Hospital Washington-Arlington-Alexandria, DC-VA-MD-WV

Spotsylvania Regional Medical Center

Spotsylvania Regional Medical Center in Fredericksburg, VA publishes cash prices for 294 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Virginia median for 290 of 292 procedures and below it for 2. By typical cash price it ranks #56 of 64 Virginia hospitals and #19 of 19 hospitals in the Washington, DC area, cheapest first. Click a procedure to compare it with other hospitals nearby.

5005 PLANK RD, FREDERICKSBURG, VA, 22407 Collected Sep 28, 2026 Source price file (540) 498-4000

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 490141 · CMS hospital register NPI 1376876664

The price file shows no self-pay discount

For 561 of the 561 prices listed here, the cash price in Spotsylvania Regional Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Spotsylvania Regional Medical Center in Fredericksburg, VA:

Dec 14, 2023 Met requirements
Apr 28, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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 Virginia	Off list
Abdominal CT scan without and with contrast CPT 74170 Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections	$5,626.40	$5,626.40	$401.74	198% above	—
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W&WO CONT	$5,626.40	$5,626.40	$1,069.02–$5,063.76	198% above	—
Abdominal X-ray, 2 views CPT 74019 ABD XR 2V	$830.96	$830.96	$157.88–$747.86	154% above	—
Abdominal X-ray, 2 views CPT 74019 Radiologic examination, abdomen; 2 views	$830.96	$830.96	$96.11–$245.18	154% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V RT	$1,008.80	$1,008.80	$191.67–$907.92	198% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V LT	$1,008.80	$1,008.80	$191.67–$907.92	198% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a	$1,177.20	$1,177.20	$430.93–$528.87	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP ART 1-2 LEVELS BIL	$1,177.20	$1,177.20	$190.24–$1,059.48	183% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREM W/O CONT RT	$4,094.48	$4,094.48	$777.95–$3,685.03	247% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREM W/O CONT LT	$4,094.48	$4,094.48	$777.95–$3,685.03	247% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study	$853.84	$853.84	$251.20–$401.74	83% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$853.84	$853.84	$162.23–$768.46	83% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$4,374.00	$4,374.00	$831.06–$3,936.60	204% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body	$4,374.00	$4,374.00	$695.39–$956.91	204% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI RT W AX COMP	$993.20	$993.20	$188.71–$893.88	77% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI LT W AX COMP	$993.20	$993.20	$188.71–$893.88	77% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI RT W AX LTD	$993.20	$993.20	$188.71–$893.88	94% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI LT W AX LTD	$993.20	$993.20	$188.71–$893.88	94% above	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing	$1,960.40	$1,960.40	$828.27	36% below	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PEL W CONT	$1,960.40	$1,960.40	$372.48–$1,764.36	36% below	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD VIZ AI TECH	$3,354.00	$3,354.00	$637.26–$3,018.60	85% above	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD	$3,354.00	$3,354.00	$637.26–$3,018.60	85% above	—
CT angiography (CTA) of the neck CPT 70498 CTA NECK	$3,354.00	$3,354.00	$637.26–$3,018.60	74% above	—
CT angiography (CTA) of the neck CPT 70498 CTA NECK VIZ AI TECH	$3,354.00	$3,354.00	$637.26–$3,018.60	74% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing	$12,345.84	$12,345.84	$747.68–$1,028.87	590% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$12,345.84	$12,345.84	$2,345.71–$11,111.26	590% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo	$13,085.28	$13,085.28	$866.62–$1,192.54	1188% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo 65 Slice CTA	$13,085.28	$13,085.28	$1,543.00	1188% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART W CN ART/GRAFTS	$13,085.28	$13,085.28	$2,486.20–$11,776.75	1188% above	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium	$1,336.40	$1,336.40	$265.49–$365.33	600% above	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium 65 Slice CTA	$1,336.40	$1,336.40	$1,543.00	600% above	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO CN W QUAN CA	$1,336.40	$1,336.40	$253.92–$1,202.76	600% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PELVIS W/O CONT	$4,229.68	$4,229.68	$803.64–$3,806.71	90% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Computed tomography, abdomen and pelvis; without contrast material	$4,229.68	$4,229.68	$484.91–$667.28	90% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Computed tomography, abdomen and pelvis; with contrast material(s)	$5,869.76	$5,869.76	$828.27	76% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PELVIS W/CONT	$5,869.76	$5,869.76	$1,115.25–$5,282.78	76% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS W&WO CONT	$7,104.24	$7,104.24	$1,349.81–$6,393.82	103% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions	$7,104.24	$7,104.24	$901.98–$1,241.20	103% above	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT	$5,241.60	$5,241.60	$995.90–$4,717.44	219% above	—
CT scan of the abdomen with contrast CPT 74160 Computed tomography, abdomen; with contrast material(s)	$5,241.60	$5,241.60	$614.81–$846.03	219% above	—
CT scan of the abdomen without contrast CPT 74150 Computed tomography, abdomen; without contrast material	$3,693.04	$3,693.04	$245.18	159% above	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$3,693.04	$3,693.04	$701.68–$3,323.74	159% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Computed tomography, maxillofacial area; without contrast material	$4,781.92	$4,781.92	$341.80–$470.34	252% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIFAC W/O CNT	$4,781.92	$4,781.92	$908.56–$4,303.73	252% above	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT	$3,669.12	$3,669.12	$697.13–$3,302.21	176% above	—
CT scan of the head or brain, no contrast dye CPT 70450 Computed tomography, head or brain; without contrast material	$3,669.12	$3,669.12	$245.18	176% above	—
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONT	$3,947.84	$3,947.84	$750.09–$3,553.06	159% above	—
CT scan of the head with contrast CPT 70460 Computed tomography, head or brain; with contrast material(s)	$3,947.84	$3,947.84	$394.09–$542.29	159% above	—
CT scan of the head without and with contrast CPT 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections	$4,328.48	$4,328.48	$401.74	147% above	—
CT scan of the head without and with contrast CPT 70470 CT HD/BR W&W/O CONT	$4,328.48	$4,328.48	$822.41–$3,895.63	147% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST	$6,677.84	$6,677.84	$1,268.79–$6,010.06	315% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Computed tomography, lumbar spine; without contrast material	$6,677.84	$6,677.84	$345.41–$475.31	315% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST	$4,499.04	$4,499.04	$854.82–$4,049.14	181% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Computed tomography, cervical spine; without contrast material	$4,499.04	$4,499.04	$1,892.00	181% above	—
