Hospital Marietta, OH

Marietta Memorial Hospital

Marietta Memorial Hospital in Marietta, OH publishes cash prices for 381 common procedures listed here, from its own machine-readable price file updated Oct 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Ohio median for 243 of 376 procedures and above it for 128. By typical cash price it ranks #37 of 139 Ohio hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

401 Matthew Street, Marietta, OH 45750|206 Columbus Avenue, Athens, OH 45701|799 Farson Street, Belpre, OH 45714 Collected Oct 1, 2026 Source price file Check a bill from this hospital (740) 374-1400

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 360147 · CMS hospital register NPI 1215936927

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

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

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Marietta Memorial Hospital in Marietta, OH:

Aug 17, 2023 Warning notice
Nov 22, 2023 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 Ct Abd, W & W/O	$1,529.96	$2,549.94	—	15% above	40%
Abdominal CT scan without and with contrast CPT 74170 Ct 3 Phase Liver	$1,529.96	$2,549.94	—	15% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct Abd, W & W/O	$1,529.96	$2,549.94	—	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct 3 Phase Liver	$1,529.96	$2,549.94	—	—	40%
Abdominal X-ray, 2 views CPT 74019 Xr Abdomen Ap/Lat	$264.53	$440.88	—	22% below	40%
Abdominal X-ray, 2 views CPT 74019 Xr Abd (Kub)(Greenfield Cath.)	$264.53	$440.88	—	22% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 Xr Abdomen Ap/Lat	$264.53	$440.88	—	—	40%
Abdominal X-ray, 2 views inpatient CPT 74019 Xr Abd (Kub)(Greenfield Cath.)	$264.53	$440.88	—	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle, Left, 3V	$254.19	$423.65	—	20% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle, Right, 3V	$254.19	$423.65	—	20% below	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Xr Ankle, Right, 3V	$254.19	$423.65	—	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Xr Ankle, Left, 3V	$254.19	$423.65	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Us Segmentals Abi Only	$724.37	$1,207.29	—	50% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Usv Cardiology Only Abis	$724.37	$1,207.29	—	50% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Usv Abi With Toes	$724.37	$1,207.29	—	50% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Usv Abi With Toes	$724.37	$1,207.29	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Us Segmentals Abi Only	$724.37	$1,207.29	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Usv Cardiology Only Abis	$724.37	$1,207.29	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Clavicle, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Clavicle, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Wrist, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Shoulder, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Elbow, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Humerus, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Clavicle, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Hand, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Elbow, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Forearm, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Shoulder, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Wrist, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Hand, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Humerus, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Forearm, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Clavicle, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Ir Xr Esophagus Swallow	$433.83	$723.05	—	2% below	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Barium Swallow	$433.83	$723.05	—	2% below	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Exam Esophagus Bariatric	$433.83	$723.05	—	2% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Ir Xr Esophagus Swallow	$433.83	$723.05	—	—	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Xr Exam Esophagus Bariatric	$433.83	$723.05	—	—	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Xr Barium Swallow	$433.83	$723.05	—	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Scan, Whole Body	$1,538.99	$2,564.99	—	at median	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Nm Bone Scan, Whole Body	$1,538.99	$2,564.99	—	—	40%
Breast ultrasound, complete, one breast one side CPT 76641 Usg.Breast Left W Axilla C	$375.83	$626.39	—	21% below	40%
Breast ultrasound, complete, one breast one side CPT 76641 Usg.Breast Right W Axilla C	$375.83	$626.39	—	21% below	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Usg.Breast Left W Axilla C	$375.83	$626.39	—	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Usg.Breast Right W Axilla C	$375.83	$626.39	—	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 Ultrasound Breast Limited	$375.83	$626.39	—	8% below	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Usg.Breast Left W/O Axilla L	$375.83	$626.39	—	8% below	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Usg.Breast Right W/O Axilla L	$375.83	$626.39	—	8% below	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Ultrasound Breast Limited	$375.83	$626.39	—	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Usg.Breast Left W/O Axilla L	$375.83	$626.39	—	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Usg.Breast Right W/O Axilla L	$375.83	$626.39	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta A&P Endovascular	$1,529.96	$2,549.94	—	29% below	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta Abd & Pelvis Wo/W Contr	$1,586.65	$2,644.41	—	26% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Cta A&P Endovascular	$1,529.96	$2,549.94	—	—	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Cta Abd & Pelvis Wo/W Contr	$1,586.65	$2,644.41	—	—	40%
