Hospital

Memorial Hospital of Converse County

Memorial Hospital of Converse County in Douglas, WY publishes cash prices for 410 common procedures listed here, from its own machine-readable price file updated Mar 25, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wyoming median for 283 of 376 procedures and above it for 29. By typical cash price it ranks #5 of 18 Wyoming hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

111 S 5th St,Douglas,WY,82633 Collected Nov 10, 2026 Source price file Check a bill from this hospital (307) 358-2122

Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CMS star rating 4 of 5 CCN 531302 · CMS hospital register NPI 1326085408

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Memorial Hospital of Converse County is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Memorial Hospital of Converse County in Douglas, WY:

Feb 17, 2023 Warning notice
May 31, 2023 Corrective action plan requested
Jun 15, 2023 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Abdominal CT scan without and with contrast CPT 74170 CT SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,069.67	$3,631.00	$701.00	1% below	43%
Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$2,215.02	$3,886.00	$701.00	5% above	43%
Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS	$277.59	$487.00	$95.00	26% below	43%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$290.70	$510.00	$94.00	10% below	43%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$311.22	$546.00	$94.00	3% below	43%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$290.70	$510.00	—	10% below	43%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$290.70	$510.00	—	10% below	43%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$419.52	$736.00	$117.00	46% above	43%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$1,338.36	$2,348.00	$430.00	15% above	43%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE	$1,432.41	$2,513.00	$430.00	23% above	43%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$1,338.36	$2,348.00	—	15% above	43%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$1,338.36	$2,348.00	—	15% above	43%
Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS	$456.57	$801.00	$255.00	at median	43%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$489.06	$858.00	$255.00	7% above	43%
Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY	$1,664.97	$2,921.00	$705.00	at median	43%
Breast ultrasound, complete, one breast CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$346.56	$608.00	$266.00	32% below	43%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$371.07	$651.00	$266.00	28% below	43%
Breast ultrasound, complete, one breast one side CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$346.56	$608.00	—	32% below	43%
Breast ultrasound, complete, one breast one side CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$346.56	$608.00	—	32% below	43%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT SCAN OF BLOOD VESSELS OF ABDOMEN AND PELVIS WITH CONTRAST	$3,872.58	$6,794.00	$1,013.00	4% above	43%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST	$4,143.90	$7,270.00	$1,013.00	12% above	43%
CT angiography (CTA) of the head CPT 70496 CT SCAN OF BLOOD VESSELS OF HEAD WITH CONTRAST	$1,707.15	$2,995.00	$734.00	at median	43%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$1,826.85	$3,205.00	$734.00	7% above	43%
CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST	$1,833.12	$3,216.00	$733.00	at median	43%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$1,961.94	$3,442.00	$733.00	7% above	43%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST	$1,824.00	$3,200.00	$747.00	10% below	43%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,951.68	$3,424.00	$747.00	3% below	43%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$1,224.93	$2,149.00	$848.00	2% below	43%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM	$107.73	$189.00	$189.00	10% below	43%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST	$2,832.33	$4,969.00	$485.00	at median	43%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$3,030.69	$5,317.00	$485.00	7% above	43%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$2,892.18	$5,074.00	$813.00	11% below	43%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$3,095.10	$5,430.00	$813.00	4% below	43%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST	$2,932.08	$5,144.00	$911.00	6% below	43%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$3,137.85	$5,505.00	$911.00	1% above	43%
CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST	$1,784.67	$3,131.00	$625.00	2% below	43%
CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST	$1,529.88	$2,684.00	$362.00	2% below	43%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,637.04	$2,872.00	$362.00	4% above	43%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST	$1,223.79	$2,147.00	$340.00	20% below	43%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$1,309.86	$2,298.00	$340.00	14% below	43%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$1,249.44	$2,192.00	$280.00	4% below	43%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$1,337.22	$2,346.00	$280.00	3% above	43%
CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST	$1,373.70	$2,410.00	$392.00	at median	43%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$1,470.03	$2,579.00	$392.00	7% above	43%
CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST	$1,893.54	$3,322.00	$461.00	at median	43%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$2,026.35	$3,555.00	$461.00	7% above	43%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST	$1,615.38	$2,834.00	$342.00	9% below	43%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$1,728.81	$3,033.00	$342.00	3% below	43%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST	$1,665.54	$2,922.00	$344.00	14% below	43%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$1,782.39	$3,127.00	$344.00	8% below	43%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST	$1,679.22	$2,946.00	$614.00	8% below	43%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,797.21	$3,153.00	$614.00	1% below	43%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$813.96	$1,428.00	$272.00	—	43%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW	$760.38	$1,334.00	$272.00	8% above	43%
Chest CT scan without and with contrast CPT 71270 CT SCAN OF CHEST BEFORE AND AFTER CONTRAST	$2,038.32	$3,576.00	$521.00	at median	43%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$2,181.39	$3,827.00	$521.00	7% above	43%
Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS	$253.08	$444.00	$86.00	19% below	43%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$271.32	$476.00	$86.00	13% below	43%
Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW	$186.39	$327.00	$66.00	4% below	43%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$199.50	$350.00	$66.00	2% above	43%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY OF COLLAR BONE	$234.84	$412.00	$82.00	28% below	43%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE	$251.37	$441.00	$82.00	23% below	43%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$234.84	$412.00	—	28% below	43%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$251.37	$441.00	—	23% below	43%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY	$609.33	$1,069.00	$279.00	1% above	43%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$652.08	$1,144.00	$279.00	8% above	43%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE	$299.25	$525.00	$97.00	31% below	43%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$320.34	$562.00	$97.00	26% below	43%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$912.57	$1,601.00	$450.00	19% above	43%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST	$1,317.84	$2,312.00	$353.00	at median	43%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$1,410.18	$2,474.00	$353.00	7% above	43%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST	$1,650.72	$2,896.00	$442.00	at median	43%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$1,766.43	$3,099.00	$442.00	7% above	43%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$352.26	$618.00	$405.00	—	43%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$328.89	$577.00	$405.00	8% below	43%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$272.46	$478.00	$321.00	at median	43%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$291.84	$512.00	$321.00	7% above	43%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$885.21	$1,553.00	$341.00	at median	43%
Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$977.55	$1,715.00	$268.00	at median	43%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$1,046.52	$1,836.00	$268.00	7% above	43%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION	$1,697.46	$2,978.00	$278.00	1% below	43%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,816.59	$3,187.00	$278.00	6% above	43%
Elbow X-ray, 2 views CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$205.77	$361.00	$75.00	34% below	43%
Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW	$220.59	$387.00	$75.00	29% below	43%
Elbow X-ray, 2 views one side CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$205.77	$361.00	—	34% below	43%
Elbow X-ray, 2 views one side CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$205.77	$361.00	—	34% below	43%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$271.32	$476.00	$83.00	20% below	43%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW	$290.70	$510.00	$83.00	15% below	43%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$271.32	$476.00	—	20% below	43%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$271.32	$476.00	—	20% below	43%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN OF CRANIAL CAVITY WITHOUT CONTRAST	$1,352.04	$2,372.00	$420.00	10% below	43%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY OF FACE BONES; MINIMUM OF 3 VIEWS	$423.51	$743.00	$121.00	at median	43%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$231.42	$406.00	$76.00	23% below	43%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM	$247.95	$435.00	$76.00	18% below	43%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$231.42	$406.00	—	23% below	43%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$231.42	$406.00	—	23% below	43%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$788.88	$1,384.00	$775.00	30% below	43%
Hand X-ray, 2 views CPT 73120 X-RAY OF HAND; 2 VIEWS	$235.41	$413.00	$80.00	at median	43%
Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND	$251.94	$442.00	$80.00	7% above	43%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$235.41	$413.00	—	at median	43%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$235.41	$413.00	—	at median	43%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY OF HEEL; MINIMUM OF 2 VIEWS	$214.89	$377.00	$74.00	6% above	43%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL	$230.28	$404.00	$74.00	13% above	43%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$419.52	$736.00	$130.00	19% below	43%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER)	$2,848.29	$4,997.00	$901.00	30% below	43%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$3,047.79	$5,347.00	$901.00	25% below	43%
Knee X-ray, 3 views CPT 73562 X-RAY OF KNEE; 3 VIEWS	$314.64	$552.00	$104.00	12% below	43%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$336.87	$591.00	$104.00	6% below	43%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$314.64	$552.00	—	12% below	43%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$314.64	$552.00	—	12% below	43%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$327.75	$575.00	$119.00	10% below	43%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$351.12	$616.00	$119.00	4% below	43%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$327.75	$575.00	—	10% below	43%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$327.75	$575.00	—	10% below	43%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$1,395.93	$2,449.00	$343.00	3% above	43%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE	$1,493.97	$2,621.00	$343.00	10% above	43%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$1,395.93	$2,449.00	—	3% above	43%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$1,395.93	$2,449.00	—	3% above	43%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN	$552.90	$970.00	$227.00	10% below	43%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$591.66	$1,038.00	$227.00	3% below	43%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$288.42	$506.00	$108.00	22% below	43%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$308.94	$542.00	$108.00	17% below	43%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$172.71	$303.00	$303.00	58% below	43%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$258.21	$453.00	$81.00	3% above	43%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG	$276.45	$485.00	$81.00	10% above	43%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$258.21	$453.00	—	3% above	43%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$258.21	$453.00	—	3% above	43%
MR angiography (MRA) of the head without contrast CPT 70544 MRI SCAN OF BLOOD VESSELS OF HEAD WITHOUT CONTRAST	$1,554.39	$2,727.00	$574.00	18% below	43%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$1,663.26	$2,918.00	$574.00	12% below	43%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,652.43	$2,899.00	$539.00	14% below	43%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,768.14	$3,102.00	$539.00	7% below	43%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,652.43	$2,899.00	—	14% below	43%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,652.43	$2,899.00	—	14% below	43%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$2,192.79	$3,847.00	$1,036.00	22% below	43%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$2,346.69	$4,117.00	$1,036.00	16% below	43%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$2,192.79	$3,847.00	—	22% below	43%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$2,346.69	$4,117.00	—	16% below	43%
MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST	$2,157.45	$3,785.00	$524.00	18% below	43%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,308.50	$4,050.00	$524.00	12% below	43%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,823.21	$4,953.00	$906.00	22% below	43%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$3,021.00	$5,300.00	$906.00	17% below	43%
MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST	$2,057.70	$3,610.00	$521.00	at median	43%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$2,201.91	$3,863.00	$521.00	7% above	43%
MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,972.55	$5,215.00	$851.00	at median	43%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$3,181.17	$5,581.00	$851.00	7% above	43%
MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,983.03	$3,479.00	$509.00	13% below	43%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$2,122.11	$3,723.00	$509.00	7% below	43%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,522.82	$4,426.00	$853.00	1% below	43%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$2,699.52	$4,736.00	$853.00	6% above	43%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST	$1,751.61	$3,073.00	$507.00	11% below	43%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$1,874.73	$3,289.00	$507.00	5% below	43%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,384.31	$4,183.00	$855.00	7% below	43%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$2,551.32	$4,476.00	$855.00	at median	43%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST	$1,800.06	$3,158.00	$507.00	16% below	43%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,926.60	$3,380.00	$507.00	10% below	43%
MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST	$2,412.81	$4,233.00	$903.00	28% below	43%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$2,582.10	$4,530.00	$903.00	22% below	43%
MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST	$1,798.92	$3,156.00	$613.00	19% below	43%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$1,924.89	$3,377.00	$613.00	14% below	43%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,658.13	$2,909.00	$540.00	5% below	43%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,774.41	$3,113.00	$540.00	2% above	43%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,658.13	$2,909.00	—	5% below	43%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,658.13	$2,909.00	—	5% below	43%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY OF UPPER SPINE; 4-5 VIEWS	$368.22	$646.00	$136.00	31% below	43%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$394.44	$692.00	$136.00	26% below	43%
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST	$1,630.20	$2,860.00	$490.00	12% below	43%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$1,744.77	$3,061.00	$490.00	6% below	43%
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST	$1,534.44	$2,692.00	$398.00	at median	43%
Neck soft tissue X-ray CPT 70360 X-RAY OF SOFT TISSUE OF NECK	$260.49	$457.00	$81.00	at median	43%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT	$3,118.47	$5,471.00	$1,119.00	at median	43%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$3,336.78	$5,854.00	$1,119.00	7% above	43%
Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST	$1,439.82	$2,526.00	$353.00	6% below	43%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$1,540.71	$2,703.00	$353.00	at median	43%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS	$328.89	$577.00	$125.00	4% below	43%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$342.57	$601.00	$125.00	at median	43%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS	$555.18	$974.00	$272.00	27% below	43%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$594.51	$1,043.00	$272.00	22% below	43%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$635.55	$1,115.00	$348.00	9% below	43%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$680.58	$1,194.00	$348.00	2% below	43%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS	$534.66	$938.00	$303.00	3% below	43%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$572.28	$1,004.00	$303.00	3% above	43%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$394.44	$692.00	$209.00	at median	43%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS	$438.90	$770.00	$209.00	11% above	43%