CT scan of the pelvis, with contrast dye CPT 72193 Computed tomography, pelvis; with contrast material(s)	$4,235.92	$4,235.92	$401.74	150% above	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$4,235.92	$4,235.92	$804.82–$3,812.33	150% above	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex scan of extracranial arteries; complete bilateral study	$3,624.48	$3,624.48	$931.60–$1,143.33	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUP EXTRACRANIAL BIL	$3,624.48	$3,624.48	$585.72–$3,262.03	68% above	—
Chest CT scan without and with contrast CPT 71270 CT CHEST W&W/O CONT	$5,550.48	$5,550.48	$1,054.59–$4,995.43	185% above	—
Chest CT scan without and with contrast CPT 71270 Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections	$5,550.48	$5,550.48	$521.85–$718.10	185% above	—
Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views	$933.92	$933.92	$88.03–$182.03	232% above	—
Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 V	$933.92	$933.92	$177.44–$840.53	232% above	—
Chest X-ray, single view CPT 71045 CHEST XRAY 1 V	$847.60	$847.60	$161.04–$762.84	262% above	—
Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view	$847.60	$847.60	$67.39–$182.03	262% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMP LT	$655.20	$655.20	$124.49–$589.68	121% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMP RT	$655.20	$655.20	$124.49–$589.68	121% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COM	$2,080.00	$2,080.00	$395.20–$1,872.00	222% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete	$2,080.00	$2,080.00	$282.90–$389.29	222% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG W/FTL AN EX SGL	$2,695.24	$2,695.24	$512.10–$2,425.72	306% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$3,897.92	$3,897.92	$740.60–$3,508.13	184% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Computed tomography, thorax, diagnostic; with contrast material(s)	$4,987.84	$4,987.84	$443.63–$610.47	180% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$4,987.84	$4,987.84	$947.69–$4,489.06	180% above	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG CAD BI	$684.32	$684.32	$130.02–$615.89	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$684.32	$684.32	$112.83	—	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI LT	$614.64	$614.64	$116.78–$553.18	80% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI RT	$614.64	$614.64	$116.78–$553.18	80% above	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	$1,692.36	$1,692.36	$1,240.76–$1,522.75	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUP LE ART BIL	$1,692.36	$1,692.36	$273.49–$1,523.12	16% above	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	$2,835.00	$2,835.00	$943.82–$1,158.33	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 DUP VEIN BIL	$2,835.00	$2,835.00	$458.14–$2,551.50	43% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D COMP W CF DOP	$7,441.50	$7,441.50	$1,202.55–$6,697.35	331% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc	$7,441.50	$7,441.50	—	331% above	—
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$655.20	$655.20	$124.49–$589.68	144% above	—
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$655.20	$655.20	$124.49–$589.68	144% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 + V LT	$853.84	$853.84	$162.23–$768.46	89% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 + V RT	$853.84	$853.84	$162.23–$768.46	89% above	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/IAC WO	$4,010.24	$4,010.24	$761.95–$3,609.22	195% above	—
Eye socket (orbit) CT scan without contrast CPT 70480 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material	$4,010.24	$4,010.24	$420.52–$578.67	195% above	—
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3 + V	$1,568.32	$1,568.32	$297.98–$1,411.49	198% above	—
Facial bones X-ray, complete, 3 or more views CPT 70150 Radiologic examination, facial bones; complete, minimum of 3 views	$1,568.32	$1,568.32	$213.42–$261.92	198% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$1,008.80	$1,008.80	$191.67–$907.92	206% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$1,008.80	$1,008.80	$191.67–$907.92	206% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPA IMAG INCL GB	$1,150.20	$1,150.20	$218.54–$1,035.18	1% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present;	$1,150.20	$1,150.20	$765.24–$1,053.04	1% above	—
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 V LT	$655.20	$655.20	$124.49–$589.68	152% above	—
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 V RT	$655.20	$655.20	$124.49–$589.68	152% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2 + V RT	$698.88	$698.88	$132.79–$628.99	150% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2 + V LT	$698.88	$698.88	$132.79–$628.99	150% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V LT	$1,255.28	$1,255.28	$238.50–$1,129.75	275% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V RT	$1,255.28	$1,255.28	$238.50–$1,129.75	275% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 + V LT	$1,465.36	$1,465.36	$278.42–$1,318.82	237% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 + V RT	$1,465.36	$1,465.36	$278.42–$1,318.82	237% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTRM W/O C RT	$4,094.48	$4,094.48	$777.95–$3,685.03	215% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTRM W/O C LT	$4,094.48	$4,094.48	$777.95–$3,685.03	215% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD	$4,011.28	$4,011.28	$762.14–$3,610.15	481% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss	$1,552.72	$1,552.72	$169.30–$245.18	407% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREM NON VASC LTD	$1,552.72	$1,552.72	$295.02–$1,397.45	407% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LUNG CA SCREEN WO CON	$1,118.00	$1,118.00	$212.42–$1,006.20	298% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)	$1,118.00	$1,118.00	$182.03	298% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 V LT	$1,291.68	$1,291.68	$245.42–$1,162.51	315% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 V RT	$1,291.68	$1,291.68	$245.42–$1,162.51	315% above	—
MR angiography (MRA) of the head without contrast CPT 70544 MRA HD W/O CONT	$6,162.86	$6,162.86	$1,170.94–$5,546.57	170% above	—
MR angiography (MRA) of the head without contrast CPT 70544 Magnetic resonance angiography, head; without contrast material(s)	$6,162.86	$6,162.86	$573.32–$788.94	170% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT RT	$10,051.98	$10,051.98	$1,909.88–$9,046.78	420% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT LT	$10,051.98	$10,051.98	$1,909.88–$9,046.78	420% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LW JNT W&WO CONT LT	$11,821.05	$11,821.05	$2,246.00–$10,638.94	244% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LW JNT W&WO CONT RT	$11,821.05	$11,821.05	$2,246.00–$10,638.94	244% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)	$10,812.80	$10,812.80	$517.79	565% above	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT	$10,812.80	$10,812.80	$2,054.43–$9,731.52	565% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences	$11,849.39	$11,849.39	$828.27	292% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONT	$11,849.39	$11,849.39	$2,251.38–$10,664.45	292% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$7,782.60	$7,782.60	$1,478.69–$7,004.34	303% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material	$7,782.60	$7,782.60	$519.71–$715.17	303% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONT	$7,782.60	$7,782.60	$1,478.69–$7,004.34	167% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences	$7,782.60	$7,782.60	$843.64–$1,160.92	167% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$7,983.16	$7,983.16	$517.79	299% above	—