CT angiography (CTA) of the head CPT 70496 Cta Head W & W/O	$1,208.22	$2,013.70	—	10% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 Cta Head W & W/O	$1,208.22	$2,013.70	—	—	40%
CT angiography (CTA) of the neck CPT 70498 Cta Neck	$1,208.22	$2,013.70	—	7% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 Cta Neck	$1,208.22	$2,013.70	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Thoracic+Aorta W/O + W	$1,529.96	$2,549.94	—	8% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Cta Thoracic+Aorta W/O + W	$1,529.96	$2,549.94	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Cta Cardiac	$1,586.65	$2,644.41	—	1% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Ct Angio Hrt W/3D Image	$1,586.65	$2,644.41	—	1% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Ct Angio Hrt W/3D Image	$1,586.65	$2,644.41	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Cta Cardiac	$1,586.65	$2,644.41	—	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Cardiac W/O+Calcium Scoring	$1,586.65	$2,644.41	—	466% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Ct Cardiac W/O+Calcium Scoring	$1,586.65	$2,644.41	—	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abd & Pelvis, W/O	$1,529.96	$2,549.94	—	4% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Stone Study	$1,529.96	$2,549.94	—	4% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Stone Study	$1,529.96	$2,549.94	—	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Abd & Pelvis, W/O	$1,529.96	$2,549.94	—	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Venogram, Ivc Pelvis Veins	$1,529.96	$2,549.94	—	23% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Inquinal Nodes, W	$1,529.96	$2,549.94	—	23% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Enterography	$1,529.96	$2,549.94	—	23% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Venogram, Ivc Pelvis Veins	$1,529.96	$2,549.94	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Inquinal Nodes, W	$1,529.96	$2,549.94	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Enterography	$1,529.96	$2,549.94	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Urogram	$1,529.96	$2,549.94	—	34% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd, Pelvis, W & W/O	$1,529.96	$2,549.94	—	34% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abd, Pelvis, W & W/O	$1,529.96	$2,549.94	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Urogram	$1,529.96	$2,549.94	—	—	40%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen, W	$1,529.96	$2,549.94	—	31% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 Ct Abdomen, W	$1,529.96	$2,549.94	—	—	40%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen, W/O	$1,529.96	$2,549.94	—	46% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 Ct Abdomen, W/O	$1,529.96	$2,549.94	—	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinuses, W/O Routine	$1,208.22	$2,013.70	—	38% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Facial Bones, W/O	$1,208.22	$2,013.70	—	38% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Sinuses, W/O Routine	$1,208.22	$2,013.70	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Facial Bones, W/O	$1,208.22	$2,013.70	—	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 Ct Head Brain, W/O Cont	$1,208.22	$2,013.70	—	45% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 Ct Head Brain W/O Stroke Alert	$1,208.22	$2,013.70	—	45% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct Head Brain, W/O Cont	$1,208.22	$2,013.70	—	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct Head Brain W/O Stroke Alert	$1,208.22	$2,013.70	—	—	40%
CT scan of the head with contrast CPT 70460 Ct Head Brain, W	$1,208.22	$2,013.70	—	20% above	40%
CT scan of the head with contrast inpatient CPT 70460 Ct Head Brain, W	$1,208.22	$2,013.70	—	—	40%
CT scan of the head without and with contrast CPT 70470 Ct Head Brain, W & W/O	$1,208.22	$2,013.70	—	1% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 Ct Head Brain, W & W/O	$1,208.22	$2,013.70	—	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Lumbar Spine, W/O	$1,529.96	$2,549.94	—	39% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Ct Lumbar Spine, W/O	$1,529.96	$2,549.94	—	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Cervical Spine, W/O	$1,247.69	$2,079.49	—	16% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct Cervical Spine, W/O	$1,247.69	$2,079.49	—	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 Ct Pelvis, W	$1,529.96	$2,549.94	—	25% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct Pelvis, W	$1,529.96	$2,549.94	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Usv Carotid Doppler Bilateral	$668.53	$1,114.21	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Usg Carotid Doppler Bilat	$668.53	$1,114.21	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Usg Carotid Doppler Bilat	$668.53	$1,114.21	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Usv Carotid Doppler Bilateral	$668.53	$1,114.21	—	—	40%
Chest CT scan without and with contrast CPT 71270 Ct Chest, W & W/O	$1,529.96	$2,549.94	—	1% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 Ct Chest, W & W/O	$1,529.96	$2,549.94	—	—	40%
Chest X-ray, 2 views CPT 71046 Xr Chest, B-Reader, 2V	$199.43	$332.38	—	24% below	40%
Chest X-ray, 2 views CPT 71046 Xr Chest, 2V	$199.43	$332.38	—	24% below	40%
Chest X-ray, 2 views inpatient CPT 71046 Xr Chest, B-Reader, 2V	$199.43	$332.38	—	—	40%
Chest X-ray, 2 views inpatient CPT 71046 Xr Chest, 2V	$199.43	$332.38	—	—	40%
Chest X-ray, single view CPT 71045 Xr Chest, Pa B-Reader, 1V	$217.31	$362.19	—	3% below	40%
Chest X-ray, single view CPT 71045 Xr Chest, 1V	$228.18	$380.30	—	2% above	40%
