Hospital Toledo, OH

Nationwide Children's Hospital Toledo

Nationwide Children's Hospital Toledo in Toledo, OH publishes cash prices for 407 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 282 of 404 procedures and below it for 122. By typical cash price it ranks #130 of 139 Ohio hospitals and #7 of 7 hospitals in the Toledo, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

2213 Cherry Street, Toledo OH 43608 Collected Sep 22, 2026 Source price file Check a bill from this hospital (419) 251-3232

Children's hospital Nonprofit hospital No emergency department CCN 363309 · CMS hospital register NPI 1588254650

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABD W&W/O CONT	$2,889.60	$4,816.00	$1,204.00–$3,708.32	118% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABD W&W/O CONT	$2,889.60	$4,816.00	$1,204.00–$3,708.32	—	40%
Abdominal X-ray, 2 views CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS	$382.20	$637.00	$159.25–$490.49	13% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS	$382.20	$637.00	$159.25–$490.49	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 HC X-RAY ANKLE ROUT 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	91% above	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC X-RAY ANKLE ROUT 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	131% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC FLURO ESOPHAGRAM	$785.40	$1,309.00	$327.25–$1,007.93	77% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC FLURO ESOPHAGRAM	$785.40	$1,309.00	$327.25–$1,007.93	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN WHOLE BODY	$2,217.00	$3,695.00	$923.75–$2,845.15	44% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE SCAN WHOLE BODY	$2,217.00	$3,695.00	$923.75–$2,845.15	—	40%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST COMP	$1,093.20	$1,822.00	$455.50–$1,402.94	129% above	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST COMP	$1,093.20	$1,822.00	$455.50–$1,402.94	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST LTD	$1,066.80	$1,778.00	$444.50–$1,369.06	160% above	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST LTD	$1,066.80	$1,778.00	$444.50–$1,369.06	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABD & PELVIS W & W/O CONT	$7,242.60	$12,071.00	$3,017.75–$9,294.67	238% above	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABD & PELVIS W & W/O CONT	$7,242.60	$12,071.00	$3,017.75–$9,294.67	—	40%
CT angiography (CTA) of the head CPT 70496 HC CTA HEAD W & W/O CONT	$3,177.60	$5,296.00	$1,324.00–$4,077.92	138% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD W & W/O CONT	$3,177.60	$5,296.00	$1,324.00–$4,077.92	—	40%
CT angiography (CTA) of the neck CPT 70498 HC CTA NECK/CAROTID W & W/O CONT	$3,177.60	$5,296.00	$1,324.00–$4,077.92	144% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK/CAROTID W & W/O CONT	$3,177.60	$5,296.00	$1,324.00–$4,077.92	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO CHEST W & W/O CONT	$3,621.00	$6,035.00	$1,508.75–$4,646.95	156% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO CHEST W & W/O CONT	$3,621.00	$6,035.00	$1,508.75–$4,646.95	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART W/WO CALCIUM	$1,150.80	$1,918.00	$479.50–$1,476.86	28% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART W/WO CALCIUM	$1,150.80	$1,918.00	$479.50–$1,476.86	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$1,150.80	$1,918.00	$479.50–$1,476.86	311% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$1,150.80	$1,918.00	$479.50–$1,476.86	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD/PELVIS W/O CONTRAST	$3,277.20	$5,462.00	$1,365.50–$4,205.74	107% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD/PELVIS W/O CONTRAST	$3,277.20	$5,462.00	$1,365.50–$4,205.74	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD/PEL W CONT	$3,768.60	$6,281.00	$1,570.25–$4,836.37	90% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD/PEL W CONT	$3,768.60	$6,281.00	$1,570.25–$4,836.37	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD/PELVIS W W/O CONTRAST	$4,334.40	$7,224.00	$1,806.00–$5,562.48	86% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD/PELVIS W W/O CONTRAST	$4,334.40	$7,224.00	$1,806.00–$5,562.48	—	40%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/ CONT	$2,511.60	$4,186.00	$1,046.50–$3,223.22	115% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/ CONT	$2,511.60	$4,186.00	$1,046.50–$3,223.22	—	40%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONT	$2,184.60	$3,641.00	$910.25–$2,803.57	108% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONT	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT FACIAL BONES W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	119% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT FACIAL BONES W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT BRAIN W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	129% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT BRAIN W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	—	40%
CT scan of the head with contrast CPT 70460 HC CT BRAIN W/ CONTRAST	$2,204.40	$3,674.00	$918.50–$2,828.98	119% above	40%
CT scan of the head with contrast inpatient CPT 70460 HC CT BRAIN W/ CONTRAST	$2,204.40	$3,674.00	$918.50–$2,828.98	—	40%
CT scan of the head without and with contrast CPT 70470 HC CT BRAIN W/WO CONTRAST	$2,533.80	$4,223.00	$1,055.75–$3,251.71	113% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT BRAIN W/WO CONTRAST	$2,533.80	$4,223.00	$1,055.75–$3,251.71	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-SPINE W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	99% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT L-SPINE W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT C-SPINE W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	104% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT C-SPINE W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST	$2,511.60	$4,186.00	$1,046.50–$3,223.22	105% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST	$2,511.60	$4,186.00	$1,046.50–$3,223.22	—	40%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST W/WO CONTRAST	$2,889.60	$4,816.00	$1,204.00–$3,708.32	91% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT CHEST W/WO CONTRAST	$2,889.60	$4,816.00	$1,204.00–$3,708.32	—	40%
Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS	$666.00	$1,110.00	$277.50–$854.70	153% above	40%
Chest X-ray, 2 views inpatient CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS	$666.00	$1,110.00	$277.50–$854.70	—	40%
Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW	$666.00	$1,110.00	$277.50–$854.70	198% above	40%
Chest X-ray, single view inpatient CPT 71045 HC X-RAY EXAM CHEST 1 VIEW	$666.00	$1,110.00	$277.50–$854.70	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 HC X-RAY CLAVICLE	$582.00	$970.00	$242.50–$746.90	115% above	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC X-RAY CLAVICLE	$582.00	$970.00	$242.50–$746.90	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$1,701.00	$2,835.00	$708.75–$2,182.95	140% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$1,701.00	$2,835.00	$708.75–$2,182.95	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA AXIAL SKELETON	$582.00	$970.00	$242.50–$746.90	29% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA AXIAL SKELETON	$582.00	$970.00	$242.50–$746.90	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DEXA APPENDICULAR SKELETON	$390.00	$650.00	$162.50–$500.50	52% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DEXA APPENDICULAR SKELETON	$390.00	$650.00	$162.50–$500.50	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US FETAL ANATOMIC EVAL	$231.60	$386.00	$96.50–$297.22	73% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US FETAL ANATOMIC EVAL	$231.60	$386.00	$96.50–$297.22	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	132% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W/ CONTRAST	$2,511.60	$4,186.00	$1,046.50–$3,223.22	107% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W/ CONTRAST	$2,511.60	$4,186.00	$1,046.50–$3,223.22	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMO DGX BILATERAL INCL CAD IF PERF	$652.20	$1,087.00	$271.75–$836.99	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMO DGX BILATERAL INCL CAD IF PERF	$652.20	$1,087.00	$271.75–$836.99	—	40%
Diagnostic mammogram, one breast one side CPT 77065 HC MAMMO DGX UNILATERAL INCL CAD IF PERF	$528.00	$880.00	$220.00–$677.60	47% above	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMO DGX UNILATERAL INCL CAD IF PERF	$528.00	$880.00	$220.00–$677.60	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC NIV VENOUS DUPLEX BILAT STUDY	$2,166.60	$3,611.00	$902.75–$2,780.47	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC NIV VENOUS DUPLEX BILAT STUDY	$2,166.60	$3,611.00	$902.75–$2,780.47	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC 2D ECHO WITHOUT CONTRAST - WITH DOP/COLOR FLOW	$4,296.60	$7,161.00	$1,790.25–$5,513.97	154% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC 2D ECHO WITHOUT CONTRAST - WITH DOP/COLOR FLOW	$4,296.60	$7,161.00	$1,790.25–$5,513.97	—	40%
Elbow X-ray, 2 views CPT 73070 HC ELBOW 2 VIEWS	$582.00	$970.00	$242.50–$746.90	123% above	40%
Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW MIN 3 VIEWS	$582.00	$970.00	$242.50–$746.90	85% above	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW MIN 3 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	122% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	62% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM 2 VIEWS	$582.00	$970.00	$242.50–$746.90	114% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY IMAGING WO PHARM	$2,418.60	$4,031.00	$1,007.75–$3,103.87	52% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY IMAGING WO PHARM	$2,418.60	$4,031.00	$1,007.75–$3,103.87	—	40%
Hand X-ray, 2 views CPT 73120 HC HAND 2 VIEWS	$582.00	$970.00	$242.50–$746.90	118% above	40%
Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-RAY OS CALCIS MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	114% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC X-RAY OS CALCIS MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PEDS - SLEEP STUDY UNATT/RESP EFFT	$660.60	$1,101.00	$275.25–$847.77	6% below	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC PEDS - SLEEP STUDY UNATT/RESP EFFT	$660.60	$1,101.00	$275.25–$847.77	—	40%
Knee X-ray, 3 views CPT 73562 HC X-RAY KNEE 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	73% above	40%
Knee X-ray, 3 views inpatient CPT 73562 HC X-RAY KNEE 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 HC X-RAY KNEE ROUT INC TUN PAT MIN 4 VIEW	$610.80	$1,018.00	$254.50–$783.86	55% above	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC X-RAY KNEE ROUT INC TUN PAT MIN 4 VIEW	$610.80	$1,018.00	$254.50–$783.86	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXT W/O CONT	$2,184.60	$3,641.00	$910.25–$2,803.57	131% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXT W/O CONT	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL LIMITED	$972.60	$1,621.00	$405.25–$1,248.17	76% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMINAL LIMITED	$972.60	$1,621.00	$405.25–$1,248.17	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US EXTREM LIMITED NONVASC	$933.60	$1,556.00	$389.00–$1,198.12	96% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US EXTREM LIMITED NONVASC	$933.60	$1,556.00	$389.00–$1,198.12	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT CHEST SCREENING LOW DOSE WOUT CONT	$104.40	$174.00	$43.50–$133.98	65% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT CHEST SCREENING LOW DOSE WOUT CONT	$104.40	$174.00	$43.50–$133.98	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC X-RAY TIBIA/FIBULA 2 VIEWS	$582.00	$970.00	$242.50–$746.90	113% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC X-RAY TIBIA/FIBULA 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRI-ANGIO HEAD WO CONTRAST	$3,130.20	$5,217.00	$1,304.25–$4,017.09	115% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRI-ANGIO HEAD WO CONTRAST	$3,130.20	$5,217.00	$1,304.25–$4,017.09	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST W CONT BILATERAL	$6,256.20	$10,427.00	$2,606.75–$8,028.79	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST W CONT BILATERAL	$6,256.20	$10,427.00	$2,606.75–$8,028.79	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXT JNT W/O CONT	$3,140.40	$5,234.00	$1,308.50–$4,030.18	79% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXT JNT W/O CONT	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXT JNT W&W/O CONT	$4,153.20	$6,922.00	$1,730.50–$5,329.94	74% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXT JNT W&W/O CONT	$4,153.20	$6,922.00	$1,730.50–$5,329.94	—	40%
MRI of the abdomen without contrast CPT 74181 HC MRI-ABDOMEN WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	70% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-ABDOMEN WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI-ABDOMEN W & WO CONTRAST	$4,152.60	$6,921.00	$1,730.25–$5,329.17	81% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI-ABDOMEN W & WO CONTRAST	$4,152.60	$6,921.00	$1,730.25–$5,329.17	—	40%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN WO CTRST	$3,130.20	$5,217.00	$1,304.25–$4,017.09	94% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN WO CTRST	$3,130.20	$5,217.00	$1,304.25–$4,017.09	—	40%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN WO & W CONTRAST	$4,140.00	$6,900.00	$1,725.00–$5,313.00	89% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN WO & W CONTRAST	$4,140.00	$6,900.00	$1,725.00–$5,313.00	—	40%
MRI of the lower back, no contrast dye CPT 72148 HC MRI-SPINE LUMBAR WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	88% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-SPINE LUMBAR WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI-SPINE LUMBAR WO & W CONT	$4,153.20	$6,922.00	$1,730.50–$5,329.94	78% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI-SPINE LUMBAR WO & W CONT	$4,153.20	$6,922.00	$1,730.50–$5,329.94	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI-SPINE THORACIC WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	87% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI-SPINE THORACIC WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI-SPINE CERVICAL W & WO CONT	$4,153.20	$6,922.00	$1,730.50–$5,329.94	84% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI-SPINE CERVICAL W & WO CONT	$4,153.20	$6,922.00	$1,730.50–$5,329.94	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-SPINE CERVICAL WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	90% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-SPINE CERVICAL WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