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT	$7,983.16	$7,983.16	$1,516.80–$7,184.84	299% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&W/O CONT	$12,324.63	$12,324.63	$2,341.68–$11,092.17	272% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar	$12,324.63	$12,324.63	$828.27	272% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT	$7,717.20	$7,717.20	$1,466.27–$6,945.48	286% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material	$7,717.20	$7,717.20	$517.79	286% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&W/O CONT	$12,324.63	$12,324.63	$2,341.68–$11,092.17	277% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical	$12,324.63	$12,324.63	$846.33–$1,164.62	277% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT	$7,717.20	$7,717.20	$1,466.27–$6,945.48	286% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material	$7,717.20	$7,717.20	$517.79	286% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences	$11,849.39	$11,849.39	$828.27	274% above	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&WO CONT	$11,849.39	$11,849.39	$2,251.38–$10,664.45	274% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)	$6,598.86	$6,598.86	$517.79	254% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT	$6,598.86	$6,598.86	$1,253.78–$5,938.97	254% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT RT	$7,347.69	$7,347.69	$1,396.06–$6,612.92	280% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT LT	$7,347.69	$7,347.69	$1,396.06–$6,612.92	280% above	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Radiologic examination, spine, cervical; 4 or 5 views	$950.56	$950.56	$147.18–$245.18	86% above	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4-5 V	$950.56	$950.56	$180.61–$855.50	86% above	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST	$5,046.08	$5,046.08	$958.76–$4,541.47	201% above	—
Neck soft tissue CT scan with contrast CPT 70491 Computed tomography, soft tissue neck; with contrast material(s)	$5,046.08	$5,046.08	$487.84–$671.30	201% above	—
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$3,836.56	$3,836.56	$728.95–$3,452.90	328% above	—
Neck soft tissue CT scan without contrast CPT 70490 Computed tomography, soft tissue neck; without contrast material	$3,836.56	$3,836.56	$245.18	328% above	—
Neck soft tissue X-ray CPT 70360 Radiologic examination; neck, soft tissue	$766.48	$766.48	$82.74–$182.03	80% above	—
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$766.48	$766.48	$145.63–$689.83	80% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat	$4,597.56	$4,597.56	$1,147.15–$2,938.37	45% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCRD SPECT R/S MULT	$4,597.56	$4,597.56	$873.54–$4,137.80	45% above	—
Pelvic CT scan without contrast CPT 72192 Computed tomography, pelvis; without contrast material	$3,867.76	$3,867.76	$245.18	162% above	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$3,867.76	$3,867.76	$734.87–$3,480.98	162% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD OR FU	$1,226.16	$1,226.16	$232.97–$1,103.54	185% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)	$1,226.16	$1,226.16	$160.47–$196.94	185% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$2,320.24	$2,320.24	$440.85–$2,088.22	215% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRI	$2,248.48	$2,248.48	$427.21–$2,023.63	230% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMTR	$1,823.22	$1,823.22	$346.41–$1,640.90	280% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD	$2,854.59	$2,854.59	$542.37–$2,569.13	502% above	—
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI 2 V LT	$941.20	$941.20	$178.83–$847.08	186% above	—
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI 2 V RT	$941.20	$941.20	$178.83–$847.08	186% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI W/CXR 3+V LT	$1,161.68	$1,161.68	$220.72–$1,045.51	183% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI W/CXR 3+V RT	$1,161.68	$1,161.68	$220.72–$1,045.51	183% above	—
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR CAD BI	$684.32	$684.32	$130.02–$615.89	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V LT	$1,115.92	$1,115.92	$212.02–$1,004.33	250% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V RT	$1,115.92	$1,115.92	$212.02–$1,004.33	250% above	—
Sinus X-ray, complete, 3 or more views CPT 70220 Radiologic examination, sinuses, paranasal, complete, minimum of 3 views	$1,556.88	$1,556.88	$182.03	160% above	—
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES 3 + V	$1,556.88	$1,556.88	$295.81–$1,401.19	160% above	—
Skull X-ray, fewer than 4 views CPT 70250 Radiologic examination, skull; less than 4 views	$1,093.04	$1,093.04	$95.38–$245.18	191% above	—
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 V	$1,093.04	$1,093.04	$207.68–$983.74	191% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study	$904.80	$904.80	$321.97–$443.06	84% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLW FUNC W/C&V	$904.80	$904.80	$171.91–$814.32	84% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 V LT	$602.16	$602.16	$114.41–$541.94	80% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 V RT	$602.16	$602.16	$114.41–$541.94	80% above	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE W/O CONTRAST	$6,677.84	$6,677.84	$1,268.79–$6,010.06	315% above	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 Computed tomography, thoracic spine; without contrast material	$6,677.84	$6,677.84	$245.18	315% above	—
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2 + V LT	$576.16	$576.16	$109.47–$518.54	130% above	—
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2 + V RT	$576.16	$576.16	$109.47–$518.54	130% above	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$937.04	$937.04	$178.04–$843.34	61% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UT TRANSVAGINAL	$706.16	$706.16	$134.17–$635.54	51% above	—
Ultrasound of the abdomen, complete CPT 76700 Ultrasound, abdominal, real time with image documentation; complete	$2,920.32	$2,920.32	$304.02–$418.36	236% above	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$2,920.32	$2,920.32	$554.86–$2,628.29	236% above	—