Chest X-ray, single view inpatient CPT 71045 Xr Chest, Pa B-Reader, 1V	$217.31	$362.19	—	—	40%
Chest X-ray, single view inpatient CPT 71045 Xr Chest, 1V	$228.18	$380.30	—	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle, Rt, 2V	$242.99	$404.98	—	10% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle, Lt, 2V	$242.99	$404.98	—	10% below	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Xr Clavicle, Lt, 2V	$242.99	$404.98	—	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Xr Clavicle, Rt, 2V	$242.99	$404.98	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Abd Retro Per (Complete)	$831.09	$1,385.15	—	17% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us Abd Retro Per (Complete)	$831.09	$1,385.15	—	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Xr Dexa Bone Dens Axialskel 1+	$473.66	$789.43	—	5% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Xr Dexa Bone Dens Axialskel 1+	$473.66	$789.43	—	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Xr Dexa Bone Dens Appen 1/+Sit	$257.55	$429.25	—	at median	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Xr Dexa Bone Dens Appen 1/+Sit	$257.55	$429.25	—	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Echopelvic Detailed Sing Fetus	$357.11	$595.18	—	58% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Echopelvic Detailed Sing Fetus	$357.11	$595.18	—	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/O Contrast	$1,529.96	$2,549.94	—	63% above	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Ld Lung Ca Scrn F/U Dx	$1,713.57	$2,855.95	—	82% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Chest W/O Contrast	$1,529.96	$2,549.94	—	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Ld Lung Ca Scrn F/U Dx	$1,713.57	$2,855.95	—	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Axilla, W	$1,529.96	$2,549.94	—	26% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Ct Axilla, W	$1,529.96	$2,549.94	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 Mam Diag W Wo Cad Bilat	$311.66	$519.44	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mam Diag W Wo Cad Bilat	$311.66	$519.44	—	—	40%
Diagnostic mammogram, one breast one side CPT 77065 Mam Diag W Wo Cad Lt	$249.51	$415.85	—	31% below	40%
Diagnostic mammogram, one breast one side CPT 77065 Mam Diag W Wo Cad Rt	$249.51	$415.85	—	31% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mam Diag W Wo Cad Lt	$249.51	$415.85	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mam Diag W Wo Cad Rt	$249.51	$415.85	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Usv Arterial Duplex Le Bilat	$760.99	$1,268.31	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Usv Axillary Bi Femoral Graft	$760.99	$1,268.31	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Arterial By Pass Bilateral	$760.99	$1,268.31	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Us Arterial By Pass Bilateral	$760.99	$1,268.31	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Usv Arterial Duplex Le Bilat	$760.99	$1,268.31	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Usv Axillary Bi Femoral Graft	$760.99	$1,268.31	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Image Bilat Lowre Extre	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Bilateral Low Ext	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Bilateral Upp Ext	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Image Bilat Upper Extre	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Usv Saphenous Vein Map Bilat	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 Venous Doppler Study Lower Bil	$266.90	$444.84	—	70% below	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 Usv Vein Map Ue Bil Bypaspreop	$630.75	$1,051.25	—	30% below	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous Image Bilat Lowre Extre	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Us Venous Bilateral Upp Ext	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous Image Bilat Upper Extre	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Us Venous Bilateral Low Ext	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Usv Saphenous Vein Map Bilat	$710.32	$1,183.87	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Venous Doppler Study Lower Bil	$266.90	$444.84	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Usv Vein Map Ue Bil Bypaspreop	$630.75	$1,051.25	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Usv Echo Cmpl Bubble Proc	$1,667.72	$2,779.53	—	1% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Usv Echocardiogram Complete	$1,667.72	$2,779.53	—	1% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Usv Echo Cmpl Bubble Proc	$1,667.72	$2,779.53	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Usv Echocardiogram Complete	$1,667.72	$2,779.53	—	—	40%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow, Right, 2V	$267.62	$446.04	—	3% above	40%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow, Left, 2V	$267.62	$446.04	—	3% above	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 Xr Elbow, Right, 2V	$267.62	$446.04	—	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 Xr Elbow, Left, 2V	$267.62	$446.04	—	—	40%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 Xr Elbow, Bilateral, 3V	$396.41	$660.68	—	—	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow, Right, 3V	$264.27	$440.45	—	16% below	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow, Left, 3V	$264.27	$440.45	—	16% below	40%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 Xr Elbow, Bilateral, 3V	$396.41	$660.68	—	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Xr Elbow, Left, 3V	$264.27	$440.45	—	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Xr Elbow, Right, 3V	$264.27	$440.45	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbit Temp Bone,W & W/O Iac	$1,208.22	$2,013.70	—	40% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Temp Bone, W/O	$1,208.22	$2,013.70	—	40% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Iac+Tem Bone, W/O	$1,208.22	$2,013.70	—	40% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Iac+Tem Bone, W/O	$1,208.22	$2,013.70	—	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Orbit Temp Bone,W & W/O Iac	$1,208.22	$2,013.70	—	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Temp Bone, W/O	$1,208.22	$2,013.70	—	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones, 3/+V	$329.21	$548.69	—	13% below	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Zygomatic Arches, 3+V	$329.21	$548.69	—	13% below	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Xr Zygomatic Arches, 3+V	$329.21	$548.69	—	—	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Xr Facial Bones, 3/+V	$329.21	$548.69	—	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm, Right, 2V	$242.99	$404.98	—	11% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm, Left, 2V	$242.99	$404.98	—	11% below	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Xr Forearm, Left, 2V	$242.99	$404.98	—	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Xr Forearm, Right, 2V	$242.99	$404.98	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatolyte (Hida)(Gb Scan)	$1,211.36	$2,018.94	—	24% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatolyte (Hida)(Gb Scan)	$1,211.36	$2,018.94	—	—	40%
Hand X-ray, 2 views one side CPT 73120 Xr Hand, Lt, 2 Views	$187.00	$311.66	—	30% below	40%
Hand X-ray, 2 views one side CPT 73120 Xr Hand, Rt, 2 Views	$187.00	$311.66	—	30% below	40%
Hand X-ray, 2 views inpatient one side CPT 73120 Xr Hand, Lt, 2 Views	$187.00	$311.66	—	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 Xr Hand, Rt, 2 Views	$187.00	$311.66	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Heel, Lt, 2/+V	$260.90	$434.83	—	4% below	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Heel, Rt, 2/+V	$260.90	$434.83	—	4% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Xr Heel, Lt, 2/+V	$260.90	$434.83	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Xr Heel, Rt, 2/+V	$260.90	$434.83	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography 4/> W/Cpap	$3,236.43	$5,394.05	—	21% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnography 4/> W/Cpap	$3,236.43	$5,394.05	—	—	40%
Knee X-ray, 3 views one side CPT 73562 Xr Knee, Right, 3 Views	$263.14	$438.57	—	25% below	40%
Knee X-ray, 3 views one side CPT 73562 Xr Knee, Left, 3 Views	$263.14	$438.57	—	25% below	40%
Knee X-ray, 3 views inpatient one side CPT 73562 Xr Knee, Left, 3 Views	$263.14	$438.57	—	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 Xr Knee, Right, 3 Views	$263.14	$438.57	—	—	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee, Right, 4 Views	$342.66	$571.10	—	13% below	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee, Left, 4 Views	$342.66	$571.10	—	13% below	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Xr Knee, Left, 4 Views	$342.66	$571.10	—	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Xr Knee, Right, 4 Views	$342.66	$571.10	—	—	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Leg, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Leg, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee, Right, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip, Left, W/O	$1,529.96	$2,549.94	—	62% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Foot, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Hip, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Ankle, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Knee, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Lower Leg, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Knee, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Hip, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Foot, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Femur, Left, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Femur, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Lower Leg, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Ankle, Right, W/O	$1,529.96	$2,549.94	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Volvulus Peds	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg. Soft Tissue Lower Back	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen, (Limited)	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Abdomen Ltd Bariatric	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Appendicitis	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Intussusception	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Pyloric Stenosis	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Gallbladder	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ir Us Abdominal W/Image Ltd	$818.35	$1,363.91	—	48% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Abdomen Ltd Bariatric	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Appendicitis	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Pyloric Stenosis	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Volvulus Peds	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Intussusception	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg. Soft Tissue Lower Back	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Gallbladder	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ir Us Abdominal W/Image Ltd	$818.35	$1,363.91	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Abdomen, (Limited)	$818.35	$1,363.91	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usv Ext Soft Tissue Lmtd (Uni)	$311.96	$519.93	—	35% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ir Usg Soft Tissue Groin	$652.63	$1,087.72	—	37% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg. Soft Tissue Groin	$652.63	$1,087.72	—	37% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg Extremity Non Vasc Ltd	$652.63	$1,087.72	—	37% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg. Soft Tissue Axilla	$652.63	$1,087.72	—	37% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg Soft Tissue Abdomen	$818.35	$1,363.91	—	72% above	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Usg Extr Soft Tissue Lmtd Lt	$311.96	$519.93	—	35% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Usg Extr Soft Tissue Lmtd Rt	$311.96	$519.93	—	35% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usv Ext Soft Tissue Lmtd (Uni)	$311.96	$519.93	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Ir Usg Soft Tissue Groin	$652.63	$1,087.72	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg Extremity Non Vasc Ltd	$652.63	$1,087.72	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg. Soft Tissue Groin	$652.63	$1,087.72	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg. Soft Tissue Axilla	$652.63	$1,087.72	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg Soft Tissue Abdomen	$818.35	$1,363.91	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Usg Extr Soft Tissue Lmtd Rt	$311.96	$519.93	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Usg Extr Soft Tissue Lmtd Lt	$311.96	$519.93	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Ld Lung Ca Scrn, Subseq Yr	$294.53	$490.89	—	at median	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Ld Lung Ca Scrn, Initial	$294.53	$490.89	—	at median	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Ld Lung Ca Scrn, Initial	$294.53	$490.89	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Ld Lung Ca Scrn, Subseq Yr	$294.53	$490.89	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia Fibula, Rt, 2V	$254.19	$423.65	—	7% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia Fibula, Lt, 2V	$254.19	$423.65	—	7% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Xr Tibia Fibula, Lt, 2V	$254.19	$423.65	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Xr Tibia Fibula, Rt, 2V	$254.19	$423.65	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 Mrv Head/Brain, W/O	$2,075.90	$3,459.84	—	43% above	40%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head Wo Contrast	$2,162.40	$3,604.00	—	49% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mrv Head/Brain, W/O	$2,075.90	$3,459.84	—	—	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mra Head Wo Contrast	$2,162.40	$3,604.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Ankle, Left, W/O	$1,920.00	$3,200.00	—	10% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Right, W/O	$1,920.00	$3,200.00	—	10% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Left, W/O	$1,920.00	$3,200.00	—	10% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Right, (Zimmer)	$2,270.40	$3,784.00	—	30% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Hip, Right, W/O	$2,270.40	$3,784.00	—	30% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Ankle, Right, W/O	$2,270.40	$3,784.00	—	30% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Hip, Left, W/O	$2,270.40	$3,784.00	—	30% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Left, (Zimmer)	$2,270.40	$3,784.00	—	30% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Right, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Ankle, Left, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Left, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Right, (Zimmer)	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Left, (Zimmer)	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Hip, Left, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Ankle, Right, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Hip, Right, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee, Right, W & W/O	$1,920.00	$3,200.00	—	20% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee, Left, W & W/O	$2,270.40	$3,784.00	—	5% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip, Left, W & W/O	$2,270.40	$3,784.00	—	5% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle, Left, W & W/O	$2,270.40	$3,784.00	—	5% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip, Right, W & W/O	$2,270.40	$3,784.00	—	5% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle, Right, W & W/O	$2,270.40	$3,784.00	—	5% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Knee, Right, W & W/O	$1,920.00	$3,200.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Knee, Left, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Hip, Left, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Ankle, Left, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Ankle, Right, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Hip, Right, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the abdomen without contrast CPT 74181 Mri Abdomen, Mrcp, W/O	$1,920.00	$3,200.00	—	4% above	40%
MRI of the abdomen without contrast CPT 74181 Mri Liver, W/O	$2,270.40	$3,784.00	—	23% above	40%
MRI of the abdomen without contrast CPT 74181 Mri Abdomen, W/O	$2,270.40	$3,784.00	—	23% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 Mri Abdomen, Mrcp, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 Mri Abdomen, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 Mri Liver, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Liver, W & W/O	$1,920.00	$3,200.00	—	16% below	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen, W & W/O	$2,270.40	$3,784.00	—	1% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri Liver, W & W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri Abdomen, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the brain, no contrast dye CPT 70551 Mri Brain, W/O	$1,920.00	$3,200.00	—	19% above	40%
MRI of the brain, no contrast dye CPT 70551 Mri Pituitary, W/O	$1,920.00	$3,200.00	—	19% above	40%
