Hospital

Chambers Health

Chambers Health publishes cash prices for 385 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Click a procedure to compare it with other hospitals nearby.

Collected Sep 27, 2026 Source price file

The price file shows no self-pay discount

For 1014 of the 1014 prices listed here, the cash price in Chambers Health'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.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	Off list
Abdominal CT scan without and with contrast CPT 74170 Wc Ct Adrenal Mass Protocol	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen W Wo Contrast	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal CT scan without and with contrast CPT 74170 Ct Liver Mass Protocol	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal CT scan without and with contrast CPT 74170 Ct Adrenal Mass Protocol	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal CT scan without and with contrast CPT 74170 Wc Ct Abdomen W/wo Cntrst	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal CT scan without and with contrast CPT 74170 Wc Ct Liver Mass Protocol	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal CT scan without and with contrast CPT 74170 Wc Adrenal Mass Protocol	$3,568.00	$3,568.00	$1,427.00–$2,319.00	—
Abdominal X-ray, 2 views CPT 74019 Abdomen Cmplte 2 Views	$555.00	$555.00	$222.00–$361.00	—
Abdominal X-ray, 2 views CPT 74019 Wc Abdomen Cmplte 2 Views	$555.00	$555.00	$222.00–$361.00	—
Abdominal X-ray, 2 views CPT 74019 Dc Abdomen Cmplte 2 Views	$555.00	$555.00	$222.00–$361.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle Cmplte 3-4 Views L	$453.00	$453.00	$181.00–$294.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Dc Ankle Cmplte 3 Views L	$453.00	$453.00	$181.00–$294.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Wc Ankle Cmplte 3 Views R	$453.00	$453.00	$181.00–$294.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle Cmplte 3-4 Views R	$453.00	$453.00	$181.00–$294.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Wc Ankle Cmplte 3 Views L	$453.00	$453.00	$181.00–$294.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Dc Ankle Cmplte 4 Views L	$492.00	$492.00	$197.00–$320.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Wc Ankle Cmplte 4 Views R	$492.00	$492.00	$197.00–$320.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Wc Ankle Cmplte 4 Views L	$492.00	$492.00	$197.00–$320.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle Cmplte 4 Views R	$492.00	$492.00	$197.00–$320.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle Cmplte 4 Views L	$492.00	$492.00	$197.00–$320.00	—
Ankle X-ray, complete, 3 or more views CPT 73610 Dc Ankle Cmplte 4 Views R	$492.00	$492.00	$197.00–$320.00	—
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Limited Bilateral- Abi	$785.00	$785.00	$314.00–$510.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Ext Upper Wo Rt	$2,267.00	$2,267.00	$907.00–$1,474.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Ext Upper Wo Rt	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Ext Upper Wo Lt	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Forearm Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Humerus Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Wrist Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Hand Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Hand Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Humerus Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Elbow Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Wrist Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Elbow Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Shoulder Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Shoulder Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Wc Ct Forearm Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Breast ultrasound, complete, one breast both sides CPT 76641 Us Breast Unli Or Bilat R	$447.00	$447.00	$179.00–$291.00	—
Breast ultrasound, complete, one breast both sides CPT 76641 Us Breast Unli Or Bilat L	$447.00	$447.00	$179.00–$291.00	—
CT angiography (CTA) of the head CPT 70496 Cta Head/neck	$3,000.00	$3,000.00	$1,200.00–$1,950.00	—
CT angiography (CTA) of the head CPT 70496 Wc Cta Head/neck	$3,000.00	$3,000.00	$1,200.00–$1,950.00	—
CT angiography (CTA) of the head CPT 70496 Wc Cta Head	$3,000.00	$3,000.00	$1,200.00–$1,950.00	—
CT angiography (CTA) of the head CPT 70496 Cta Head	$3,000.00	$3,000.00	$1,200.00–$1,950.00	—
CT angiography (CTA) of the neck CPT 70498 Wc Cta Neck	$3,106.00	$3,106.00	$1,242.00–$2,019.00	—
CT angiography (CTA) of the neck CPT 70498 Cta Neck	$3,106.00	$3,106.00	$1,242.00–$2,019.00	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest	$3,211.00	$3,211.00	$1,284.00–$2,087.00	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Wc Cta Pe Chest & Ct Abdomen/pel W/c	$3,211.00	$3,211.00	$1,284.00–$2,087.00	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Wc Cta Pe Chest	$3,211.00	$3,211.00	$1,284.00–$2,087.00	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Pe Chest & Ct Abdomen And Pelvis W/c	$3,211.00	$3,211.00	$1,284.00–$2,087.00	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Cardiac Ca Score	$520.00	$520.00	$208.00–$338.00	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Wc Ct Cardiac Ca Score	$520.00	$520.00	$208.00–$338.00	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Cardiac Ca Score & Ct Abd Pelvis	$572.00	$572.00	$229.00–$372.00	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abd Pel Wo Contrast	$4,194.00	$4,194.00	$1,678.00–$2,726.00	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Wc Ct Abd/pel Wo Cntrst	$4,194.00	$4,194.00	$1,678.00–$2,726.00	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast	$5,551.00	$5,551.00	$2,220.00–$3,608.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Wc Ct Chest/abd/pelvis W&wo	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Urogram	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Renal Mass Protocol	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Wc Ct Urogram	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd Pel W Wo Contrast	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Wc Ct Abd/pel W & Wo Contrast	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Wc Ct Renal Mass Protocol	$5,688.00	$5,688.00	$2,275.00–$3,697.00	—
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W Contrast	$3,116.00	$3,116.00	$1,246.00–$2,025.00	—
CT scan of the abdomen with contrast CPT 74160 Wc Ct Abdomen W/cntrst	$3,116.00	$3,116.00	$1,246.00–$2,025.00	—
CT scan of the abdomen without contrast CPT 74150 Wc Ct Abdomen W/o Cntrst	$2,596.00	$2,596.00	$1,038.00–$1,687.00	—
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen Wo Contrast	$2,596.00	$2,596.00	$1,038.00–$1,687.00	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Wc Ct Sinus Wo	$2,324.00	$2,324.00	$930.00–$1,511.00	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxofacial Wo Contrast	$2,324.00	$2,324.00	$930.00–$1,511.00	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinus Wo	$2,324.00	$2,324.00	$930.00–$1,511.00	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Wc Ct Maxofacial W/o Cntrst	$2,324.00	$2,324.00	$930.00–$1,511.00	—
CT scan of the head or brain, no contrast dye CPT 70450 CT scan	$2,478.00	$2,478.00	$991.00–$1,611.00	—
CT scan of the head with contrast CPT 70460 Ct Head And Neck W Contrast	$2,499.00	$2,499.00	$1,000.00–$1,624.00	—
CT scan of the head with contrast CPT 70460 Wc Ct Head W/cntrst	$2,499.00	$2,499.00	$1,000.00–$1,624.00	—
CT scan of the head with contrast CPT 70460 Ct Head W Contrast	$2,499.00	$2,499.00	$1,000.00–$1,624.00	—
CT scan of the head with contrast CPT 70460 Wc Ct Head And Neck W Contrast	$2,499.00	$2,499.00	$1,000.00–$1,624.00	—
CT scan of the head without and with contrast CPT 70470 Wc Ct Head W/o & W/cntrst	$3,130.00	$3,130.00	$1,252.00–$2,035.00	—
CT scan of the head without and with contrast CPT 70470 Ct Head Wo W Contrast	$3,130.00	$3,130.00	$1,252.00–$2,035.00	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Wc Ct Spine Lumbar W/o Cntr	$2,645.00	$2,645.00	$1,058.00–$1,719.00	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar Wo Contrast	$2,645.00	$2,645.00	$1,058.00–$1,719.00	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical Wo Contrast	$3,000.00	$3,000.00	$1,200.00–$1,950.00	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Wc Ct Spine Cervical W/o Cn	$3,000.00	$3,000.00	$1,200.00–$1,950.00	—
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast	$2,627.00	$2,627.00	$1,051.00–$1,708.00	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Us Carotid & Vert Doppler	$1,418.00	$1,418.00	$567.00–$922.00	—
Chest CT scan without and with contrast CPT 71270 Ct Chest W And Wo Contrast	$3,278.00	$3,278.00	$1,311.00–$2,131.00	—
Chest CT scan without and with contrast CPT 71270 Wc Ct Chest W/o & W/cntrst	$3,278.00	$3,278.00	$1,311.00–$2,131.00	—
Chest CT scan without and with contrast CPT 71270 Ct Chest/abd/pel W&wo Contrast	$9,420.00	$9,420.00	$3,768.00–$6,123.00	—
Chest X-ray, 2 views CPT 71046 Chest 2 Views Pa & La	$422.00	$422.00	$169.00–$274.00	—
Chest X-ray, 2 views CPT 71046 Chest 2 Views Pa And Lat	$485.00	$485.00	$194.00–$315.00	—
Chest X-ray, 2 views CPT 71046 Wc Chest 2 Views Pa & La	$485.00	$485.00	$194.00–$315.00	—
Chest X-ray, 2 views CPT 71046 Dc Chest 2 Views Pa & La	$485.00	$485.00	$194.00–$315.00	—
Chest X-ray, single view CPT 71045 Wc Chest 1 View Portable	$386.00	$386.00	$154.00–$251.00	—
Chest X-ray, single view CPT 71045 Dc Chest 1 View Pa Or Ap	$428.00	$428.00	$171.00–$278.00	—
Chest X-ray, single view CPT 71045 Wc Chest 1 View Pa Or Ap	$428.00	$428.00	$171.00–$278.00	—
Chest X-ray, single view CPT 71045 Dc Chest 1 View Portable	$428.00	$428.00	$171.00–$278.00	—
Chest X-ray, single view CPT 71045 Chest 1 View Pa Or Ap	$447.00	$447.00	$179.00–$291.00	—
Chest X-ray, single view CPT 71045 Chest 1 View Portable	$447.00	$447.00	$179.00–$291.00	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt	$442.00	$442.00	$177.00–$287.00	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Dc Clavicle Lt	$442.00	$442.00	$177.00–$287.00	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Dc Clavicle Rt	$442.00	$442.00	$177.00–$287.00	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Wc Clavicle Lt	$442.00	$442.00	$177.00–$287.00	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Wc Clavicle Rt	$442.00	$442.00	$177.00–$287.00	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt	$442.00	$442.00	$177.00–$287.00	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Renal Cmplte	$1,042.00	$1,042.00	$417.00–$677.00	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Us Pregnant Anatomy Scan 20 Weeks	$711.00	$711.00	$284.00–$462.00	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Wc Ct Chest W/o Cntrst	$2,483.00	$2,483.00	$993.00–$1,614.00	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct High Resolution Chest Wo	$2,483.00	$2,483.00	$993.00–$1,614.00	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest Wo Contrast	$2,483.00	$2,483.00	$993.00–$1,614.00	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Wc Ct Chest Abd Pel W/o Cont	$2,906.00	$2,906.00	$1,162.00–$1,889.00	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest Abd Pel W/o Contrast	$2,906.00	$2,906.00	$1,162.00–$1,889.00	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Wc Ct Chest/abd/pel W Cont	$2,906.00	$2,906.00	$1,162.00–$1,889.00	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Wc Ct Chest W/cntrst	$2,906.00	$2,906.00	$1,162.00–$1,889.00	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest Abd Pel W Contrast	$2,906.00	$2,906.00	$1,162.00–$1,889.00	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W Contrast	$2,906.00	$2,906.00	$1,162.00–$1,889.00	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Wc Ct Chest/abd W Contrast	$5,507.00	$5,507.00	$2,203.00–$3,580.00	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest/ Abdomen W Contrast	$5,507.00	$5,507.00	$2,203.00–$3,580.00	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Arterial Bilateral Legs	$1,441.00	$1,441.00	$576.00–$937.00	—
Duplex ultrasound of the leg arteries, both legs one side CPT 93925 Us Artery Ext Rt Low Cmplte	$848.00	$848.00	$339.00–$551.00	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Vein Bilat Extremity	$1,613.00	$1,613.00	$645.00–$1,048.00	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Bilateral Extremity	$1,613.00	$1,613.00	$645.00–$1,048.00	—