MRI of the pelvis without and with contrast CPT 72197 HC MRI-PELVIS WO & W CONTRAST	$4,153.20	$6,922.00	$1,730.50–$5,329.94	112% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI-PELVIS WO & W CONTRAST	$4,153.20	$6,922.00	$1,730.50–$5,329.94	—	40%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI-PELVIS WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	107% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI-PELVIS WO CONTRAST	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI-UPPER EXT JNT WO CONT	$3,140.40	$5,234.00	$1,308.50–$4,030.18	108% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI-UPPER EXT JNT WO CONT	$3,140.40	$5,234.00	$1,308.50–$4,030.18	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC C-SPINE MIN 4 VIEWS	$1,008.00	$1,680.00	$420.00–$1,293.60	124% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC C-SPINE MIN 4 VIEWS	$1,008.00	$1,680.00	$420.00–$1,293.60	—	40%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W/ CONTRAST	$2,204.40	$3,674.00	$918.50–$2,828.98	87% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W/ CONTRAST	$2,204.40	$3,674.00	$918.50–$2,828.98	—	40%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	108% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK W/O CONTRAST	$1,916.40	$3,194.00	$798.50–$2,459.38	—	40%
Neck soft tissue X-ray CPT 70360 HC SOFT TISSUE LAT NECK	$382.20	$637.00	$159.25–$490.49	47% above	40%
Neck soft tissue X-ray inpatient CPT 70360 HC SOFT TISSUE LAT NECK	$382.20	$637.00	$159.25–$490.49	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM SEST. REST STRESS MULT	$5,400.60	$9,001.00	$2,250.25–$6,930.77	35% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM SEST. REST STRESS MULT	$5,400.60	$9,001.00	$2,250.25–$6,930.77	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET/CT SKULL BASE TO MID THIGH	$5,664.00	$9,440.00	$2,360.00–$7,268.80	17% above	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET/CT SKULL BASE TO MID THIGH	$5,664.00	$9,440.00	$2,360.00–$7,268.80	—	40%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	117% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS LIMITED	$1,196.40	$1,994.00	$498.50–$1,535.38	175% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS LIMITED	$1,196.40	$1,994.00	$498.50–$1,535.38	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS COMPLETE	$1,508.40	$2,514.00	$628.50–$1,935.78	199% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS COMPLETE	$1,508.40	$2,514.00	$628.50–$1,935.78	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC FETAL EVAL 2-3 TRIM SGL GEST	$185.40	$309.00	$77.25–$237.93	69% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC FETAL EVAL 2-3 TRIM SGL GEST	$185.40	$309.00	$77.25–$237.93	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC FETAL EVAL 1ST TRI SGL GEST	$185.40	$309.00	$77.25–$237.93	66% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC FETAL EVAL 1ST TRI SGL GEST	$185.40	$309.00	$77.25–$237.93	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US FETAL EVALUATION-LIMITED	$498.60	$831.00	$207.75–$639.87	5% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US FETAL EVALUATION-LIMITED	$498.60	$831.00	$207.75–$639.87	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS UNILATERAL 2 VIEWS	$582.00	$970.00	$242.50–$746.90	91% above	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RIBS UNILATERAL 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC X-RAY RIBS PA CHEST 3	$610.80	$1,018.00	$254.50–$783.86	60% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC X-RAY RIBS PA CHEST 3	$610.80	$1,018.00	$254.50–$783.86	—	40%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREENING INCL CAD IF PERF	$664.80	$1,108.00	$277.00–$853.16	246% above	40%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREENING INCL CAD IF PERF	$664.80	$1,108.00	$277.00–$853.16	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER COMPLETE MIN 2 VIEWS	$610.80	$1,018.00	$254.50–$783.86	81% above	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER COMPLETE MIN 2 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUSES MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	69% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC SINUSES MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
Skull X-ray, fewer than 4 views CPT 70250 HC SKULL LESS THAN 4 VIEWS	$582.00	$970.00	$242.50–$746.90	101% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC SKULL LESS THAN 4 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC DYSPHAGIA/SWALLOWING STUDY	$785.40	$1,309.00	$327.25–$1,007.93	55% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC DYSPHAGIA/SWALLOWING STUDY	$785.40	$1,309.00	$327.25–$1,007.93	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	115% above	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM OF FEMUR MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT T-SPINE W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	141% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT T-SPINE W/O CONTRAST	$2,184.60	$3,641.00	$910.25–$2,803.57	—	40%
Toe X-ray, 2 or more views CPT 73660 HC X-RAY TOES MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	133% above	40%
Toe X-ray, 2 or more views inpatient CPT 73660 HC X-RAY TOES MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB	$1,217.40	$2,029.00	$507.25–$1,562.33	116% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB	$1,217.40	$2,029.00	$507.25–$1,562.33	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 HC US TRANSVAGINAL OBSETRICAL	$498.60	$831.00	$207.75–$639.87	1% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US TRANSVAGINAL OBSETRICAL	$498.60	$831.00	$207.75–$639.87	—	40%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE	$1,293.60	$2,156.00	$539.00–$1,660.12	106% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE	$1,293.60	$2,156.00	$539.00–$1,660.12	—	40%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM & CONTENTS	$796.20	$1,327.00	$331.75–$1,021.79	48% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM & CONTENTS	$796.20	$1,327.00	$331.75–$1,021.79	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC SOFT TISSUE NECK US	$1,251.00	$2,085.00	$521.25–$1,605.45	118% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC SOFT TISSUE NECK US	$1,251.00	$2,085.00	$521.25–$1,605.45	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC RAD EXAM UPR GI TRACT SINGLE CONTRAST STUDY	$998.40	$1,664.00	$416.00–$1,281.28	68% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC RAD EXAM UPR GI TRACT SINGLE CONTRAST STUDY	$998.40	$1,664.00	$416.00–$1,281.28	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS MIN 2 VIEW	$582.00	$970.00	$242.50–$746.90	112% above	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS MIN 2 VIEW	$582.00	$970.00	$242.50–$746.90	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC NIV VENOUS DUPLEX UNI/LTD STUDY	$2,166.60	$3,611.00	$902.75–$2,780.47	194% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC NIV VENOUS DUPLEX UNI/LTD STUDY	$2,166.60	$3,611.00	$902.75–$2,780.47	—	40%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$582.00	$970.00	$242.50–$746.90	123% above	40%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	82% above	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	99% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW	$177.00	$295.00	$73.75–$227.15	31% below	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW	$177.00	$295.00	$73.75–$227.15	—	40%
X-ray of the ankle, 2 views CPT 73600 HC X-RAY ANKLE 2 VIEWS	$582.00	$970.00	$242.50–$746.90	134% above	40%
X-ray of the ankle, 2 views inpatient CPT 73600 HC X-RAY ANKLE 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 HC FINGERS MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	126% above	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGERS MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the foot, 2 views CPT 73620 HC X-RAY FOOT 2 VIEWS	$582.00	$970.00	$242.50–$746.90	151% above	40%
X-ray of the foot, 2 views inpatient CPT 73620 HC X-RAY FOOT 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 HC X-RAY FOOT MIN 3 VIEWS COMPLETE	$610.80	$1,018.00	$254.50–$783.86	100% above	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC X-RAY FOOT MIN 3 VIEWS COMPLETE	$610.80	$1,018.00	$254.50–$783.86	—	40%
X-ray of the hand, 3 or more views CPT 73130 HC HAND ROUTINE MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	87% above	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND ROUTINE MIN 3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 HC X-RAY KNEE 1-2 VIEWS	$582.00	$970.00	$242.50–$746.90	113% above	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC X-RAY KNEE 1-2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC L-SPINE 2-3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	89% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC L-SPINE 2-3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
X-ray of the lower back, 4 or more views CPT 72110 HC L-SPINE MIN 4 VIEWS	$1,008.00	$1,680.00	$420.00–$1,293.60	115% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC L-SPINE MIN 4 VIEWS	$1,008.00	$1,680.00	$420.00–$1,293.60	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC T-SPINE 2 VIEWS	$582.00	$970.00	$242.50–$746.90	93% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC T-SPINE 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES MIN 3 VIEWS	$582.00	$970.00	$242.50–$746.90	99% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES MIN 3 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC C-SPINE 2-3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	83% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC C-SPINE 2-3 VIEWS	$610.80	$1,018.00	$254.50–$783.86	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS AP ONLY	$582.00	$970.00	$242.50–$746.90	131% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS AP ONLY	$582.00	$970.00	$242.50–$746.90	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM AND COCCYX MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	96% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM AND COCCYX MIN 2 VIEWS	$582.00	$970.00	$242.50–$746.90	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 HC ACTH	$407.40	$679.00	$169.75–$522.83	209% above	40%
ACTH blood test inpatient CPT 82024 HC ACTH	$407.40	$679.00	$169.75–$522.83	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT)	$17.40	$29.00	$7.25–$22.33	38% below	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SO SGPT (ALT)	$76.80	$128.00	$32.00–$98.56	175% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT)	$17.40	$29.00	$7.25–$22.33	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SO SGPT (ALT)	$76.80	$128.00	$32.00–$98.56	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$16.80	$28.00	$7.00–$21.56	33% below	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SO SGOT (AST)	$75.60	$126.00	$31.50–$97.02	200% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$16.80	$28.00	$7.00–$21.56	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SO SGOT (AST)	$75.60	$126.00	$31.50–$97.02	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL	$375.60	$626.00	$156.50–$482.02	72% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL	$375.60	$626.00	$156.50–$482.02	—	40%
Albumin blood test CPT 82040 HC ALBUMIN	$93.60	$156.00	$39.00–$120.12	324% above	40%
Albumin blood test inpatient CPT 82040 HC ALBUMIN	$93.60	$156.00	$39.00–$120.12	—	40%
Aldosterone blood test CPT 82088 HC SO ALDOSTERONE SERUM	$337.20	$562.00	$140.50–$432.74	141% above	40%
Aldosterone blood test inpatient CPT 82088 HC SO ALDOSTERONE SERUM	$337.20	$562.00	$140.50–$432.74	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE	$57.00	$95.00	$23.75–$73.15	138% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 HC SO ALKALINE PHOSPHATASE	$58.20	$97.00	$24.25–$74.69	142% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE	$57.00	$95.00	$23.75–$73.15	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC SO ALKALINE PHOSPHATASE	$58.20	$97.00	$24.25–$74.69	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$12.00	$20.00	$5.00–$15.40	49% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO1 ALLERGEN SPECIFIC	$18.00	$30.00	$7.50–$23.10	23% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO ALLERGEN SPECIFIC	$19.20	$32.00	$8.00–$24.64	18% below	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$12.00	$20.00	$5.00–$15.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO1 ALLERGEN SPECIFIC	$18.00	$30.00	$7.50–$23.10	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO ALLERGEN SPECIFIC	$19.20	$32.00	$8.00–$24.64	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC SO ALPHA FETOPROTEIN	$78.60	$131.00	$32.75–$100.87	30% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$91.20	$152.00	$38.00–$117.04	50% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC SO ALPHA FETOPROTEIN	$78.60	$131.00	$32.75–$100.87	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$91.20	$152.00	$38.00–$117.04	—	40%
Ammonia blood test CPT 82140 HC SO AMMONIA	$12.00	$20.00	$5.00–$15.40	78% below	40%
Ammonia blood test CPT 82140 HC AMMONIA	$184.80	$308.00	$77.00–$237.16	238% above	40%
Ammonia blood test inpatient CPT 82140 HC SO AMMONIA	$12.00	$20.00	$5.00–$15.40	—	40%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$184.80	$308.00	$77.00–$237.16	—	40%
Amylase blood test CPT 82150 HC SO AMYLASE	$103.80	$173.00	$43.25–$133.21	117% above	40%
Amylase blood test CPT 82150 HC AMYLASE	$121.20	$202.00	$50.50–$155.54	153% above	40%