MRI of the brain, no contrast dye CPT 70551 Mri Intern Auditory Canal, W/O	$2,179.58	$3,632.64	—	35% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Brain, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Pituitary, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Intern Auditory Canal, W/O	$2,179.58	$3,632.64	—	—	40%
MRI of the brain, with and without contrast dye CPT 70553 Mri Intern Audi Canal, W & W/O	$1,920.00	$3,200.00	—	12% below	40%
MRI of the brain, with and without contrast dye CPT 70553 Mri Brain, W & W/O	$2,270.40	$3,784.00	—	4% above	40%
MRI of the brain, with and without contrast dye CPT 70553 Mri Pituitary, W & W/O	$2,270.40	$3,784.00	—	4% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Intern Audi Canal, W & W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Brain, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Pituitary, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the lower back, no contrast dye CPT 72148 Mri Lumbar Spine, W/O	$2,270.40	$3,784.00	—	36% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 Mri Lumbar Spine, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Lumbar Spine, W & W/O	$2,270.40	$3,784.00	—	3% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mri Lumbar Spine, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Thoracic Spine, W/O	$2,270.40	$3,784.00	—	35% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mri Thoracic Spine, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Cervical Spine, W & W/O	$2,270.40	$3,784.00	—	at median	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mri Cervical Spine, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Cervical Spine, W/O	$2,270.40	$3,784.00	—	38% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mri Cervical Spine, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis, Soft Tissue, W&W/O	$1,920.00	$3,200.00	—	2% below	40%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis, Bone Str, W & W/O	$2,270.40	$3,784.00	—	16% above	40%
MRI of the pelvis without and with contrast CPT 72197 Mri Prostate, W & W/O	$2,270.40	$3,784.00	—	16% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Pelvis, Soft Tissue, W&W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Pelvis, Bone Str, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Prostate, W & W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis, Bone Str, W/O	$1,920.00	$3,200.00	—	26% above	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Prostate, W/O	$2,270.40	$3,784.00	—	49% above	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis, Soft Tissue, W/O	$2,270.40	$3,784.00	—	49% above	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Ltd Prostate, Tx Plan	$2,270.40	$3,784.00	—	49% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Pelvis, Bone Str, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Pelvis, Soft Tissue, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Ltd Prostate, Tx Plan	$2,270.40	$3,784.00	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Prostate, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow, Left, W/O	$1,920.00	$3,200.00	—	27% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder, Right, W/O	$1,920.00	$3,200.00	—	27% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist, Right, W/O	$1,920.00	$3,200.00	—	27% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow, Right, W/O	$2,270.40	$3,784.00	—	50% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder, Left, W/O	$2,270.40	$3,784.00	—	50% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist, Left, W/O	$2,270.40	$3,784.00	—	50% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Wrist, Right, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Elbow, Left, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Shoulder, Right, W/O	$1,920.00	$3,200.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Wrist, Left, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Elbow, Right, W/O	$2,270.40	$3,784.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Shoulder, Left, W/O	$2,270.40	$3,784.00	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr C-Spine, 4-5V	$478.15	$796.91	—	6% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Xr C-Spine, 4-5V	$478.15	$796.91	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck, W	$1,208.22	$2,013.70	—	2% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Ct Soft Tissue Neck, W	$1,208.22	$2,013.70	—	—	40%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck, W/O	$1,208.22	$2,013.70	—	31% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Ct Soft Tissue Neck, W/O	$1,208.22	$2,013.70	—	—	40%
Neck soft tissue X-ray CPT 70360 Xr Neck Soft Tissue	$204.89	$341.48	—	21% below	40%
Neck soft tissue X-ray inpatient CPT 70360 Xr Neck Soft Tissue	$204.89	$341.48	—	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Thall Via W 24Hr Redistrib	$3,207.85	$5,346.42	—	20% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Myocard Per/Spec/Mul/Stress	$3,876.55	$6,460.91	—	3% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nm Thall Via W 24Hr Redistrib	$3,207.85	$5,346.42	—	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nm Myocard Per/Spec/Mul/Stress	$3,876.55	$6,460.91	—	—	40%
OCT scan of the retina (optical coherence tomography) one side CPT 92134 Retinal Img Post Segment Rt	$288.63	$481.05	—	266% above	40%
OCT scan of the retina (optical coherence tomography) one side CPT 92134 Retinal Img Post Segment Lt	$288.63	$481.05	—	266% above	40%
OCT scan of the retina (optical coherence tomography) inpatient one side CPT 92134 Retinal Img Post Segment Rt	$288.63	$481.05	—	—	40%