Rib X-ray, one side, 2 views CPT 71100 X-RAY OF RIBS ON SIDE OF BODY; 2 VIEWS	$233.13	$409.00	$94.00	19% below	43%
Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$249.66	$438.00	$94.00	13% below	43%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$321.48	$564.00	$108.00	11% below	43%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$344.28	$604.00	—	4% below	43%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$344.28	$604.00	$108.00	4% below	43%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$316.35	$555.00	$329.00	—	43%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY	$295.26	$518.00	$329.00	at median	43%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$266.19	$467.00	$89.00	15% below	43%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$285.00	$500.00	$89.00	9% below	43%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$266.19	$467.00	—	15% below	43%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$266.19	$467.00	—	15% below	43%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES	$372.78	$654.00	$96.00	6% above	43%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL	$283.86	$498.00	$92.00	at median	43%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$2,381.46	$4,178.00	$861.00	35% below	43%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,728.02	$4,786.00	$861.00	25% below	43%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$274.74	$482.00	$91.00	31% above	43%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$256.50	$450.00	—	22% above	43%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$256.50	$450.00	—	22% above	43%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST	$2,035.47	$3,571.00	$344.00	14% above	43%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$2,177.97	$3,821.00	$344.00	22% above	43%
Toe X-ray, 2 or more views CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$186.39	$327.00	$75.00	19% below	43%
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$199.50	$350.00	$75.00	13% below	43%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$516.42	$906.00	$309.00	9% below	43%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$552.90	$970.00	$309.00	2% below	43%
Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS	$488.49	$857.00	$238.00	at median	43%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$522.69	$917.00	$238.00	7% above	43%
Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN	$742.14	$1,302.00	$299.00	27% below	43%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$794.58	$1,394.00	$299.00	22% below	43%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM	$480.51	$843.00	$260.00	22% below	43%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$514.71	$903.00	$260.00	16% below	43%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE	$515.85	$905.00	$286.00	18% below	43%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$552.33	$969.00	$286.00	12% below	43%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT	$530.67	$931.00	$319.00	19% below	43%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$568.29	$997.00	$319.00	14% below	43%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$198.93	$349.00	$82.00	23% below	43%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS	$213.18	$374.00	$82.00	17% below	43%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$198.93	$349.00	—	23% below	43%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$198.93	$349.00	—	23% below	43%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$703.95	$1,235.00	$170.00	4% below	43%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$753.54	$1,322.00	$170.00	3% above	43%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$703.95	$1,235.00	—	4% below	43%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$703.95	$1,235.00	—	4% below	43%
Wrist X-ray, 2 views CPT 73100 X-RAY OF WRIST; 2 VIEWS	$196.65	$345.00	$87.00	31% below	43%
Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST	$210.90	$370.00	$87.00	26% below	43%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$196.65	$345.00	—	31% below	43%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$196.65	$345.00	—	31% below	43%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$261.63	$459.00	$105.00	4% below	43%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$280.44	$492.00	$105.00	3% above	43%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$261.63	$459.00	—	4% below	43%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$261.63	$459.00	—	4% below	43%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$240.54	$422.00	$120.00	11% below	43%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$257.64	$452.00	$120.00	5% below	43%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$240.54	$422.00	—	11% below	43%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$240.54	$422.00	—	11% below	43%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$245.10	$430.00	$77.00	at median	43%
X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW	$457.14	$802.00	$77.00	87% above	43%
X-ray of the ankle, 2 views CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$216.03	$379.00	$83.00	4% below	43%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$231.42	$406.00	$83.00	3% above	43%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$216.03	$379.00	—	4% below	43%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$432.06	$758.00	—	92% above	43%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$174.42	$306.00	$97.00	3% below	43%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$186.96	$328.00	$97.00	4% above	43%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$186.96	$328.00	—	4% above	43%
X-ray of the foot, 2 views CPT 73620 X-RAY OF FOOT; 2 VIEWS	$198.36	$348.00	$73.00	29% below	43%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$212.61	$373.00	$73.00	24% below	43%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$198.36	$348.00	—	29% below	43%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$198.36	$348.00	—	29% below	43%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$251.94	$442.00	$87.00	24% below	43%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$269.61	$473.00	$87.00	19% below	43%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$251.94	$442.00	—	24% below	43%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$251.94	$442.00	—	24% below	43%
X-ray of the hand, 3 or more views CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$254.79	$447.00	$94.00	11% below	43%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$273.03	$479.00	$94.00	5% below	43%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$254.79	$447.00	—	11% below	43%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$254.79	$447.00	—	11% below	43%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$250.23	$439.00	$87.00	16% below	43%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$233.70	$410.00	—	22% below	43%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$233.70	$410.00	—	22% below	43%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS	$327.18	$574.00	$102.00	at median	43%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$350.55	$615.00	$102.00	7% above	43%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$470.25	$825.00	$132.00	13% below	43%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$503.31	$883.00	$132.00	7% below	43%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS	$275.31	$483.00	$85.00	23% below	43%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$294.69	$517.00	$85.00	17% below	43%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS	$310.65	$545.00	$98.00	15% above	43%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS	$286.14	$502.00	$101.00	4% below	43%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$306.66	$538.00	$101.00	3% above	43%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$249.09	$437.00	$71.00	4% below	43%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS	$465.12	$816.00	$71.00	80% above	43%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS	$259.35	$455.00	$83.00	at median	43%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$277.59	$487.00	$83.00	7% above	43%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) LEVEL	$60.42	$106.00	$60.00	53% below	43%
ACTH blood test CPT 82024 ASSAY OF ACTH	$82.65	$145.00	$60.00	36% below	43%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$25.08	$44.00	$8.20	at median	43%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL	$44.46	$78.00	$8.20	77% above	43%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$24.51	$43.00	$8.05	at median	43%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL	$52.44	$92.00	$8.05	114% above	43%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$26.22	$46.00	$7.65	at median	43%