Elbow X-ray, 2 views CPT 73070 Elbow 2 Views L	$419.00	$419.00	$168.00–$272.00	—
Elbow X-ray, 2 views CPT 73070 Dc Elbow 2 Views L	$419.00	$419.00	$168.00–$272.00	—
Elbow X-ray, 2 views CPT 73070 Elbow 2 Views R	$419.00	$419.00	$168.00–$272.00	—
Elbow X-ray, 2 views CPT 73070 Wc Elbow 2 Views L	$419.00	$419.00	$168.00–$272.00	—
Elbow X-ray, 2 views one side CPT 73070 Wc Elbow 2 Views Rt	$419.00	$419.00	$168.00–$272.00	—
Elbow X-ray, 2 views one side CPT 73070 Dc Elbow 2 Views Rt	$419.00	$419.00	$168.00–$272.00	—
Elbow X-ray, complete, 3 or more views CPT 73080 Dc Elbow 3 Or More Views L	$507.00	$507.00	$203.00–$330.00	—
Elbow X-ray, complete, 3 or more views CPT 73080 Elbow 3 Or More Views R	$507.00	$507.00	$203.00–$330.00	—
Elbow X-ray, complete, 3 or more views CPT 73080 Wc Elbow 3 Or More Views R	$507.00	$507.00	$203.00–$330.00	—
Elbow X-ray, complete, 3 or more views CPT 73080 Wc Elbow 3 Or More Views L	$507.00	$507.00	$203.00–$330.00	—
Elbow X-ray, complete, 3 or more views CPT 73080 Elbow 3 Or More Views L	$507.00	$507.00	$203.00–$330.00	—
Elbow X-ray, complete, 3 or more views CPT 73080 Dc Elbow 3 Or More Views R	$507.00	$507.00	$203.00–$330.00	—
Eye socket (orbit) CT scan without contrast CPT 70480 Wc Ct Orbitmastoids, Inner & Outer Ea	$1,944.00	$1,944.00	$778.00–$1,264.00	—
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbit Wo Contrast	$1,944.00	$1,944.00	$778.00–$1,264.00	—
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbitmastoids, Inner & Outer Ear	$1,944.00	$1,944.00	$778.00–$1,264.00	—
Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bones Cmplte 3	$458.00	$458.00	$183.00–$298.00	—
Facial bones X-ray, complete, 3 or more views CPT 70150 Dc Facial Bones Cmplte 3	$458.00	$458.00	$183.00–$298.00	—
Facial bones X-ray, complete, 3 or more views CPT 70150 Wc Facial Bones Cmplte 3	$458.00	$458.00	$183.00–$298.00	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Forearm 2 Views L	$439.00	$439.00	$176.00–$285.00	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Dc Forearm 2 Views R	$439.00	$439.00	$176.00–$285.00	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Dc Forearm 2 Views L	$439.00	$439.00	$176.00–$285.00	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Wc Forearm 2 Views R	$439.00	$439.00	$176.00–$285.00	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Forearm 2 Views R	$439.00	$439.00	$176.00–$285.00	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Wc Forearm 2 Views L	$439.00	$439.00	$176.00–$285.00	—
Hand X-ray, 2 views CPT 73120 Hand 2 Views L	$374.00	$374.00	$150.00–$243.00	—
Hand X-ray, 2 views CPT 73120 Hand 2 Views R	$374.00	$374.00	$150.00–$243.00	—
Hand X-ray, 2 views CPT 73120 Wc Hand 2 Views L	$374.00	$374.00	$150.00–$243.00	—
Hand X-ray, 2 views CPT 73120 Wc Hand 2 Views R	$374.00	$374.00	$150.00–$243.00	—
Hand X-ray, 2 views CPT 73120 Dc Hand 2 Views L	$374.00	$374.00	$150.00–$243.00	—
Hand X-ray, 2 views CPT 73120 Dc Hand 2 Views R	$374.00	$374.00	$150.00–$243.00	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Wc Os Calcis 2 Views R	$352.00	$352.00	$141.00–$229.00	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Os Calcis 2 Views L	$352.00	$352.00	$141.00–$229.00	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Os Calcis 2 Views R	$352.00	$352.00	$141.00–$229.00	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Dc Os Calcis 2 Views R	$352.00	$352.00	$141.00–$229.00	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Wc Os Calcis 2 Views Lt	$352.00	$352.00	$141.00–$229.00	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Dc Os Calcis 2 Views Lt	$352.00	$352.00	$141.00–$229.00	—
Knee X-ray, 3 views CPT 73562 Wc Knee 3 Views L	$453.00	$453.00	$181.00–$294.00	—
Knee X-ray, 3 views CPT 73562 Knee 3 Views L	$453.00	$453.00	$181.00–$294.00	—
Knee X-ray, 3 views CPT 73562 Knee 3 Views R	$453.00	$453.00	$181.00–$294.00	—
Knee X-ray, 3 views CPT 73562 Wc Knee 3 Views R	$453.00	$453.00	$181.00–$294.00	—
Knee X-ray, 3 views CPT 73562 Dc Knee 3 Views L	$453.00	$453.00	$181.00–$294.00	—
Knee X-ray, 3 views CPT 73562 Dc Knee 3 Views R	$453.00	$453.00	$181.00–$294.00	—
Knee X-ray, complete, 4 or more views CPT 73564 Knee 4 Views L	$598.00	$598.00	$239.00–$389.00	—
Knee X-ray, complete, 4 or more views CPT 73564 Wc Knee 4 Views R	$598.00	$598.00	$239.00–$389.00	—
Knee X-ray, complete, 4 or more views CPT 73564 Wc Knee 4 Views L	$598.00	$598.00	$239.00–$389.00	—
Knee X-ray, complete, 4 or more views CPT 73564 Knee 4 Views R	$598.00	$598.00	$239.00–$389.00	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Wc Ct Ext Low W/o Cntrst L	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Ct Ext Low Wo L	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Leg Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Foot Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Foot Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Ankle Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Ankle Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Lower Leg Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Lower Leg Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Knee Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Knee Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Femur Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Femur Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Hip Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Wc Ct Hip Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Leg Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip Rt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip Lt Wo	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ext Low Wo Rt	$2,287.00	$2,287.00	$915.00–$1,487.00	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited Wall	$991.00	$991.00	$396.00–$644.00	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Gallbladder	$991.00	$991.00	$396.00–$644.00	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Ruq	$991.00	$991.00	$396.00–$644.00	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Liver	$991.00	$991.00	$396.00–$644.00	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Soft Tissue Leg	$859.00	$859.00	$344.00–$558.00	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ultrasound Soft Tissue	$859.00	$859.00	$344.00–$558.00	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Soft Tissue Lt Leg	$834.00	$834.00	$334.00–$542.00	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Soft Tissue Rt Arm	$859.00	$859.00	$344.00–$558.00	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Soft Tissue Lt Arm	$859.00	$859.00	$344.00–$558.00	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Soft Tissue Rt Leg	$859.00	$859.00	$344.00–$558.00	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Wc Ct Low Dose Lung Cancer Screening	$415.00	$415.00	$166.00–$270.00	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Cancer Screening	$415.00	$415.00	$166.00–$270.00	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Tib Fib 2 Views L	$456.00	$456.00	$182.00–$296.00	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Tib Fib 2 Views R	$456.00	$456.00	$182.00–$296.00	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Wc Tib Fib 2 Views L	$456.00	$456.00	$182.00–$296.00	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Dc Tib Fib 2 Views R	$456.00	$456.00	$182.00–$296.00	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Dc Tib Fib 2 Views L	$456.00	$456.00	$182.00–$296.00	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Wc Tib Fib 2 Views R	$456.00	$456.00	$182.00–$296.00	—
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head Wo Contrast	$2,944.00	$2,944.00	$1,178.00–$1,914.00	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint	$3,356.00	$3,356.00	$1,342.00–$2,181.00	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri Le Jnt W&wo Contr L	$4,266.00	$4,266.00	$1,706.00–$2,773.00	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri Le Jnt W&wo Contr R	$4,266.00	$4,266.00	$1,706.00–$2,773.00	—
MRI of the abdomen without contrast CPT 74181 Mri Abdomen Wo Contras	$3,409.00	$3,409.00	$1,364.00–$2,216.00	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W & Wo Con	$4,794.00	$4,794.00	$1,918.00–$3,116.00	—
MRI of the brain, no contrast dye CPT 70551 Mri Brain Wo	$3,185.00	$3,185.00	$1,274.00–$2,070.00	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Scan	$5,045.00	$5,045.00	$2,018.00–$3,279.00	—
MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal	$3,332.00	$3,332.00	$1,333.00–$2,166.00	—
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Lumb Spine W & Wo	$5,013.00	$5,013.00	$2,005.00–$3,258.00	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Thorac Spine Wo	$3,344.00	$3,344.00	$1,338.00–$2,174.00	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Cerv Spine W & Wo	$4,955.00	$4,955.00	$1,982.00–$3,221.00	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Cerv Spine Wo Cont	$3,651.00	$3,651.00	$1,460.00–$2,373.00	—
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W&wo Contra	$4,544.00	$4,544.00	$1,818.00–$2,954.00	—
MRI of the pelvis, no contrast dye CPT 72195 Mri Sacrum/coccyx Wo Contrast	$2,113.00	$2,113.00	$845.00–$1,373.00	—
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis Wo Contrast	$3,168.00	$3,168.00	$1,267.00–$2,059.00	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Uexany Joint Wo C Lt	$2,938.00	$2,938.00	$1,175.00–$1,910.00	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Uexany Joint Wo C Rt	$2,938.00	$2,938.00	$1,175.00–$1,910.00	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cervical 4 Or More Views	$790.00	$790.00	$316.00–$514.00	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Wc Spine Cervical 4 Or More	$791.00	$791.00	$316.00–$514.00	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Dc Spine Cervical 4 Views	$791.00	$791.00	$316.00–$514.00	—
Neck soft tissue CT scan with contrast CPT 70491 Ct Neck And Chest With Contrast	$2,624.00	$2,624.00	$1,050.00–$1,706.00	—
Neck soft tissue CT scan with contrast CPT 70491 Wc Ct Neck And Chest With Cont	$2,624.00	$2,624.00	$1,050.00–$1,706.00	—
Neck soft tissue CT scan with contrast CPT 70491 Wc Ct Soft Tissue Neck W Con	$2,624.00	$2,624.00	$1,050.00–$1,706.00	—
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck W Contrast	$2,624.00	$2,624.00	$1,050.00–$1,706.00	—
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck Wo	$2,328.00	$2,328.00	$931.00–$1,513.00	—
Neck soft tissue CT scan without contrast CPT 70490 Wc Ct Soft Tissue Neck W/o Contrast	$2,328.00	$2,328.00	$931.00–$1,513.00	—
Neck soft tissue X-ray CPT 70360 Wc Neck Soft Tissue	$420.00	$420.00	$168.00–$273.00	—
Neck soft tissue X-ray CPT 70360 Neck Soft Tissue	$420.00	$420.00	$168.00–$273.00	—
Neck soft tissue X-ray CPT 70360 Dc Neck Soft Tissue	$420.00	$420.00	$168.00–$273.00	—
Pelvic CT scan without contrast CPT 72192 Wc Ct Pelvis W/o Cntrst	$2,429.00	$2,429.00	$972.00–$1,579.00	—
Pelvic CT scan without contrast CPT 72192 Ct Pelvis Wo Contrast	$2,429.00	$2,429.00	$972.00–$1,579.00	—
Pelvic CT scan without contrast CPT 72192 Wc Ct Sacrum	$2,429.00	$2,429.00	$972.00–$1,579.00	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Bladder	$1,120.00	$1,120.00	$448.00–$728.00	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvic Wall/limited	$1,120.00	$1,120.00	$448.00–$728.00	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Trans Abd Non-ob	$1,120.00	$1,120.00	$448.00–$728.00	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Male Pelvis Compelte	$1,120.00	$1,120.00	$448.00–$728.00	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus	$682.00	$682.00	$273.00–$443.00	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Ob First Trimester	$985.00	$985.00	$394.00–$640.00	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Pregnant Uterus First Tri <=14 Weeks	$1,120.00	$1,120.00	$448.00–$728.00	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Pelvic Complete Ob Ta And Tv	$2,025.00	$2,025.00	$810.00–$1,316.00	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited Transabdominal	$626.00	$626.00	$250.00–$407.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Wc Ribs Unilat 1 View R	$471.00	$471.00	$188.00–$306.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilat 1 View L	$471.00	$471.00	$188.00–$306.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilat 1 View R	$471.00	$471.00	$188.00–$306.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Dc Ribs Unilat 1 View L	$471.00	$471.00	$188.00–$306.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Wc Ribs Unilat 1 View L	$471.00	$471.00	$188.00–$306.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Dc Ribs Unilat 2 Views L	$492.00	$492.00	$197.00–$320.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilat 2 Views L	$492.00	$492.00	$197.00–$320.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilat 2 Views R	$492.00	$492.00	$197.00–$320.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Dc Ribs Unilat 2 Views Rt	$492.00	$492.00	$197.00–$320.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Wc Ribs Unilat 2 Views R	$492.00	$492.00	$197.00–$320.00	—