Amylase blood test inpatient CPT 82150 HC SO AMYLASE	$103.80	$173.00	$43.25–$133.21	—	40%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$121.20	$202.00	$50.50–$155.54	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$128.40	$214.00	$53.50–$164.78	122% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$128.40	$214.00	$53.50–$164.78	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC SO ANTI NUCLEAR ANTIBODY	$30.00	$50.00	$12.50–$38.50	46% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA	$104.40	$174.00	$43.50–$133.98	89% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC SO ANTI NUCLEAR ANTIBODY	$30.00	$50.00	$12.50–$38.50	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA	$104.40	$174.00	$43.50–$133.98	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$382.20	$637.00	$159.25–$490.49	156% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$382.20	$637.00	$159.25–$490.49	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE AEROBIC	$108.60	$181.00	$45.25–$139.37	65% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE AEROBIC	$108.60	$181.00	$45.25–$139.37	—	40%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL	$225.00	$375.00	$93.75–$288.75	243% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL	$225.00	$375.00	$93.75–$288.75	—	40%
Bilirubin blood test, total CPT 82247 HC SO BILIRUBIN TOTAL	$64.20	$107.00	$26.75–$82.39	168% above	40%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$74.40	$124.00	$31.00–$95.48	210% above	40%
Bilirubin blood test, total inpatient CPT 82247 HC SO BILIRUBIN TOTAL	$64.20	$107.00	$26.75–$82.39	—	40%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$74.40	$124.00	$31.00–$95.48	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SO1 TISSUE LEVEL IV	$103.80	$173.00	$43.25–$133.21	49% below	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SO TISSUE LEVEL IV	$293.40	$489.00	$122.25–$376.53	44% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC TISSUE LEVEL IV	$336.60	$561.00	$140.25–$431.97	65% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SO1 TISSUE LEVEL IV	$103.80	$173.00	$43.25–$133.21	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SO TISSUE LEVEL IV	$293.40	$489.00	$122.25–$376.53	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC TISSUE LEVEL IV	$336.60	$561.00	$140.25–$431.97	—	40%
Blood culture for bacteria CPT 87040 HC CULTURE BLOOD	$126.60	$211.00	$52.75–$162.47	35% above	40%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE BLOOD	$126.60	$211.00	$52.75–$162.47	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION VENOUS BLOOD VENIPUNCTURE	$21.60	$36.00	$9.00–$27.72	36% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION VENOUS BLOOD VENIPUNCTURE	$21.60	$36.00	$9.00–$27.72	—	40%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANT FOR CMPK/BMPK	$42.60	$71.00	$17.75–$54.67	81% above	40%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE FASTING	$78.60	$131.00	$32.75–$100.87	233% above	40%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANT FOR CMPK/BMPK	$42.60	$71.00	$17.75–$54.67	—	40%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE FASTING	$78.60	$131.00	$32.75–$100.87	—	40%
Blood lead test CPT 83655 HC SO LEAD	$125.40	$209.00	$52.25–$160.93	158% above	40%
Blood lead test CPT 83655 HC ASSAY OF LEAD	$145.20	$242.00	$60.50–$186.34	199% above	40%
Blood lead test inpatient CPT 83655 HC SO LEAD	$125.40	$209.00	$52.25–$160.93	—	40%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD	$145.20	$242.00	$60.50–$186.34	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC (HCG) QUALITATIVE	$97.20	$162.00	$40.50–$124.74	78% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC (HCG) QUALITATIVE	$97.20	$162.00	$40.50–$124.74	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING ABO	$141.60	$236.00	$59.00–$181.72	138% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING ABO	$141.60	$236.00	$59.00–$181.72	—	40%
Blood urea nitrogen (BUN) test CPT 84520 HC SO BUN	$69.60	$116.00	$29.00–$89.32	198% above	40%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE	$81.00	$135.00	$33.75–$103.95	246% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC SO BUN	$69.60	$116.00	$29.00–$89.32	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE	$81.00	$135.00	$33.75–$103.95	—	40%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE	$220.80	$368.00	$92.00–$283.36	179% above	40%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE	$220.80	$368.00	$92.00–$283.36	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC SO CRP	$48.60	$81.00	$20.25–$62.37	3% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$63.00	$105.00	$26.25–$80.85	25% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC SO CRP	$48.60	$81.00	$20.25–$62.37	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$63.00	$105.00	$26.25–$80.85	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$214.80	$358.00	$89.50–$275.66	65% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$214.80	$358.00	$89.50–$275.66	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$121.20	$202.00	$50.50–$155.54	66% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$121.20	$202.00	$50.50–$155.54	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125	$121.20	$202.00	$50.50–$155.54	29% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125	$121.20	$202.00	$50.50–$155.54	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SO IADNA SARS-COV-2-19 AMP PROBE TQ	$96.00	$160.00	$40.00–$123.20	32% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2-19 AMP PROBE TQ	$105.60	$176.00	$44.00–$135.52	25% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SO IADNA SARS-COV-2-19 AMP PROBE TQ	$96.00	$160.00	$40.00–$123.20	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2-19 AMP PROBE TQ	$105.60	$176.00	$44.00–$135.52	—	40%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL	$96.00	$160.00	$40.00–$123.20	204% above	40%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL	$96.00	$160.00	$40.00–$123.20	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 HC SO CEA	$46.80	$78.00	$19.50–$60.06	46% below	40%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA	$117.00	$195.00	$48.75–$150.15	35% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC SO CEA	$46.80	$78.00	$19.50–$60.06	—	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA	$117.00	$195.00	$48.75–$150.15	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 HC SO VARICELLA IGG IGM	$109.80	$183.00	$45.75–$140.91	90% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER	$140.40	$234.00	$58.50–$180.18	143% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC SO VARICELLA IGG IGM	$109.80	$183.00	$45.75–$140.91	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER	$140.40	$234.00	$58.50–$180.18	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC SO CHYLMD TRACH DNA AMP PROBE	$83.40	$139.00	$34.75–$107.03	10% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA AMP PROBE TECH 1	$113.40	$189.00	$47.25–$145.53	23% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC SO CHYLMD TRACH DNA AMP PROBE	$83.40	$139.00	$34.75–$107.03	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA AMP PROBE TECH 1	$113.40	$189.00	$47.25–$145.53	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC SO LIPID PANEL	$157.20	$262.00	$65.50–$201.74	197% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$171.00	$285.00	$71.25–$219.45	223% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC SO LIPID PANEL	$157.20	$262.00	$65.50–$201.74	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$171.00	$285.00	$71.25–$219.45	—	40%
Complete blood count (CBC) with differential CPT 85025 HC CBC	$136.80	$228.00	$57.00–$175.56	276% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC	$136.80	$228.00	$57.00–$175.56	—	40%
Complete blood count (CBC), no differential CPT 85027 HC CBC (HEMOGRAM)	$121.80	$203.00	$50.75–$156.31	259% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC (HEMOGRAM)	$121.80	$203.00	$50.75–$156.31	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$268.80	$448.00	$112.00–$344.96	323% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$268.80	$448.00	$112.00–$344.96	—	40%
Cortisol blood test, total CPT 82533 HC SO CORTISOLSERUM	$75.00	$125.00	$31.25–$96.25	3% above	40%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$87.00	$145.00	$36.25–$111.65	20% above	40%
Cortisol blood test, total inpatient CPT 82533 HC SO CORTISOLSERUM	$75.00	$125.00	$31.25–$96.25	—	40%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL	$87.00	$145.00	$36.25–$111.65	—	40%
Creatine kinase (CK) blood test, total CPT 82550 HC SO CPK (CK)	$103.80	$173.00	$43.25–$133.21	193% above	40%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL	$121.20	$202.00	$50.50–$155.54	242% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC SO CPK (CK)	$103.80	$173.00	$43.25–$133.21	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL	$121.20	$202.00	$50.50–$155.54	—	40%
Creatinine blood test CPT 82565 HC CREATININESERUM	$96.60	$161.00	$40.25–$123.97	291% above	40%
Creatinine blood test inpatient CPT 82565 HC CREATININESERUM	$96.60	$161.00	$40.25–$123.97	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 HC SO CYTOMEGALOVIRUS IGG ANTIBODY	$91.80	$153.00	$38.25–$117.81	34% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV	$107.40	$179.00	$44.75–$137.83	56% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC SO CYTOMEGALOVIRUS IGG ANTIBODY	$91.80	$153.00	$38.25–$117.81	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV	$107.40	$179.00	$44.75–$137.83	—	40%
D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE	$142.20	$237.00	$59.25–$182.49	104% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE	$142.20	$237.00	$59.25–$182.49	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE	$213.60	$356.00	$89.00–$274.12	115% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE	$213.60	$356.00	$89.00–$274.12	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC SO DRG SCRN CLASS LIST A	$126.00	$210.00	$52.50–$161.70	32% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR	$130.80	$218.00	$54.50–$167.86	37% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$249.60	$416.00	$104.00–$320.32	161% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC SO DRG SCRN CLASS LIST A	$126.00	$210.00	$52.50–$161.70	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR	$130.80	$218.00	$54.50–$167.86	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$249.60	$416.00	$104.00–$320.32	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$132.60	$221.00	$55.25–$170.17	178% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$132.60	$221.00	$55.25–$170.17	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC SO EPSTEIN-BARR VIRUS VCA	$91.80	$153.00	$38.25–$117.81	41% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA	$107.40	$179.00	$44.75–$137.83	65% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC SO EPSTEIN-BARR VIRUS VCA	$91.80	$153.00	$38.25–$117.81	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA	$107.40	$179.00	$44.75–$137.83	—	40%
Estradiol blood test CPT 82670 HC ASSAY OF TOTAL ESTRADIOL	$158.40	$264.00	$66.00–$203.28	41% above	40%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF TOTAL ESTRADIOL	$158.40	$264.00	$66.00–$203.28	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE	$186.60	$311.00	$77.75–$239.47	117% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE	$186.60	$311.00	$77.75–$239.47	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 HC SO CALPROTECTIN FECAL	$177.60	$296.00	$74.00–$227.92	19% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC SO CALPROTECTIN FECAL	$177.60	$296.00	$74.00–$227.92	—	40%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN	$121.80	$203.00	$50.75–$156.31	60% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN	$121.80	$203.00	$50.75–$156.31	—	40%
Fibrinogen blood test CPT 85384 HC SO FIBRINOGEN	$102.60	$171.00	$42.75–$131.67	128% above	40%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY	$118.80	$198.00	$49.50–$152.46	164% above	40%
Fibrinogen blood test inpatient CPT 85384 HC SO FIBRINOGEN	$102.60	$171.00	$42.75–$131.67	—	40%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN ACTIVITY	$118.80	$198.00	$49.50–$152.46	—	40%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM	$189.00	$315.00	$78.75–$242.55	180% above	40%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM	$189.00	$315.00	$78.75–$242.55	—	40%
Free T3 thyroid hormone test CPT 84481 HC SO TRIIODOTHYRONINE T-3 FREE	$100.80	$168.00	$42.00–$129.36	33% above	40%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE	$136.80	$228.00	$57.00–$175.56	80% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 HC SO TRIIODOTHYRONINE T-3 FREE	$100.80	$168.00	$42.00–$129.36	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE	$136.80	$228.00	$57.00–$175.56	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE	$127.20	$212.00	$53.00–$163.24	199% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE	$127.20	$212.00	$53.00–$163.24	—	40%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$142.80	$238.00	$59.50–$183.26	47% above	40%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$142.80	$238.00	$59.50–$183.26	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC SO GGTP	$93.60	$156.00	$39.00–$120.12	120% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA	$109.20	$182.00	$45.50–$140.14	156% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC SO GGTP	$93.60	$156.00	$39.00–$120.12	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA	$109.20	$182.00	$45.50–$140.14	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL	$253.80	$423.00	$105.75–$325.71	15% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL	$253.80	$423.00	$105.75–$325.71	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$73.20	$122.00	$30.50–$93.94	91% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$73.20	$122.00	$30.50–$93.94	—	40%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST	$136.20	$227.00	$56.75–$174.79	103% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST	$136.20	$227.00	$56.75–$174.79	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC SO N GONORRHOEAE DNA AMP PROB	$107.40	$179.00	$44.75–$137.83	16% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHEA DNA AMP PROBE	$134.40	$224.00	$56.00–$172.48	45% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC SO N GONORRHOEAE DNA AMP PROB	$107.40	$179.00	$44.75–$137.83	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHEA DNA AMP PROBE	$134.40	$224.00	$56.00–$172.48	—	40%
