP | $15.60 | $26.00 | $5.98–$23.40 | 71% below | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM LABCORP | $15.60 | $26.00 | $5.98–$23.40 | 71% below | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA | $110.40 | $184.00 | $10.95–$165.60 | 103% above | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA | $110.40 | $184.00 | $10.95–$165.60 | 103% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGM LABCORP | $15.60 | $26.00 | $5.98–$23.40 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA | $110.40 | $184.00 | $10.95–$165.60 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES | $45.00 | $75.00 | $4.40–$67.50 | 28% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES | $45.00 | $75.00 | $4.40–$67.50 | 28% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO | $88.80 | $148.00 | $4.40–$133.20 | 41% above | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO | $88.80 | $148.00 | $4.40–$133.20 | 41% above | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES | $45.00 | $75.00 | $4.40–$67.50 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO | $88.80 | $148.00 | $4.40–$133.20 | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $155.40 | $259.00 | $15.64–$233.10 | 31% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $155.40 | $259.00 | $15.64–$233.10 | 31% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $155.40 | $259.00 | $15.64–$233.10 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $184.20 | $307.00 | $15.64–$276.30 | 24% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $184.20 | $307.00 | $15.64–$276.30 | 24% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $184.20 | $307.00 | $15.64–$276.30 | 24% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $184.20 | $307.00 | $15.64–$276.30 | 24% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING | $184.20 | $307.00 | $15.64–$276.30 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $184.20 | $307.00 | $15.64–$276.30 | — | 40% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUIDED HPV REFLEX | $39.00 | $65.00 | $14.95–$58.50 | 27% below | 40% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUIDED HPV REFLEX | $39.00 | $65.00 | $14.95–$58.50 | 27% below | 40% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IMAGE GUIDED HPV REFLEX | $39.00 | $65.00 | $14.95–$58.50 | — | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR THIN LAYER | $108.60 | $181.00 | $17.22–$162.90 | 79% above | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR THIN LAYER | $108.60 | $181.00 | $17.22–$162.90 | 79% above | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR THIN LAYER | $108.60 | $181.00 | $17.22–$162.90 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH SERUM | $137.40 | $229.00 | $35.08–$206.10 | 42% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH SERUM | $137.40 | $229.00 | $35.08–$206.10 | 42% below | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH SERUM | $137.40 | $229.00 | $35.08–$206.10 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $89.40 | $149.00 | $5.10–$134.10 | 4% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $89.40 | $149.00 | $5.10–$134.10 | 4% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $89.40 | $149.00 | $5.10–$134.10 | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 CELL FREE DNA PRENATAL SCREEN | $2,230.20 | $3,717.00 | $683.15–$3,345.30 | 73% above | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 CELL FREE DNA PRENATAL SCREEN | $2,230.20 | $3,717.00 | $683.15–$3,345.30 | 73% above | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 CELL FREE DNA PRENATAL SCREEN | $2,230.20 | $3,717.00 | $683.15–$3,345.30 | — | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE | $208.80 | $348.00 | $17.73–$313.20 | 21% above | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE | $208.80 | $348.00 | $17.73–$313.20 | 21% above | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $208.80 | $348.00 | $17.73–$313.20 | — | 40% |
| Prolactin blood test CPT 84146 PROLACTIN | $217.20 | $362.00 | $16.47–$325.80 | 36% above | 40% |
| Prolactin blood test CPT 84146 PROLACTIN | $217.20 | $362.00 | $16.47–$325.80 | 36% above | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $217.20 | $362.00 | $16.47–$325.80 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $50.40 | $84.00 | $3.34–$75.60 | 4% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $50.40 | $84.00 | $3.34–$75.60 | 4% below | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $50.40 | $84.00 | $3.34–$75.60 | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST | $54.60 | $91.00 | $9.73–$81.90 | 11% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST | $54.60 | $91.00 | $9.73–$81.90 | 11% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA TEST | $54.60 | $91.00 | $9.73–$81.90 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W OPTIC | $19.20 | $32.00 | $7.36–$112.50 | 70% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W OPTIC | $19.20 | $32.00 | $7.36–$112.50 | 70% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W OPTIC | $19.20 | $32.00 | $7.36–$112.50 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN | $42.00 | $70.00 | $4.82–$63.00 | 20% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN | $42.00 | $70.00 | $4.82–$63.00 | 20% below | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUAN | $42.00 | $70.00 | $4.82–$63.00 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $120.60 | $201.00 | $12.23–$180.90 | 22% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $120.60 | $201.00 | $12.23–$180.90 | 22% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA | $120.60 | $201.00 | $12.23–$180.90 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE IN HOUSE | $67.20 | $112.00 | $2.30–$100.80 | 66% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE IN HOUSE | $67.20 | $112.00 | $2.30–$100.80 | 66% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE IN HOUSE | $67.20 | $112.00 | $2.30–$100.80 | — | 40% |