Rib X-ray, one side, 2 views one side CPT 71100 Wc Ribs Unilat 2 Views L	$492.00	$492.00	$197.00–$320.00	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 Pregabalin (Lyrica) 50mg Cap	$11.00	$11.00	$4.00–$7.00	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 Pregabalin (Lyrica) 75mg Cap	$11.00	$11.00	$4.00–$7.00	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 Dc Ribs Unil W Pa Chest3 Views Min	$570.00	$570.00	$228.00–$371.00	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 Ribs Unil W Pa Chest 3views Min	$570.00	$570.00	$228.00–$371.00	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 Wc Ribs Unil W Pa Chest3 Views Min	$570.00	$570.00	$228.00–$371.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Wc Shoulder Cmplte 2 View L	$459.00	$459.00	$184.00–$298.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Cmplte 2 View R	$459.00	$459.00	$184.00–$298.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Cmplte 2 View L	$459.00	$459.00	$184.00–$298.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Dc Shoulder Cmplte 2 View R	$459.00	$459.00	$184.00–$298.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Dc Shoulder Cmplte 2 View L	$459.00	$459.00	$184.00–$298.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Wc Shoulder Cmplte 2 View R	$459.00	$459.00	$184.00–$298.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Wc Shoulder Cmplete 3 Vie R	$476.00	$476.00	$190.00–$309.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Dc Shoulder Cmplete 3 Vie L	$476.00	$476.00	$190.00–$309.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Dc Shoulder Cmplete 3 Vie R	$476.00	$476.00	$190.00–$309.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Wc Shoulder Cmplete 3 Vie L	$476.00	$476.00	$190.00–$309.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Cmplete 3 Vie R	$476.00	$476.00	$190.00–$309.00	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Cmplete 3 Vie L	$476.00	$476.00	$190.00–$309.00	—
Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses 3v Min	$527.00	$527.00	$211.00–$343.00	—
Sinus X-ray, complete, 3 or more views CPT 70220 Dc Sinuses/paranasal Cmpl	$527.00	$527.00	$211.00–$343.00	—
Sinus X-ray, complete, 3 or more views CPT 70220 Wc Sinuses/paranasal Cmpl	$527.00	$527.00	$211.00–$343.00	—
Skull X-ray, fewer than 4 views CPT 70250 Skull 3v Or Less	$415.00	$415.00	$166.00–$270.00	—
Sleep study in a lab (polysomnography) CPT 95810 Sleep study	$620.00	$620.00	$248.00–$403.00	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Femur 2 Views L	$484.00	$484.00	$194.00–$315.00	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Dc Femur 2 Views R	$484.00	$484.00	$194.00–$315.00	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Dc Femur 2 Views L	$484.00	$484.00	$194.00–$315.00	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Wc Femur 2 Views R	$484.00	$484.00	$194.00–$315.00	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Wc Femur 2 Views L	$484.00	$484.00	$194.00–$315.00	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Femur 2 Views R	$484.00	$484.00	$194.00–$315.00	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 Wc Ct Spine Thoracic W/o Cn	$2,714.00	$2,714.00	$1,086.00–$1,764.00	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Spine Thoracic Wo Contrast	$2,714.00	$2,714.00	$1,086.00–$1,764.00	—
Toe X-ray, 2 or more views CPT 73660 Wc Toe(s) 2 Views Or> L	$366.00	$366.00	$146.00–$238.00	—
Toe X-ray, 2 or more views CPT 73660 Dc Toe(s) 2 Views Or> L	$366.00	$366.00	$146.00–$238.00	—
Toe X-ray, 2 or more views CPT 73660 Dc Toe(s) 2 Views Or> R	$366.00	$366.00	$146.00–$238.00	—
Toe X-ray, 2 or more views CPT 73660 Wc Toe(s) 2 Views Or> R	$366.00	$366.00	$146.00–$238.00	—
Toe X-ray, 2 or more views one side CPT 73660 Toes 2v Or More Lt	$366.00	$366.00	$146.00–$238.00	—
Toe X-ray, 2 or more views one side CPT 73660 Toes 2v Or More Rt	$366.00	$366.00	$146.00–$238.00	—
Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina	$1,092.00	$1,092.00	$437.00–$710.00	—
Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvag	$732.00	$732.00	$293.00–$476.00	—
Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen	$1,223.00	$1,223.00	$489.00–$795.00	—
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum	$990.00	$990.00	$396.00–$644.00	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Soft Tissue Neck And Head	$900.00	$900.00	$360.00–$585.00	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid	$900.00	$900.00	$360.00–$585.00	—
Upper arm X-ray (humerus), 2 views CPT 73060 Humerus 2 Views L	$433.00	$433.00	$173.00–$281.00	—
Upper arm X-ray (humerus), 2 views CPT 73060 Wc Humerus 2 Views L	$433.00	$433.00	$173.00–$281.00	—
Upper arm X-ray (humerus), 2 views CPT 73060 Dc Humerus 2 Views L	$433.00	$433.00	$173.00–$281.00	—
Upper arm X-ray (humerus), 2 views CPT 73060 Humerus 2 Views R	$433.00	$433.00	$173.00–$281.00	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 Wc Humerus 2 Views Rt	$433.00	$433.00	$173.00–$281.00	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 Dc Humerus 2 Views Rt	$433.00	$433.00	$173.00–$281.00	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Us Venous Rue	$1,063.00	$1,063.00	$425.00–$691.00	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Us Venous Lue	$1,063.00	$1,063.00	$425.00–$691.00	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Us Venous Rle	$1,063.00	$1,063.00	$425.00–$691.00	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Us Venous Lle	$1,063.00	$1,063.00	$425.00–$691.00	—
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Views Lt	$260.00	$260.00	$104.00–$169.00	—
Wrist X-ray, 2 views one side CPT 73100 Wc Wrist 2 Views Lt	$260.00	$260.00	$104.00–$169.00	—
Wrist X-ray, 2 views one side CPT 73100 Wc Wrist 2 Views Rt	$260.00	$260.00	$104.00–$169.00	—
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Views Rt	$260.00	$260.00	$104.00–$169.00	—
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist Cmplte 3 Views Min R	$468.00	$468.00	$187.00–$304.00	—
Wrist X-ray, complete, 3 or more views CPT 73110 Dc Wrist Cmplte 3 Views Min R	$468.00	$468.00	$187.00–$304.00	—
Wrist X-ray, complete, 3 or more views CPT 73110 Dc Wrist Cmplte 3 Views Min L	$468.00	$468.00	$187.00–$304.00	—
Wrist X-ray, complete, 3 or more views CPT 73110 Wc Wrist Cmplte 3 Views Min R	$468.00	$468.00	$187.00–$304.00	—
Wrist X-ray, complete, 3 or more views CPT 73110 Wc Wrist Cmplte 3 Views Min L	$468.00	$468.00	$187.00–$304.00	—
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist Cmplte 3 Views Min L	$468.00	$468.00	$187.00–$304.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Dc Hip Unilateral 2-3 View L	$457.00	$457.00	$183.00–$297.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Wc Hip Unilateral 2-3 View R	$457.00	$457.00	$183.00–$297.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Dc Hip Unilateral 2-3 View R	$457.00	$457.00	$183.00–$297.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Wc Hip Unilateral 2-3 View L	$457.00	$457.00	$183.00–$297.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Unilateral 2 Or 3 View R	$457.00	$457.00	$183.00–$297.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Unilateral 2 Or 3 View L	$457.00	$457.00	$183.00–$297.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip With Pelvis 2 Or 3 View Lt	$884.00	$884.00	$354.00–$575.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Dc Hip W/ Pelvis Unilat Cmplte 2-3 Vi L	$884.00	$884.00	$354.00–$575.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Wc Hip W/ Pelvis Unilat Cmplte 2-3 Vi L	$884.00	$884.00	$354.00–$575.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Wc Hip W/ Pelvis Unilat Cmplte 2-3 Vi R	$884.00	$884.00	$354.00–$575.00	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W Pelvis 2 Or 3 View Rt	$884.00	$884.00	$354.00–$575.00	—
X-ray of the abdomen, 1 view CPT 74018 Dc Kub 1 View	$411.00	$411.00	$164.00–$267.00	—
X-ray of the abdomen, 1 view CPT 74018 Wc Kub 1 View	$411.00	$411.00	$164.00–$267.00	—
X-ray of the abdomen, 1 view CPT 74018 Kub 1 View	$411.00	$411.00	$164.00–$267.00	—
X-ray of the ankle, 2 views CPT 73600 Ankle 2 Views L	$379.00	$379.00	$152.00–$246.00	—
X-ray of the ankle, 2 views CPT 73600 Wc Ankle Cmplte 1-2 Views R	$381.00	$381.00	$152.00–$248.00	—
X-ray of the ankle, 2 views CPT 73600 Ankle 2 Views R	$381.00	$381.00	$152.00–$248.00	—
X-ray of the ankle, 2 views CPT 73600 Wc Ankle Cmplte 1-2 Views L	$381.00	$381.00	$152.00–$248.00	—
X-ray of the ankle, 2 views CPT 73600 Dc Ankle Cmplte 1-2 Views L	$381.00	$381.00	$152.00–$248.00	—
X-ray of the ankle, 2 views CPT 73600 Dc Ankle Cmplte 1-2 Views R	$381.00	$381.00	$152.00–$248.00	—
X-ray of the finger(s), 2 or more views CPT 73140 Wc Finger(s) 2 Views R	$391.00	$391.00	$156.00–$254.00	—
X-ray of the finger(s), 2 or more views CPT 73140 Dc Finger(s) 2 Views R	$391.00	$391.00	$156.00–$254.00	—
X-ray of the finger(s), 2 or more views CPT 73140 Dc Finger(s) 2 Views L	$391.00	$391.00	$156.00–$254.00	—
X-ray of the finger(s), 2 or more views CPT 73140 Wc Finger(s) 2 Views L	$391.00	$391.00	$156.00–$254.00	—
X-ray of the finger(s), 2 or more views CPT 73140 Fingers 2 Or More Views R	$391.00	$391.00	$156.00–$254.00	—
X-ray of the finger(s), 2 or more views CPT 73140 Fingers 2 Or More Views L	$391.00	$391.00	$156.00–$254.00	—
X-ray of the foot, 2 views CPT 73620 Foot 2 Views R	$390.00	$390.00	$156.00–$254.00	—
X-ray of the foot, 2 views CPT 73620 Dc Foot 2 Views R	$390.00	$390.00	$156.00–$254.00	—
X-ray of the foot, 2 views CPT 73620 Foot 2 Views L	$390.00	$390.00	$156.00–$254.00	—
X-ray of the foot, 2 views CPT 73620 Dc Foot 2 Views L	$390.00	$390.00	$156.00–$254.00	—
X-ray of the foot, 2 views CPT 73620 Wc Foot 2 Views R	$390.00	$390.00	$156.00–$254.00	—
X-ray of the foot, 2 views CPT 73620 Wc Foot 2 Views L	$390.00	$390.00	$156.00–$254.00	—
X-ray of the foot, complete, 3 or more views CPT 73630 Wc Foot Cmplte 3views R	$456.00	$456.00	$182.00–$296.00	—
X-ray of the foot, complete, 3 or more views CPT 73630 Foot Cmplte Minimum 3v L	$456.00	$456.00	$182.00–$296.00	—
X-ray of the foot, complete, 3 or more views CPT 73630 Dc Foot Cmplte 3 Views L	$456.00	$456.00	$182.00–$296.00	—
X-ray of the foot, complete, 3 or more views CPT 73630 Dc Foot Cmplte 3 Views R	$456.00	$456.00	$182.00–$296.00	—
X-ray of the foot, complete, 3 or more views CPT 73630 Foot Cmplte Minimum 3v R	$456.00	$456.00	$182.00–$296.00	—
X-ray of the foot, complete, 3 or more views CPT 73630 Wc Foot Cmplte 3 Views L	$456.00	$456.00	$182.00–$296.00	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 Wc Foot Lt Cmplte Minimum 3v	$456.00	$456.00	$182.00–$296.00	—
X-ray of the hand, 3 or more views CPT 73130 Dc Hand 3 Views Or> R	$451.00	$451.00	$180.00–$293.00	—
X-ray of the hand, 3 or more views CPT 73130 Dc Hand 3 Views Or> L	$451.00	$451.00	$180.00–$293.00	—
X-ray of the hand, 3 or more views CPT 73130 Wc Hand 3 Views Or> R	$451.00	$451.00	$180.00–$293.00	—
X-ray of the hand, 3 or more views CPT 73130 Wc Hand 3 Views Or> L	$451.00	$451.00	$180.00–$293.00	—
X-ray of the hand, 3 or more views one side CPT 73130 Hand Comp 3 Views Min Rt	$451.00	$451.00	$180.00–$293.00	—
X-ray of the hand, 3 or more views one side CPT 73130 Hand Comp 3 Views Min Lt	$451.00	$451.00	$180.00–$293.00	—
X-ray of the knee, 1 or 2 views CPT 73560 Wc Knee 1-2 View R	$410.00	$410.00	$164.00–$267.00	—