H. pylori antibody blood test CPT 86677 HC SO H.PYLORI. SERUM	$91.20	$152.00	$38.00–$117.04	21% above	40%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI	$105.60	$176.00	$44.00–$135.52	40% above	40%
H. pylori antibody blood test inpatient CPT 86677 HC SO H.PYLORI. SERUM	$91.20	$152.00	$38.00–$117.04	—	40%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI	$105.60	$176.00	$44.00–$135.52	—	40%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL	$68.40	$114.00	$28.50–$87.78	2% below	40%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL	$68.40	$114.00	$28.50–$87.78	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC SO HIV-1 QUANTIFICATION	$325.20	$542.00	$135.50–$417.34	9% below	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION	$339.00	$565.00	$141.25–$435.05	5% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC SO HIV-1 QUANTIFICATION	$325.20	$542.00	$135.50–$417.34	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION	$339.00	$565.00	$141.25–$435.05	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 HC ANTIBODY HIV-1&HIV-2 SINGLE RESULT	$114.00	$190.00	$47.50–$146.30	85% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC ANTIBODY HIV-1&HIV-2 SINGLE RESULT	$114.00	$190.00	$47.50–$146.30	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE	$102.60	$171.00	$42.75–$131.67	38% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE	$102.60	$171.00	$42.75–$131.67	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC SO HPV DNA AMP PROBE	$108.00	$180.00	$45.00–$138.60	9% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT	$147.60	$246.00	$61.50–$189.42	24% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC SO HPV DNA AMP PROBE	$108.00	$180.00	$45.00–$138.60	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT	$147.60	$246.00	$61.50–$189.42	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC SO GLYCOHEMOGLOBIN	$64.80	$108.00	$27.00–$83.16	42% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C	$75.00	$125.00	$31.25–$96.25	64% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC SO GLYCOHEMOGLOBIN	$64.80	$108.00	$27.00–$83.16	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C	$75.00	$125.00	$31.25–$96.25	—	40%
Hemoglobin blood test CPT 85018 HC SO HEMOGLOBIN	$14.40	$24.00	$6.00–$18.48	11% below	40%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$45.00	$75.00	$18.75–$57.75	178% above	40%
Hemoglobin blood test inpatient CPT 85018 HC SO HEMOGLOBIN	$14.40	$24.00	$6.00–$18.48	—	40%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$45.00	$75.00	$18.75–$57.75	—	40%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL	$125.40	$209.00	$52.25–$160.93	132% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL	$125.40	$209.00	$52.25–$160.93	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB	$141.00	$235.00	$58.75–$180.95	192% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB	$141.00	$235.00	$58.75–$180.95	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN	$151.80	$253.00	$63.25–$194.81	221% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN	$151.80	$253.00	$63.25–$194.81	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$123.00	$205.00	$51.25–$157.85	92% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$123.00	$205.00	$51.25–$157.85	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC SO HCV ULTRAQUANT	$70.20	$117.00	$29.25–$90.09	64% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$156.60	$261.00	$65.25–$200.97	19% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC SO1 HCV ULTRAQUANT	$171.60	$286.00	$71.50–$220.22	11% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC SO HCV ULTRAQUANT	$70.20	$117.00	$29.25–$90.09	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$156.60	$261.00	$65.25–$200.97	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC SO1 HCV ULTRAQUANT	$171.60	$286.00	$71.50–$220.22	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1	$139.80	$233.00	$58.25–$179.41	136% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1	$139.80	$233.00	$58.25–$179.41	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2	$139.80	$233.00	$58.25–$179.41	111% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2	$139.80	$233.00	$58.25–$179.41	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$127.80	$213.00	$53.25–$164.01	89% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$127.80	$213.00	$53.25–$164.01	—	40%
Homocysteine blood test CPT 83090 HC SO HOMOCYSTINE	$151.80	$253.00	$63.25–$194.81	88% above	40%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE	$176.40	$294.00	$73.50–$226.38	119% above	40%
Homocysteine blood test inpatient CPT 83090 HC SO HOMOCYSTINE	$151.80	$253.00	$63.25–$194.81	—	40%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE	$176.40	$294.00	$73.50–$226.38	—	40%
Insulin blood test CPT 83525 HC SO INSULIN	$121.20	$202.00	$50.50–$155.54	136% above	40%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL	$141.00	$235.00	$58.75–$180.95	175% above	40%
Insulin blood test inpatient CPT 83525 HC SO INSULIN	$121.20	$202.00	$50.50–$155.54	—	40%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL	$141.00	$235.00	$58.75–$180.95	—	40%
Iron blood test (serum iron) CPT 83540 HC SO IRON	$186.60	$311.00	$77.75–$239.47	391% above	40%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON	$216.60	$361.00	$90.25–$277.97	470% above	40%
Iron blood test (serum iron) inpatient CPT 83540 HC SO IRON	$186.60	$311.00	$77.75–$239.47	—	40%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON	$216.60	$361.00	$90.25–$277.97	—	40%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$101.40	$169.00	$42.25–$130.13	160% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$101.40	$169.00	$42.25–$130.13	—	40%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$102.60	$171.00	$42.75–$131.67	43% above	40%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$102.60	$171.00	$42.75–$131.67	—	40%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE	$186.60	$311.00	$77.75–$239.47	95% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE	$186.60	$311.00	$77.75–$239.47	—	40%
Lactate (lactic acid) blood test CPT 83605 HC SO LACTIC ACID	$136.20	$227.00	$56.75–$174.79	162% above	40%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE	$157.80	$263.00	$65.75–$202.51	203% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 HC SO LACTIC ACID	$136.20	$227.00	$56.75–$174.79	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE	$157.80	$263.00	$65.75–$202.51	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC SO LDH	$97.80	$163.00	$40.75–$125.51	258% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH	$113.40	$189.00	$47.25–$145.53	315% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC SO LDH	$97.80	$163.00	$40.75–$125.51	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH	$113.40	$189.00	$47.25–$145.53	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 HC SO LIPASE	$111.00	$185.00	$46.25–$142.45	91% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE	$128.40	$214.00	$53.50–$164.78	121% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC SO LIPASE	$111.00	$185.00	$46.25–$142.45	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE	$128.40	$214.00	$53.50–$164.78	—	40%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$114.00	$190.00	$47.50–$146.30	88% above	40%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$114.00	$190.00	$47.50–$146.30	—	40%
Lyme disease antibody test CPT 86618 HC SO LYME DISEASE TOTAL ANITBODIES	$91.80	$153.00	$38.25–$117.81	20% above	40%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$107.40	$179.00	$44.75–$137.83	40% above	40%
Lyme disease antibody test inpatient CPT 86618 HC SO LYME DISEASE TOTAL ANITBODIES	$91.80	$153.00	$38.25–$117.81	—	40%
Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$107.40	$179.00	$44.75–$137.83	—	40%
Magnesium blood test CPT 83735 HC SO MAGNESIUM	$45.00	$75.00	$18.75–$57.75	33% above	40%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM	$107.40	$179.00	$44.75–$137.83	218% above	40%
Magnesium blood test inpatient CPT 83735 HC SO MAGNESIUM	$45.00	$75.00	$18.75–$57.75	—	40%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM	$107.40	$179.00	$44.75–$137.83	—	40%
Measles (rubeola) antibody test CPT 86765 HC SO RUBEOLA IGG / IGM	$91.20	$152.00	$38.00–$117.04	60% above	40%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA	$116.40	$194.00	$48.50–$149.38	104% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 HC SO RUBEOLA IGG / IGM	$91.20	$152.00	$38.00–$117.04	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA	$116.40	$194.00	$48.50–$149.38	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONO SPOT TESTAGGLUTINATION	$63.00	$105.00	$26.25–$80.85	18% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONO SPOT TESTAGGLUTINATION	$63.00	$105.00	$26.25–$80.85	—	40%
Mumps immunity blood test CPT 86735 HC SO ANTIBODY; MUMPS	$115.80	$193.00	$48.25–$148.61	98% above	40%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS	$148.80	$248.00	$62.00–$190.96	154% above	40%
Mumps immunity blood test inpatient CPT 86735 HC SO ANTIBODY; MUMPS	$115.80	$193.00	$48.25–$148.61	—	40%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS	$148.80	$248.00	$62.00–$190.96	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$178.20	$297.00	$74.25–$228.69	116% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$178.20	$297.00	$74.25–$228.69	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC SO ASSAY OF PSA TOTAL	$64.20	$107.00	$26.75–$82.39	19% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$82.80	$138.00	$34.50–$106.26	5% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC SO ASSAY OF PSA TOTAL	$64.20	$107.00	$26.75–$82.39	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$82.80	$138.00	$34.50–$106.26	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$92.40	$154.00	$38.50–$118.58	5% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$92.40	$154.00	$38.50–$118.58	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN	$92.40	$154.00	$38.50–$118.58	2% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN	$92.40	$154.00	$38.50–$118.58	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE	$163.20	$272.00	$68.00–$209.44	15% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE	$163.20	$272.00	$68.00–$209.44	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT	$104.40	$174.00	$43.50–$133.98	178% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT	$104.40	$174.00	$43.50–$133.98	—	40%
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY OF PHOSPHORUS INORGANIC	$88.80	$148.00	$37.00–$113.96	148% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY OF PHOSPHORUS INORGANIC	$88.80	$148.00	$37.00–$113.96	—	40%
Potassium blood test CPT 84132 HC SO POTASSIUM	$73.80	$123.00	$30.75–$94.71	216% above	40%
Potassium blood test CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD	$86.40	$144.00	$36.00–$110.88	270% above	40%
Potassium blood test inpatient CPT 84132 HC SO POTASSIUM	$73.80	$123.00	$30.75–$94.71	—	40%
Potassium blood test inpatient CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD	$86.40	$144.00	$36.00–$110.88	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC SO FETAL CHRMOML ANEUPLOIDY	$559.20	$932.00	$233.00–$717.64	62% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC SO FETAL CHRMOML ANEUPLOIDY	$559.20	$932.00	$233.00–$717.64	—	40%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE	$171.00	$285.00	$71.25–$219.45	111% above	40%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE	$171.00	$285.00	$71.25–$219.45	—	40%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN	$198.60	$331.00	$82.75–$254.87	128% above	40%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN	$198.60	$331.00	$82.75–$254.87	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$70.80	$118.00	$29.50–$90.86	194% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$70.80	$118.00	$29.50–$90.86	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE	$46.80	$78.00	$19.50–$60.06	19% below	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE	$46.80	$78.00	$19.50–$60.06	—	40%
Rapid flu test (influenza antigen) CPT 87804 HC IAADIADOO INFLUENZA	$144.00	$240.00	$60.00–$184.80	119% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC IAADIADOO INFLUENZA	$144.00	$240.00	$60.00–$184.80	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A	$134.40	$224.00	$56.00–$172.48	135% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A	$134.40	$224.00	$56.00–$172.48	—	40%
Renin blood test CPT 84244 HC SO RENIN	$137.40	$229.00	$57.25–$176.33	61% above	40%
Renin blood test inpatient CPT 84244 HC SO RENIN	$137.40	$229.00	$57.25–$176.33	—	40%
Rh blood typing CPT 86901 HC BLOOD TYPING RH(D)	$97.20	$162.00	$40.50–$124.74	161% above	40%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING RH(D)	$97.20	$162.00	$40.50–$124.74	—	40%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE	$99.00	$165.00	$41.25–$127.05	199% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE	$99.00	$165.00	$41.25–$127.05	—	40%
Rubella antibody test (immunity check) CPT 86762 HC SO RUBELLA LATEX TEST	$67.20	$112.00	$28.00–$86.24	37% above	40%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA	$86.40	$144.00	$36.00–$110.88	76% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 HC SO RUBELLA LATEX TEST	$67.20	$112.00	$28.00–$86.24	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA	$86.40	$144.00	$36.00–$110.88	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SED RATE	$40.80	$68.00	$17.00–$52.36	8% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SED RATE	$40.80	$68.00	$17.00–$52.36	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS COMPLETE	$273.00	$455.00	$113.75–$350.35	105% above	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS COMPLETE	$273.00	$455.00	$113.75–$350.35	—	40%
Sodium blood test CPT 84295 HC SODIUM SERUM PLASMA OR WHOLE BLOOD	$86.40	$144.00	$36.00–$110.88	218% above	40%
Sodium blood test inpatient CPT 84295 HC SODIUM SERUM PLASMA OR WHOLE BLOOD	$86.40	$144.00	$36.00–$110.88	—	40%
Stool ova and parasites exam CPT 87177 HC SO OVA AND PARASITES	$18.00	$30.00	$7.50–$23.10	55% below	40%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES	$112.20	$187.00	$46.75–$143.99	183% above	40%