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound, scrotum and contents	$1,985.36	$1,985.36	$245.18–$361.31	178% above	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CNTS	$1,985.36	$1,985.36	$377.22–$1,786.82	178% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD AND NECK	$1,525.68	$1,525.68	$289.88–$1,373.11	138% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation	$1,525.68	$1,525.68	$290.22–$399.37	138% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SNGL CONTRAST	$2,134.08	$2,134.08	$405.48–$1,920.67	157% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study	$2,134.08	$2,134.08	$325.10–$447.36	157% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 + V RT	$511.68	$511.68	$97.22–$460.51	52% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 + V LT	$511.68	$511.68	$97.22–$460.51	52% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP VEIN UNI/LTD	$1,451.52	$1,451.52	$234.57–$1,306.37	97% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	$1,451.52	$1,451.52	$600.01–$736.38	97% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT	$576.16	$576.16	$109.47–$518.54	114% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT	$576.16	$576.16	$109.47–$518.54	114% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V RT	$687.44	$687.44	$130.61–$618.70	106% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V LT	$687.44	$687.44	$130.61–$618.70	106% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W PEL UN 2-3 V RT	$602.16	$602.16	$114.41–$541.94	140% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W PEL UN 2-3 V LT	$602.16	$602.16	$114.41–$541.94	140% above	—
X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view	$1,104.48	$1,104.48	$79.13–$182.03	299% above	—
X-ray of the abdomen, 1 view CPT 74018 ABD XR 1V	$1,104.48	$1,104.48	$209.85–$994.03	299% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$758.16	$758.16	$144.05–$682.34	182% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$758.16	$758.16	$144.05–$682.34	182% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V RT	$576.16	$576.16	$109.47–$518.54	139% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V LT	$576.16	$576.16	$109.47–$518.54	139% above	—
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$754.00	$754.00	$143.26–$678.60	155% above	—
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$754.00	$754.00	$143.26–$678.60	155% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V RT	$990.08	$990.08	$188.12–$891.07	213% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V LT	$990.08	$990.08	$188.12–$891.07	213% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V RT	$754.00	$754.00	$143.26–$678.60	134% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V LT	$754.00	$754.00	$143.26–$678.60	134% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V RT	$821.60	$821.60	$156.10–$739.44	214% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V LT	$821.60	$821.60	$156.10–$739.44	214% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination, spine, lumbosacral; 2 or 3 views	$915.20	$915.20	$107.91–$245.18	150% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VIEWS	$915.20	$915.20	$173.89–$823.68	150% above	—
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4 + VIEWS	$1,333.28	$1,333.28	$253.32–$1,199.95	153% above	—
X-ray of the lower back, 4 or more views CPT 72110 Radiologic examination, spine, lumbosacral; minimum of 4 views	$1,333.28	$1,333.28	$142.71–$245.18	153% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination, spine; thoracic, 2 views	$821.60	$821.60	$88.08–$245.18	145% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS	$821.60	$821.60	$156.10–$739.44	145% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination, nasal bones, complete, minimum of 3 views	$867.36	$867.36	$182.03	197% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP	$867.36	$867.36	$164.80–$780.62	197% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS	$958.88	$958.88	$182.19–$862.99	156% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radiologic examination, spine, cervical; 2 or 3 views	$958.88	$958.88	$106.10–$182.03	156% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic examination, pelvis; 1 or 2 views	$1,026.48	$1,026.48	$74.66–$245.18	213% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS	$1,026.48	$1,026.48	$195.03–$923.83	213% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination, sacrum and coccyx, minimum of 2 views	$687.44	$687.44	$85.49–$182.03	64% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 + V	$687.44	$687.44	$130.61–$618.70	64% above	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH)	$1,237.68	$1,237.68	$38.62–$202.68	356% above	—
ACTH blood test CPT 82024 ACTH QN	$1,237.68	$1,237.68	$235.16–$1,113.91	356% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$185.76	$185.76	$35.29–$167.18	271% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT)	$185.76	$185.76	$5.30–$27.81	271% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT)	$403.92	$403.92	$5.18–$27.18	713% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$403.92	$403.92	$76.74–$363.53	713% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$605.88	$605.88	$115.12–$545.29	110% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA	$605.88	$605.88	$49.54	110% above	—
Albumin blood test CPT 82040 Albumin; serum, plasma or whole blood	$374.76	$374.76	$4.95–$25.98	856% above	—
Albumin blood test CPT 82040 ALBUMIN SERUM QN	$374.76	$374.76	$71.20–$337.28	856% above	—
Aldosterone blood test CPT 82088 ALDOSTERONE UR QN	$226.80	$226.80	$43.09–$204.12	17% above	—
Aldosterone blood test CPT 82088 ALDOSTERONE QN	$525.96	$525.96	$99.93–$473.36	172% above	—
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS (ALP)	$488.16	$488.16	$92.75–$439.34	1228% above	—
Alkaline phosphatase (ALP) blood test CPT 84075 Phosphatase, alkaline;	$488.16	$488.16	$5.39	1228% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each	$451.44	$451.44	$5.22–$27.39	1708% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH	$451.44	$451.44	$85.77–$406.30	1708% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROT SERUM MAT	$860.76	$860.76	$163.54–$774.68	618% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROT SERUM	$860.76	$860.76	$163.54–$774.68	618% above	—
Ammonia blood test CPT 82140 AMMONIA	$504.36	$504.36	$95.83–$453.92	449% above	—
Ammonia blood test CPT 82140 Ammonia	$504.36	$504.36	$14.57–$76.46	449% above	—
Amylase blood test CPT 82150 AMYLASE FL	$382.32	$382.32	$72.64–$344.09	583% above	—
Amylase blood test CPT 82150 AMYLASE BLD	$434.16	$434.16	$82.49–$390.74	675% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$513.00	$513.00	$97.47–$461.70	569% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody	$513.00	$513.00	$13.47	569% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibodies (ANA);	$171.72	$171.72	$12.09–$63.45	25% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUAL SCREEN	$171.72	$171.72	$32.63–$154.55	25% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$409.32	$409.32	$77.77–$368.39	108% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP QT	$545.40	$545.40	$103.63–$490.86	178% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BONE MARROW	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SURGICAL SPEC	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM	$555.12	$555.12	$105.47–$499.61	705% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT ENVIRON EPIDEMI	$652.32	$652.32	$123.94–$587.09	846% above	—
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium	$749.52	$749.52	$8.40–$42.00	653% above	—