OCT scan of the retina (optical coherence tomography) inpatient one side CPT 92134 Retinal Img Post Segment Lt	$288.63	$481.05	—	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nm Pet/Ct Gallium 68 Scan	$4,491.26	$7,485.43	—	7% below	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nm Pet/Ct Copper 64 Scan	$4,491.26	$7,485.43	—	7% below	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Nm Pet/Ct Gallium 68 Scan	$4,491.26	$7,485.43	—	—	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Nm Pet/Ct Copper 64 Scan	$4,491.26	$7,485.43	—	—	40%
Pelvic CT scan without contrast CPT 72192 Ct Cystogram	$1,529.96	$2,549.94	—	52% above	40%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis, W/O	$1,529.96	$2,549.94	—	52% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Cystogram	$1,529.96	$2,549.94	—	—	40%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis, W/O	$1,529.96	$2,549.94	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg Pelvic Non Ob Ltd Wo Travg	$521.33	$868.89	—	20% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg. Soft Tissue Penis	$521.33	$868.89	—	20% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg. Soft Tissue Perineum	$521.33	$868.89	—	20% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg Bladder Only	$521.33	$868.89	—	20% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg. Soft Tissue Buttock	$521.33	$868.89	—	20% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg. Soft Tissue Penis	$521.33	$868.89	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg Pelvic Non Ob Ltd Wo Travg	$521.33	$868.89	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg. Soft Tissue Buttock	$521.33	$868.89	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg. Soft Tissue Perineum	$521.33	$868.89	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg Bladder Only	$521.33	$868.89	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis (Non Ob) (Complete)	$594.00	$990.00	—	18% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us Pelvis (Non Ob) (Complete)	$594.00	$990.00	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us Pelvis Ob	$367.11	$611.85	—	39% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us Pelvis Ob	$367.11	$611.85	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Usg Echopelv Sngl Fetus <14Wks	$318.67	$531.12	—	42% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Usg Echopelv Sngl Fetus <14Wks	$318.67	$531.12	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Usg Echopelvic (Lmtd) Ob Eval	$257.48	$429.14	—	46% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Usg Echopelvic (Lmtd) Ob Eval	$257.48	$429.14	—	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs, Rt, 2V	$178.05	$296.75	—	41% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs, Lt, 2V	$178.05	$296.75	—	41% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Xr Ribs, Rt, 2V	$178.05	$296.75	—	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Xr Ribs, Lt, 2V	$178.05	$296.75	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs, Lt, 3+V	$367.28	$612.14	—	4% below	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs, Rt, 3+V	$367.28	$612.14	—	4% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Xr Ribs, Rt, 3+V	$367.28	$612.14	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Xr Ribs, Lt, 3+V	$367.28	$612.14	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 Mam Screening W Wo Cad Bilat	$256.93	$428.22	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 Mam Screening W Wo Cad Bilat	$256.93	$428.22	—	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder, Rt, 2+ V	$286.66	$477.77	—	15% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder, Lt, 2+ V	$286.66	$477.77	—	15% below	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Xr Shoulder, Lt, 2+ V	$286.66	$477.77	—	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Xr Shoulder, Rt, 2+ V	$286.66	$477.77	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses, 3+V	$344.89	$574.82	—	5% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Xr Sinuses, 3+V	$344.89	$574.82	—	—	40%
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull, 4<V	$288.89	$481.49	—	at median	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Xr Skull, 4<V	$288.89	$481.49	—	—	40%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnography 4+	$3,149.15	$5,248.59	—	12% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography 4+	$3,149.15	$5,248.59	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Tte Complete	$1,085.97	$1,809.95	—	47% below	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Tte Complete	$1,085.97	$1,809.95	—	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Xr Foregut Exam Esophagus W/	$263.56	$439.26	—	48% below	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Xr Mod Barium Swallow W/Video	$628.13	$1,046.88	—	24% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Xr Foregut Exam Esophagus W/	$263.56	$439.26	—	—	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Xr Mod Barium Swallow W/Video	$628.13	$1,046.88	—	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur, Left, 2V	$181.04	$301.73	—	33% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur, Right, 2V	$181.04	$301.73	—	33% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Xr Femur, Left, 2V	$181.04	$301.73	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Xr Femur, Right, 2V	$181.04	$301.73	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Thoracic Spine, W/O	$1,529.96	$2,549.94	—	69% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Ct Thoracic Spine, W/O	$1,529.96	$2,549.94	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 Us Transvaginal (Non Ob)	$760.99	$1,268.31	—	35% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 Us Transvaginal (Non Ob)	$760.99	$1,268.31	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 Us Pelvis Transvaginal Ob	$254.92	$424.87	—	49% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us Pelvis Transvaginal Ob	$254.92	$424.87	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 