X-ray of the knee, 1 or 2 views CPT 73560 Dc Knee 1-2 View R	$410.00	$410.00	$164.00–$267.00	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 Or 2 View Lt	$410.00	$410.00	$164.00–$267.00	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Wc Knee 1-2 View Lt	$410.00	$410.00	$164.00–$267.00	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Dc Knee 1-2 View Lt	$410.00	$410.00	$164.00–$267.00	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 Or 2 View Rt	$410.00	$410.00	$164.00–$267.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Dont Use	$526.00	$526.00	$210.00–$342.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Dc Spine Lumbar 2-3 Views	$550.00	$550.00	$220.00–$358.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Dc Scoliosis Series	$550.00	$550.00	$220.00–$358.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Wc Spine Lumbar 2-3 Views	$550.00	$550.00	$220.00–$358.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Wc Scoliosis Series	$550.00	$550.00	$220.00–$358.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbar 2 Or 3 Views	$550.00	$550.00	$220.00–$358.00	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Scoliosis Series	$550.00	$550.00	$220.00–$358.00	—
X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back	$873.00	$873.00	$349.00–$567.00	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spine Dorsal 2 Views	$508.00	$508.00	$203.00–$330.00	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Dc Spine Dorsal 2 Views	$508.00	$508.00	$203.00–$330.00	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Wc Spine Dorsal 2 Views	$508.00	$508.00	$203.00–$330.00	—
X-ray of the nasal bones, 3 or more views CPT 70160 Dc Nasal Bones Cmplte 3 V	$454.00	$454.00	$182.00–$295.00	—
X-ray of the nasal bones, 3 or more views CPT 70160 Wc Nasal Bones Cmplte 3 V	$454.00	$454.00	$182.00–$295.00	—
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bones Cmplte 3 V	$454.00	$454.00	$182.00–$295.00	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Wc Spine Cervical 2-3 Vie	$512.00	$512.00	$205.00–$333.00	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical 2-3 Views	$512.00	$512.00	$205.00–$333.00	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Dc Spine Cervical 2-3 Vie	$512.00	$512.00	$205.00–$333.00	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Dc Pelvis 1 View	$468.00	$468.00	$187.00–$304.00	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Wc Pelvis 1 View	$468.00	$468.00	$187.00–$304.00	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Wc Pelvis Cmplte 1-2 View	$468.00	$468.00	$187.00–$304.00	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Dc Pelvis Cmplte 1-2 View	$468.00	$468.00	$187.00–$304.00	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 View	$468.00	$468.00	$187.00–$304.00	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 Or 2 Views	$468.00	$468.00	$187.00–$304.00	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Coccyx And Sacrum 3 Views	$467.00	$467.00	$187.00–$304.00	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum/coccyx 3 Views	$467.00	$467.00	$187.00–$304.00	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Wc Coccyx And Sacrum 2 Views	$467.00	$467.00	$187.00–$304.00	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Wc Sacrum/coccyx 3 Views	$467.00	$467.00	$187.00–$304.00	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Dc Coccyx And Sacrum 2 Views	$467.00	$467.00	$187.00–$304.00	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Dc Sacrum/coccyx 3 Views	$467.00	$467.00	$187.00–$304.00	—

Lab tests

Procedure	Cash price	List price	Insurers pay	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Ho	$269.00	$269.00	$108.00–$175.00	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt (Alt)	$76.00	$76.00	$30.00–$49.00	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Wc Alt	$76.00	$76.00	$30.00–$49.00	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Fib-4 With Reflex To Elf	$74.00	$74.00	$30.00–$48.00	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Wc Ast	$79.00	$79.00	$32.00–$51.00	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Sgot (Ast)	$79.00	$79.00	$32.00–$51.00	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel	$560.00	$560.00	$224.00–$364.00	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Panelno Wc	$560.00	$560.00	$224.00–$364.00	—
Albumin blood test CPT 82040 Wc Albumin Serum	$68.00	$68.00	$27.00–$44.00	—
Albumin blood test CPT 82040 Albumin Serum	$68.00	$68.00	$27.00–$44.00	—
Albumin blood test CPT 82040 Testosterone Free Profile I	$338.00	$338.00	$135.00–$220.00	—
Aldosterone blood test CPT 82088 Aldosterone	$362.00	$362.00	$145.00–$235.00	—
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$69.00	$69.00	$28.00–$45.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Strawberry Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Ige	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cinnamon	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F202 Ige Cashew Nut	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F201 Ige Pecan Nut	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F018 Ige Brazil Nut	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Salmon Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,ragweed	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,bipolaris	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Avocado Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tuna Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,bahia Grass	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Flounder Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tilapia Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Catfish Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Trout Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Johnson Grass	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cochroach American	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pineapple Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Kiwi Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tomato Allergen	$39.00	$39.00	$16.00–$25.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Carmine Red Dye	$40.00	$40.00	$16.00–$26.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F256 Ige Walnut	$42.00	$42.00	$17.00–$27.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Cow Epitheliu	$42.00	$42.00	$17.00–$27.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F026 Ige Pork	$42.00	$42.00	$17.00–$27.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F017 Ige Hazelnut	$42.00	$42.00	$17.00–$27.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F203 Ige Pistachio Nut	$42.00	$42.00	$17.00–$27.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 F013 Ige Peanut	$42.00	$42.00	$17.00–$27.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Horse Epitheli	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Tuna	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Wheat	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Doghair/dander	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Profile Zone	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Cow's Milk	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Goose Feather	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Shrimp	$43.00	$43.00	$17.00–$28.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat Allergen	$51.00	$51.00	$20.00–$33.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Barley Allergen	$58.00	$58.00	$23.00–$38.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten Allergen	$58.00	$58.00	$23.00–$38.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food Meat	$117.00	$117.00	$47.00–$76.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Part I-celiac Profile	$152.00	$152.00	$61.00–$99.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food- Citrus	$195.00	$195.00	$78.00–$127.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food- Fruit	$195.00	$195.00	$78.00–$127.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food- Shellfish	$234.00	$234.00	$94.00–$152.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Pediatric	$234.00	$234.00	$94.00–$152.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food- Spices	$234.00	$234.00	$94.00–$152.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food-grain	$234.00	$234.00	$94.00–$152.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food-milk	$250.00	$250.00	$100.00–$163.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food-nuts	$273.00	$273.00	$109.00–$177.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food- Fish	$273.00	$273.00	$109.00–$177.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Vegetable I	$287.00	$287.00	$115.00–$187.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ige, Each Antigen	$345.00	$345.00	$138.00–$224.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Vegetable Ii	$369.00	$369.00	$148.00–$240.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Basic Food	$383.00	$383.00	$153.00–$249.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Perennial	$451.00	$451.00	$180.00–$293.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Do Not Use	$469.00	$469.00	$188.00–$305.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mold Profile	$469.00	$469.00	$188.00–$305.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Reg Allergen Zone 6	$575.00	$575.00	$230.00–$374.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Perennial Allergen	$690.00	$690.00	$276.00–$449.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Panel, Reg Allergen Zone 6	$1,112.00	$1,112.00	$445.00–$723.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Zone 6 Profile	$1,112.00	$1,112.00	$445.00–$723.00	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Reg Allergen Zone 7	$1,150.00	$1,150.00	$460.00–$748.00	—
Alpha-fetoprotein (AFP) blood test CPT 82105 Afp Maternal Serum	$110.00	$110.00	$44.00–$72.00	—
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Ser	$164.00	$164.00	$66.00–$107.00	—
Ammonia blood test CPT 82140 Ammonia	$193.00	$193.00	$77.00–$125.00	—
Amylase blood test CPT 82150 Amylase, Isoenzymes Serum	$188.00	$188.00	$75.00–$122.00	—
Amylase blood test CPT 82150 Amylase Body Fluid	$197.00	$197.00	$79.00–$128.00	—
Amylase blood test CPT 82150 Wc Amylase Serum	$208.00	$208.00	$83.00–$135.00	—
Amylase blood test CPT 82150 Amylase Serum	$208.00	$208.00	$83.00–$135.00	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Antibody	$117.00	$117.00	$47.00–$76.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anachoice Panel 1 With Reflexes	$106.00	$106.00	$42.00–$69.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Rfx 11 Biomarker	$108.00	$108.00	$43.00–$70.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Rfx Pattern	$111.00	$111.00	$44.00–$72.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody W/reflex	$144.00	$144.00	$58.00–$94.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Screen	$167.00	$167.00	$67.00–$109.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Direct	$167.00	$167.00	$67.00–$109.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Autoimmune Profile	$262.00	$262.00	$105.00–$170.00	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Reflex Cascade	$1,531.00	$1,531.00	$612.00–$995.00	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Triage Bnp	$314.00	$314.00	$126.00–$204.00	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Wc Bnp	$314.00	$314.00	$126.00–$204.00	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum	$190.00	$190.00	$76.00–$124.00	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Any Other Source	$190.00	$190.00	$76.00–$124.00	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture	$190.00	$190.00	$76.00–$124.00	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Anaerobic & Aerobic Culture	$252.00	$252.00	$101.00–$164.00	—
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel	$278.00	$278.00	$111.00–$181.00	—
Bilirubin blood test, total CPT 82247 Wc Bilirubin Total	$65.00	$65.00	$26.00–$42.00	—
Bilirubin blood test, total CPT 82247 Bilirubin Total	$65.00	$65.00	$26.00–$42.00	—
Bilirubin blood test, total CPT 82247 Bilirubin Total And Direct	$74.00	$74.00	$30.00–$48.00	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cervical Biopsy/culpos	$302.00	$302.00	$121.00–$196.00	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Exam By Patholo	$302.00	$302.00	$121.00–$196.00	—
Blood culture for bacteria CPT 87040 Culture Blood	$238.00	$238.00	$95.00–$155.00	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Routine	$16.00	$16.00	$6.00–$10.00	—
Blood glucose (sugar) test CPT 82947 Wc Glucose Serum	$65.00	$65.00	$26.00–$42.00	—
Blood glucose (sugar) test CPT 82947 Glucose Serum	$65.00	$65.00	$26.00–$42.00	—
Blood glucose (sugar) test CPT 82947 Glucose 2hr Post Pran	$65.00	$65.00	$26.00–$42.00	—