Stool ova and parasites exam inpatient CPT 87177 HC SO OVA AND PARASITES	$18.00	$30.00	$7.50–$23.10	—	40%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES	$112.20	$187.00	$46.75–$143.99	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER	$60.00	$100.00	$25.00–$77.00	108% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER	$60.00	$100.00	$25.00–$77.00	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$51.60	$86.00	$21.50–$66.22	4% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$51.60	$86.00	$21.50–$66.22	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SO FTA-ABS	$124.20	$207.00	$51.75–$159.39	115% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$143.40	$239.00	$59.75–$184.03	148% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SO FTA-ABS	$124.20	$207.00	$51.75–$159.39	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$143.40	$239.00	$59.75–$184.03	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SO VDRL / RPR	$33.60	$56.00	$14.00–$43.12	41% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$74.40	$124.00	$31.00–$95.48	212% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SO VDRL / RPR	$33.60	$56.00	$14.00–$43.12	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$74.40	$124.00	$31.00–$95.48	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC SO TB TEST CELL IMMUN MEASURE	$225.60	$376.00	$94.00–$289.52	93% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC SO TB TEST CELL IMMUN MEASURE	$225.60	$376.00	$94.00–$289.52	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$104.40	$174.00	$43.50–$133.98	13% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$104.40	$174.00	$43.50–$133.98	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC SO MICROSOMAL ANTIBODY	$120.60	$201.00	$50.25–$154.77	86% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH	$140.40	$234.00	$58.50–$180.18	116% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC SO MICROSOMAL ANTIBODY	$120.60	$201.00	$50.25–$154.77	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH	$140.40	$234.00	$58.50–$180.18	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE	$203.40	$339.00	$84.75–$261.03	170% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE	$203.40	$339.00	$84.75–$261.03	—	40%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$159.00	$265.00	$66.25–$204.05	156% above	40%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$159.00	$265.00	$66.25–$204.05	—	40%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL	$81.00	$135.00	$33.75–$103.95	121% above	40%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL	$81.00	$135.00	$33.75–$103.95	—	40%
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF THYROXINE TOTAL	$121.80	$203.00	$50.75–$156.31	191% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF THYROXINE TOTAL	$121.80	$203.00	$50.75–$156.31	—	40%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$165.60	$276.00	$69.00–$212.52	175% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$165.60	$276.00	$69.00–$212.52	—	40%
Transferrin blood test CPT 84466 HC ASSAY OF L7383TRANSFERRIN	$133.80	$223.00	$55.75–$171.71	80% above	40%
Transferrin blood test inpatient CPT 84466 HC ASSAY OF L7383TRANSFERRIN	$133.80	$223.00	$55.75–$171.71	—	40%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$60.60	$101.00	$25.25–$77.77	30% below	40%
Trichomonas test (NAAT) CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF	$87.00	$145.00	$36.25–$111.65	1% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$60.60	$101.00	$25.25–$77.77	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF	$87.00	$145.00	$36.25–$111.65	—	40%
Triglycerides blood test CPT 84478 HC SO TRIGLYCERIDES	$59.40	$99.00	$24.75–$76.23	72% above	40%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES	$109.20	$182.00	$45.50–$140.14	217% above	40%
Triglycerides blood test inpatient CPT 84478 HC SO TRIGLYCERIDES	$59.40	$99.00	$24.75–$76.23	—	40%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES	$109.20	$182.00	$45.50–$140.14	—	40%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE	$162.60	$271.00	$67.75–$208.67	94% above	40%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE	$162.60	$271.00	$67.75–$208.67	—	40%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID	$84.60	$141.00	$35.25–$108.57	140% above	40%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID	$84.60	$141.00	$35.25–$108.57	—	40%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS W/ MICROSCOPY	$52.80	$88.00	$22.00–$67.76	96% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS W/ MICROSCOPY	$52.80	$88.00	$22.00–$67.76	—	40%
Urinalysis with microscope exam, manual CPT 81000 HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY	$10.20	$17.00	$4.25–$13.09	44% below	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY	$10.20	$17.00	$4.25–$13.09	—	40%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$30.00	$50.00	$12.50–$38.50	28% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$30.00	$50.00	$12.50–$38.50	—	40%
Urinalysis without microscope exam, manual CPT 81002 HC NON-AUTOURINE W/O MICROSCOPY	$24.00	$40.00	$10.00–$30.80	48% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON-AUTOURINE W/O MICROSCOPY	$24.00	$40.00	$10.00–$30.80	—	40%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULT./COLONY COUNT	$89.40	$149.00	$37.25–$114.73	57% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULT./COLONY COUNT	$89.40	$149.00	$37.25–$114.73	—	40%
Urine microalbumin (albumin) test CPT 82043 HC URINEMICROALBUMINQUANTITATIV	$109.20	$182.00	$45.50–$140.14	115% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 HC URINEMICROALBUMINQUANTITATIV	$109.20	$182.00	$45.50–$140.14	—	40%
Urine pregnancy test, read by color change CPT 81025 HC HCG (URINE) PREGNANCY TEST	$87.00	$145.00	$36.25–$111.65	79% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 HC HCG (URINE) PREGNANCY TEST	$87.00	$145.00	$36.25–$111.65	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12	$82.20	$137.00	$34.25–$105.49	10% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12	$82.20	$137.00	$34.25–$105.49	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC SO VITAMIN D HYDROXYVITAMIN D	$22.80	$38.00	$9.50–$29.26	76% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$238.20	$397.00	$99.25–$305.69	153% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC SO VITAMIN D HYDROXYVITAMIN D	$22.80	$38.00	$9.50–$29.26	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$238.20	$397.00	$99.25–$305.69	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC SO DIHYDROXYVITAMIN D 1 25	$139.80	$233.00	$58.25–$179.41	9% below	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC SO DIHYDROXYVITAMIN D 1 25	$139.80	$233.00	$58.25–$179.41	—	40%
Zinc blood test CPT 84630 HC SO ZINC SERUM	$147.00	$245.00	$61.25–$188.65	186% above	40%
Zinc blood test inpatient CPT 84630 HC SO ZINC SERUM	$147.00	$245.00	$61.25–$188.65	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC SO HCG QUANTITATIVE	$30.60	$51.00	$12.75–$39.27	55% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUANTITATIVE	$127.20	$212.00	$53.00–$163.24	88% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC SO HCG QUANTITATIVE	$30.60	$51.00	$12.75–$39.27	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUANTITATIVE	$127.20	$212.00	$53.00–$163.24	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STRTCTC	$6,491.40	$10,819.00	$2,704.75–$8,330.63	62% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STRTCTC	$6,491.40	$10,819.00	$2,704.75–$8,330.63	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$375.00	$625.00	$156.25–$481.25	1% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$375.00	$625.00	$156.25–$481.25	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$1,673.40	$2,789.00	$697.25–$2,147.53	360% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX	$498.00	$830.00	$207.50–$639.10	71% below	40%
Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX	$498.00	$830.00	$207.50–$639.10	—	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC PBB CIRCUMCISION AGE>28 DAYS	$3,984.00	$6,640.00	$1,660.00–$5,112.80	35% below	40%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC PBB CIRCUMCISION AGE>28 DAYS	$3,984.00	$6,640.00	$1,660.00–$5,112.80	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$2,782.20	$4,637.00	$1,159.25–$3,570.49	57% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$2,782.20	$4,637.00	$1,159.25–$3,570.49	—	40%
Circumcision, surgical, older than a newborn CPT 54160 HC CIRCUMCISION NEONATE	$937.80	$1,563.00	$390.75–$1,203.51	53% below	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 HC CIRCUMCISION NEONATE	$937.80	$1,563.00	$390.75–$1,203.51	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$360.00	$600.00	$150.00–$462.00	12% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$360.00	$600.00	$150.00–$462.00	—	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSCOPY W/BIOPSY	$1,673.40	$2,789.00	$697.25–$2,147.53	84% above	40%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLPOSCOPY W/BIOPSY	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT BENIGN LESION 1ST	$125.40	$209.00	$52.25–$160.93	38% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT BENIGN LESION 1ST	$125.40	$209.00	$52.25–$160.93	—	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC PBB TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$693.00	$1,155.00	$288.75–$889.35	48% below	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC PBB TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$693.00	$1,155.00	$288.75–$889.35	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOV IMP EAR WAX 1 EAR	$268.80	$448.00	$112.00–$344.96	74% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOV IMP EAR WAX 1 EAR	$268.80	$448.00	$112.00–$344.96	—	40%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN UNILATERAL	$268.80	$448.00	$112.00–$344.96	74% above	40%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN UNILATERAL	$268.80	$448.00	$112.00–$344.96	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMETRIAL BIOPSY	$1,673.40	$2,789.00	$697.25–$2,147.53	336% above	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMETRIAL BIOPSY	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$2,856.60	$4,761.00	$1,190.25–$3,665.97	28% above	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$2,856.60	$4,761.00	$1,190.25–$3,665.97	—	40%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INTRAVITREAL NJX PHARMACOLOGIC AGT SPX	$636.60	$1,061.00	$265.25–$816.97	62% above	40%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC INTRAVITREAL NJX PHARMACOLOGIC AGT SPX	$636.60	$1,061.00	$265.25–$816.97	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC N BLOCK PARAVERT LUMBAR 1ST	$3,476.40	$5,794.00	$1,448.50–$4,461.38	59% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC N BLOCK PARAVERT LUMBAR 1ST	$3,476.40	$5,794.00	$1,448.50–$4,461.38	—	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC LIGATION OF HEMORRHOIDS	$1,312.80	$2,188.00	$547.00–$1,684.76	31% below	40%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC LIGATION OF HEMORRHOIDS	$1,312.80	$2,188.00	$547.00–$1,684.76	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH/INTRO SAL CONT HYST	$1,861.80	$3,103.00	$775.75–$2,389.31	388% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATH/INTRO SAL CONT HYST	$1,861.80	$3,103.00	$775.75–$2,389.31	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPYW/ENDO BX	$4,241.40	$7,069.00	$1,767.25–$5,443.13	55% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC HYSTEROSCOPYW/ENDO BX	$4,241.40	$7,069.00	$1,767.25–$5,443.13	—	40%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE	$1,673.40	$2,789.00	$697.25–$2,147.53	232% above	40%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT INTRAUTERINE DEVICE	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I & D SUBCUTANEOUS ABSCESS-SIMPLE	$491.40	$819.00	$204.75–$630.63	27% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I & D SUBCUTANEOUS ABSCESS-SIMPLE	$491.40	$819.00	$204.75–$630.63	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON SHEATH/LIGAMENT	$175.80	$293.00	$73.25–$225.61	48% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ TENDON SHEATH/LIGAMENT	$175.80	$293.00	$73.25–$225.61	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC JOINT INJECTION/ASPIR LARGE WO US	$304.20	$507.00	$126.75–$390.39	56% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC JOINT INJECTION/ASPIR LARGE WO US	$304.20	$507.00	$126.75–$390.39	—	40%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$190.20	$317.00	$79.25–$244.09	50% below	40%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$190.20	$317.00	$79.25–$244.09	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC JOINT INJECTION/ASPIR MEDIUM WO US	$264.60	$441.00	$110.25–$339.57	57% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC JOINT INJECTION/ASPIR MEDIUM WO US	$264.60	$441.00	$110.25–$339.57	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC INJECTION SMALL JOINT/BURSA	$230.40	$384.00	$96.00–$295.68	53% below	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC INJECTION SMALL JOINT/BURSA	$230.40	$384.00	$96.00–$295.68	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$2,683.20	$4,472.00	$1,118.00–$3,443.44	32% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$2,683.20	$4,472.00	$1,118.00–$3,443.44	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ A/S TRANSFORAM LUMBAR	$3,867.00	$6,445.00	$1,611.25–$4,962.65	87% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ A/S TRANSFORAM LUMBAR	$3,867.00	$6,445.00	$1,611.25–$4,962.65	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXCIS BENIGN LES TO 0.5 CM; TRUNK/ARMS/LEGS	$1,673.40	$2,789.00	$697.25–$2,147.53	24% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXCIS BENIGN LES TO 0.5 CM; TRUNK/ARMS/LEGS	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIG <5MM FACE FACIAL	$529.20	$882.00	$220.50–$679.14	61% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC SKIN BENIG <5MM FACE FACIAL	$529.20	$882.00	$220.50–$679.14	—	40%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE SINGLE	$596.40	$994.00	$248.50–$765.38	87% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE SINGLE	$596.40	$994.00	$248.50–$765.38	—	40%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W GUIDE	$1,222.80	$2,038.00	$509.50–$1,569.26	30% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W GUIDE	$1,222.80	$2,038.00	$509.50–$1,569.26	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$246.00	$410.00	$102.50–$315.70	68% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED	$246.00	$410.00	$102.50–$315.70	—	40%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVAL FB - SUBCUTANEOUS	$664.20	$1,107.00	$276.75–$852.39	1% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVAL FB - SUBCUTANEOUS	$664.20	$1,107.00	$276.75–$852.39	—	40%