| Stool ova and parasites exam CPT 87177 PARASITE IDENTIFICATION | $120.00 | $200.00 | $7.42–$180.00 | 28% above | 40% |
| Stool ova and parasites exam CPT 87177 PARASITE IDENTIFICATION | $120.00 | $200.00 | $7.42–$180.00 | 28% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 PARASITE IDENTIFICATION | $120.00 | $200.00 | $7.42–$180.00 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 IFOBT/FIT | $252.60 | $421.00 | $13.52–$378.90 | 421% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 IFOBT/FIT | $252.60 | $421.00 | $13.52–$378.90 | 421% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IFOBT/FIT | $252.60 | $421.00 | $13.52–$378.90 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAl REF | $31.80 | $53.00 | $3.63–$47.70 | 34% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAl REF | $31.80 | $53.00 | $3.63–$47.70 | 34% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST QUAl REF | $31.80 | $53.00 | $3.63–$47.70 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 M.TUBERCULOSIS QUANTIFERON B | $132.60 | $221.00 | $50.83–$198.90 | 15% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 M.TUBERCULOSIS QUANTIFERON B | $132.60 | $221.00 | $50.83–$198.90 | 15% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 M.TUBERCULOSIS QUANTIFERON B | $132.60 | $221.00 | $50.83–$198.90 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $47.40 | $79.00 | $18.17–$71.10 | 57% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $47.40 | $79.00 | $18.17–$71.10 | 57% below | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $47.40 | $79.00 | $18.17–$71.10 | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 IMMUNASSY INF AGNT AB QUAN | $15.60 | $26.00 | $5.98–$23.40 | 83% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 IMMUNASSY INF AGNT AB QUAN | $15.60 | $26.00 | $5.98–$23.40 | 83% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB SERUM | $40.80 | $68.00 | $12.37–$61.20 | 56% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB SERUM | $40.80 | $68.00 | $12.37–$61.20 | 56% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ANTIBODIES | $97.80 | $163.00 | $12.37–$146.70 | 6% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ANTIBODIES | $97.80 | $163.00 | $12.37–$146.70 | 6% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 IMMUNASSY INF AGNT AB QUAN | $15.60 | $26.00 | $5.98–$23.40 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB SERUM | $40.80 | $68.00 | $12.37–$61.20 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID ANTIBODIES | $97.80 | $163.00 | $12.37–$146.70 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $168.00 | $280.00 | $14.28–$252.00 | 29% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $168.00 | $280.00 | $14.28–$252.00 | 29% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $168.00 | $280.00 | $14.28–$252.00 | — | 40% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $67.20 | $112.00 | $3.84–$100.80 | 18% above | 40% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $67.20 | $112.00 | $3.84–$100.80 | 18% above | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD | $67.20 | $112.00 | $3.84–$100.80 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO | $55.20 | $92.00 | $2.69–$82.80 | at median | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO | $55.20 | $92.00 | $2.69–$82.80 | at median | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO | $55.20 | $92.00 | $2.69–$82.80 | — | 40% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS PARTIAL DIPSTICK | $58.20 | $97.00 | $2.69–$87.30 | 178% above | 40% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS PARTIAL DIPSTICK | $58.20 | $97.00 | $2.69–$87.30 | 178% above | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS PARTIAL DIPSTICK | $58.20 | $97.00 | $2.69–$87.30 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO | $13.20 | $22.00 | $1.91–$50.40 | 51% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO | $13.20 | $22.00 | $1.91–$50.40 | 51% below | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO MICRO | $13.20 | $22.00 | $1.91–$50.40 | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK/TAB-AMB | $12.60 | $21.00 | $2.05–$20.70 | 26% below | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK/TAB-AMB | $12.60 | $21.00 | $2.05–$20.70 | 26% below | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK/TABLET | $35.40 | $59.00 | $2.05–$53.10 | 107% above | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK/TABLET | $35.40 | $59.00 | $2.05–$53.10 | 107% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS BY DIPSTICK/TAB-AMB | $12.60 | $21.00 | $2.05–$20.70 | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS BY DIPSTICK/TABLET | $35.40 | $59.00 | $2.05–$53.10 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $124.20 | $207.00 | $6.86–$186.30 | 24% above | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $124.20 | $207.00 | $6.86–$186.30 | 24% above | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE | $124.20 | $207.00 | $6.86–$186.30 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE | $35.40 | $59.00 | $1.02–$79.20 | 45% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE | $35.40 | $59.00 | $1.02–$79.20 | 45% below | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE | $35.40 | $59.00 | $1.02–$79.20 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 DEFICIENCY CASCADE | $19.20 | $32.00 | $7.36–$28.80 | 79% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 DEFICIENCY CASCADE | $19.20 | $32.00 | $7.36–$28.80 | 79% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $217.20 | $362.00 | $12.81–$325.80 | 134% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $217.20 | $362.00 | $12.81–$325.80 | 134% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 DEFICIENCY CASCADE | $19.20 | $32.00 | $7.36–$28.80 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $217.20 | $362.00 | $12.81–$325.80 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY) | $232.20 | $387.00 | $23.22–$348.30 | 71% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY) | $232.20 | $387.00 | $23.22–$348.30 | 71% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY) REF | $232.20 | $387.00 | $23.22–$348.30 | 71% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D(25-HYDROXY) REF | $232.20 | $387.00 | $23.22–$348.30 | 71% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D(25-HYDROXY) REF | $232.20 | $387.00 | $23.22–$348.30 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D(25-HYDROXY) | $232.20 | $387.00 | $23.22–$348.30 | — | 40% |