Basic metabolic panel (blood test) CPT 80048 BMP TOTAL CALCIUM	$749.52	$749.52	$142.41–$674.57	653% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT FL	$158.76	$158.76	$30.16–$142.88	207% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT BLD	$198.72	$198.72	$37.76–$178.85	284% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast,	$1,122.12	$1,122.12	$49.76–$261.14	415% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4	$1,122.12	$1,122.12	$181.33–$1,009.91	415% above	—
Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)	$622.08	$622.08	$10.32–$54.16	501% above	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$622.08	$622.08	$118.20–$559.87	501% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$65.40	$65.40	$18.31–$58.86	254% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture	$65.40	$65.40	$9.71	254% above	—
Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip)	$439.56	$439.56	$3.93–$20.62	877% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN	$439.56	$439.56	$83.52–$395.60	877% above	—
Blood lead test CPT 83655 LEAD URINE	$260.28	$260.28	$49.45–$234.25	284% above	—
Blood lead test CPT 83655 LEAD BLOOD	$260.28	$260.28	$49.45–$234.25	284% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QL SERUM/URINE INSTR	$335.88	$335.88	$63.82–$302.29	218% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM	$504.36	$504.36	$95.83–$453.92	378% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$145.80	$145.80	$27.70–$131.22	61% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO	$145.80	$145.80	$2.99–$15.69	61% above	—
Blood urea nitrogen (BUN) test CPT 84520 Urea nitrogen; quantitative	$340.20	$340.20	$3.95–$20.73	552% above	—
Blood urea nitrogen (BUN) test CPT 84520 BUN	$340.20	$340.20	$64.64–$306.18	552% above	—
C-peptide blood test CPT 84681 C-peptide	$923.40	$923.40	$20.81–$109.21	746% above	—
C-peptide blood test CPT 84681 C-PEPTIDE	$923.40	$923.40	$175.45–$831.06	746% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein;	$399.60	$399.60	$5.18–$27.18	302% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$399.60	$399.60	$75.92–$359.64	302% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX B NAP1 ST AMP	$354.24	$354.24	$67.31–$318.82	149% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE AMP PROB	$1,013.04	$1,013.04	$192.48–$911.74	611% above	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QN	$648.00	$648.00	$123.12–$583.20	514% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9	$648.00	$648.00	$20.81–$109.21	514% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125	$719.28	$719.28	$21.64	485% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QN	$719.28	$719.28	$136.66–$647.35	485% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique	$78.84	$78.84	$51.31–$269.27	4% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 DNA/RNA AMP	$78.84	$78.84	$14.98–$70.96	4% above	—
Calcium blood test, total CPT 82310 CALCIUM UR RANDOM QN	$312.12	$312.12	$59.30–$280.91	665% above	—
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$382.32	$382.32	$72.64–$344.09	837% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen (CEA)	$555.12	$555.12	$18.96–$99.50	382% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$555.12	$555.12	$105.47–$499.61	382% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARIC ZOSTER IGG	$166.32	$166.32	$31.60–$149.69	51% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARIC ZOSTER IGM	$654.48	$654.48	$124.35–$589.03	496% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique	$585.36	$585.36	$36.49	339% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE	$585.36	$585.36	$111.22–$526.82	339% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)	$867.24	$867.24	$13.39–$70.27	920% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$867.24	$867.24	$164.78–$780.52	920% above	—
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$245.16	$245.16	$46.58–$220.64	193% above	—
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$952.56	$952.56	$180.99–$857.30	459% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL 1 HR	$562.68	$562.68	$106.91–$506.41	548% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL BASELINE	$562.68	$562.68	$106.91–$506.41	548% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$798.12	$798.12	$151.64–$718.31	819% above	—
Creatine kinase (CK) blood test, total CPT 82550 Creatine kinase (CK), (CPK); total	$476.28	$476.28	$6.51–$34.16	590% above	—
Creatine kinase (CK) blood test, total CPT 82550 CREAT KINASE (CK) TOTAL	$476.28	$476.28	$90.49–$428.65	590% above	—
Creatinine blood test CPT 82565 CREATININE BLD	$216.00	$216.00	$41.04–$194.40	238% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG QUAL	$466.56	$466.56	$88.65–$419.90	455% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB QL SQN	$549.00	$549.00	$104.31–$494.10	554% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$657.72	$657.72	$124.97–$591.95	320% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$282.96	$282.96	$53.76–$254.66	99% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S)	$282.96	$282.96	$22.23–$116.66	99% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCR ANY NBR PER DOS	$759.24	$759.24	$144.26–$683.32	334% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295)	$636.12	$636.12	$7.01–$36.79	563% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$636.12	$636.12	$120.86–$572.51	563% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGM QUAL	$439.56	$439.56	$83.52–$395.60	361% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGG QUAL	$625.32	$625.32	$118.81–$562.79	555% above	—
Estradiol blood test CPT 82670 Estradiol; total	$867.24	$867.24	$27.94–$146.63	610% above	—
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$867.24	$867.24	$164.78–$780.52	610% above	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$702.00	$702.00	$133.38–$631.80	557% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH)	$702.00	$702.00	$18.58–$97.51	557% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal	$709.56	$709.56	$20.42	316% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$709.56	$709.56	$134.82–$638.60	316% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$168.48	$168.48	$32.01–$151.63	31% above	—
Ferritin blood test (iron stores) CPT 82728 Ferritin	$168.48	$168.48	$13.63–$71.53	31% above	—
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$498.96	$498.96	$94.80–$449.06	498% above	—
Fibrinogen blood test CPT 85384 Fibrinogen; activity	$498.96	$498.96	$10.11	498% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum	$564.84	$564.84	$14.70–$77.15	334% above	—
Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) SER	$564.84	$564.84	$107.32–$508.36	334% above	—
Free T3 thyroid hormone test CPT 84481 T3 FREE	$212.76	$212.76	$40.42–$191.48	107% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free	$212.76	$212.76	$16.94–$88.90	107% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free	$455.76	$455.76	$9.02–$47.34	488% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$455.76	$455.76	$86.59–$410.18	488% above	—
Free testosterone test CPT 84402 TESTOSTERONE FREE	$1,392.12	$1,392.12	$264.50–$1,252.91	573% above	—