Blood lead test CPT 83655 Lead	$129.00	$129.00	$52.00–$84.00	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Wc Pregnancy Test Serum	$190.00	$190.00	$76.00–$124.00	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum	$190.00	$190.00	$76.00–$124.00	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Rh-hr Genotype With Abo Grouping	$70.00	$70.00	$28.00–$46.00	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Blood Typing Serologic	$77.00	$77.00	$31.00–$50.00	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bb Abo Blood Typing Serologic	$90.00	$90.00	$36.00–$59.00	—
Blood urea nitrogen (BUN) test CPT 84520 Wc Urea Nitrogen Blood	$72.00	$72.00	$29.00–$47.00	—
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Blood	$72.00	$72.00	$29.00–$47.00	—
C-peptide blood test CPT 84681 C Peptide	$197.00	$197.00	$79.00–$128.00	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$100.00	$100.00	$40.00–$65.00	—
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9	$164.00	$164.00	$66.00–$107.00	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus Covid-19 Pcr	$170.00	$170.00	$68.00–$111.00	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid Covid Molecular	$170.00	$170.00	$68.00–$111.00	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Wc Rapid Covid Molecular	$170.00	$170.00	$68.00–$111.00	—
Calcium blood test, total CPT 82310 Calcium Total	$65.00	$65.00	$26.00–$42.00	—
Calcium blood test, total CPT 82310 Pth With Calcium	$333.00	$333.00	$133.00–$216.00	—
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Anti	$218.00	$218.00	$87.00–$142.00	—
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igm	$109.00	$109.00	$44.00–$71.00	—
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igg	$147.00	$147.00	$59.00–$96.00	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Throat Naa	$124.00	$124.00	$50.00–$81.00	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Gonococcus Pharyngeal Swab	$229.00	$229.00	$92.00–$149.00	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis, Nucleic Acid Ampl	$229.00	$229.00	$92.00–$149.00	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Vaginitis Plus Vgt	$960.00	$960.00	$384.00–$624.00	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids	$187.00	$187.00	$75.00–$122.00	—
Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated	$309.00	$309.00	$124.00–$201.00	—
Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals	$1,548.00	$1,548.00	$619.00–$1,006.00	—
Cortisol blood test, total CPT 82533 Salivary Cortisol	$89.00	$89.00	$36.00–$58.00	—
Cortisol blood test, total CPT 82533 Cortisol Pm	$89.00	$89.00	$36.00–$58.00	—
Cortisol blood test, total CPT 82533 Dexamethasone Suppression W/ Reflex	$106.00	$106.00	$42.00–$69.00	—
Cortisol blood test, total CPT 82533 Salivary Cortisol ( 2 Specimens)	$163.00	$163.00	$65.00–$106.00	—
Cortisol blood test, total CPT 82533 Cortisol, Am&pm	$213.00	$213.00	$85.00–$138.00	—
Cortisol blood test, total CPT 82533 Cortisol- Am	$213.00	$213.00	$85.00–$138.00	—
Cortisol blood test, total CPT 82533 Cortisol Level	$224.00	$224.00	$90.00–$146.00	—
Creatine kinase (CK) blood test, total CPT 82550 Ck	$148.00	$148.00	$59.00–$96.00	—
Creatine kinase (CK) blood test, total CPT 82550 Wc Ck	$156.00	$156.00	$62.00–$101.00	—
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Total Plus Tsoenzyres	$168.00	$168.00	$67.00–$109.00	—
Creatinine blood test CPT 82565 Bun + Creat, Ratio	$40.00	$40.00	$16.00–$26.00	—
Creatinine blood test CPT 82565 Creatinine	$91.00	$91.00	$36.00–$59.00	—
Creatinine blood test CPT 82565 Wc Creatinine	$91.00	$91.00	$36.00–$59.00	—
Creatinine blood test CPT 82565 Egfr	$91.00	$91.00	$36.00–$59.00	—
Creatinine blood test CPT 82565 Creatinine Serum	$91.00	$91.00	$36.00–$59.00	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Cmv	$178.00	$178.00	$71.00–$116.00	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab Igg	$178.00	$178.00	$71.00–$116.00	—
D-dimer blood test (blood clot marker) CPT 85379 Wc D-dimer	$234.00	$234.00	$94.00–$152.00	—
D-dimer blood test (blood clot marker) CPT 85379 D-dimer	$234.00	$234.00	$94.00–$152.00	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s	$164.00	$164.00	$66.00–$107.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Alcohol Screen W/ Confirmation	$32.00	$32.00	$13.00–$21.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine Screen Only Urine	$76.00	$76.00	$30.00–$49.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Tramadol Screen, Urine	$78.00	$78.00	$31.00–$51.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite Screen, Urine	$83.00	$83.00	$33.00–$54.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Mdma Screen & Confirmation Urine	$126.00	$126.00	$50.00–$82.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Anabolic Steroids Screening	$164.00	$164.00	$66.00–$107.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Profile, Urine 7 Drugs Plus	$178.00	$178.00	$71.00–$116.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Y- Hydroxybutyric Acid	$189.00	$189.00	$76.00–$123.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 9 Mdma-unb	$219.00	$219.00	$88.00–$142.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 W/ Conf Whole Blood	$253.00	$253.00	$101.00–$164.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 Urine W/ Conf	$253.00	$253.00	$101.00–$164.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Pregnancy Drug Profile Urine	$278.00	$278.00	$111.00–$181.00	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Profile, Serum (13)	$410.00	$410.00	$164.00–$267.00	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Wc Electrolyte Panel	$206.00	$206.00	$82.00–$134.00	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$206.00	$206.00	$82.00–$134.00	—
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein- Barr Virus (Ebv) Antibody To Vi	$111.00	$111.00	$44.00–$72.00	—
Estradiol blood test CPT 82670 Estradiol Serum	$223.00	$223.00	$89.00–$145.00	—
Estradiol blood test CPT 82670 Hrt Female Post Pellet	$507.00	$507.00	$203.00–$330.00	—
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulsting Hormone Fsh Pedi	$112.00	$112.00	$45.00–$73.00	—
FSH (follicle-stimulating hormone) test CPT 83001 Fsh Follicle Stimul Ho	$202.00	$202.00	$81.00–$131.00	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal	$211.00	$211.00	$84.00–$137.00	—
Ferritin blood test (iron stores) CPT 82728 Ferritin	$143.00	$143.00	$57.00–$93.00	—
Fibrinogen blood test CPT 85384 Fibrinogen Quantitativ	$135.00	$135.00	$54.00–$88.00	—
Folate (folic acid) blood test CPT 82746 Folic Acid Serum	$162.00	$162.00	$65.00–$105.00	—
Free T3 thyroid hormone test CPT 84481 T3 Free Triiodothyron	$186.00	$186.00	$74.00–$121.00	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Wc Thyroxine Free (T4)	$117.00	$117.00	$47.00–$76.00	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free (T4)	$117.00	$117.00	$47.00–$76.00	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxin Free T4	$118.00	$118.00	$47.00–$77.00	—
Free testosterone test CPT 84402 Free Testosterone	$189.00	$189.00	$76.00–$123.00	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transfe	$116.00	$116.00	$46.00–$75.00	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$736.00	$736.00	$294.00–$478.00	—
Glucose tolerance test, 3 samples CPT 82951 Wc Glucose Tolerance 2hr	$135.00	$135.00	$54.00–$88.00	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 3hr	$135.00	$135.00	$54.00–$88.00	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2hr	$135.00	$135.00	$54.00–$88.00	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 1hr	$135.00	$135.00	$54.00–$88.00	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 4hr	$183.00	$183.00	$73.00–$119.00	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 5hr	$213.00	$213.00	$85.00–$138.00	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhea Throat Naa	$136.00	$136.00	$54.00–$88.00	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhea (Naa)	$228.00	$228.00	$91.00–$148.00	—
H. pylori antibody blood test CPT 86677 Pylori	$185.00	$185.00	$74.00–$120.00	—
H. pylori antibody blood test CPT 86677 H Pylori Igg	$185.00	$185.00	$74.00–$120.00	—
H. pylori antibody blood test CPT 86677 H Pylori Iga	$185.00	$185.00	$74.00–$120.00	—
H. pylori antibody blood test CPT 86677 H Pylori Igm	$185.00	$185.00	$74.00–$120.00	—
H. pylori antibody blood test CPT 86677 H Pylori Ab; Iga,igg,igm	$371.00	$371.00	$148.00–$241.00	—
H. pylori stool antigen test CPT 87338 H Pylori Stool Antigen	$232.00	$232.00	$93.00–$151.00	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1, Quantitative Real-time Pcr	$529.00	$529.00	$212.00–$344.00	—
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/0/2 Antibodies Pre Lim Test W/conf	$509.00	$509.00	$204.00–$331.00	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv Screen	$186.00	$186.00	$74.00–$121.00	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 Papillomavirus Humanpr Tech-	$228.00	$228.00	$91.00–$148.00	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 High Risk Hpv With Hpv Genotypes 16 & 18	$283.00	$283.00	$113.00–$184.00	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c	$112.00	$112.00	$45.00–$73.00	—
Hemoglobin blood test CPT 85018 Hemoglobin Hemocue	$1.00	$1.00	$1.00	—
Hemoglobin blood test CPT 85018 Wc Hemoglobin (Hgb)	$59.00	$59.00	$24.00–$38.00	—
Hemoglobin blood test CPT 85018 Hemoglobin (Hgb)	$59.00	$59.00	$24.00–$38.00	—
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab	$140.00	$140.00	$56.00–$91.00	—
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Virus Profile	$298.00	$298.00	$119.00–$194.00	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody Qualitative	$134.00	$134.00	$54.00–$87.00	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surface Ag	$156.00	$156.00	$62.00–$101.00	—
Hepatitis C antibody blood test (screening) CPT 86803 Hep C Virus Ab	$159.00	$159.00	$64.00–$103.00	—
Hepatitis C antibody blood test (screening) CPT 86803 Hep C Antibody	$159.00	$159.00	$64.00–$103.00	—
Hepatitis C antibody blood test (screening) one side CPT 86803 Hep C Virus Ab W/rfx To Rt-pcr	$119.00	$119.00	$48.00–$77.00	—
Hepatitis C antibody blood test (screening) one side CPT 86803 Hcv Ab W/reflex To Rt Pcr	$506.00	$506.00	$202.00–$329.00	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C Virus, Qn, Rna	$538.00	$538.00	$215.00–$350.00	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Rna W/ Reflex To Genotyping	$568.00	$568.00	$227.00–$369.00	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus (Hsv) Type 1	$94.00	$94.00	$38.00–$61.00	—
Herpes blood test, HSV-2 antibody CPT 86696 Histoplasma Antibody	$128.00	$128.00	$51.00–$83.00	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus (Hsv) Type2 Igg	$136.00	$136.00	$54.00–$88.00	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus Type 2 Specific Ab	$136.00	$136.00	$54.00–$88.00	—
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp-cardiac	$111.00	$111.00	$44.00–$72.00	—
Homocysteine blood test CPT 83090 Homocystine Level	$216.00	$216.00	$86.00–$140.00	—
Homocysteine blood test CPT 83090 Homocystine	$216.00	$216.00	$86.00–$140.00	—
Insulin blood test CPT 83525 Insulin Total	$133.00	$133.00	$53.00–$86.00	—
Iron blood test (serum iron) CPT 83540 Iron Serum	$82.00	$82.00	$33.00–$53.00	—
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity, Total (Tibc)	$107.00	$107.00	$43.00–$70.00	—
Kidney function blood test panel CPT 80069 Kidney function panel test	$304.00	$304.00	$122.00–$198.00	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (Lh) Pedi	$49.00	$49.00	$20.00–$32.00	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$191.00	$191.00	$76.00–$124.00	—
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Labcorp	$152.00	$152.00	$61.00–$99.00	—
Lactate (lactic acid) blood test CPT 83605 Lactic Acid	$152.00	$152.00	$61.00–$99.00	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Body Fluid	$122.00	$122.00	$49.00–$79.00	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Wc Ldh Serum	$188.00	$188.00	$75.00–$122.00	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Serum	$188.00	$188.00	$75.00–$122.00	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$182.00	$182.00	$73.00–$118.00	—
Lipase blood test (pancreas enzyme) CPT 83690 Wc Lipase	$182.00	$182.00	$73.00–$118.00	—
Liver function blood test panel CPT 80076 Liver function blood test	$248.00	$248.00	$99.00–$161.00	—
Lyme disease antibody test CPT 86618 Lyme Ab	$140.00	$140.00	$56.00–$91.00	—