| Zinc blood test CPT 84630 ZINC | $150.60 | $251.00 | $9.67–$225.90 | 28% above | 40% |
| Zinc blood test CPT 84630 ZINC | $150.60 | $251.00 | $9.67–$225.90 | 28% above | 40% |
| Zinc blood test inpatient CPT 84630 ZINC | $150.60 | $251.00 | $9.67–$225.90 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG FREE/TOTAL | $183.60 | $306.00 | $12.80–$275.40 | 12% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG FREE/TOTAL | $183.60 | $306.00 | $12.80–$275.40 | 12% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG FREE/TOTAL | $183.60 | $306.00 | $12.80–$275.40 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Kentucky | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS | $403.20 | $672.00 | $147.88–$304.46 | 91% below | 40% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS | $403.20 | $672.00 | $147.88–$304.46 | — | 40% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHOULDER ARTHROSCOPY W ROTATOR | $2,064.00 | $3,440.00 | $787.23–$1,537.07 | at median | 40% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SHOULDER ARTHROSCOPY W ROTATOR | $2,064.00 | $3,440.00 | $787.23–$1,537.07 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREOTAC BRST BX 1ST LES RT | $729.60 | $1,216.00 | $122.50–$224.09 | 66% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREOTAC BRST BX 1ST LES RT | $729.60 | $1,216.00 | $122.50–$224.09 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXT | $273.60 | $456.00 | $80.29–$152.05 | 71% below | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXT | $821.40 | $1,369.00 | $209.46–$1,232.10 | 12% below | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE EXT | $273.60 | $456.00 | $80.29–$152.05 | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY | $1,185.00 | $1,975.00 | $284.77–$655.10 | at median | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY | $1,185.00 | $1,975.00 | $284.77–$655.10 | — | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY LESION REMOVAL | $1,038.60 | $1,731.00 | $189.67–$401.36 | 14% below | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY LESION REMOVAL | $1,038.60 | $1,731.00 | $189.67–$401.36 | — | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $847.20 | $1,412.00 | $150.55–$338.07 | 48% below | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY | $847.20 | $1,412.00 | $150.55–$338.07 | — | 40% |
| Colonoscopy, diagnostic CPT 45378 COLORECTAL SCRN NOT HIGH RISK | $745.20 | $1,242.00 | $138.20–$282.66 | 68% below | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLORECTAL SCRN NOT HIGH RISK | $745.20 | $1,242.00 | $138.20–$282.66 | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING | $384.60 | $641.00 | $64.62–$225.65 | 92% below | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING | $384.60 | $641.00 | $64.62–$225.65 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING | $110.40 | $184.00 | $64.62–$225.65 | 58% below | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING | $301.80 | $503.00 | $64.62–$225.65 | 15% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING | $301.80 | $503.00 | $64.62–$225.65 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMV IMPACTED CERUMEN-LAVAGE | $25.20 | $42.00 | $9.29–$25.13 | 77% below | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMV IMPACTED CERUMEN-LAVAGE | $37.20 | $62.00 | $9.49–$3,136.00 | 66% below | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMV IMPACTED CERUMEN-LAVAGE | $25.20 | $42.00 | $9.29–$25.13 | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN | $51.60 | $86.00 | $13.16–$3,136.00 | 66% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN | $86.40 | $144.00 | $21.47–$43.61 | 43% below | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN | $86.40 | $144.00 | $21.47–$43.61 | — | 40% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 SINUS SURGICAL ENDOSCOPY | $1,226.40 | $2,044.00 | $286.69–$630.20 | 42% above | 40% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 SINUS SURGICAL ENDOSCOPY | $1,226.40 | $2,044.00 | $286.69–$630.20 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS | $1,114.20 | $1,857.00 | $200.48–$396.64 | 53% below | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 ENDOSCOPY MAXILLARY SINUS | $1,114.20 | $1,857.00 | $200.48–$396.64 | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR ANT ABD HERNIA 3CM-10CM | $1,096.80 | $1,828.00 | $450.11–$839.27 | 54% below | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR ANT ABD HERNIA 3CM-10CM | $1,096.80 | $1,828.00 | $450.11–$839.27 | — | 40% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST >10 RDE | $1,426.20 | $2,377.00 | $607.10–$1,126.98 | at median | 40% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST >10 RDE | $1,426.20 | $2,377.00 | $607.10–$1,126.98 | — | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST<3CM REDUCIBL | $694.20 | $1,157.00 | $267.65–$503.17 | 84% below | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST<3CM REDUCIBL | $694.20 | $1,157.00 | $267.65–$503.17 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY DIAGNOSTIC | $189.00 | $315.00 | $42.46–$84.48 | 82% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY DIAGNOSTIC | $189.00 | $315.00 | $42.46–$84.48 | — | 40% |
| Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY | $1,827.60 | $3,046.00 | $513.93–$998.20 | 70% below | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY | $1,827.60 | $3,046.00 | $513.93–$998.20 | — | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE C CHOLANGIOGRAM | $2,020.20 | $3,367.00 | $559.49–$1,081.86 | at median | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE C CHOLANGIOGRAM | $2,020.20 | $3,367.00 | $559.49–$1,081.86 | — | 40% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER | $1,563.60 | $2,606.00 | $553.75–$1,682.29 | 1% above | 40% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 REMOVAL OF GALLBLADDER | $1,563.60 | $2,606.00 | $553.75–$1,682.29 | — | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY | $841.20 | $1,402.00 | $267.65–$749.33 | at median | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY | $841.20 | $1,402.00 | $267.65–$749.33 | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE OR SINGLE | $135.00 | $225.00 | $39.74–$155.71 | 54% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE OR SINGLE | $145.80 | $243.00 | $39.74–$155.71 | 51% below | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE OR SINGLE | $135.00 | $225.00 | $39.74–$155.71 | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA | $995.40 | $1,659.00 | $350.04–$960.20 | 32% below | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INGUINAL HERNIA | $995.40 | $1,659.00 | $350.04–$960.20 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON LIGAMENT | $45.60 | $76.00 | $29.85–$53.86 | 90% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON LIGAMENT | $91.80 | $153.00 | $29.85–$53.86 | 80% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON LIGAMENT | $91.80 | $153.00 | $29.85–$53.86 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JNT | $502.20 | $837.00 | $100.00–$753.30 | 7% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JNT | $502.20 | $837.00 | $100.00–$753.30 | 7% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JNT | $502.20 | $837.00 | $100.00–$753.30 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMED JNT/BURSA | $445.20 | $742.00 | $100.00–$667.80 | 13% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMED JNT/BURSA | $445.20 | $742.00 | $100.00–$667.80 | 13% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMED JNT/BURSA | $445.20 | $742.00 | $100.00–$667.80 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ SM JNT/BURSA | $427.20 | $712.00 | $100.00–$640.80 | 14% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ SM JNT/BURSA | $427.20 | $712.00 | $100.00–$640.80 | 14% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ SM JNT/BURSA | $427.20 | $712.00 | $100.00–$640.80 | — | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MENISTMY | $1,960.80 | $3,268.00 | $410.99–$804.38 | 65% below | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MENISTMY | $1,960.80 | $3,268.00 | $410.99–$804.38 | — | 40% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY SURGERY | $2,224.80 | $3,708.00 | $407.90–$962.21 | 60% below | 40% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY SURGERY | $2,224.80 | $3,708.00 | $407.90–$962.21 | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 APPENDECTOMY | $1,398.60 | $2,331.00 | $64.60–$912.37 | 78% below | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 APPENDECTOMY | $1,398.60 | $2,331.00 | $64.60–$912.37 | — | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 ESOPHOGASTRIC FUNDOPLASTY | $2,221.20 | $3,702.00 | $820.29–$1,607.07 | at median | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 ESOPHOGASTRIC FUNDOPLASTY | $2,221.20 | $3,702.00 | $820.29–$1,607.07 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP INITIAL INGUINAL HERNIA | $1,123.20 | $1,872.00 | $302.13–$665.79 | 61% below | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP INITIAL INGUINAL HERNIA | $1,123.20 | $1,872.00 | $302.13–$665.79 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP RECURRENT INGUINAL HERNIA | $1,205.40 | $2,009.00 | $387.99–$864.29 | at median | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP RECURRENT INGUINAL HERNIA | $1,205.40 | $2,009.00 | $387.99–$864.29 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER WND SCLP ARM LEG<2.5CM | $295.20 | $492.00 | $75.28–$442.80 | 2% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER WND SCLP ARM LEG<2.5CM | $295.20 | $492.00 | $75.28–$442.80 | 2% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER WND SCLP ARM LEG<2.5CM | $295.20 | $492.00 | $75.28–$442.80 | — | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY | $1,122.60 | $1,871.00 | $281.70–$996.98 | at median | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY | $1,122.60 | $1,871.00 | $281.70–$996.98 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES TRNK ARM LEG<.5CM | $75.00 | $125.00 | $33.56–$118.32 | 80% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES TRNK ARM LEG<.5CM | $187.80 | $313.00 | $33.56–$118.32 | 49% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LES TRNK ARM LEG<.5CM | $187.80 | $313.00 | $33.56–$118.