Free testosterone test CPT 84402 Testosterone; free	$1,392.12	$1,392.12	$25.47–$133.67	573% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Glutamyltransferase, gamma (GGT)	$193.32	$193.32	$7.20–$37.79	360% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$193.32	$193.32	$36.73–$173.99	360% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR W GLUCOLA	$260.28	$260.28	$49.45–$234.25	536% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose; post glucose dose (includes glucose)	$260.28	$260.28	$4.71–$23.58	536% above	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$476.28	$476.28	$90.49–$428.65	479% above	—
Glucose tolerance test, 3 samples CPT 82951 Glucose; tolerance test (GTT), 3 specimens (includes glucose)	$476.28	$476.28	$12.78–$63.88	479% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique	$325.08	$325.08	$35.09–$184.15	197% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE	$325.08	$325.08	$61.77–$292.57	197% above	—
H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL	$419.04	$419.04	$79.62–$377.14	289% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$419.04	$419.04	$14.96	289% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN	$966.60	$966.60	$183.65–$869.94	235% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed	$966.60	$966.60	$85.10–$446.60	235% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$1,105.92	$1,105.92	$24.08–$126.37	852% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1AG HIV-1/2AB SINGLE	$1,105.92	$1,105.92	$210.12–$995.33	852% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C)	$437.40	$437.40	$10.10	301% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$437.40	$437.40	$83.11–$393.66	301% above	—
Hemoglobin blood test CPT 85018 Blood count; hemoglobin (Hgb)	$72.36	$72.36	$2.37–$12.44	302% above	—
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$72.36	$72.36	$13.75–$65.12	302% above	—
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL	$504.36	$504.36	$95.83–$453.92	629% above	—
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B core antibody (HBcAb); total	$504.36	$504.36	$12.53	629% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUAL	$562.68	$562.68	$106.91–$506.41	570% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb)	$562.68	$562.68	$10.67–$53.28	570% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B S AG EIA QL	$455.76	$455.76	$86.59–$410.18	623% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$455.76	$455.76	$10.33–$54.21	623% above	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB QUAL	$702.00	$702.00	$133.38–$631.80	689% above	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody;	$702.00	$702.00	$14.27–$74.89	689% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QN	$966.60	$966.60	$183.65–$869.94	323% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed	$966.60	$966.60	$44.55	323% above	—
Herpes blood test, HSV-1 antibody CPT 86695 Antibody; herpes simplex, type 1	$168.48	$168.48	$13.19–$69.22	101% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB IGG	$168.48	$168.48	$32.01–$151.63	101% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Antibody; herpes simplex, type 2	$193.32	$193.32	$19.35–$101.55	94% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGG	$193.32	$193.32	$36.73–$173.99	94% above	—
Homocysteine blood test CPT 83090 Homocysteine	$691.20	$691.20	$18.64	523% above	—
Homocysteine blood test CPT 83090 HOMOCYSTEINE QN	$691.20	$691.20	$131.33–$622.08	523% above	—
Insulin blood test CPT 83525 INSULIN TOTAL	$423.36	$423.36	$80.44–$381.02	465% above	—
Insulin blood test CPT 83525 Insulin; total	$423.36	$423.36	$11.43–$59.98	465% above	—
Iron blood test (serum iron) CPT 83540 IRON	$390.96	$390.96	$74.28–$351.86	383% above	—
Iron blood test (serum iron) CPT 83540 Iron	$390.96	$390.96	$6.47–$33.95	383% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity	$518.40	$518.40	$8.74–$45.87	577% above	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING	$518.40	$518.40	$98.50–$466.56	577% above	—
Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i	$867.24	$867.24	$8.68–$45.55	683% above	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$867.24	$867.24	$164.78–$780.52	683% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH)	$702.00	$702.00	$18.52–$97.19	422% above	—
LH (luteinizing hormone) test CPT 83002 LH	$702.00	$702.00	$133.38–$631.80	422% above	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BODY FL	$439.56	$439.56	$83.52–$395.60	354% above	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$439.56	$439.56	$83.52–$395.60	354% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD)	$223.56	$223.56	$42.48–$201.20	303% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD) BODY FLUID	$439.56	$439.56	$83.52–$395.60	692% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$491.40	$491.40	$93.37–$442.26	354% above	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$491.40	$491.40	$6.89–$36.16	354% above	—
Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani	$654.48	$654.48	$8.17–$42.88	647% above	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$654.48	$654.48	$124.35–$589.03	647% above	—
Lyme disease antibody test CPT 86618 Antibody; Borrelia burgdorferi (Lyme disease)	$747.36	$747.36	$17.03–$89.37	747% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB QL	$747.36	$747.36	$142.00–$672.62	747% above	—
Magnesium blood test CPT 83735 MAGNESIUM URINE	$228.96	$228.96	$43.50–$206.06	291% above	—
Magnesium blood test CPT 83735 MAGNESIUM RBC	$344.52	$344.52	$65.46–$310.07	488% above	—
Magnesium blood test CPT 83735 MAGNESIUM BLD	$374.76	$374.76	$71.20–$337.28	540% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$379.08	$379.08	$72.03–$341.17	406% above	—
Measles (rubeola) antibody test CPT 86765 Antibody; rubeola	$379.08	$379.08	$12.79–$63.88	406% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening	$347.76	$347.76	$5.18–$27.18	262% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE)	$347.76	$347.76	$66.07–$312.98	262% above	—
Mumps immunity blood test CPT 86735 MUMPS IGM QUAL	$166.32	$166.32	$31.60–$149.69	139% above	—
Mumps immunity blood test CPT 86735 MUMPS IGG QUAL	$608.04	$608.04	$115.53–$547.24	773% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free	$608.04	$608.04	$18.39–$96.51	449% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PROS SPEC AG FREE	$608.04	$608.04	$115.53–$547.24	449% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total	$608.04	$608.04	$18.39–$96.51	496% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA) TOTAL	$608.04	$608.04	$115.53–$547.24	496% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$962.28	$962.28	$182.83–$866.05	314% above	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone)	$962.28	$962.28	$41.28–$216.64	314% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$287.28	$287.28	$54.58–$258.55	328% above	—
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS BLD	$198.72	$198.72	$37.76–$178.85	276% above	—
Potassium blood test CPT 84132 Potassium; serum, plasma or whole blood	$141.48	$141.48	$4.76–$24.98	263% above	—
Potassium blood test CPT 84132 POTASSIUM BLD	$141.48	$141.48	$26.88–$127.33	263% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL ANEPLOIDY 131821	$1,902.96	$1,902.96	$361.56–$1,712.66	91% above	—
Progesterone blood test CPT 84144 PROGESTERONE	$677.16	$677.16	$128.66–$609.44	274% above	—