Lyme disease antibody test CPT 86618 Lyme Igm Early Test	$144.00	$144.00	$58.00–$94.00	—
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab With Reflex	$144.00	$144.00	$58.00–$94.00	—
Lyme disease antibody test CPT 86618 Lyme Abs 2 Tier Testing	$151.00	$151.00	$60.00–$98.00	—
Lyme disease antibody test CPT 86618 Lyme Igm Early Test W/ Reflex	$190.00	$190.00	$76.00–$124.00	—
Magnesium blood test CPT 83735 Magnesium,rbc	$118.00	$118.00	$47.00–$77.00	—
Magnesium blood test CPT 83735 Wc Magnesium Serum	$121.00	$121.00	$48.00–$79.00	—
Magnesium blood test CPT 83735 Urine Magnesium, Random	$121.00	$121.00	$48.00–$79.00	—
Magnesium blood test CPT 83735 Magnesium Serum	$121.00	$121.00	$48.00–$79.00	—
Magnesium blood test CPT 83735 Magnesium Ua	$121.00	$121.00	$48.00–$79.00	—
Measles (rubeola) antibody test CPT 86765 Rubella Ab Igg	$79.00	$79.00	$32.00–$51.00	—
Measles (rubeola) antibody test CPT 86765 Measles Antibodies, Igg	$99.00	$99.00	$40.00–$64.00	—
Measles (rubeola) antibody test CPT 86765 Measles Antibodies, Igm	$99.00	$99.00	$40.00–$64.00	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Qual Quant	$68.00	$68.00	$27.00–$44.00	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Qual W Reflex Quant	$76.00	$76.00	$30.00–$49.00	—
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile (Monospot)	$105.00	$105.00	$42.00–$68.00	—
Mono test (heterophile antibody, Monospot) CPT 86308 Wc Heterophile (Monospot)	$105.00	$105.00	$42.00–$68.00	—
Mumps immunity blood test CPT 86735 Mumps (Igm)	$120.00	$120.00	$48.00–$78.00	—
Mumps immunity blood test CPT 86735 Mumps Igg	$120.00	$120.00	$48.00–$78.00	—
Obstetric blood test panel CPT 80055 Obstetric blood test panel	$95.00	$95.00	$38.00–$62.00	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test	$133.00	$133.00	$53.00–$86.00	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test	$298.00	$298.00	$119.00–$194.00	—
Pap test (liquid-based, automated screening with review) CPT 88175 Gynecologic Pap Test/reflex Ig	$84.00	$84.00	$34.00–$55.00	—
Pap test (liquid-based, automated screening with review) CPT 88175 Gynecologic Pap Test/reflex	$100.00	$100.00	$40.00–$65.00	—
Pap test (liquid-based, automated screening with review) CPT 88175 Gynecologic Pap Test/reflex Genotype	$144.00	$144.00	$58.00–$94.00	—
Pap test (liquid-based, automated screening with review) CPT 88175 Gynecologic Pap Test/reflex Hpv	$214.00	$214.00	$86.00–$139.00	—
Pap test (liquid-based, automated screening with review) CPT 88175 Pap Smear W/ Reflex Hpv	$339.00	$339.00	$136.00–$220.00	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Smear-thin Prepsend Out	$159.00	$159.00	$64.00–$103.00	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Smear-thin Prep	$166.00	$166.00	$66.00–$108.00	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Intact	$370.00	$370.00	$148.00–$241.00	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone(pt	$381.00	$381.00	$152.00–$248.00	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Immune Ass	$381.00	$381.00	$152.00–$248.00	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test	$147.00	$147.00	$59.00–$96.00	—
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum	$81.00	$81.00	$32.00–$53.00	—
Potassium blood test CPT 84132 Wc Potassium Serum	$74.00	$74.00	$30.00–$48.00	—
Potassium blood test CPT 84132 Potassium Serum	$74.00	$74.00	$30.00–$48.00	—
Progesterone blood test CPT 84144 Progesterone	$164.00	$164.00	$66.00–$107.00	—
Progesterone blood test CPT 84144 Progesterone Level	$170.00	$170.00	$68.00–$111.00	—
Prolactin blood test CPT 84146 Macroprolactin	$138.00	$138.00	$55.00–$90.00	—
Prolactin blood test CPT 84146 Prolactin	$210.00	$210.00	$84.00–$137.00	—
Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time	$95.00	$95.00	$38.00–$62.00	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Custom Law Enforcement Drug Sc 12 Panel	$53.00	$53.00	$21.00–$34.00	—
Rapid flu test (influenza antigen) CPT 87804 Influenza B	$49.00	$49.00	$20.00–$32.00	—
Rapid flu test (influenza antigen) CPT 87804 Influenza A	$49.00	$49.00	$20.00–$32.00	—
Rapid flu test (influenza antigen) CPT 87804 Influenza Ia W Do	$50.00	$50.00	$20.00–$33.00	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Wc Strep A Screen	$205.00	$205.00	$82.00–$133.00	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Screen	$205.00	$205.00	$82.00–$133.00	—
Renin blood test CPT 84244 Renin	$132.00	$132.00	$53.00–$86.00	—
Renin blood test CPT 84244 Aldosterone Renin Ratio	$324.00	$324.00	$130.00–$211.00	—
Rh blood typing CPT 86901 Bb Rh (D) Blood Typing Serologic	$80.00	$80.00	$32.00–$52.00	—
Rh blood typing CPT 86901 Rh (D) Blood Typing Serologic	$80.00	$80.00	$32.00–$52.00	—
Rheumatoid factor (RF) test CPT 86431 Quan Rheum Factor	$85.00	$85.00	$34.00–$55.00	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quan	$85.00	$85.00	$34.00–$55.00	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Isotypes, Igg, Iga, Ig	$304.00	$304.00	$122.00–$198.00	—
Rubella antibody test (immunity check) CPT 86762 Antibody Rubella Titer	$95.00	$95.00	$38.00–$62.00	—
Rubella antibody test (immunity check) CPT 86762 Antibody Rubella Igm	$102.00	$102.00	$41.00–$66.00	—
Rubella antibody test (immunity check) CPT 86762 Rubella Igg	$102.00	$102.00	$41.00–$66.00	—
Rubella antibody test (immunity check) CPT 86762 Rubella Igm	$131.00	$131.00	$52.00–$85.00	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Sperm Count Cmplte	$52.00	$52.00	$21.00–$34.00	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis Cmplte	$60.00	$60.00	$24.00–$39.00	—
Sodium blood test CPT 84295 Sodium Serum	$59.00	$59.00	$24.00–$38.00	—
Sodium blood test CPT 84295 Wc Sodium Serum	$59.00	$59.00	$24.00–$38.00	—
Stool ova and parasites exam CPT 87177 Ova & Parasites	$149.00	$149.00	$60.00–$97.00	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces Single/screening	$67.00	$67.00	$27.00–$44.00	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Mha Tp	$84.00	$84.00	$34.00–$55.00	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Fta Treponema Pallidum	$84.00	$84.00	$34.00–$55.00	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Antibodies (Tp-pa)	$103.00	$103.00	$41.00–$67.00	—
Syphilis antibody test (Treponema pallidum) CPT 86780 T Pallidium Sceening Cascade	$109.00	$109.00	$44.00–$71.00	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Rfx Tp-pa	$43.00	$43.00	$17.00–$28.00	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Rpr Qua	$95.00	$95.00	$38.00–$62.00	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Rpr Sts Qual	$95.00	$95.00	$38.00–$62.00	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Prenatal Profile 1 Rpr Positive	$103.00	$103.00	$41.00–$67.00	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr With Reflex To Titer	$151.00	$151.00	$60.00–$98.00	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Lyme/syphilis Diff Profile	$591.00	$591.00	$236.00–$384.00	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon- Tb Gold	$248.00	$248.00	$99.00–$161.00	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$201.00	$201.00	$80.00–$131.00	—
Testosterone blood test, total (not free testosterone) CPT 84403 Wc Testosterone Total	$201.00	$201.00	$80.00–$131.00	—
Testosterone blood test, total (not free testosterone) CPT 84403 Weakly Bound	$201.00	$201.00	$80.00–$131.00	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Free Profile Ii	$348.00	$348.00	$139.00–$226.00	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Free, Equibrium	$434.00	$434.00	$174.00–$282.00	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies	$136.00	$136.00	$54.00–$88.00	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-kidney Microsomal Antibodies	$136.00	$136.00	$54.00–$88.00	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase	$136.00	$136.00	$54.00–$88.00	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH)	$195.00	$195.00	$78.00–$127.00	—
Total IgE blood test CPT 82785 Immunoglobulin E Total	$159.00	$159.00	$64.00–$103.00	—
Total IgE blood test CPT 82785 Gammaglobulin Ige	$159.00	$159.00	$64.00–$103.00	—
Total IgE blood test CPT 82785 Allergen Profile Childhood	$749.00	$749.00	$300.00–$487.00	—
Total IgE blood test CPT 82785 Allergen Area 10 Profile	$751.00	$751.00	$300.00–$488.00	—
Total cholesterol blood test CPT 82465 Cholesterol Total Ser	$90.00	$90.00	$36.00–$59.00	—
Total cholesterol blood test CPT 82465 Wc Cholesterol Total Ser	$90.00	$90.00	$36.00–$59.00	—
Total thyroxine (T4) blood test CPT 84436 Wc Thyroxine Total (T4)	$119.00	$119.00	$48.00–$77.00	—
Total thyroxine (T4) blood test CPT 84436 Thyroxine Total (T4)	$119.00	$119.00	$48.00–$77.00	—
Total triiodothyronine (T3) blood test CPT 84480 T3 Total (Triiodothyronine)	$144.00	$144.00	$58.00–$94.00	—
Transferrin blood test CPT 84466 Transferrin	$114.00	$114.00	$46.00–$74.00	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Pcr	$146.00	$146.00	$58.00–$95.00	—
Triglycerides blood test CPT 84478 Wc Triglycerides	$136.00	$136.00	$54.00–$88.00	—
Triglycerides blood test CPT 84478 Triglycerides	$136.00	$136.00	$54.00–$88.00	—
Troponin test, quantitative CPT 84484 Troponin Quant	$272.00	$272.00	$109.00–$177.00	—
Troponin test, quantitative CPT 84484 Wc Troponin Quant	$272.00	$272.00	$109.00–$177.00	—
Uric acid blood test CPT 84550 Wc Uric Acid Serum	$92.00	$92.00	$37.00–$60.00	—
Uric acid blood test CPT 84550 Uric Acid Serum	$92.00	$92.00	$37.00–$60.00	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope	$27.00	$27.00	$11.00–$18.00	—
Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope	$68.00	$68.00	$27.00–$44.00	—
Urinalysis without microscope exam, automated CPT 81003 Urinalysis test	$18.00	$18.00	$7.00–$12.00	—
Urinalysis without microscope exam, manual CPT 81002 Urinalysis test	$19.00	$19.00	$8.00–$12.00	—
Urine culture for bacteria, with colony count CPT 87086 Culture Ua	$154.00	$154.00	$62.00–$100.00	—
Urine microalbumin (albumin) test CPT 82043 Microalbumin/crea Ratio, Random Urine	$1.00	$1.00	$1.00	—
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine	$99.00	$99.00	$40.00–$64.00	—
Urine microalbumin (albumin) test CPT 82043 Microalbumin 24-urine	$110.00	$110.00	$44.00–$72.00	—
Urine pregnancy test, read by color change CPT 81025 Wc Hcg Urine	$169.00	$169.00	$68.00–$110.00	—
Urine pregnancy test, read by color change CPT 81025 Hcg Urinesix Test	$169.00	$169.00	$68.00–$110.00	—
Urine pregnancy test, read by color change CPT 81025 Hcg Urine	$169.00	$169.00	$68.00–$110.00	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Cyanocobal	$175.00	$175.00	$70.00–$114.00	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vit D-3 25-oh	$232.00	$232.00	$93.00–$151.00	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Oh D2 T D3	$378.00	$378.00	$151.00–$246.00	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D, 1, 25 Dihydroxy	$298.00	$298.00	$119.00–$194.00	—
Zinc blood test CPT 84630 Zinc Plasma	$155.00	$155.00	$62.00–$101.00	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant Serum	$229.00	$229.00	$92.00–$149.00	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 Appendectomyrupture W	$3,430.00	$3,430.00	$1,372.00–$2,230.00	—
Appendectomy, open surgery CPT 44950 Pf-appendectomy Incidental	$640.00	$640.00	$256.00–$416.00	—
Appendectomy, open surgery CPT 44950 Appendectomy Incidental	$3,372.00	$3,372.00	$1,349.00–$2,192.00	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Trt Distal Fib Fx Clsdw/o Mnp	$297.00	$297.00	$119.00–$193.00	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Treatment Of Ankle Fracture	$325.00	$325.00	$130.00–$211.00	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Clo Trt Metatarsalfx, W/out Manip	$772.00	$772.00	$309.00–$502.00	—
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction Hallux Valgus W/ Metatarsal	$5,730.00	$5,730.00	$2,292.00–$3,725.00	—
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Pf- Correction, Hallux Valgus W/ Metatar	$5,730.00	$5,730.00	$2,292.00–$3,725.00	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective	$1,679.00	$1,679.00	$672.00–$1,091.00	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Pf Cardioversion	$1,679.00	$1,679.00	$672.00–$1,091.00	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Burn Dress/debride Me	$1,679.00	$1,679.00	$672.00–$1,091.00	—
Carpal tunnel release, open surgery CPT 64721 Pf-carpal Tunnel	$413.00	$413.00	$165.00–$268.00	—
Carpal tunnel release, open surgery CPT 64721 Carpal Tunnel	$4,709.00	$4,709.00	$1,884.00–$3,061.00	—