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES FEENL <=0.5CM | $87.00 | $145.00 | $42.99–$150.69 | 82% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES FEENL <=0.5CM | $87.00 | $145.00 | $42.99–$150.69 | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $286.20 | $477.00 | $72.98–$429.30 | 10% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $286.20 | $477.00 | $72.98–$429.30 | 10% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE | $286.20 | $477.00 | $72.98–$429.30 | — | 40% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGE | $1,125.00 | $1,875.00 | $79.53–$149.18 | 2% below | 40% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGE | $1,863.00 | $3,105.00 | $100.00–$2,794.50 | 63% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGE | $1,125.00 | $1,875.00 | $79.53–$149.18 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 RMVL NAIL PART/COMP PERM | $336.60 | $561.00 | $75.15–$166.08 | 33% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 RMVL NAIL PART/COMP PERM | $540.60 | $901.00 | $137.85–$810.90 | 8% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 RMVL NAIL PART/COMP PERM | $336.60 | $561.00 | $75.15–$166.08 | — | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC BREAST CYST ONE OR MORE | $669.60 | $1,116.00 | $263.73–$638.76 | 57% below | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAST CYST ONE OR MORE | $669.60 | $1,116.00 | $263.73–$638.76 | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION REMOVAL FB SQ SIMPLE | $204.00 | $340.00 | $42.30–$158.19 | 52% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION REMOVAL FB SQ SIMPLE | $570.00 | $950.00 | $25.55–$855.00 | 34% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION REMOVAL FB SQ SIMPLE | $204.00 | $340.00 | $42.30–$158.19 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL SCRN NOT HIGH RISK | $745.20 | $1,242.00 | $138.20–$282.66 | 73% below | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLORECTAL SCRN NOT HIGH RISK | $745.20 | $1,242.00 | $138.20–$282.66 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN HIGH RISK | $745.20 | $1,242.00 | $138.20–$270.86 | 73% below | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCRN HIGH RISK | $745.20 | $1,242.00 | $138.20–$270.86 | — | 40% |
| Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM | $1,656.00 | $2,760.00 | $376.62–$947.46 | 4% below | 40% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR OF NASAL SEPTUM | $1,656.00 | $2,760.00 | $376.62–$947.46 | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 APP SHORT ARM SPLINT/ST | $50.64 | $84.40 | $23.49–$63.71 | 73% below | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHOULDER ARTHROSCOPY MUMFORD | $1,543.80 | $2,573.00 | $459.49–$998.32 | 35% below | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SHOULDER ARTHROSCOPY MUMFORD | $1,543.80 | $2,573.00 | $459.49–$998.32 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP SUPER WOUND <2.5CM | $295.20 | $492.00 | $75.28–$442.80 | 7% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP SUPER WOUND <2.5CM | $295.20 | $492.00 | $75.28–$442.80 | 7% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMP SUPER WOUND <2.5CM | $295.20 | $492.00 | $75.28–$442.80 | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $169.20 | $282.00 | $35.26–$61.25 | 33% below | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $191.40 | $319.00 | $35.26–$61.25 | 25% below | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION | $191.40 | $319.00 | $35.26–$61.25 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MAL LES TRN ARM LEG<=0.5CM | $154.20 | $257.00 | $39.32–$406.79 | 25% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS TO 15 LESIONS | $104.40 | $174.00 | $26.99–$106.95 | 28% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS TO 15 LESIONS | $105.60 | $176.00 | $26.99–$106.95 | 27% below | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS TO 15 LESIONS | $105.60 | $176.00 | $26.99–$106.95 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP SUPER WOUND 2.6-7.5CM | $276.00 | $460.00 | $45.55–$91.86 | 8% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP SUPER WOUND 2.6-7.5CM | $295.20 | $492.00 | $75.28–$442.80 | 2% below | 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 SIMP SUPER WOUND 2.6-7.5CM | $276.00 | $460.00 | $45.55–$91.86 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP LAC FACE <2.5CM | $273.00 | $455.00 | $43.49–$86.99 | 6% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP LAC FACE <2.5CM | $295.20 | $492.00 | $75.28–$442.80 | 2% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP LAC FACE <2.5CM | $273.00 | $455.00 | $43.49–$86.99 | — | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS W/IMG LT | $607.20 | $1,012.00 | $81.84–$152.26 | 53% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS W/IMG RT | $607.20 | $1,012.00 | $81.84–$152.26 | 53% below | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS W/IMG LT | $607.20 | $1,012.00 | $81.84–$152.26 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS W/IMG RT | $607.20 | $1,012.00 | $81.84–$152.26 | — | 40% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS | $651.00 | $1,085.00 | $209.24–$428.31 | 88% below | 40% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS AND ADENOIDS | $651.00 | $1,085.00 | $209.24–$428.31 | — | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS | $571.20 | $952.00 | $209.24–$428.31 | 91% below | 40% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS AND ADENOIDS | $571.20 | $952.00 | $209.24–$428.31 | — | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS | $570.60 | $951.00 | $191.98–$362.57 | 91% below | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 REMOVAL OF TONSILS | $570.60 | $951.00 | $191.98–$362.57 | — | 40% |
| Total hip replacement CPT 27130 TOTAL HIP REPLACEMENT | $4,007.40 | $6,679.00 | $981.55–$1,836.32 | 73% below | 40% |
| Total hip replacement inpatient CPT 27130 TOTAL HIP REPLACEMENT | $4,007.40 | $6,679.00 | $981.55–$1,836.32 | — | 40% |
| Total knee replacement CPT 27447 TOTAL KNEE REPLACEMENT | $3,774.60 | $6,291.00 | $980.52–$1,832.34 | 74% below | 40% |
| Total knee replacement inpatient CPT 27447 TOTAL KNEE REPLACEMENT | $3,774.60 | $6,291.00 | $980.52–$1,832.34 | — | 40% |
| Total shoulder replacement CPT 23472 ARTHROPLASTY TOTAL SHOULDER | $3,492.60 | $5,821.00 | $1,101.73–$2,055.80 | 57% below | 40% |
| Total shoulder replacement inpatient CPT 23472 ARTHROPLASTY TOTAL SHOULDER | $3,492.60 | $5,821.00 | $1,101.73–$2,055.80 | — | 40% |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $661.20 | $1,102.00 | $176.70–$443.40 | 55% below | 40% |
| Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH | $661.20 | $1,102.00 | $176.70–$443.40 | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJ 1-2 MUSCLES | $65.40 | $109.00 | $16.68–$196.00 | 89% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BX BREAST 1ST LES LT | $729.60 | $1,216.00 | $115.04–$211.58 | 65% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BX BREAST 1ST LES RT | $729.60 | $1,216.00 | $115.04–$211.58 | 65% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US BX BREAST 1ST LES LT | $729.60 | $1,216.00 | $115.04–$211.58 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US BX BREAST 1ST LES RT | $729.60 | $1,216.00 | $115.04–$211.58 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPHAGUS ENDOSCOPY DILATIO | $1,017.00 | $1,695.00 | $114.52–$217.31 | 40% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPHAGUS ENDOSCOPY DILATIO | $1,017.00 | $1,695.00 | $114.52–$217.31 | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY BIOPSY | $589.80 | $983.00 | $102.94–$196.89 | 58% below | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY BIOPSY | $589.80 | $983.00 | $102.94–$196.89 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W/INJECTION | $692.40 | $1,154.00 | $102.94–$196.89 | 64% below | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W/INJECTION | $692.40 | $1,154.00 | $102.94–$196.89 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OPERATIVE UPPER GI ENDOSCOPY | $669.60 | $1,116.00 | $133.06–$289.35 | 46% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 OPERATIVE UPPER GI ENDOSCOPY | $669.60 | $1,116.00 | $133.06–$289.35 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPER GI ENDOSCOPY GUIDEWIRE | $549.00 | $915.00 | $123.78–$236.08 | 75% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UPPER GI ENDOSCOPY GUIDEWIRE | $549.00 | $915.00 | $123.78–$236.08 | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY DIAGNOSI | $623.40 | $1,039.00 | $91.62–$175.87 | 40% below | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY DIAGNOSI | $623.40 | $1,039.00 | $91.62–$175.87 | — | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESIONS TO 14 | $39.00 | $65.00 | $22.23–$96.36 | 67% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISSUE 1ST 20 SQ CM | $542.40 | $904.00 | $37.18–$3,136.00 | 7% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISSUE 1ST 20 SQ CM | $542.40 | $904.00 | $37.18–$3,136.00 | 7% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISSUE 1ST 20 SQ CM | $542.40 | $904.00 | $37.18–$3,136.00 | — | 40% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPN TX DIST RAD FX W INT FIX | $1,179.60 | $1,966.00 | $487.92–$1,088.11 | at median | 40% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPN TX DIST RAD FX W INT FIX | $1,179.60 | $1,966.00 | $487.92–$1,088.11 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Kentucky | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $625.80 | $1,043.00 | $159.58–$3,136.00 | 4% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $625.80 | $1,043.00 | $159.58–$3,136.00 | 4% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION | $625.80 | $1,043.00 | $159.58–$3,136.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX INIT | $150.00 | $250.00 | $38.25–$225.00 | 3% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX SUBS | $150.00 | $250.00 | $38.25–$225.00 | 3% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX SUBS | $150.00 | $250.00 | $38.25–$225.00 | 3% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX INIT | $150.00 | $250.00 | $38.25–$225.00 | 3% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB TX INIT | $150.00 | $250.00 | $38.25–$225.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB TX SUBS | $150.00 | $250.00 | $38.25–$225.00 | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INITIAL HR | $489.00 | $815.00 | $124.70–$733.50 | 3% below | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INITIAL HR | $489.00 | $815.00 | $124.70–$733.50 | 3% below | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN IV INITIAL HR | $489.00 | $815.00 | $124.70–$733.50 | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74M | $280.20 | $467.00 | $157.68–$321.78 | 86% below | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74M | $280.20 | $467.00 | $157.68–$321.78 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE | $143.40 | $239.00 | $36.57–$215.10 | 5% above | 40% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE | $143.40 | $239.00 | $36.57–$215.10 | 5% above | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM COMPLETE | $143.40 | $239.00 | $36.57–$215.10 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $64.20 | $107.00 | $16.37–$369.90 | 67% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $246.60 | $411.00 | $16.37–$369.90 | 28% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY | $246.60 | $411.00 | $16.37–$369.90 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1 | $61.20 | $102.00 | $15.61–$91.80 | 57% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1 | $61.20 | $102.00 | $15.61–$91.80 | 57% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL 1 | $61.20 | $102.00 | $15.61–$91.80 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL 2 | $144.00 | $240.00 | $36.72–$216.00 | 50% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL 2 | $144.00 | $240.00 | $36.72–$216.00 | 50% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEVEL 2 | $144.00 | $240.00 | $36.72–$216.00 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL 3 | $280.20 | $467.00 | $71.45–$420.30 | 34% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL 3 | $280.20 | $467.00 | $71.45–$420.30 | 34% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEVEL 3 | $280.20 | $467.00 | $71.45–$420.30 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL 4 | $1,761.60 | $2,936.00 | $191.80–$2,642.40 | 54% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL 4 | $1,761.60 | $2,936.00 | $191.80–$2,642.40 | 54% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEVEL 4 | $1,761.60 | $2,936.00 | $191.80–$2,642.40 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE EA ADD 30M | $1,120.80 | $1,868.00 | $285.80–$1,681.20 | 5% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE EA ADD 30M | $1,120.80 | $1,868.00 | $285.80–$1,681.20 | 5% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL 5 | $2,278.80 | $3,798.00 | $354.47–$3,418.20 | 94% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL 5 | $2,278.80 | $3,798.00 | $354.47–$3,418.20 | 94% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M W/P | $3,004.20 | $5,007.00 | $354.47–$4,506.30 | 156% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M | $3,004.20 | $5,007.00 | $354.47–$4,506.30 | 156% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M | $3,004.20 | $5,007.00 | $354.47–$4,506.30 | 156% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CRITICAL CARE 1ST 30-74M W/P | $3,004.20 | $5,007.00 | $354.47–$4,506.30 | 156% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CRITICAL CARE EA ADD 30M | $1,120.80 | $1,868.00 | $285.80–$1,681.20 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEVEL 5 | $2,278.80 | $3,798.00 | $354.47–$3,418.20 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CRITICAL CARE 1ST 30-74M | $3,004.20 | $5,007.00 | $354.47–$4,506.30 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CRITICAL CARE 1ST 30-74M W/P | $3,004.20 | $5,007.00 | $354.47–$4,506.30 | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $763.20 | $1,272.00 | $180.04–$1,144.80 | 4% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $763.20 | $1,272.00 | $180.04–$1,144.80 | 4% below | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST | $763.20 | $1,272.00 | $180.04–$1,144.80 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION IV HYDRAT UP TO 1 HR | $246.00 | $410.00 | $62.73–$369.00 | 15% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION IV HYDRAT UP TO 1 HR | $246.00 | $410.00 | $62.73–$369.00 | 15% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION IV HYDRAT UP TO 1 HR | $246.00 | $410.00 | $62.73–$369.00 | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION IV THERAP UP TO 1 HR | $468.60 | $781.00 | $119.49–$702.90 | 30% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION IV THERAP UP TO 1 HR | $468.60 | $781.00 | $119.49–$702.90 | 30% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION IV THERAP UP TO 1 HR | $468.60 | $781.00 | $119.49–$702.90 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION (SC) (IM) AMB | $24.60 | $41.00 | $6.27–$41.15 | 74% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION (SC) (IM) | $118.80 | $198.00 | $30.29–$178.20 | 24% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION (SC) (IM) | $118.80 | $198.00 | $30.29–$178.20 | 24% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION (SC) (IM) | $118.80 | $198.00 | $30.29–$178.20 | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT LEVEL 3 NEW | $134.40 | $224.00 | $60.57–$115.43 | 4% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT LEVEL 3 NEW W/PRC | $198.60 | $331.00 | $50.64–$297.90 | 53% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT LEVEL 3 NEW | $198.60 | $331.00 | $16.37–$297.90 | 53% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT LEVEL 3 NEW W/PRC | $198.60 | $331.00 | $50.64–$297.90 | 53% above | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT LEVEL 3 NEW | $134.40 | $224.00 | $60.57–$115.43 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT LEVEL 3 NEW W/PRC | $198.60 | $331.00 | $50.64–$297.90 | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT LEVEL 4 NEW | $109.20 | $182.00 | $27.85–$1,043.10 | 46% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT LEVEL 4 NEW | $204.60 | $341.00 | $100.62–$188.66 | at median | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT LEVEL 4 NEW W/PRC | $695.40 | $1,159.00 | $177.33–$1,043.10 | 241% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT LEVEL 4 NEW W/PRC | $695.40 | $1,159.00 | $177.33–$1,043.10 | 241% above | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT LEVEL 4 NEW | $204.60 | $341.00 | $100.62–$188.66 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT LEVEL 4 NEW W/PRC | $695.40 | $1,159.00 | $177.33–$1,043.10 | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT LEVEL 5 NEW | $234.60 | $391.00 | $131.98–$258.37 | at median | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT LEVEL 5 NEW | $252.60 | $421.00 | $131.98–$258.37 | 8% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT LEVEL 5 NEW W/PRC | $916.20 | $1,527.00 | $233.63–$1,374.30 | 291% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT LEVEL 5 NEW W/PRC | $916.20 | $1,527.00 | $233.63–$1,374.30 | 291% above | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT LEVEL 5 NEW | $234.60 | $391.00 | $131.98–$258.37 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT LEVEL 5 NEW W/PRC | $916.20 | $1,527.00 | $233.63–$1,374.30 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT LEVEL 2 NEW | $44.40 | $74.00 | $11.32–$256.50 | 54% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT LEVEL 2 NEW | $90.60 | $151.00 | $35.00–$66.38 | 7% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT LEVEL 2 NEW W/PRC | $171.00 | $285.00 | $43.61–$256.50 | 76% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT LEVEL 2 NEW W/PRC | $171.00 | $285.00 | $43.61–$256.50 | 76% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT LEVEL 2 NEW | $90.60 | $151.00 | $35.00–$66.38 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT LEVEL 2 NEW W/PRC | $171.00 | $285.00 | $43.61–$256.50 | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PRVNT VISIT EST 40-64 YRS OLD | $121.20 | $202.00 | $70.00–$87.54 | at median | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PRVNT VISIT EST 65 & OVER | $131.40 | $219.00 | $73.34–$91.99 | at median | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE COUNSEL 3-10 MIN | $24.00 | $40.00 | $9.01–$17.26 | 26% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE COUNSEL 3-10 MIN | $24.00 | $40.00 | $9.01–$17.26 | 26% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE COUNSEL 3-10 MIN | $24.00 | $40.00 | $9.01–$17.26 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT LEVEL 5 EST | $154.20 | $257.00 | $87.17–$202.65 | 8% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT LEVEL 5 EST | $916.20 | $1,527.00 | $23.56–$1,374.30 | 444% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT LEVEL 5 EST | $154.20 | $257.00 | $87.17–$202.65 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT LEVEL 3 EST | $87.00 | $145.00 | $40.36–$92.81 | at median | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT LEVEL 3 EST | $136.20 | $227.00 | $11.32–$468.00 | 56% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT LEVEL 3 EST W/PRC | $312.00 | $520.00 | $79.56–$468.00 | 258% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT LEVEL 3 EST W/PRC | $312.00 | $520.00 | $79.56–$468.00 | 258% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT LEVEL 3 EST | $87.00 | $145.00 | $40.36–$92.81 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT LEVEL 3 EST W/PRC | $312.00 | $520.00 | $79.56–$468.00 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT LEVEL 4 EST | $65.40 | $109.00 | $16.68–$1,043.10 | 46% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT LEVEL 4 EST | $109.20 | $182.00 | $61.98–$136.59 | 9% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT LEVEL 4 EST W/PRC | $695.40 | $1,159.00 | $177.33–$1,043.10 | 478% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT LEVEL 4 EST W/PRC | $695.40 | $1,159.00 | $177.33–$1,043.10 | 478% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT LEVEL 4 EST | $109.20 | $182.00 | $61.98–$136.59 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT LEVEL 4 EST W/PRC | $695.40 | $1,159.00 | $177.33–$1,043.10 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT LEVEL 2 EST | $44.40 | $74.00 | $11.32–$70.20 | 38% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT LEVEL 2 EST | $73.80 | $123.00 | $20.41–$50.18 | 3% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP E&M VISIT LEVEL 2 EST W/PR | $253.80 | $423.00 | $64.72–$380.70 | 256% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP E&M VISIT LEVEL 2 EST | $253.80 | $423.00 | $64.72–$380.70 | 256% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP E&M VISIT LEVEL 2 EST | $253.80 | $423.00 | $64.72–$380.70 | 256% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP E&M VISIT LEVEL 2 EST W/PR | $253.80 | $423.00 | $64.72–$380.70 | 256% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT LEVEL 2 EST | $73.80 | $123.00 | $20.41–$50.18 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP E&M VISIT LEVEL 2 EST W/PR | $253.80 | $423.00 | $64.72–$380.70 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP E&M VISIT LEVEL 2 EST | $253.80 | $423.00 | $64.72–$380.70 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CONSULT >=30MI | $75.00 | $125.00 | $66.14–$96.55 | at median | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFF/OP CONSULT >=30MI | $75.00 | $125.00 | $66.14–$96.55 | — | 40% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CONSULT >=40MI | $90.00 | $150.00 | $99.86–$153.24 | 17% below | 40% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFF/OP CONSULT >=40MI | $90.00 | $150.00 | $99.86–$153.24 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $168.00 | $280.00 | $42.84–$252.00 | 7% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $168.00 | $280.00 | $42.84–$252.00 | 7% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC | $168.00 | $280.00 | $42.84–$252.00 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Kentucky | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 30 MCG/0.3 ML PFIZER | $589.50 | $982.50 | $150.27–$884.25 | 76% above | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 30 MCG/0.3 ML PFIZER | $589.50 | $982.50 | $150.27–$884.25 | 76% above | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 30 MCG/0.3 ML PFIZER | $589.50 | $982.50 | $150.27–$884.25 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VAC TRIV PF 45 MCG/0.5 ML | $54.90 | $91.50 | $14.00–$82.35 | 38% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VAC TRIV PF 45 MCG/0.5 ML | $54.90 | $91.50 | $14.00–$82.35 | 38% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VAC TRIV PF 45 MCG/0.5 ML | $54.90 | $91.50 | $14.00–$82.35 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMONIA VACCINE | $75.00 | $125.00 | $19.13–$112.50 | 1% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMONIA VACCINE | $75.00 | $125.00 | $19.13–$112.50 | 1% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE | $75.00 | $125.00 | $19.13–$112.50 | 1% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VACCINE | $75.00 | $125.00 | $19.13–$112.50 | 1% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VACCINE | $75.00 | $125.00 | $19.13–$112.50 | 1% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE | $75.00 | $125.00 | $19.13–$112.50 | 1% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN ONE VACCINE | $75.00 | $125.00 | $19.13–$112.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMONIA VACCINE | $75.00 | $125.00 | $19.13–$112.50 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VACCINE | $75.00 | $125.00 | $19.13–$112.50 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADM EA ADDL VACCINE | $39.00 | $65.00 | $9.95–$58.50 | 3% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADM EA ADDL VACCINE | $39.00 | $65.00 | $9.95–$58.50 | 3% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADM EA ADDL VACCINE | $39.00 | $65.00 | $9.95–$58.50 | — | 40% |
Source file: https://www.arh.org/wp-content/uploads/2026/05/520795508_Tug-Valley-ARH-Regional-Medical-Center_standardcharges.csv