Progesterone blood test CPT 84144 Progesterone	$677.16	$677.16	$21.69	274% above	—
Prolactin blood test CPT 84146 PROLACTIN	$779.76	$779.76	$148.15–$701.78	532% above	—
Prolactin blood test CPT 84146 Prolactin	$779.76	$779.76	$19.38–$101.71	532% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$287.28	$287.28	$54.58–$258.55	1009% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca	$374.00	$374.00	$12.60–$66.12	767% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR DOO MANUAL READ	$374.00	$374.00	$71.06–$336.60	767% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A	$451.44	$451.44	$16.53–$86.75	404% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A OPTICAL IA	$451.44	$451.44	$85.77–$406.30	404% above	—
Renin blood test CPT 84244 RENIN	$803.52	$803.52	$152.67–$723.17	507% above	—
Renin blood test CPT 84244 Renin	$803.52	$803.52	$21.99–$115.40	507% above	—
Rh blood typing CPT 86901 RH TYPE	$180.36	$180.36	$34.27–$162.32	193% above	—
Rh blood typing CPT 86901 Blood typing, serologic; Rh (D)	$180.36	$180.36	$2.99–$15.69	193% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative	$307.80	$307.80	$5.67–$29.76	755% above	—
Rheumatoid factor (RF) test CPT 86431 RA QN	$307.80	$307.80	$58.48–$277.02	755% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$347.76	$347.76	$66.07–$312.98	258% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$1,096.20	$1,096.20	$208.28–$986.58	1028% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated	$303.48	$303.48	$2.70–$14.17	428% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$303.48	$303.48	$57.66–$273.13	428% above	—
Sodium blood test CPT 84295 SODIUM BLD	$171.72	$171.72	$32.63–$154.55	241% above	—
Sodium blood test CPT 84295 Sodium; serum, plasma or whole blood	$171.72	$171.72	$5.00	241% above	—
Stool ova and parasites exam CPT 87177 O&P SMEAR CONC ID	$455.76	$455.76	$86.59–$410.18	744% above	—
Stool ova and parasites exam CPT 87177 Ova and parasites, direct smears, concentration and identification	$455.76	$455.76	$8.90–$46.71	744% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD SCN 3 SPEC	$158.76	$158.76	$30.16–$142.88	590% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o	$158.76	$158.76	$4.38–$22.99	590% above	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLD CRC IA	$282.96	$282.96	$53.76–$254.66	243% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Antibody; Treponema pallidum	$405.00	$405.00	$13.24–$69.48	472% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB	$405.00	$405.00	$76.95–$364.50	472% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF QUAL	$260.28	$260.28	$49.45–$234.25	933% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$403.92	$403.92	$76.74–$363.53	1503% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GAMMA INTERFERON RESP	$1,436.40	$1,436.40	$272.92–$1,292.76	551% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon	$1,436.40	$1,436.40	$61.98–$325.27	551% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; total	$966.60	$966.60	$25.81–$135.45	544% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$966.60	$966.60	$183.65–$869.94	544% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$183.60	$183.60	$34.88–$165.24	134% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICRO AB	$518.40	$518.40	$98.50–$466.56	560% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH)	$832.68	$832.68	$16.80–$88.17	753% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$832.68	$832.68	$158.21–$749.41	753% above	—
Total IgE blood test CPT 82785 IGE	$488.16	$488.16	$92.75–$439.34	450% above	—
Total IgE blood test CPT 82785 Gammaglobulin (immunoglobulin); IgE	$488.16	$488.16	$16.46–$86.38	450% above	—
Total cholesterol blood test CPT 82465 CHOLESTEROL BLD	$382.32	$382.32	$72.64–$344.09	591% above	—
Total cholesterol blood test CPT 82465 Cholesterol, serum or whole blood, total	$382.32	$382.32	$4.35–$22.83	591% above	—
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4 TOTAL	$151.20	$151.20	$28.73–$136.08	174% above	—
Total thyroxine (T4) blood test CPT 84436 Thyroxine; total	$151.20	$151.20	$6.87–$36.05	174% above	—
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$178.20	$178.20	$33.86–$160.38	47% above	—
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3; total (TT-3)	$178.20	$178.20	$14.08–$70.39	47% above	—
Transferrin blood test CPT 84466 TRANSFERRIN	$282.96	$282.96	$53.76–$254.66	268% above	—
Transferrin blood test CPT 84466 Transferrin	$282.96	$282.96	$12.76–$66.96	268% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique	$978.48	$978.48	$35.09–$184.15	786% above	—
Trichomonas test (NAAT) CPT 87661 TRICH VAGINALIS AMP PRBE	$978.48	$978.48	$185.91–$880.63	786% above	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES OTHER	$198.72	$198.72	$37.76–$178.85	265% above	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$466.56	$466.56	$88.65–$419.90	758% above	—
Troponin test, quantitative CPT 84484 TROPONIN QUANT	$476.28	$476.28	$90.49–$428.65	329% above	—
Uric acid blood test CPT 84550 URIC ACID BLD	$176.04	$176.04	$33.45–$158.44	151% above	—
Uric acid blood test CPT 84550 Uric acid; blood	$176.04	$176.04	$4.52–$23.72	151% above	—
Urinalysis with microscope exam, automated CPT 81001 UA W MICRO AUTO	$270.00	$270.00	$51.30–$243.00	507% above	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w	$270.00	$270.00	$3.17–$16.64	507% above	—
Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO	$131.76	$131.76	$25.03–$118.58	299% above	—
Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine	$599.40	$599.40	$8.39	667% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR	$599.40	$599.40	$113.89–$539.46	667% above	—
Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg, microalbumin), quantitative	$627.48	$627.48	$5.78–$30.33	893% above	—
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QN	$627.48	$627.48	$119.22–$564.73	893% above	—
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods	$289.44	$289.44	$8.61–$45.19	215% above	—
Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL BY DOO	$289.44	$289.44	$54.99–$260.50	215% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12);	$581.04	$581.04	$15.08–$79.14	284% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$581.04	$581.04	$110.40–$522.94	284% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH W/WO FRAC	$899.64	$899.64	$170.93–$809.68	538% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed	$899.64	$899.64	$29.60–$155.34	538% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed	$560.52	$560.52	$38.50–$202.05	153% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1-25 W/WO FRAC	$560.52	$560.52	$106.50–$504.47	153% above	—
Zinc blood test CPT 84630 ZINC BLOOD	$451.44	$451.44	$85.77–$406.30	469% above	—
Zinc blood test CPT 84630 Zinc	$451.44	$451.44	$11.39–$59.77	469% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE	$923.40	$923.40	$175.45–$831.06	523% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (hCG); quantitative	$923.40	$923.40	$15.05–$78.98	523% above	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$1,944.80	$1,944.80	$314.28–$1,750.32	62% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion, elective, electrical conversion of arrhythmia; external	$1,944.80	$1,944.80	$2,114.00	62% above	—