Short arm cast (elbow to hand) CPT 29075 HC CAST - SHORT ARM	$1,259.40	$2,099.00	$524.75–$1,616.23	319% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 HC CAST - SHORT ARM	$1,259.40	$2,099.00	$524.75–$1,616.23	—	40%
Short arm splint (forearm and hand) CPT 29125 HC SPLINT - SHORT ARM	$565.80	$943.00	$235.75–$726.11	95% above	40%
Short arm splint (forearm and hand) CPT 29125 HC PT STATIC SHORT ARM SPLINT	$608.40	$1,014.00	$253.50–$780.78	109% above	40%
Short arm splint (forearm and hand) CPT 29125 HC SPLINT APP SHORT ARM STAT	$608.40	$1,014.00	$253.50–$780.78	109% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 HC SPLINT - SHORT ARM	$565.80	$943.00	$235.75–$726.11	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 HC SPLINT APP SHORT ARM STAT	$608.40	$1,014.00	$253.50–$780.78	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PT STATIC SHORT ARM SPLINT	$608.40	$1,014.00	$253.50–$780.78	—	40%
Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST	$600.60	$1,001.00	$250.25–$770.77	58% above	40%
Short leg cast (below the knee) CPT 29405 HC CAST SHORT LEG	$645.60	$1,076.00	$269.00–$828.52	69% above	40%
Short leg cast (below the knee) inpatient CPT 29405 HC APPLY SHORT LEG CAST	$600.60	$1,001.00	$250.25–$770.77	—	40%
Short leg cast (below the knee) inpatient CPT 29405 HC CAST SHORT LEG	$645.60	$1,076.00	$269.00–$828.52	—	40%
Short leg splint (calf to foot) CPT 29515 HC SPLINT - SHORT LEG	$565.80	$943.00	$235.75–$726.11	92% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 HC SPLINT - SHORT LEG	$565.80	$943.00	$235.75–$726.11	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPR SUPERF WND BODY <2.5CM	$151.80	$253.00	$63.25–$194.81	54% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REPR SUPERF WND BODY <2.5CM	$151.80	$253.00	$63.25–$194.81	—	40%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$252.60	$421.00	$105.25–$324.17	43% below	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$252.60	$421.00	$105.25–$324.17	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC MALIG LESION <=0.5 TRUNK ARMS OR LEGS	$529.20	$882.00	$220.50–$679.14	61% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC MALIG LESION <=0.5 TRUNK ARMS OR LEGS	$529.20	$882.00	$220.50–$679.14	—	40%
Skin tag removal, up to 15 tags CPT 11200 HC EXCISION UP TO 15 SKIN TAGS	$1,673.40	$2,789.00	$697.25–$2,147.53	472% above	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC EXCISION UP TO 15 SKIN TAGS	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$865.80	$1,443.00	$360.75–$1,111.11	19% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$865.80	$1,443.00	$360.75–$1,111.11	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPR SUPERF WND FACE <2.5CM	$151.80	$253.00	$63.25–$194.81	52% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPR SUPERF WND FACE <2.5CM	$151.80	$253.00	$63.25–$194.81	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$252.60	$421.00	$105.25–$324.17	16% below	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$252.60	$421.00	$105.25–$324.17	—	40%
Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$1,851.60	$3,086.00	$771.50–$2,376.22	7% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$1,851.60	$3,086.00	$771.50–$2,376.22	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER PT 1-2 MUSC GRPS	$603.00	$1,005.00	$251.25–$773.85	14% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER PT 1-2 MUSC GRPS	$603.00	$1,005.00	$251.25–$773.85	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMG	$4,768.20	$7,947.00	$1,986.75–$6,119.19	44% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMG	$4,768.20	$7,947.00	$1,986.75–$6,119.19	—	40%
Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS RF 1ST VEIN	$8,659.80	$14,433.00	$3,608.25–$11,113.41	33% above	40%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS RF 1ST VEIN	$8,659.80	$14,433.00	$3,608.25–$11,113.41	—	40%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCT BENIGN LESIONS	$270.60	$451.00	$112.75–$347.27	14% below	40%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT BENIGN LESIONS	$270.60	$451.00	$112.75–$347.27	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISSUE 20 SQ CM/<	$601.80	$1,003.00	$250.75–$772.31	23% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISSUE 20 SQ CM/<	$601.80	$1,003.00	$250.75–$772.31	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD ADMINISTRATION	$1,273.80	$2,123.00	$530.75–$1,634.71	15% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD ADMINISTRATION	$1,273.80	$2,123.00	$530.75–$1,634.71	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AEROSOL HHN MDI IPPB	$139.20	$232.00	$58.00–$178.64	21% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AEROSOL HHN MDI IPPB	$139.20	$232.00	$58.00–$178.64	—	40%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSION 1ST HOUR CHEMO	$1,419.60	$2,366.00	$591.50–$1,821.82	85% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INFUSION 1ST HOUR CHEMO	$1,419.60	$2,366.00	$591.50–$1,821.82	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC COMPREHENSIVE HEARING EVAL	$136.20	$227.00	$56.75–$174.79	48% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC COMPREHENSIVE HEARING EVAL	$136.20	$227.00	$56.75–$174.79	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE & DROWSY	$1,749.60	$2,916.00	$729.00–$2,245.32	83% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE & DROWSY	$1,749.60	$2,916.00	$729.00–$2,245.32	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC >= 12 LEAD EKG	$213.00	$355.00	$88.75–$273.35	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC >= 12 LEAD EKG	$213.00	$355.00	$88.75–$273.35	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TEST	$1,404.00	$2,340.00	$585.00–$1,801.80	56% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TEST	$1,404.00	$2,340.00	$585.00–$1,801.80	—	40%
Family therapy with the patient, 50 minutes CPT 90847 HC OP PSYCH FAMILY W/PATIENT PRESENT 50MINS	$222.00	$370.00	$92.50–$284.90	25% below	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OP PSYCH FAMILY W/PATIENT PRESENT 50MINS	$222.00	$370.00	$92.50–$284.90	—	40%
Family therapy without the patient, 50 minutes CPT 90846 HC OP FAMILY TX WO PT PPRESENT 50MIN	$222.00	$370.00	$92.50–$284.90	28% below	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OP FAMILY TX WO PT PPRESENT 50MIN	$222.00	$370.00	$92.50–$284.90	—	40%
Group psychotherapy session CPT 90853 HC OP GROUP	$133.80	$223.00	$55.75–$171.71	22% below	40%
Group psychotherapy session inpatient CPT 90853 HC OP GROUP	$133.80	$223.00	$55.75–$171.71	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC INF 1ST HOUR HYD	$808.80	$1,348.00	$337.00–$1,037.96	94% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC INF 1ST HOUR HYD	$808.80	$1,348.00	$337.00–$1,037.96	—	40%
IV infusion of a medicine, first hour CPT 96365 HC IV 1ST HOUR INIT DRUG	$798.00	$1,330.00	$332.50–$1,024.10	84% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV 1ST HOUR INIT DRUG	$798.00	$1,330.00	$332.50–$1,024.10	—	40%
IV push of a medicine, first drug CPT 96374 HC IV PUSH MEDS	$363.60	$606.00	$151.50–$466.62	42% above	40%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH MEDS	$363.60	$606.00	$151.50–$466.62	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION IM SUB Q	$180.00	$300.00	$75.00–$231.00	27% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION IM SUB Q	$180.00	$300.00	$75.00–$231.00	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH EVALUATION	$203.40	$339.00	$84.75–$261.03	35% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH EVALUATION	$203.40	$339.00	$84.75–$261.03	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEURO FACILITATION EA 15 MIN	$157.80	$263.00	$65.75–$202.51	44% above	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEURO FACILITATION EA 15 MIN	$157.80	$263.00	$65.75–$202.51	—	40%
New patient office visit, about 30 minutes CPT 99203 HC NEW PT E/M LEVEL 3	$179.40	$299.00	$74.75–$230.23	63% above	40%
New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW PT E/M LEVEL 3	$179.40	$299.00	$74.75–$230.23	—	40%
New patient office visit, about 45 minutes CPT 99204 HC NEW PT E/M LEVEL 4	$206.40	$344.00	$86.00–$264.88	70% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW PT E/M LEVEL 4	$206.40	$344.00	$86.00–$264.88	—	40%
New patient office visit, about 60 minutes CPT 99205 HC NEW PT E/M LEVEL 5	$236.40	$394.00	$98.50–$303.38	37% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW PT E/M LEVEL 5	$236.40	$394.00	$98.50–$303.38	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC NEW PT E/M LEVEL 2	$156.00	$260.00	$65.00–$200.20	54% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC NEW PT E/M LEVEL 2	$156.00	$260.00	$65.00–$200.20	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUT THERAPY IND INIT 15 MIN	$24.00	$40.00	$10.00–$30.80	63% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUT THERAPY IND INIT 15 MIN	$24.00	$40.00	$10.00–$30.80	—	40%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX	$244.20	$407.00	$101.75–$313.39	6% below	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX	$244.20	$407.00	$101.75–$313.39	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX	$330.60	$551.00	$137.75–$424.27	10% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX	$330.60	$551.00	$137.75–$424.27	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX	$244.20	$407.00	$101.75–$313.39	6% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX	$244.20	$407.00	$101.75–$313.39	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX	$287.40	$479.00	$119.75–$368.83	3% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX	$287.40	$479.00	$119.75–$368.83	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY EA 15	$94.80	$158.00	$39.50–$121.66	15% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY EA 15	$94.80	$158.00	$39.50–$121.66	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISEEA 15 MIN	$151.20	$252.00	$63.00–$194.04	28% above	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISEEA 15 MIN	$151.20	$252.00	$63.00–$194.04	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 HC PREV VISIT NEW AGE18-39	$109.20	$182.00	$45.50–$140.14	9% below	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PREV VISIT NEW AGE18-39	$109.20	$182.00	$45.50–$140.14	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 HC PREV VISIT NEW AGE40-64	$109.20	$182.00	$45.50–$140.14	25% below	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PREV VISIT NEW AGE40-64	$109.20	$182.00	$45.50–$140.14	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 HC PREV VISIT EST AGE 18-39	$109.20	$182.00	$45.50–$140.14	13% below	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC PREV VISIT EST AGE 18-39	$109.20	$182.00	$45.50–$140.14	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 HC PREV VISIT EST AGE 40-64	$109.20	$182.00	$45.50–$140.14	13% below	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PREV VISIT EST AGE 40-64	$109.20	$182.00	$45.50–$140.14	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 HC PREV VISIT EST AGE 65+	$109.20	$182.00	$45.50–$140.14	15% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC PREV VISIT EST AGE 65+	$109.20	$182.00	$45.50–$140.14	—	40%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$236.40	$394.00	$98.50–$303.38	44% below	40%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$236.40	$394.00	$98.50–$303.38	—	40%
Psychotherapy session, 30 minutes CPT 90832 HC OP PSYCH TX 30 MIN	$170.40	$284.00	$71.00–$218.68	10% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC OP PSYCH TX 30 MIN	$170.40	$284.00	$71.00–$218.68	—	40%
Psychotherapy session, 45 minutes CPT 90834 HC OP TX 45 MIN	$230.40	$384.00	$96.00–$295.68	14% below	40%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY - INDIVIDUAL	$1,673.40	$2,789.00	$697.25–$2,147.53	527% above	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC OP TX 45 MIN	$230.40	$384.00	$96.00–$295.68	—	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY - INDIVIDUAL	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Psychotherapy session, 60 minutes CPT 90837 HC OP PSYCH TX 60 MIN	$269.40	$449.00	$112.25–$345.73	14% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC OP PSYCH TX 60 MIN	$269.40	$449.00	$112.25–$345.73	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE/TOBAC COUNSEL 3-10	$44.40	$74.00	$18.50–$56.98	1% above	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE/TOBAC COUNSEL 3-10	$44.40	$74.00	$18.50–$56.98	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC EST PT E/M LEVEL 5	$203.40	$339.00	$84.75–$261.03	21% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC EST PT E/M LEVEL 5	$203.40	$339.00	$84.75–$261.03	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC EST PT E/M LEVEL 3	$153.60	$256.00	$64.00–$197.12	32% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC EST PT E/M LEVEL 3	$153.60	$256.00	$64.00–$197.12	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC EST PT E/M LEVEL 4	$177.00	$295.00	$73.75–$227.15	29% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC EST PT E/M LEVEL 4	$177.00	$295.00	$73.75–$227.15	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT E/M LEVEL 2	$134.40	$224.00	$56.00–$172.48	33% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC EST PT E/M LEVEL 2	$134.40	$224.00	$56.00–$172.48	—	40%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$179.40	$299.00	$74.75–$230.23	63% above	40%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$179.40	$299.00	$74.75–$230.23	—	40%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND LANG COMPRHENSION	$1,376.40	$2,294.00	$573.50–$1,766.38	304% above	40%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND LANG COMPRHENSION	$1,376.40	$2,294.00	$573.50–$1,766.38	—	40%