Albumin blood test CPT 82040 ALBUMIN (PROTEIN) LEVEL	$41.61	$73.00	$7.65	59% above	43%
Aldosterone blood test CPT 82088 ALDOSTERONE HORMONE LEVEL	$73.53	$129.00	$63.00	50% below	43%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$76.38	$134.00	$63.00	48% below	43%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE (ENZYME) LEVEL; ALKALINE	$25.08	$44.00	$8.05	8% above	43%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$23.94	$42.00	$8.10	34% below	43%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH	$60.99	$107.00	$8.10	69% above	43%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$53.01	$93.00	$26.00	44% below	43%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) LEVEL; SERUM	$58.71	$103.00	$26.00	38% below	43%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$69.54	$122.00	$23.00	at median	43%
Ammonia blood test CPT 82140 AMMONIA LEVEL	$106.59	$187.00	$23.00	53% above	43%
Amylase blood test CPT 82150 AMYLASE (ENZYME) LEVEL	$54.72	$96.00	$10.00	at median	43%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT	$22.23	$39.00	$20.00	67% below	43%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$47.88	$84.00	$20.00	30% below	43%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER	$22.23	$39.00	$19.00	69% below	43%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$64.98	$114.00	$19.00	9% below	43%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$132.81	$233.00	$61.00	9% below	43%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL	$200.64	$352.00	$61.00	37% above	43%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$66.69	$117.00	$13.00	14% below	43%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC	$84.36	$148.00	$13.00	9% above	43%
Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA	$62.13	$109.00	$13.00	25% below	43%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$212.04	$372.00	$13.00	155% above	43%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$27.36	$48.00	$7.80	3% above	43%
Bilirubin blood test, total CPT 82247 BILIRUBIN LEVEL; TOTAL	$39.90	$70.00	$7.80	51% above	43%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY	$93.48	$164.00	$135.00	5% below	43%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$123.69	$217.00	$135.00	26% above	43%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$79.23	$139.00	$16.00	28% below	43%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE	$273.60	$480.00	$16.00	147% above	43%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$19.38	$34.00	$4.65	13% below	43%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$38.76	$68.00	$4.65	74% above	43%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$22.80	$40.00	$6.10	45% below	43%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL	$41.61	$73.00	$6.10	1% above	43%
Blood lead test CPT 83655 LEAD LEVEL	$21.66	$38.00	$19.00	61% below	43%
Blood lead test CPT 83655 ASSAY OF LEAD	$45.03	$79.00	$19.00	19% below	43%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$50.16	$88.00	$12.00	6% below	43%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS	$57.57	$101.00	$12.00	7% above	43%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO)	$30.78	$54.00	$4.65	62% below	43%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$82.65	$145.00	$4.65	2% above	43%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$22.23	$39.00	$6.10	5% below	43%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN LEVEL TO ASSESS KIDNEY FUNCTION; QUANTITATIVE	$43.89	$77.00	$6.10	88% above	43%
C-peptide blood test CPT 84681 C-PEPTIDE (PROTEIN) LEVEL	$58.71	$103.00	$32.00	48% below	43%
C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE	$79.80	$140.00	$32.00	29% below	43%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$51.30	$90.00	$8.05	29% below	43%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION	$64.41	$113.00	$8.05	11% below	43%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$111.15	$195.00	$58.00	28% below	43%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE	$269.04	$472.00	$58.00	73% above	43%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9	$33.06	$58.00	$32.00	66% below	43%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$73.53	$129.00	$32.00	25% below	43%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125	$33.06	$58.00	$32.00	71% below	43%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$77.52	$136.00	$32.00	33% below	43%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$90.63	$159.00	$79.00	17% below	43%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$22.80	$40.00	$8.00	12% below	43%
Calcium blood test, total CPT 82310 CALCIUM LEVEL; TOTAL	$49.02	$86.00	$8.00	89% above	43%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) PROTEIN LEVEL	$28.50	$50.00	$29.00	68% below	43%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$70.68	$124.00	$29.00	22% below	43%
Chickenpox (varicella) immunity blood test CPT 86787 ANALYSIS FOR ANTIBODY TO VARICELLA-ZOSTER VIRUS (CHICKEN POX)	$22.80	$40.00	$20.00	57% below	43%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$45.60	$80.00	$20.00	15% below	43%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE	$45.60	$80.00	$54.00	53% below	43%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$76.95	$135.00	$54.00	20% below	43%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$67.26	$118.00	$21.00	7% below	43%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$98.61	$173.00	$21.00	36% above	43%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$23.94	$42.00	$12.00	56% below	43%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$48.45	$85.00	$12.00	11% below	43%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$45.60	$80.00	$10.00	9% below	43%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$47.31	$83.00	$10.00	6% below	43%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$88.35	$155.00	$16.00	21% below	43%
Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$251.94	$442.00	$16.00	125% above	43%
Cortisol blood test, total CPT 82533 CORTISOL (HORMONE) MEASUREMENT; TOTAL	$42.18	$74.00	$25.00	60% below	43%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$68.97	$121.00	$25.00	34% below	43%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK)	$41.61	$73.00	$10.00	5% below	43%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CARDIAC ENZYME) LEVEL; TOTAL	$65.55	$115.00	$10.00	50% above	43%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$23.94	$42.00	$7.95	2% below	43%
Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL	$42.18	$74.00	$7.95	73% above	43%
Cytomegalovirus (CMV) antibody test CPT 86644 ANALYSIS FOR ANTIBODY TO CYTOMEGALOVIRUS (CMV)	$29.07	$51.00	$22.00	59% below	43%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$37.62	$66.00	$22.00	47% below	43%
D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE	$96.90	$170.00	$16.00	13% below	43%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL	$68.40	$120.00	$34.00	50% below	43%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$75.81	$133.00	$34.00	44% below	43%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$132.24	$232.00	$96.00	3% above	43%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TESTING FOR PRESENCE OF DRUG; BY CHEMISTRY ANALYZERS	$763.80	$1,340.00	$96.00	495% above	43%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$60.99	$107.00	$11.00	6% above	43%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 BLOOD TEST PANEL FOR ELECTROLYTES (SODIUM POTASSIUM; CHLORIDE; CARBON DIOXIDE)	$72.96	$128.00	$11.00	27% above	43%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANALYSIS FOR ANTIBODY TO EPSTEIN-BARR VIRUS (MONONUCLEOSIS VIRUS); VIRAL CAPSID	$61.56	$108.00	$28.00	39% below	43%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA	$71.25	$125.00	$28.00	30% below	43%
Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$96.90	$170.00	$43.00	22% below	43%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$112.86	$198.00	$43.00	9% below	43%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL	$37.05	$65.00	$29.00	68% below	43%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$87.21	$153.00	$29.00	24% below	43%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$176.70	$310.00	$30.00	17% below	43%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL	$185.82	$326.00	$30.00	13% below	43%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$71.82	$126.00	$21.00	21% below	43%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL	$116.85	$205.00	$21.00	28% above	43%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$59.85	$105.00	$15.00	16% below	43%
Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT	$117.99	$207.00	$15.00	65% above	43%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM	$39.33	$69.00	$23.00	58% below	43%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$64.41	$113.00	$23.00	30% below	43%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE	$59.28	$104.00	$26.00	45% below	43%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$78.66	$138.00	$26.00	27% below	43%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$61.56	$108.00	$14.00	20% below	43%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE	$188.10	$330.00	$14.00	143% above	43%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE	$23.94	$42.00	$39.00	79% below	43%
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$84.93	$149.00	$39.00	27% below	43%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$26.79	$47.00	$11.00	16% below	43%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE (LIVER ENZYME) LEVEL	$55.86	$98.00	$11.00	75% above	43%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE	$42.75	$75.00	$7.35	2% below	43%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$43.32	$76.00	$7.35	at median	43%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$91.20	$160.00	$20.00	at median	43%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS	$94.62	$166.00	$20.00	4% above	43%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE	$45.60	$80.00	$54.00	52% below	43%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$78.66	$138.00	$54.00	17% below	43%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$94.05	$165.00	$22.00	at median	43%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$194.37	$341.00	$132.00	20% below	43%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION	$209.76	$368.00	$132.00	14% below	43%
HIV-1 and HIV-2 antibody test CPT 86703 ANALYSIS FOR ANTIBODY TO HIV-1 AND HIV-2 VIRUS	$66.12	$116.00	$21.00	9% below	43%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$68.40	$120.00	$21.00	6% below	43%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES	$21.66	$38.00	$37.00	70% below	43%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA	$61.56	$108.00	$37.00	15% below	43%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL	$17.67	$31.00	$15.00	64% below	43%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$48.45	$85.00	$15.00	at median	43%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$19.38	$34.00	$3.65	36% below	43%
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN	$27.93	$49.00	$3.65	8% below	43%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY MEASUREMENT	$42.75	$75.00	$19.00	25% below	43%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$43.32	$76.00	$19.00	24% below	43%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT	$26.79	$47.00	$17.00	58% below	43%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$53.58	$94.00	$17.00	16% below	43%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN	$14.82	$26.00	$16.00	76% below	43%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$47.88	$84.00	$16.00	23% below	43%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT	$19.95	$35.00	$22.00	70% below	43%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$58.14	$102.00	$22.00	12% below	43%
Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION	$158.46	$278.00	$66.00	29% below	43%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$180.69	$317.00	$66.00	19% below	43%
Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1	$11.97	$21.00	$20.00	80% below	43%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$45.60	$80.00	$20.00	24% below	43%
Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2	$11.97	$21.00	$21.00	85% below	43%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$58.14	$102.00	$30.00	26% below	43%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$40.47	$71.00	$20.00	39% below	43%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY	$57.00	$100.00	$20.00	14% below	43%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL	$42.18	$74.00	$28.00	48% below	43%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$85.50	$150.00	$28.00	5% above	43%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL	$42.75	$75.00	$18.00	14% below	43%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$54.15	$95.00	$18.00	9% above	43%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$23.37	$41.00	$10.00	36% below	43%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$40.47	$71.00	$10.00	11% above	43%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$23.37	$41.00	$14.00	41% below	43%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$34.20	$60.00	$14.00	14% below	43%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$80.94	$142.00	$13.00	8% below	43%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL	$83.22	$146.00	$13.00	5% below	43%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL	$24.51	$43.00	$29.00	78% below	43%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$99.18	$174.00	$29.00	10% below	43%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$77.52	$136.00	$18.00	8% above	43%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LEVEL	$116.85	$205.00	$18.00	63% above	43%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$35.34	$62.00	$9.35	at median	43%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (ENZYME) LEVEL	$54.72	$96.00	$9.35	55% above	43%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$69.54	$122.00	$11.00	4% below	43%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL	$181.26	$318.00	$11.00	151% above	43%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$64.41	$113.00	$13.00	19% below	43%
Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL	$114.57	$201.00	$13.00	44% above	43%
Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$66.12	$116.00	$26.00	29% below	43%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$124.26	$218.00	$26.00	33% above	43%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$39.33	$69.00	$10.00	10% below	43%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$46.17	$81.00	$10.00	6% above	43%
Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS)	$22.23	$39.00	$20.00	60% below	43%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$47.31	$83.00	$20.00	16% below	43%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$49.02	$86.00	$8.05	16% below	43%
Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO)	$52.44	$92.00	$8.05	10% below	43%
Mumps immunity blood test CPT 86735 ANALYSIS FOR ANTIBODY TO MUMPS VIRUS	$22.23	$39.00	$20.00	65% below	43%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$48.45	$85.00	$20.00	24% below	43%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE	$21.66	$38.00	$29.00	75% below	43%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$70.68	$124.00	$29.00	20% below	43%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$77.52	$136.00	$29.00	5% below	43%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$110.01	$193.00	$29.00	35% above	43%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$88.92	$156.00	$51.00	11% below	43%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$83.79	$147.00	$38.00	20% above	43%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL	$54.15	$95.00	$64.00	70% below	43%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$139.08	$244.00	$64.00	23% below	43%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$44.46	$78.00	$9.30	11% below	43%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$71.82	$126.00	$9.30	44% above	43%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE LEVEL	$30.21	$53.00	$7.35	27% below	43%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$22.80	$40.00	$7.40	7% below	43%
Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL	$43.89	$77.00	$7.40	79% above	43%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$565.44	$992.00	$992.00	56% below	43%
Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL	$18.81	$33.00	$32.00	82% below	43%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$68.40	$120.00	$32.00	35% below	43%
Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL	$21.66	$38.00	$30.00	79% below	43%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$88.92	$156.00	$30.00	12% below	43%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$32.49	$57.00	$6.65	8% below	43%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME	$41.04	$72.00	$6.65	17% above	43%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$18.81	$33.00	$20.00	44% below	43%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION	$52.44	$92.00	$20.00	56% above	43%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$46.74	$82.00	$26.00	12% below	43%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR STREPTOCOCCUS; GROUP A (STREP)	$55.86	$98.00	$26.00	5% above	43%
Renin blood test CPT 84244 RENIN (KIDNEY ENZYME) LEVEL	$39.90	$70.00	$34.00	67% below	43%
Renin blood test CPT 84244 ASSAY OF RENIN	$53.01	$93.00	$34.00	57% below	43%
Rh blood typing CPT 86901 BLOOD TYPING FOR RH (D) ANTIGEN	$30.78	$54.00	$4.65	42% below	43%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$47.88	$84.00	$4.65	10% below	43%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$37.05	$65.00	$8.80	19% below	43%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL	$46.17	$81.00	$8.80	1% above	43%
Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS)	$39.33	$69.00	$22.00	39% below	43%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$51.87	$91.00	$22.00	20% below	43%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$30.78	$54.00	$4.20	3% below	43%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED	$55.29	$97.00	$4.20	74% above	43%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$19.38	$34.00	$7.45	at median	43%
Sodium blood test CPT 84295 BLOOD SODIUM LEVEL	$39.90	$70.00	$7.45	106% above	43%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES	$26.79	$47.00	$14.00	49% below	43%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$79.23	$139.00	$14.00	52% above	43%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$15.39	$27.00	$6.80	27% below	43%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANALYSIS FOR ANTIBODY; TREPONEMA PALLIDUM	$31.35	$55.00	$21.00	52% below	43%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$42.75	$75.00	$21.00	35% below	43%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST	$42.75	$75.00	$6.60	at median	43%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$119.13	$209.00	$96.00	17% below	43%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON	$160.17	$281.00	$96.00	12% above	43%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL	$23.94	$42.00	$40.00	75% below	43%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$79.23	$139.00	$40.00	18% below	43%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$51.30	$90.00	$23.00	32% below	43%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$61.56	$108.00	$23.00	18% below	43%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$68.97	$121.00	$26.00	11% below	43%
Total IgE blood test CPT 82785 ASSAY OF IGE	$55.29	$97.00	$26.00	30% below	43%
Total IgE blood test CPT 82785 IGE (IMMUNE SYSTEM PROTEIN) LEVEL	$57.00	$100.00	$26.00	28% below	43%
Total cholesterol blood test CPT 82465 CHOLESTEROL LEVEL	$27.93	$49.00	$6.75	20% below	43%
Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL	$17.67	$31.00	$11.00	61% below	43%
Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE	$49.02	$86.00	$11.00	8% above	43%
Total triiodothyronine (T3) blood test CPT 84480 THYROID HORMONE; T3 MEASUREMENT; TOTAL	$24.51	$43.00	$22.00	71% below	43%
Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$68.97	$121.00	$22.00	19% below	43%
Transferrin blood test CPT 84466 TRANSFERRIN (IRON BINDING PROTEIN) LEVEL	$21.66	$38.00	$20.00	66% below	43%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$75.24	$132.00	$20.00	17% above	43%
Triglycerides blood test CPT 84478 TRIGLYCERIDES LEVEL	$28.50	$50.00	$8.90	5% above	43%
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$90.06	$158.00	$19.00	12% below	43%
Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE	$155.04	$272.00	$19.00	51% above	43%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$29.64	$52.00	$7.00	24% below	43%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD	$39.90	$70.00	$7.00	3% above	43%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$26.22	$46.00	$4.90	38% below	43%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$74.67	$131.00	$4.90	78% above	43%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$28.50	$50.00	$6.25	6% below	43%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$14.82	$26.00	$3.50	30% below	43%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST	$35.34	$62.00	$3.50	68% above	43%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$22.80	$40.00	$5.40	3% above	43%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST	$25.65	$45.00	$5.40	16% above	43%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE	$9.12	$16.00	$13.00	88% below	43%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$51.30	$90.00	$13.00	32% below	43%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$22.80	$40.00	$8.95	61% below	43%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN (PROTEIN) LEVEL	$78.66	$138.00	$8.95	34% above	43%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$45.03	$79.00	$13.00	at median	43%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL	$39.90	$70.00	$23.00	55% below	43%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$93.48	$164.00	$23.00	6% above	43%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL	$82.65	$145.00	$46.00	30% below	43%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$95.76	$168.00	$46.00	19% below	43%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D; 1; 25 LEVEL	$44.46	$78.00	$60.00	62% below	43%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$108.87	$191.00	$60.00	6% below	43%
Zinc blood test CPT 84630 ZINC LEVEL	$24.51	$43.00	$18.00	64% below	43%
Zinc blood test CPT 84630 ASSAY OF ZINC	$51.30	$90.00	$18.00	25% below	43%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$83.79	$147.00	$23.00	1% above	43%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL	$157.89	$277.00	$23.00	90% above	43%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS)	$1,330.67	$2,334.50	$476.00	—	43%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC	$7,982.28	$14,004.00	$3,821.00	—	43%
Appendectomy, open surgery CPT 44950 REMOVAL OF APPENDIX	$4,565.13	$8,009.00	$1,424.00	—	43%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$6,322.44	$11,092.00	$2,205.00	at median	43%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$1,656.56	$2,906.25	—	at median	43%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$2,345.55	$4,115.00	—	42% above	43%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$119.70	$210.00	$210.00	at median	43%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$572.28	$1,004.00	$649.00	1% above	43%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$335.16	$588.00	$469.00	5% below	43%
Bunion correction with a bone cut near the head of the first metatarsal one side CPT 28296 CORRECTION OF BUNION WITH ALIGNMENT CORRECTION OF MIDFOOT BONE TOWARD TOE AREA	$4,046.43	$7,099.00	—	—	43%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT	$1,131.45	$1,985.00	$219.00	at median	43%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,210.68	$2,124.00	$219.00	7% above	43%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$1,138.29	$1,997.00	—	42% below	43%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$1,146.27	$2,011.00	—	41% below	43%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,310.21	$4,053.00	—	at median	43%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,405.97	$4,221.00	—	4% above	43%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$363.09	$637.00	$171.00	at median	43%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$1,768.71	$3,103.00	$7,890.00	—	43%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO	$513.00	$900.00	$704.00	at median	43%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,009.25	$3,525.00	$688.00	at median	43%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,963.94	$3,445.50	$580.00	at median	43%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,009.25	$3,525.00	$486.00	at median	43%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$483.93	$849.00	$305.00	at median	43%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE	$2,523.39	$4,427.00	$305.00	421% above	43%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,382.03	$4,179.00	—	at median	43%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,429.91	$4,263.00	—	2% above	43%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION	$64.98	$114.00	$114.00	at median	43%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$1,136.01	$1,993.00	$365.00	—	43%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$458.28	$804.00	$304.00	—	43%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$34.77	$61.00	$27.00	62% below	43%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$37.62	$66.00	$27.00	59% below	43%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX	$54.72	$96.00	$72.00	65% below	43%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$128.82	$226.00	$72.00	18% below	43%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS	$235.41	$413.00	$197.00	at median	43%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$251.94	$442.00	$197.00	7% above	43%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE	$488.49	$857.00	$250.00	65% below	43%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$244.25	$428.50	—	86% below	43%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$522.69	$917.00	—	70% below	43%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE	$2,900.73	$5,089.00	$1,282.00	—	43%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE	$2,485.77	$4,361.00	$765.00	—	43%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$3,927.87	$6,891.00	$144.00	143% above	43%
Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$4,086.33	$7,169.00	$1,462.00	—	43%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP	$2,677.29	$4,697.00	$794.00	at median	43%
Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE	$2,540.49	$4,457.00	$768.00	—	43%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$2,645.37	$4,641.00	$598.00	—	43%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION	$835.43	$1,465.66	$112.00	42% above	43%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$114.57	$201.00	$201.00	65% below	43%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$297.54	$522.00	$215.00	8% below	43%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$2,908.71	$5,103.00	$1,159.00	—	43%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$2,525.67	$4,431.00	—	—	43%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$111.15	$195.00	$91.00	44% below	43%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$261.35	$458.50	—	32% above	43%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$261.35	$458.50	—	32% above	43%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$48.45	$85.00	$85.00	88% below	43%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$473.67	$831.00	$101.00	16% above	43%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$244.25	$428.50	—	40% below	43%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$488.49	$857.00	—	20% above	43%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$187.53	$329.00	$116.00	36% below	43%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$318.63	$559.00	$116.00	9% above	43%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$244.25	$428.50	—	16% below	43%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$38.19	$67.00	$67.00	84% below	43%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$261.35	$458.50	—	8% above	43%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$4,062.39	$7,127.00	—	—	43%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$4,689.96	$8,228.00	—	—	43%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$3,822.99	$6,707.00	—	—	43%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$3,870.87	$6,791.00	—	—	43%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$4,262.46	$7,478.00	—	—	43%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE	$3,878.85	$6,805.00	$1,337.00	—	43%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$3,908.21	$6,856.50	$2,329.00	—	43%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$336.30	$590.00	$590.00	—	43%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$437.19	$767.00	$767.00	—	43%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$604.77	$1,061.00	$345.00	at median	43%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$488.49	$857.00	$228.00	62% below	43%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$488.49	$857.00	$254.00	58% below	43%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$488.49	$857.00	—	58% below	43%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$488.49	$857.00	—	58% below	43%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$7,551.36	$13,248.00	$2,162.00	—	43%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$4,269.87	$7,491.00	—	—	43%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 FUSION OF SPINE IN LOWER BACK WITH PARTIAL REMOVAL OF SPINE BONE AND DISC	$9,625.02	$16,886.00	$4,091.00	—	43%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT	$4,421.49	$7,757.00	$2,468.00	—	43%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$3,243.87	$5,691.00	—	—	43%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER	$2,557.59	$4,487.00	$810.00	—	43%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$84.36	$148.00	$148.00	36% below	43%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$108.30	$190.00	$190.00	25% below	43%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$103.17	$181.00	$110.00	56% below	43%
Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$450.30	$790.00	$110.00	93% above	43%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$53.58	$94.00	$94.00	89% below	43%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$261.35	$458.50	—	47% below	43%
Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE	$914.85	$1,605.00	$247.00	8% below	43%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$979.26	$1,718.00	$247.00	2% below	43%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$200.07	$351.00	$351.00	53% below	43%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$1,244.31	$2,183.00	—	37% below	43%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$1,287.06	$2,258.00	—	34% below	43%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$157.89	$277.00	$233.00	47% below	43%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$235.98	$414.00	$233.00	20% below	43%
Removal of a foreign object under the skin, simple one side CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$1,162.23	$2,039.00	—	293% above	43%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$2,009.25	$3,525.00	—	at median	43%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$2,009.25	$3,525.00	—	at median	43%
Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE	$1,195.15	$2,096.75	$1,418.00	—	43%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$108.30	$190.00	$140.00	35% below	43%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$229.71	$403.00	$89.00	17% below	43%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$246.24	$432.00	$89.00	11% below	43%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$114.57	$201.00	$134.00	75% below	43%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$193.23	$339.00	$112.00	36% below	43%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$228.57	$401.00	$112.00	25% below	43%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$3,017.01	$5,293.00	$1,517.00	—	43%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$1,568.07	$2,751.00	—	—	43%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$6,146.88	$10,784.00	—	—	43%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,656.56	$2,906.25	—	at median	43%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$6,635.94	$11,642.00	—	301% above	43%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$225.72	$396.00	$99.00	33% below	43%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$368.22	$646.00	$99.00	10% above	43%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$175.56	$308.00	$108.00	33% below	43%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$188.10	$330.00	$108.00	28% below	43%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15	$72.39	$127.00	$127.00	63% below	43%
Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST	$570.57	$1,001.00	$174.00	21% below	43%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$611.04	$1,072.00	$174.00	16% below	43%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$273.03	$479.00	$131.00	21% below	43%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$343.71	$603.00	$131.00	1% below	43%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs one side CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$343.71	$603.00	—	1% below	43%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$272.46	$478.00	$125.00	4% below	43%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS	$330.60	$580.00	$125.00	17% above	43%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH	$345.42	$606.00	$108.00	at median	43%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$369.93	$649.00	$108.00	7% above	43%
Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$1,007.76	$1,768.00	$248.00	7% below	43%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$2,298.81	$4,033.00	$248.00	111% above	43%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$2,754.24	$4,832.00	$659.00	—	43%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER)	$2,717.19	$4,767.00	$573.00	—	43%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS (YOUNGER THAN 12 YEARS)	$2,677.29	$4,697.00	$599.00	—	43%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$7,957.20	$13,960.00	—	at median	43%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$8,283.24	$14,532.00	—	4% above	43%
Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$8,661.15	$15,195.00	$3,423.00	6% above	43%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$8,170.38	$14,334.00	—	at median	43%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$8,546.58	$14,994.00	—	5% above	43%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$7,681.32	$13,476.00	—	—	43%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$8,044.98	$14,114.00	—	—	43%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$5,989.56	$10,508.00	$2,049.00	—	43%
Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER	$1,329.81	$2,333.00	$697.00	13% below	43%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$115.14	$202.00	$84.00	66% below	43%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$123.69	$217.00	$84.00	64% below	43%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$522.69	$917.00	—	52% above	43%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$820.80	$1,440.00	$1,369.00	65% below	43%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$878.37	$1,541.00	$1,369.00	63% below	43%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM	$959.31	$1,683.00	$389.00	47% below	43%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,963.94	$3,445.50	$385.00	3% below	43%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,820.30	$3,193.50	$488.00	at median	43%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,918.62	$3,366.00	$326.00	at median	43%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$640.11	$1,123.00	$497.00	at median	43%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT	$2,523.39	$4,427.00	$497.00	294% above	43%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS	$54.72	$96.00	$96.00	49% below	43%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$58.71	$103.00	$103.00	45% below	43%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$197.79	$347.00	$137.00	45% below	43%
Wound debridement, skin and tissue under it, first 20 sq cm one side CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$408.69	$717.00	—	14% above	43%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS	$703.38	$1,234.00	$77.00	1% below	43%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$761.52	$1,336.00	$77.00	7% above	43%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$54.15	$95.00	$7,890.00	—	43%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$151.05	$265.00	$7,890.00	—	43%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS	$347.70	$610.00	$185.00	31% below	43%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$372.21	$653.00	$185.00	26% below	43%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES	$1,523.61	$2,673.00	$468.00	34% below	43%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,630.77	$2,861.00	$468.00	29% below	43%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$178.98	$314.00	$9.00	5% below	43%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING	$334.02	$586.00	$9.00	77% above	43%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$201.21	$353.00	$20.00	23% below	43%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$310.65	$545.00	$71.00	14% below	43%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$332.88	$584.00	$71.00	8% below	43%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$457.71	$803.00	$123.00	36% below	43%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$490.20	$860.00	$123.00	31% below	43%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$682.86	$1,198.00	$206.00	43% below	43%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$730.74	$1,282.00	$206.00	38% below	43%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$995.22	$1,746.00	$300.00	40% below	43%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,065.33	$1,869.00	$300.00	36% below	43%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG)	$748.41	$1,313.00	$51.00	12% below	43%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$800.85	$1,405.00	$51.00	6% below	43%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES	$267.90	$470.00	$46.00	7% below	43%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$286.71	$503.00	$46.00	at median	43%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$292.98	$514.00	$91.00	23% below	43%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS	$307.80	$540.00	$91.00	19% below	43%
IV push of a medicine, first drug CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN	$185.25	$325.00	$53.00	13% below	43%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$198.36	$348.00	$53.00	7% below	43%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN	$133.38	$234.00	$7,890.00	—	43%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$92.91	$163.00	$20.00	2% below	43%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$96.90	$170.00	$20.00	3% above	43%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$114.00	$200.00	$7,890.00	—	43%
Neuromuscular re-education, 15 minutes CPT 97112 THERAPY PROCEDURE TO RE-EDUCATE BRAIN-TO-NERVE-TO-MUSCLE FUNCTION; EACH 15 MINUTES	$54.72	$96.00	$48.00	48% below	43%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$58.71	$103.00	$48.00	44% below	43%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$69.54	$122.00	$52.00	4% above	43%
Occupational therapy evaluation, low complexity CPT 97165 EVALUATION FOR OCCUPATIONAL THERAPY; TYPICALLY 30 MINUTES	$117.99	$207.00	$142.00	39% below	43%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$126.54	$222.00	$142.00	35% below	43%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$164.73	$289.00	$142.00	42% below	43%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$176.70	$310.00	$142.00	38% below	43%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$115.14	$202.00	$142.00	37% below	43%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$123.69	$217.00	$142.00	32% below	43%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$144.78	$254.00	$142.00	41% below	43%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$155.04	$272.00	$142.00	37% below	43%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$60.42	$106.00	$38.00	48% below	43%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$58.71	$103.00	$42.00	47% below	43%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$65.55	$115.00	$42.00	41% below	43%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$25.65	$45.00	$21.00	at median	43%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$128.25	$225.00	$225.00	48% below	43%
Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION	$315.78	$554.00	$54.00	28% below	43%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$338.01	$593.00	$54.00	23% below	43%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPY PROCEDURE USING FUNCTIONAL ACTIVITIES	$54.72	$96.00	$53.00	44% below	43%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$58.71	$103.00	$53.00	40% below	43%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM	$121.98	$214.00	$138.00	38% below	43%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$130.53	$229.00	$138.00	33% below	43%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE 4-6 YRS IM	$67.26	$118.00	—	40% below	43%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM	$38.19	$67.00	—	53% below	43%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE IM	$112.29	$197.00	—	at median	43%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE; TRIVALENT; SPLIT VIRUS; PRESERVATIVE-FREE; 0.5 ML DOSAGE	$22.23	$39.00	—	1% below	43%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$23.37	$41.00	—	4% above	43%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$109.44	$192.00	—	29% below	43%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$116.28	$204.00	—	at median	43%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM	$57.57	$101.00	—	at median	43%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$115.14	$202.00	—	29% below	43%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$60.42	$106.00	—	14% below	43%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM	$27.36	$48.00	—	18% below	43%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM	$41.61	$73.00	—	5% below	43%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE SPLIT VIRUS; PRESERVATIVE FREE	$148.20	$260.00	—	48% above	43%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$154.47	$271.00	—	54% above	43%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$76.95	$135.00	—	55% below	43%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC	$229.14	$402.00	—	at median	43%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM	$106.02	$186.00	—	42% below	43%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PCV15 VACCINE IM	$308.37	$541.00	—	at median	43%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM	$56.43	$99.00	—	86% below	43%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PCV21 VACCINE IM	$323.19	$567.00	—	—	43%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$56.43	$99.00	—	68% below	43%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM	$42.75	$75.00	—	8% below	43%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$314.07	$551.00	—	20% below	43%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE FOR INJECTION INTO MUSCLE	$1,223.08	$2,145.75	—	210% above	43%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL	$115.14	$202.00	—	11% below	43%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$42.75	$75.00	—	38% below	43%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$39.33	$69.00	—	66% below	43%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA; TETANUS; AND ACELLULAR PERTUSSIS VACCINE (7 YEARS OR OLDER)	$189.95	$333.25	—	62% above	43%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix	$189.95	$333.25	—	62% above	43%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM	$84.93	$149.00	—	at median	43%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$10.26	$18.00	$18.00	82% below	43%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$11.40	$20.00	$20.00	80% below	43%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$18.24	$32.00	$20.00	20% below	43%

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://apim.services.craneware.com/api-pricing-transparency/api/public/f8bfd33ee3ef0de934dcd806e09fcd05/charges/mrf