Catheter ablation for atrial fibrillation CPT 93656 COM EP REPO CTH TX AFIB	$68,938.10	$68,938.10	$19,302.67–$62,044.29	211% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including	$68,938.10	$68,938.10	$4,943.00	211% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion, blood or blood components	$4,366.54	$4,366.54	$1,573.00–$2,685.00	406% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$4,366.54	$4,366.54	$705.63–$3,929.89	406% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INH TX AC AWY OBST	$396.76	$396.76	$64.12–$357.08	150% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MINS	$4,790.88	$4,790.88	$1,341.45–$4,311.79	89% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram (EEG); including recording awake and drowsy	$2,862.00	$2,862.00	—	407% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AW & DROWSY	$2,862.00	$2,862.00	$462.50–$2,575.80	407% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	$865.08	$865.08	—	314% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$865.08	$865.08	$139.80–$778.57	314% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LVL 1 EMER DEPT	$996.84	$996.84	$279.12–$897.16	416% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LVL 2 EMER DEPT	$1,582.20	$1,582.20	$443.02–$1,423.98	337% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LVL 3 EMER DEPT	$2,784.24	$2,784.24	$779.59–$2,505.82	414% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LVL 4 EMER DEPT	$3,814.56	$3,814.56	$1,068.08–$3,433.10	319% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LVL 5 EMER DEPT	$4,986.36	$4,986.36	$1,396.18–$4,487.72	228% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation an	$2,790.70	$2,790.70	$444.00–$604.00	272% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$2,790.70	$2,790.70	$450.98–$2,511.63	272% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INIT UP TO 1HR	$609.31	$609.31	$98.46–$548.38	81% above	—
IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HOUR	$1,487.16	$1,487.16	$240.33–$1,338.44	307% above	—
IV push of a medicine, first drug CPT 96374 IVP SINGLE/INITIAL DRUG	$417.96	$417.96	$67.54–$376.16	54% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ	$402.84	$402.84	$65.10–$362.56	270% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When	$92.73	$92.73	—	12% below	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 BASIC CARE NP	$92.73	$92.73	$13.91–$92.73	12% below	—
Occupational therapy evaluation, low complexity CPT 97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or	$690.12	$690.12	$103.59	220% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination	$732.24	$732.24	$100.86	188% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st	$690.12	$690.12	$100.86	220% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o	$710.64	$710.64	$100.86	190% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 EST	$488.16	$488.16	$73.22–$488.16	242% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making	$488.16	$488.16	—	242% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision mak	$322.92	$322.92	—	165% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 EST	$322.92	$322.92	$48.44–$322.92	165% above	—
Speech and language evaluation CPT 92523 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)	$1,343.52	$1,343.52	$233.69	309% above	—
Spirometry (breathing test) CPT 94010 SPIROMETRY	$293.00	$293.00	$47.35–$263.70	4% above	—
Spirometry (breathing test) CPT 94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation	$293.00	$293.00	—	4% above	—
Spirometry before and after a bronchodilator CPT 94060 BRONCH EV SPIR PRE/POST	$425.36	$425.36	$68.74–$382.82	4% above	—
Spirometry before and after a bronchodilator CPT 94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration	$425.36	$425.36	—	4% above	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use	$187.92	$187.92	$98.16	87% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL < 7 YRS VAC IM	$187.92	$187.92	$28.19–$187.92	87% above	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use	$613.44	$613.44	$374.37	38% above	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL VAC IM	$613.44	$613.44	$92.02–$613.44	38% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use	$259.38	$259.38	$22.52–$32.27	654% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRI 0.5 ML PF IM	$259.38	$259.38	$72.63–$233.44	654% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX PED 5MCG IM	$294.84	$294.84	$82.56–$265.36	207% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use	$294.84	$294.84	$87.98	207% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAXHIB 3 DOSE VAC IM	$1,944.00	$1,944.00	$291.60–$1,944.00	716% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use	$1,944.00	$1,944.00	$99.69	716% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use	$877.48	$877.48	$260.12	304% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF IM	$877.48	$877.48	$245.69–$789.73	304% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC LIVE SQ	$1,105.92	$1,105.92	$165.89–$1,105.92	214% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use	$1,105.92	$1,105.92	$310.42	214% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use	$1,547.64	$1,547.64	$562.81	425% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI VAC IM	$1,547.64	$1,547.64	$232.15–$1,547.64	425% above	—
Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use	$1,762.56	$1,762.56	$717.99	56% above	—
Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA VAC IM	$1,762.56	$1,762.56	$264.38–$1,762.56	56% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAXNEUVANCE VAC IM	$2,018.52	$2,018.52	$565.19–$1,816.67	18% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use	$2,018.52	$2,018.52	$713.67	18% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use	$1,203.12	$1,203.12	$353.70	215% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 VAC IMSQ	$1,203.12	$1,203.12	$336.87–$1,082.81	215% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use	$3,386.88	$3,386.88	$1,892.29	184% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 0.5 ML IM	$3,386.88	$3,386.88	$508.03–$3,386.88	184% above	—
Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VAC IM	$2,070.36	$2,070.36	$579.70–$1,863.32	126% above	—
Rabies vaccine, one dose CPT 90675 Rabies vaccine, for intramuscular use	$2,070.36	$2,070.36	$847.34	126% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use	$145.80	$145.80	$103.27	10% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC VAC >= 7 YRS IM	$145.80	$145.80	$21.87–$145.80	10% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use	$925.56	$925.56	$38.30–$79.72	897% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL VAC >= 7 YRS IM	$925.56	$925.56	$138.83–$925.56	897% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN SGL	$120.96	$120.96	$19.55–$108.86	129% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDTL	$157.68	$157.68	$23.65–$157.68	257% above	—

Source file: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/06-1760818_SPOTSYLVANIA-REGIONAL-MEDICAL-CENTER_standardcharges.json?si=dpx-pt-json-access-policy&spr=https&sv=2026-02-06&sr=c&sig=ks%2BgfAjyEHlZmeP2PYJ%2F9NpMuCoRStjTb2bhIy9Y6LM%3D