Speech therapy session, individual CPT 92507 HC SPEECH/LANGUAGE THERAPY	$175.20	$292.00	$73.00–$224.84	20% below	40%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH/LANGUAGE THERAPY	$175.20	$292.00	$73.00–$224.84	—	40%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY / TVC / MVV	$352.80	$588.00	$147.00–$452.76	14% above	40%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY / TVC / MVV	$352.80	$588.00	$147.00–$452.76	—	40%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE & POST BD	$602.40	$1,004.00	$251.00–$773.08	5% above	40%
Spirometry before and after a bronchodilator CPT 94060 HC BEFORE / AFTER BRONCHODILATOR	$1,673.40	$2,789.00	$697.25–$2,147.53	192% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE & POST BD	$602.40	$1,004.00	$251.00–$773.08	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BEFORE / AFTER BRONCHODILATOR	$1,673.40	$2,789.00	$697.25–$2,147.53	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUTIC ACTIVITIES 15 MIN	$161.40	$269.00	$67.25–$207.13	32% above	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUTIC ACTIVITIES 15 MIN	$161.40	$269.00	$67.25–$207.13	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$66.00	$110.00	$0.03–$110.00	13% below	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$66.00	$110.00	$11.29–$11.40	13% below	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$66.00	$110.00	$27.50–$84.70	—	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$66.00	$110.00	$0.03–$110.00	—	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$175.20	$292.00	$11.29–$11.40	16% below	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$175.20	$292.00	$73.00–$224.84	16% below	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$175.20	$292.00	$73.00–$224.84	—	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$175.20	$292.00	$73.00–$224.84	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$99.00	$165.00	$41.25–$127.05	70% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$99.00	$165.00	$11.29–$11.40	70% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$157.20	$262.00	$11.29–$11.40	53% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$157.20	$262.00	$65.50–$201.74	53% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$99.00	$165.00	$41.25–$127.05	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$99.00	$165.00	$41.25–$127.05	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$157.20	$262.00	$65.50–$201.74	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$157.20	$262.00	$65.50–$201.74	—	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$112.80	$188.00	$188.00	70% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$112.80	$188.00	$19.04–$19.23	70% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$408.55	$680.91	$328.71–$639.48	10% above	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$408.55	$680.91	$19.04–$19.23	10% above	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$112.80	$188.00	$47.00–$144.76	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$112.80	$188.00	$188.00	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$408.55	$680.91	$170.23–$524.30	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$408.55	$680.91	$328.71–$639.48	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$54.00	$90.00	$90.00	58% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$54.00	$90.00	$11.29–$11.40	58% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$134.27	$223.79	$119.70–$219.52	4% above	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$134.27	$223.79	$11.29–$11.40	4% above	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$54.00	$90.00	$90.00	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$54.00	$90.00	$22.50–$69.30	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$134.27	$223.79	$119.70–$219.52	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$134.27	$223.79	$55.95–$172.32	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DTAP VACCINE < 7 YRS IM	$33.00	$55.00	$55.00	49% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DTAP VACCINE < 7 YRS IM	$33.00	$55.00	$11.29–$11.40	49% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$65.62	$109.36	$11.29–$11.40	1% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$65.62	$109.36	$56.15–$103.40	1% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DTAP VACCINE < 7 YRS IM	$33.00	$55.00	$55.00	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DTAP VACCINE < 7 YRS IM	$33.00	$55.00	$13.75–$42.35	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$65.62	$109.36	$27.34–$84.21	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$65.62	$109.36	$56.15–$103.40	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$224.27	$373.79	$11.29–$11.40	15% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$224.27	$373.79	$192.33–$362.08	15% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$1,517.40	$2,529.00	$192.33–$362.08	677% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$1,517.40	$2,529.00	$11.29–$11.40	677% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$224.27	$373.79	$93.45–$287.82	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$224.27	$373.79	$192.33–$362.08	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$1,517.40	$2,529.00	$192.33–$362.08	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$1,517.40	$2,529.00	$632.25–$1,947.33	—	40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP-IPV/HIB VACCINE IM	$73.80	$123.00	$11.29–$11.40	54% below	40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP-IPV/HIB VACCINE IM	$73.80	$123.00	$123.00	54% below	40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP-IPV/HIB VACCINE IM	$73.80	$123.00	$30.75–$94.71	—	40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP-IPV/HIB VACCINE IM	$73.80	$123.00	$123.00	—	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC DTAP-IPV-HIB-HEPB VACCINE IM	$130.20	$217.00	$11.29–$11.40	62% below	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC DTAP-IPV-HIB-HEPB VACCINE IM	$130.20	$217.00	$217.00	62% below	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$232.64	$387.73	$293.24–$387.73	32% below	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$232.64	$387.73	$11.29–$11.40	32% below	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC DTAP-IPV-HIB-HEPB VACCINE IM	$130.20	$217.00	$54.25–$167.09	—	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC DTAP-IPV-HIB-HEPB VACCINE IM	$130.20	$217.00	$217.00	—	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$232.64	$387.73	$96.93–$298.55	—	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$232.64	$387.73	$293.24–$387.73	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$11.29–$11.40	48% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$0.03–$40.00	48% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$11.29–$11.40	48% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$0.03–$40.00	48% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$0.03–$40.00	48% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$11.29–$11.40	48% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$25.20	$42.00	$11.29–$11.40	45% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$25.20	$42.00	$0.03–$42.00	45% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$0.03–$40.00	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$0.03–$40.00	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$10.00–$30.80	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$10.00–$30.80	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$0.03–$40.00	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$24.00	$40.00	$10.00–$30.80	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$25.20	$42.00	$10.50–$32.34	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$25.20	$42.00	$0.03–$42.00	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC 9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE	$112.20	$187.00	$187.00	78% below	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC 9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE	$112.20	$187.00	$19.04–$19.23	78% below	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$674.89	$1,124.82	$19.04–$19.23	30% above	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$674.89	$1,124.82	$542.35–$1,074.90	30% above	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC 9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE	$112.20	$187.00	$187.00	—	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC 9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE	$112.20	$187.00	$46.75–$143.99	—	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$674.89	$1,124.82	$281.21–$866.11	—	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$674.89	$1,124.82	$542.35–$1,074.90	—	40%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$183.79	$306.31	$130.22–$284.17	5% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$183.79	$306.31	$11.29–$11.40	5% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HC HEPA VACCINE ADULT IM	$1,593.00	$2,655.00	$11.29–$11.40	720% above	40%
Hepatitis A vaccine, adult dose CPT 90632 HC HEPA VACCINE ADULT IM	$1,593.00	$2,655.00	$130.22–$284.17	720% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$183.79	$306.31	$130.22–$284.17	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$183.79	$306.31	$76.58–$235.86	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEPA VACCINE ADULT IM	$1,593.00	$2,655.00	$130.22–$284.17	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEPA VACCINE ADULT IM	$1,593.00	$2,655.00	$663.75–$2,044.35	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$40.80	$68.00	$11.29–$11.40	55% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$40.80	$68.00	$68.00	55% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$82.73	$137.88	$72.63–$135.75	8% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$82.73	$137.88	$11.29–$11.40	8% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$40.80	$68.00	$68.00	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$40.80	$68.00	$17.00–$52.36	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$82.73	$137.88	$72.63–$135.75	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$82.73	$137.88	$34.47–$106.17	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPATITIS B VACCINE	$80.40	$134.00	$11.29–$11.40	48% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPATITIS B VACCINE	$80.40	$134.00	$130.20–$134.00	48% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$154.13	$256.88	$11.29–$11.40	1% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$154.13	$256.88	$130.20–$240.46	1% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPATITIS B VACCINE	$80.40	$134.00	$33.50–$103.18	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPATITIS B VACCINE	$80.40	$134.00	$130.20–$134.00	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$154.13	$256.88	$130.20–$240.46	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$154.13	$256.88	$64.22–$197.80	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE	$175.20	$292.00	$292.00	20% below	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE	$175.20	$292.00	$11.29–$11.40	20% below	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$285.54	$475.90	$311.36–$475.90	31% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$285.54	$475.90	$11.29–$11.40	31% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE	$175.20	$292.00	$292.00	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE	$175.20	$292.00	$73.00–$224.84	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$285.54	$475.90	$118.98–$366.44	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$285.54	$475.90	$311.36–$475.90	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$47.40	$79.00	$56.92–$79.00	21% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$47.40	$79.00	$11.29–$11.40	21% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$65.41	$109.01	$11.29–$11.40	9% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$65.41	$109.01	$56.92–$101.54	9% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$47.40	$79.00	$19.75–$60.83	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$47.40	$79.00	$56.92–$79.00	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$65.41	$109.01	$56.92–$101.54	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$65.41	$109.01	$27.25–$83.94	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC HIB PRP-OMP VACC 3 DOSE IM	$27.00	$45.00	$45.00	62% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC HIB PRP-OMP VACC 3 DOSE IM	$27.00	$45.00	$11.29–$11.40	62% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC HIB PRP-OMP VACC 3 DOSE IM	$27.00	$45.00	$11.25–$34.65	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC HIB PRP-OMP VACC 3 DOSE IM	$27.00	$45.00	$45.00	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$27.02	$45.03	$11.29–$11.40	12% below	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$27.02	$45.03	$24.12–$45.03	12% below	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$34.20	$57.00	$11.29–$11.40	12% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$34.20	$57.00	$24.12–$46.02	12% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$27.02	$45.03	$11.26–$34.67	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$27.02	$45.03	$24.12–$45.03	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$34.20	$57.00	$14.25–$43.89	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$34.20	$57.00	$24.12–$46.02	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$24.00	$40.00	$40.00	77% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$24.00	$40.00	$11.29–$11.40	77% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC IIV VACCINE PRESERV FREE INCREASED AG COUNT IM	$61.80	$103.00	$103.00	40% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC IIV VACCINE PRESERV FREE INCREASED AG COUNT IM	$61.80	$103.00	$11.29–$11.40	40% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$24.00	$40.00	$40.00	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$24.00	$40.00	$10.00–$30.80	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC IIV VACCINE PRESERV FREE INCREASED AG COUNT IM	$61.80	$103.00	$25.75–$79.31	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC IIV VACCINE PRESERV FREE INCREASED AG COUNT IM	$61.80	$103.00	$103.00	—	40%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$660.39	$1,100.65	$542.70–$1,031.13	52% below	40%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$660.39	$1,100.65	$19.04–$19.23	52% below	40%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$660.39	$1,100.65	$542.70–$1,031.13	—	40%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$660.39	$1,100.65	$275.16–$847.50	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MMR VIRUS IMMUNIZATION SUBCUT	$58.20	$97.00	$97.00	72% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MMR VIRUS IMMUNIZATION SUBCUT	$58.20	$97.00	$11.29–$11.40	72% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$193.40	$322.34	$11.29–$11.40	7% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$193.40	$322.34	$179.97–$322.34	7% below	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MMR VIRUS IMMUNIZATION SUBCUT	$58.20	$97.00	$97.00	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MMR VIRUS IMMUNIZATION SUBCUT	$58.20	$97.00	$24.25–$74.69	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$193.40	$322.34	$80.59–$248.20	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$193.40	$322.34	$179.97–$322.34	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC COMBINED VACCINEMMR+VARICELLASUB-Q	$139.80	$233.00	$11.29–$11.40	73% below	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC COMBINED VACCINEMMR+VARICELLASUB-Q	$139.80	$233.00	$233.00	73% below	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$602.33	$1,003.88	$11.29–$11.40	18% above	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$602.33	$1,003.88	$508.82–$972.00	18% above	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC COMBINED VACCINEMMR+VARICELLASUB-Q	$139.80	$233.00	$233.00	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC COMBINED VACCINEMMR+VARICELLASUB-Q	$139.80	$233.00	$58.25–$179.41	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$602.33	$1,003.88	$250.97–$772.99	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$602.33	$1,003.88	$508.82–$972.00	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM	$138.00	$230.00	$230.00	56% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM	$138.00	$230.00	$19.04–$19.23	56% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$342.03	$570.05	$296.68–$570.05	8% above	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$342.03	$570.05	$19.04–$19.23	8% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM	$138.00	$230.00	$57.50–$177.10	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM	$138.00	$230.00	$230.00	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$342.03	$570.05	$296.68–$570.05	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$342.03	$570.05	$142.51–$438.94	—	40%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$251.09	$418.48	$19.04–$19.23	37% below	40%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$251.09	$418.48	$314.87–$418.48	37% below	40%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$251.09	$418.48	$104.62–$322.23	—	40%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$251.09	$418.48	$314.87–$418.48	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$466.75	$777.92	$421.99–$777.92	15% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$466.75	$777.92	$19.04–$19.23	15% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC MENB 4C VACC 2 DOSE IM	$1,593.00	$2,655.00	$19.04–$19.23	189% above	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC MENB 4C VACC 2 DOSE IM	$1,593.00	$2,655.00	$421.99–$828.64	189% above	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$466.75	$777.92	$421.99–$777.92	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$466.75	$777.92	$194.48–$599.00	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC MENB 4C VACC 2 DOSE IM	$1,593.00	$2,655.00	$421.99–$828.64	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC MENB 4C VACC 2 DOSE IM	$1,593.00	$2,655.00	$663.75–$2,044.35	—	40%
Meningococcal B vaccine (Trumenba) CPT 90621 HC MENINGOCOCCAL B RECOMBINANT (AGE 10Y-25Y) IM (TRUMENBA)	$1,593.00	$2,655.00	$19.04–$19.23	306% above	40%
Meningococcal B vaccine (Trumenba) CPT 90621 HC MENINGOCOCCAL B RECOMBINANT (AGE 10Y-25Y) IM (TRUMENBA)	$1,593.00	$2,655.00	$358.79–$724.46	306% above	40%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC MENINGOCOCCAL B RECOMBINANT (AGE 10Y-25Y) IM (TRUMENBA)	$1,593.00	$2,655.00	$663.75–$2,044.35	—	40%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC MENINGOCOCCAL B RECOMBINANT (AGE 10Y-25Y) IM (TRUMENBA)	$1,593.00	$2,655.00	$358.79–$724.46	—	40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$24.00	$40.00	$0.02–$40.00	40% below	40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$24.00	$40.00	$11.29–$11.40	40% below	40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 HC LAIV3 VACCINE INTRANASAL	$25.80	$43.00	$0.02–$43.00	35% below	40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 HC LAIV3 VACCINE INTRANASAL	$25.80	$43.00	$11.29–$11.40	35% below	40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$24.00	$40.00	$0.02–$40.00	—	40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$24.00	$40.00	$10.00–$30.80	—	40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 HC LAIV3 VACCINE INTRANASAL	$25.80	$43.00	$10.75–$33.11	—	40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 HC LAIV3 VACCINE INTRANASAL	$25.80	$43.00	$0.02–$43.00	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PNEUMOCOCCAL VACC 13 VAL IM	$89.40	$149.00	$19.04–$19.23	80% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PNEUMOCOCCAL VACC 13 VAL IM	$89.40	$149.00	$149.00	80% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PNEUMOCOCCAL VACC 13 VAL IM	$89.40	$149.00	$37.25–$114.73	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PNEUMOCOCCAL VACC 13 VAL IM	$89.40	$149.00	$149.00	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$589.72	$982.86	$19.04–$19.23	11% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$589.72	$982.86	$551.37–$982.86	11% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$589.72	$982.86	$551.37–$982.86	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$589.72	$982.86	$245.72–$756.80	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE	$124.80	$208.00	$208.00	55% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE	$124.80	$208.00	$11.29–$11.40	55% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$235.21	$392.02	$11.29–$11.40	14% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$235.21	$392.02	$246.92–$392.02	14% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE	$124.80	$208.00	$52.00–$160.16	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE	$124.80	$208.00	$208.00	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$235.21	$392.02	$98.01–$301.86	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$235.21	$392.02	$246.92–$392.02	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 HC POLIOMYELITIS IMMUNIZATNINACTVSUB-Q	$38.40	$64.00	$11.29–$11.40	40% below	40%
Polio vaccine, inactivated (IPV) CPT 90713 HC POLIOMYELITIS IMMUNIZATNINACTVSUB-Q	$38.40	$64.00	$64.00	40% below	40%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$64.80	$108.00	$84.01–$108.00	2% above	40%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$64.80	$108.00	$11.29–$11.40	2% above	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC POLIOMYELITIS IMMUNIZATNINACTVSUB-Q	$38.40	$64.00	$64.00	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC POLIOMYELITIS IMMUNIZATNINACTVSUB-Q	$38.40	$64.00	$16.00–$49.28	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$64.80	$108.00	$84.01–$108.00	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$64.80	$108.00	$27.00–$83.16	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC RSV VACCINE SYNCYTIAL MONOCLONAL 1ML DOSE FOR IM	$312.00	$520.00	$1,584.09–$1,599.32	70% below	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC RSV VACCINE SYNCYTIAL MONOCLONAL 1ML DOSE FOR IM	$312.00	$520.00	$520.00	70% below	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$933.56	$1,555.94	$980.78–$1,555.94	10% below	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$933.56	$1,555.94	$1,584.09–$1,599.32	10% below	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC RSV VACCINE SYNCYTIAL MONOCLONAL 1ML DOSE FOR IM	$312.00	$520.00	$520.00	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC RSV VACCINE SYNCYTIAL MONOCLONAL 1ML DOSE FOR IM	$312.00	$520.00	$130.00–$400.40	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$933.56	$1,555.94	$980.78–$1,555.94	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$933.56	$1,555.94	$388.99–$1,198.07	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC RSV VACCINE SYNCYTIAL MONOCLONAL 0.5ML DOSE FOR IM	$156.00	$260.00	$260.00	88% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC RSV VACCINE SYNCYTIAL MONOCLONAL 0.5ML DOSE FOR IM	$156.00	$260.00	$1,584.09–$1,599.32	88% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$933.56	$1,555.94	$1,584.09–$1,599.32	31% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$933.56	$1,555.94	$980.78–$1,555.94	31% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC RSV VACCINE SYNCYTIAL MONOCLONAL 0.5ML DOSE FOR IM	$156.00	$260.00	$65.00–$200.20	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC RSV VACCINE SYNCYTIAL MONOCLONAL 0.5ML DOSE FOR IM	$156.00	$260.00	$260.00	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$933.56	$1,555.94	$980.78–$1,555.94	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$933.56	$1,555.94	$388.99–$1,198.07	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$609.99	$1,016.65	$11.29–$11.40	15% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$609.99	$1,016.65	$556.67–$1,016.65	15% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$609.99	$1,016.65	$254.16–$782.82	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$609.99	$1,016.65	$556.67–$1,016.65	—	40%
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$937.88	$1,563.14	$626.21–$1,518.69	1% below	40%
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$937.88	$1,563.14	$19.04–$19.23	1% below	40%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$937.88	$1,563.14	$626.21–$1,518.69	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$937.88	$1,563.14	$390.79–$1,203.62	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC RH1 VACC 2 DOES LIVE ORAL	$99.00	$165.00	$165.00	62% below	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC RH1 VACC 2 DOES LIVE ORAL	$99.00	$165.00	$11.29–$11.40	62% below	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$319.58	$532.63	$11.29–$11.40	22% above	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$319.58	$532.63	$261.57–$513.74	22% above	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC RH1 VACC 2 DOES LIVE ORAL	$99.00	$165.00	$41.25–$127.05	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC RH1 VACC 2 DOES LIVE ORAL	$99.00	$165.00	$165.00	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$319.58	$532.63	$261.57–$513.74	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$319.58	$532.63	$133.16–$410.13	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$87.00	$145.00	$145.00	36% below	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$87.00	$145.00	$19.04–$19.23	36% below	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$87.00	$145.00	$145.00	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$87.00	$145.00	$36.25–$111.65	—	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$445.88	$743.14	$373.42–$743.14	12% below	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$445.88	$743.14	$19.04–$19.23	12% below	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$445.88	$743.14	$373.42–$743.14	—	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$445.88	$743.14	$185.79–$572.22	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$68.89	$114.81	$11.29–$11.40	23% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$68.89	$114.81	$51.47–$114.81	23% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$68.89	$114.81	$51.47–$114.81	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$68.89	$114.81	$28.70–$88.40	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE >7 IM	$12.00	$20.00	$11.29–$11.40	89% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE >7 IM	$12.00	$20.00	$20.00	89% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$86.10	$143.50	$11.29–$11.40	22% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$86.10	$143.50	$70.84–$143.50	22% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE >7 IM	$12.00	$20.00	$20.00	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE >7 IM	$12.00	$20.00	$5.00–$15.40	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$86.10	$143.50	$70.84–$143.50	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$86.10	$143.50	$35.88–$110.50	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$255.25	$425.41	$250.86–$425.41	11% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$255.25	$425.41	$11.29–$11.40	11% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$255.25	$425.41	$250.86–$425.41	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$255.25	$425.41	$106.35–$327.57	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION	$47.40	$79.00	$19.75–$60.83	16% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMINISTRATION	$47.40	$79.00	$19.75–$60.83	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC SUBSEQUENT IMMUN ADMIN	$22.80	$38.00	$9.50–$29.26	34% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC SUBSEQUENT IMMUN ADMIN	$22.80	$38.00	$9.50–$29.26	—	40%
Yellow fever vaccine, live CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$314.80	$524.67	$369.28–$524.67	25% below	40%
Yellow fever vaccine, live CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$314.80	$524.67	$19.04–$19.23	25% below	40%
Yellow fever vaccine, live inpatient CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$314.80	$524.67	$369.28–$524.67	—	40%
Yellow fever vaccine, live inpatient CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$314.80	$524.67	$131.17–$404.00	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://nationwidechildrens.pt.panaceainc.com/MRFDownload/nationwidechildrens/toledo