Cataract surgery with lens implant CPT 66984 Removal of cataract with insertion of lens	$686.00	$686.00	$274.00–$446.00	—
Cesarean delivery, including prenatal and postpartum care CPT 59510 Obstetric care, planned cesarean delivery	$2,459.00	$2,459.00	$984.00–$1,598.00	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Pf Circumcision Older Than 28 Years Old	$1,267.00	$1,267.00	$507.00–$824.00	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Not Nb	$5,421.00	$5,421.00	$2,168.00–$3,524.00	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Trt Colles Fx Clsdw/o Mnp	$311.00	$311.00	$124.00–$202.00	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Treat Fracture Radius/ulna	$334.00	$334.00	$134.00–$217.00	—
Colonoscopy with endoscopic ultrasound CPT 45391 Ultrasound examination of lower large bowel using an endoscope	$311.00	$311.00	$124.00–$202.00	—
Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope	$2,676.00	$2,676.00	$1,070.00–$1,739.00	—
Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope	$3,100.00	$3,100.00	$1,240.00–$2,015.00	—
Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope	$2,805.00	$2,805.00	$1,122.00–$1,823.00	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&c Dx	$5,390.00	$5,390.00	$2,156.00–$3,504.00	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Pf Des Les Ben Fce 1st L	$164.00	$164.00	$66.00–$107.00	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Dest Of Ben Les 1st L	$277.00	$277.00	$111.00–$180.00	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 Pf Removal Of Impacted Cerumen	$792.00	$792.00	$317.00–$515.00	—
Earwax removal with instruments, one ear CPT 69210 Pf Rmvl Impacted Cerumen	$79.00	$79.00	$32.00–$51.00	—
Earwax removal with instruments, one ear CPT 69210 Rmvl Impacted Cerumen	$113.00	$113.00	$45.00–$73.00	—
Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope	$7,571.00	$7,571.00	$3,028.00–$4,921.00	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Pf-lap Cholecystectomy W/ Cholangiograph	$6,709.00	$6,709.00	$2,684.00–$4,361.00	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Lap Cholecystectomy With Cholangiography	$10,491.00	$10,491.00	$4,196.00–$6,819.00	—
Gallbladder removal, open surgery through a larger incision CPT 47600 Pf- Cholecystectomy	$1,118.00	$1,118.00	$447.00–$727.00	—
Gallbladder removal, open surgery through a larger incision CPT 47600 Cholecystectomyip Only	$4,480.00	$4,480.00	$1,792.00–$2,912.00	—
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorroidectomy Smple	$4,344.00	$4,344.00	$1,738.00–$2,824.00	—
Hysterectomy through an abdominal incision (total) CPT 58150 Pf-total Abd Hysterectomy	$1,074.00	$1,074.00	$430.00–$698.00	—
Hysterectomy through an abdominal incision (total) CPT 58150 Tah17 Rvu	$4,116.00	$4,116.00	$1,646.00–$2,675.00	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Inj Hysterosalpingogr	$554.00	$554.00	$222.00–$360.00	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abscess Simple	$1,023.00	$1,023.00	$409.00–$665.00	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&d Abscess Smple Sngl	$1,760.00	$1,760.00	$704.00–$1,144.00	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia patient age 5 years or older	$5,044.00	$5,044.00	$2,018.00–$3,279.00	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tndn Shth/lig/trig Pt/cyst	$455.00	$455.00	$182.00–$296.00	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Acentesis Asprte Jnt M	$674.00	$674.00	$270.00–$438.00	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Pf Acentesis Asprte Jnt M	$674.00	$674.00	$270.00–$438.00	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Acentesis Asprte Jnt I	$545.00	$545.00	$218.00–$354.00	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Pf Acentesis Asprte Jnt I	$545.00	$545.00	$218.00–$354.00	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Pf Acentisis Asprte Jnt S	$480.00	$480.00	$192.00–$312.00	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Acentesis Asprte Jnt S	$480.00	$480.00	$192.00–$312.00	—
Knee arthroscopy with meniscus trim CPT 29881 Removal of one knee cartilage using an endoscope	$564.00	$564.00	$226.00–$367.00	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Appendectomy Laparosc	$6,561.00	$6,561.00	$2,624.00–$4,265.00	—
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Tif Andr Fundoplication/non Medicare	$12,036.00	$12,036.00	$4,814.00–$7,823.00	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap Ing Hernia Repair Init	$10,742.00	$10,742.00	$4,297.00–$6,982.00	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Laparoscopy Repair Inrecurrent	$4,593.00	$4,593.00	$1,837.00–$2,985.00	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Lap; W Rem Adnexal Structures	$4,434.00	$4,434.00	$1,774.00–$2,882.00	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Removal of recurring cataract in lens capsule using laser	$347.00	$347.00	$139.00–$226.00	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Int Rep S/a/t/ex 2.5c	$720.00	$720.00	$288.00–$468.00	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Rpr Int Sclp Trnk Ext2.5cm Or <	$756.00	$756.00	$302.00–$491.00	—
Left heart catheterization, diagnostic one side CPT 93452 Insertion of catheter into left heart for diagnosis	$885.00	$885.00	$354.00–$575.00	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection(s) of anesthetic into lower spine using imaging guidance	$228.00	$228.00	$91.00–$148.00	—
Lumpectomy (partial mastectomy) CPT 19301 Pf- Mastectomy Partial	$947.00	$947.00	$379.00–$616.00	—
Lumpectomy (partial mastectomy) CPT 19301 Mastectomy Partial	$5,283.00	$5,283.00	$2,113.00–$3,434.00	—
Mastectomy (total removal of the breast) CPT 19303 Pf- Mastectomy Simple Complete	$5,858.00	$5,858.00	$2,343.00–$3,808.00	—
Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete	$5,858.00	$5,858.00	$2,343.00–$3,808.00	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Ex Ben Les Trnk Arms0.5cm Or Less	$750.00	$750.00	$300.00–$488.00	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Pf Excision Of Benign Lesion	$417.00	$417.00	$167.00–$271.00	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Facemm B90.5 Cm < Cm	$860.00	$860.00	$344.00–$559.00	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plt Prtsmpl Sngle	$231.00	$231.00	$92.00–$150.00	—
Nail removal (partial or complete), one nail CPT 11730 Pf Avulsion Nail Plte Sn	$278.00	$278.00	$111.00–$181.00	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plte Sn	$278.00	$278.00	$111.00–$181.00	—
Paracentesis with imaging guidance CPT 49083 Pf Peritoneocentesis	$1,256.00	$1,256.00	$502.00–$816.00	—
Paracentesis with imaging guidance CPT 49083 Peritoneocentesis	$1,256.00	$1,256.00	$502.00–$816.00	—
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/imaging Guidance	$1,256.00	$1,256.00	$502.00–$816.00	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Sip Rep Sclp/trnk 2.5 Cm/less	$1,141.00	$1,141.00	$456.00–$742.00	—
Prostate biopsy CPT 55700 Biopsy of prostate gland	$223.00	$223.00	$89.00–$145.00	—
Prostate removal (prostatectomy), laparoscopic CPT 55866 Surgical removal of prostate and surrounding lymph nodes using an endoscope	$1,832.00	$1,832.00	$733.00–$1,191.00	—
Removal of a breast lump, open surgery CPT 19120 Removal of one or more breast growth, open procedure	$4,717.00	$4,717.00	$1,887.00–$3,066.00	—
Removal of a foreign object under the skin, simple CPT 10120 Rem Fb Subcutaneous Simple	$940.00	$940.00	$376.00–$611.00	—
Removal of a foreign object under the skin, simple CPT 10120 I&rmve Fb Subq Smple	$987.00	$987.00	$395.00–$642.00	—
Removal of a foreign object under the skin, simple CPT 10120 Pf Rmvl Fb Subcut Tissue	$987.00	$987.00	$395.00–$642.00	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colorec Cncr Scr;colnscpy No Hi Rsk	$399.00	$399.00	$160.00–$259.00	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Pf Colonoscopy Screennot High Ris	$637.00	$637.00	$255.00–$414.00	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colonoscopy Screennot High Ris	$2,565.00	$2,565.00	$1,026.00–$1,667.00	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorec Cancr Scr; Colnscpy Hi Risk	$399.00	$399.00	$160.00–$259.00	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Pf- Colonoscopy Screeninghigh Risk	$606.00	$606.00	$242.00–$394.00	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colonoscopy Screenhigh Risk	$2,343.00	$2,343.00	$937.00–$1,523.00	—
Short arm cast (elbow to hand) CPT 29075 Cast Arm Short Apply	$376.00	$376.00	$150.00–$244.00	—
Short arm cast (elbow to hand) CPT 29075 Pf Cast Arm Short Apply	$420.00	$420.00	$168.00–$273.00	—
Short arm splint (forearm and hand) CPT 29125 Short Arm Splint	$135.00	$135.00	$54.00–$88.00	—
Short arm splint (forearm and hand) CPT 29125 Pf Application Splint Arm Short	$206.00	$206.00	$82.00–$134.00	—
Short arm splint (forearm and hand) CPT 29125 Splint Arm Short Apply	$348.00	$348.00	$139.00–$226.00	—
Short leg cast (below the knee) CPT 29405 Pf Cast Leg Short Apply	$425.00	$425.00	$170.00–$276.00	—
Short leg cast (below the knee) CPT 29405 Cast Leg Short Apply	$425.00	$425.00	$170.00–$276.00	—
Short leg splint (calf to foot) CPT 29515 Pf Splint Leg Short Apply	$257.00	$257.00	$103.00–$167.00	—
Short leg splint (calf to foot) CPT 29515 Splint Leg Short Apply	$401.00	$401.00	$160.00–$261.00	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shaving of shoulder bone using endoscope	$187.00	$187.00	$75.00–$122.00	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr Smpl Sclp Nck Trnk<2.5cm	$399.00	$399.00	$160.00–$259.00	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr Smpl Sclp Nck Trnk2.5cm Or<	$419.00	$419.00	$168.00–$272.00	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Mlest/a/l0.5cm/<	$4,916.00	$4,916.00	$1,966.00–$3,195.00	—
Skin tag removal, up to 15 tags CPT 11200 Pf Electrosur Dest/fibroc	$259.00	$259.00	$104.00–$168.00	—
Skin tag removal, up to 15 tags CPT 11200 Rmve Skin Tag Mult Fiup To Inc 15	$259.00	$259.00	$104.00–$168.00	—
Skin tag removal, up to 15 tags CPT 11200 Removal Skin Tags To 15 Lesions	$295.00	$295.00	$118.00–$192.00	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Pf Lumbar Puncture Dx	$967.00	$967.00	$387.00–$629.00	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture	$967.00	$967.00	$387.00–$629.00	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr Smpl Sclp Nck Trnk2.6-7.5cm	$382.00	$382.00	$153.00–$248.00	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr Smpl Fce Ear Elid2.5cm Or<	$410.00	$410.00	$164.00–$267.00	—
Thoracentesis with imaging guidance CPT 32555 Pf Thoracentesis	$850.00	$850.00	$340.00–$553.00	—
Tonsil and adenoid removal, age 12 or older CPT 42821 Pf- T & A 12 Or >12 Or Over	$443.00	$443.00	$177.00–$288.00	—
Tonsil and adenoid removal, age 12 or older CPT 42821 T&a Age 12 Or >12 Or Over	$2,347.00	$2,347.00	$939.00–$1,526.00	—
Tonsil and adenoid removal, child under 12 CPT 42820 Removal of tonsils and adenoid glands, patient younger than age 12	$1,727.00	$1,727.00	$691.00–$1,123.00	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Age 12 O	$1,508.00	$1,508.00	$603.00–$980.00	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Pf- Tonsillectomy < Age 12	$594.00	$594.00	$238.00–$386.00	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Tonsillectomy < Age 12	$1,514.00	$1,514.00	$606.00–$984.00	—
Trigger finger release surgery CPT 26055 Tendon Sheath Incisionrvu 5.4	$3,168.00	$3,168.00	$1,267.00–$2,059.00	—
Trigger point injections, 1 or 2 muscles CPT 20552 Pf Inject Sngle/multi Tr1/2 Muscle	$546.00	$546.00	$218.00–$355.00	—
Trigger point injections, 1 or 2 muscles CPT 20552 Inject Sngle/multi Tr1/2 Muscle	$580.00	$580.00	$232.00–$377.00	—
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Laparoscopy, Surgical W/ Fulguration	$2,760.00	$2,760.00	$1,104.00–$1,794.00	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd W Balloon Dilatio	$2,621.00	$2,621.00	$1,048.00–$1,704.00	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd W Baloon Dilation Esophag	$2,684.00	$2,684.00	$1,074.00–$1,745.00	—
Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope	$2,509.00	$2,509.00	$1,004.00–$1,631.00	—
Upper endoscopy (EGD) with injection into the lining CPT 43236 Egd W Directed Submucosal Inje	$1,800.00	$1,800.00	$720.00–$1,170.00	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd W/rmvl By Snare	$1,990.00	$1,990.00	$796.00–$1,294.00	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Up Gi Endo W/ Dilation Esophag	$2,354.00	$2,354.00	$942.00–$1,530.00	—
Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope	$1,921.00	$1,921.00	$768.00–$1,249.00	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Obstetric care, planned vaginal delivery (post delivery by cesarean section)	$2,331.00	$2,331.00	$932.00–$1,515.00	—
Vaginal delivery, including prenatal and postpartum care CPT 59400 Obstetric care, planned vaginal delivery	$2,224.00	$2,224.00	$890.00–$1,446.00	—
Vasectomy, one or both sides, including follow-up semen testing one side CPT 55250 Vasectomy Unilat W/posemen Exam	$1,608.00	$1,608.00	$643.00–$1,045.00	—
Wart removal, up to 14 warts CPT 17110 Destruct Les Up To 14	$174.00	$174.00	$70.00–$113.00	—
Wart removal, up to 14 warts CPT 17110 Destruct Wart Up To 1	$185.00	$185.00	$74.00–$120.00	—
Wart removal, up to 14 warts CPT 17110 Destr Wart Up To 14 Lesions	$285.00	$285.00	$114.00–$185.00	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin+subq Tis	$888.00	$888.00	$355.00–$577.00	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Pf Debridment Sq	$888.00	$888.00	$355.00–$577.00	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Incl Subq	$2,217.00	$2,217.00	$887.00–$1,441.00	—
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Trt Open Distal Radialw/wo Int Fix	$8,516.00	$8,516.00	$3,406.00–$5,535.00	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Of Blood 6	$499.00	$499.00	$200.00–$324.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 6-8	$499.00	$499.00	$200.00–$324.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood > 8	$554.00	$554.00	$222.00–$360.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood	$697.00	$697.00	$279.00–$453.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 4-6	$697.00	$697.00	$279.00–$453.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Bld/bld Components	$697.00	$697.00	$279.00–$453.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Bb Platelet Apheresis Sin	$697.00	$697.00	$279.00–$453.00	—
Blood transfusion (giving blood or blood components) CPT 36430 Bb Transfusion Blood	$697.00	$697.00	$279.00–$453.00	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb Trmt	$60.00	$60.00	$24.00–$39.00	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Updrft Neb Trmt-ea Addtl	$89.00	$89.00	$36.00–$58.00	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Subs Treatment	$89.00	$89.00	$36.00–$58.00	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ultrasonic Neb Per Tx	$132.00	$132.00	$53.00–$86.00	—
Critical care, first 30 to 74 minutes CPT 99291 Pf Critical Care 1st 30-7	$2,942.00	$2,942.00	$1,177.00–$1,912.00	—
Critical care, first 30 to 74 minutes CPT 99291 Critical Care 31-74 Mi	$2,942.00	$2,942.00	$1,177.00–$1,912.00	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake & Drowsy	$943.00	$943.00	$377.00–$613.00	—
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram, routine, with interpretation and report	$164.00	$164.00	$66.00–$107.00	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, Tracing	$8.00	$8.00	$3.00–$5.00	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Xxekg 12 Leads Tracingw/o Int/rpt	$92.00	$92.00	$37.00–$60.00	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg W/out Inter	$158.00	$158.00	$63.00–$103.00	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Pf Ekg 12 Lead W/out Interpretation	$290.00	$290.00	$116.00–$189.00	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram Routine	$290.00	$290.00	$116.00–$189.00	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Screening	$137.00	$137.00	$55.00–$89.00	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Pf E/r Visit Level 1 Non Urgent	$264.00	$264.00	$106.00–$172.00	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Room L-1	$296.00	$296.00	$118.00–$192.00	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Pf E/r Visit Level 2 Deferrable	$239.00	$239.00	$96.00–$155.00	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Room L-2	$602.00	$602.00	$241.00–$391.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room L-3/laceration 12001	$378.00	$378.00	$151.00–$246.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room L-3/laceration 12002	$444.00	$444.00	$178.00–$289.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room L-3/laceration 12013	$765.00	$765.00	$306.00–$497.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room L-3/laceration 12011	$765.00	$765.00	$306.00–$497.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Pf E/r Visit Level 3 Urgent	$804.00	$804.00	$322.00–$523.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room L-3	$961.00	$961.00	$384.00–$625.00	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room L-3 W/m	$1,014.00	$1,014.00	$406.00–$659.00	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Pf E/r Visit Level 4 Emergent	$915.00	$915.00	$366.00–$595.00	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Room L-4	$1,489.00	$1,489.00	$596.00–$968.00	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Room L-4 W/m	$1,801.00	$1,801.00	$720.00–$1,171.00	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Pf E/r Visit Level 5 Resuscitative	$1,718.00	$1,718.00	$687.00–$1,117.00	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Room L-5 W/m	$2,051.00	$2,051.00	$820.00–$1,333.00	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Room L-5	$2,133.00	$2,133.00	$853.00–$1,386.00	—
Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min	$171.00	$171.00	$68.00–$111.00	—
Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min	$153.00	$153.00	$61.00–$99.00	—
Group psychotherapy session CPT 90853 Group psychotherapy	$65.00	$65.00	$26.00–$42.00	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Infusion 1st Hr	$375.00	$375.00	$150.00–$244.00	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Infusion 1 Hr Max	$375.00	$375.00	$150.00–$244.00	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Infusion 1st Hour	$394.00	$394.00	$158.00–$256.00	—
IV infusion of a medicine, first hour CPT 96365 Ther/proph/diag Iv Inf	$466.00	$466.00	$186.00–$303.00	—
IV push of a medicine, first drug CPT 96374 Iv Push	$238.00	$238.00	$95.00–$155.00	—
IV push of a medicine, first drug CPT 96374 Injection Iv Push	$249.00	$249.00	$100.00–$162.00	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Im	$32.00	$32.00	$13.00–$21.00	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Im Or Sqprev 90772	$124.00	$124.00	$50.00–$81.00	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection T/p/d Sq/im	$124.00	$124.00	$50.00–$81.00	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/proph/dia Inj Scm	$137.00	$137.00	$55.00–$89.00	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Evaluation	$371.00	$371.00	$148.00–$241.00	—
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation	$143.00	$143.00	$57.00–$93.00	—
New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min	$322.00	$322.00	$129.00–$209.00	—
New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min	$234.00	$234.00	$94.00–$152.00	—
New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min	$660.00	$660.00	$264.00–$429.00	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Treatment Rm L-2 Np	$132.00	$132.00	$53.00–$86.00	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Assessment Individual	$117.00	$117.00	$47.00–$76.00	—
Occupational therapy evaluation, low complexity CPT 97165 Ot- Tele Occupational Initial Ev Low	$333.00	$333.00	$133.00–$216.00	—
Occupational therapy evaluation, low complexity CPT 97165 Ot- Occupational Therapy Initial Ev Low	$333.00	$333.00	$133.00–$216.00	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pttele Physical Evaluation-high	$422.00	$422.00	$169.00–$274.00	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Ptphysical Therapy Evaluation-high	$443.00	$443.00	$177.00–$288.00	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Ptphysical Therapy Evaluation-low	$333.00	$333.00	$133.00–$216.00	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt -Tele Physical Therapy Evaluation-low	$333.00	$333.00	$133.00–$216.00	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Ptphysical Therapy Evaluation-moderat	$375.00	$375.00	$150.00–$244.00	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pttele Physical Evaluation-moderat	$375.00	$375.00	$150.00–$244.00	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy	$111.00	$111.00	$44.00–$72.00	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Ea 15 Minutes	$161.00	$161.00	$64.00–$105.00	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise	$143.00	$143.00	$57.00–$93.00	—
Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years)	$241.00	$241.00	$96.00–$157.00	—
Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years)	$231.00	$231.00	$92.00–$150.00	—
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min	$110.00	$110.00	$44.00–$72.00	—
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min	$143.00	$143.00	$57.00–$93.00	—
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min	$204.00	$204.00	$82.00–$133.00	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Treatment Rm L-5 Ep	$291.00	$291.00	$116.00–$189.00	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Treatment Rm L-3 Ep	$197.00	$197.00	$79.00–$128.00	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Treatment Rm L-4 Ep	$111.00	$111.00	$44.00–$72.00	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Treatment Rm L-4 Np	$138.00	$138.00	$55.00–$90.00	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Visit, Est Pt., Level 4	$147.00	$147.00	$59.00–$96.00	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Treatment Rm L-2 Ep	$183.00	$183.00	$73.00–$119.00	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 Patient office consultation, 40 min	$215.00	$215.00	$86.00–$140.00	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Patient office consultation, 60 min	$276.00	$276.00	$110.00–$179.00	—
Spirometry (breathing test) CPT 94010 Spirometry -Baseline	$174.00	$174.00	$70.00–$113.00	—
Spirometry (breathing test) CPT 94010 Spiromery Do Not Use	$217.00	$217.00	$87.00–$141.00	—
Spirometry (breathing test) CPT 94010 Spirometry	$344.00	$344.00	$138.00–$224.00	—
Spirometry before and after a bronchodilator CPT 94060 Bronchospasmpre & P	$438.00	$438.00	$175.00–$285.00	—
Spirometry before and after a bronchodilator CPT 94060 Spirometry/pre And Post Bronch	$682.00	$682.00	$273.00–$443.00	—
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activity, Dir Ea 15 Min	$138.00	$138.00	$55.00–$90.00	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy	$319.00	$319.00	$128.00–$207.00	—

Vaccines

Procedure	Cash price	List price	Insurers pay	Off list
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Medroxyprogesterone Inj	$135.00	$135.00	$54.00–$88.00	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pcv-13 Pneumococcal Vaccine	$97.00	$97.00	$39.00–$63.00	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Famotidine (Pepcid) 20mg Tab	$3.00	$3.00	$1.00–$2.00	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Metformin (Glucophage) 500mg Tab	$4.00	$4.00	$2.00–$3.00	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Inj Immunization	$99.00	$99.00	$40.00–$64.00	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Sodium Chloride 1 Gm Tab	$3.00	$3.00	$1.00–$2.00	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Nifedipine Cap 10 Mg	$5.00	$5.00	$2.00–$3.00	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Ciprofloxacin (Cipro) 500mg Tab	$9.00	$9.00	$4.00–$6.00	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin.2 Or More	$36.00	$36.00	$14.00–$23.00	—

Dental

Procedure	Cash price	List price	Insurers pay	Off list
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 Periodontal Scaling & Root	$150.00	$150.00	$60.00–$98.00	—
Porcelain crown CDT D2740 Crownporcelain/ceramic Substrate	$1,675.00	$1,675.00	$670.00–$1,089.00	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 Removal Impacted Toothcmpl Bony	$455.00	$455.00	$182.00–$296.00	—
Root canal treatment on a molar (back tooth), not including the final crown CDT D3330 Molar	$1,563.00	$1,563.00	$625.00–$1,016.00	—
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 Prophylaxisadult	$172.00	$172.00	$69.00–$112.00	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 Extrac Erupted Tooth/exposed Root	$198.00	$198.00	$79.00–$129.00	—

Source file: https://secure.claraprice.net/price-transparency/OHL3996173618/machine-readable/760153629_chambers-health_standardcharges.json