Us Abd Complete	$880.79	$1,467.99	—	40% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us Abd Complete	$880.79	$1,467.99	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum	$820.89	$1,368.15	—	53% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Us Scrotum	$820.89	$1,368.15	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Usg Parotid Gland	$468.89	$781.49	—	18% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Soft Tissue Neck	$525.16	$875.26	—	8% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Usg Thyroid Gland	$525.16	$875.26	—	8% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Usg Parotid Gland	$468.89	$781.49	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Usg Thyroid Gland	$525.16	$875.26	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Soft Tissue Neck	$525.16	$875.26	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Upper Gi, Single Contrast	$563.68	$939.46	—	5% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Xr Upper Gi, Single Contrast	$563.68	$939.46	—	—	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus, Left, 1V	$135.50	$225.83	—	51% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus, Right, 2V	$269.87	$449.78	—	2% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus, Left, 2V	$269.87	$449.78	—	2% below	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Xr Humerus, Left, 1V	$135.50	$225.83	—	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Xr Humerus, Right, 2V	$269.87	$449.78	—	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Xr Humerus, Left, 2V	$269.87	$449.78	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Dvt Rt Ven Im Lower Ext	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dplx Ext Veins; Unil/Limit Lt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dplx Ext Veins; Unil/Limit Rt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usv Saphenous Vein Map Uni Rt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usg Venous Doppler Ue Lt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Lower Ext Rt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usg Venous Doppler Le Lt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Upper Extr Rt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Lower Ext Lt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usg Venous Doppler Ue Rt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Upper Extr Lt	$599.08	$998.47	—	19% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Upper Extr Rt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Lower Ext Lt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usg Venous Doppler Ue Rt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Us Dvt Rt Ven Im Lower Ext	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usg Venous Doppler Le Lt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Lower Ext Rt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usg Venous Doppler Ue Lt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usv Saphenous Vein Map Uni Rt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dplx Ext Veins; Unil/Limit Rt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dplx Ext Veins; Unil/Limit Lt	$599.08	$998.47	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Upper Extr Lt	$599.08	$998.47	—	—	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Rt, 2V	$167.97	$279.95	—	36% below	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Lt, 2V	$167.97	$279.95	—	36% below	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Rt, 2V	$167.97	$279.95	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Lt, 2V	$167.97	$279.95	—	—	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist, Lt, 3V	$240.76	$401.27	—	28% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist, Rt, 3 V	$240.76	$401.27	—	28% below	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Xr Wrist, Lt, 3V	$240.76	$401.27	—	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Xr Wrist, Rt, 3 V	$240.76	$401.27	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xr Hip, Uni, W/Pelvis, 2-3V	$181.04	$301.73	—	41% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Xr Hip, Uni, W/Pelvis, 2-3V	$181.04	$301.73	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Portable	$241.43	$402.39	—	6% below	40%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View	$241.43	$402.39	—	6% below	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xr Abdomen Portable	$241.43	$402.39	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xr Abdomen 1 View	$241.43	$402.39	—	—	40%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle, Left, 2V	$133.25	$222.09	—	46% below	40%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle, Right, 2V	$133.25	$222.09	—	46% below	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 Xr Ankle, Left, 2V	$133.25	$222.09	—	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 Xr Ankle, Right, 2V	$133.25	$222.09	—	—	40%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot, Right, 2V	$161.24	$268.73	—	30% below	40%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot, Left, 2V	$161.24	$268.73	—	30% below	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 Xr Foot, Right, 2V	$161.24	$268.73	—	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 Xr Foot, Left, 2V	$161.24	$268.73	—	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot, Right, 3V	$255.31	$425.52	—	17% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot, Left, 3V	$255.31	$425.52	—	17% below	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Xr Foot, Left, 3V	$255.31	$425.52	—	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Xr Foot, Right, 3V	$255.31	$425.52	—	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand, Lt, 3/+ Views	$288.89	$481.49	—	11% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand, Rt, 3/+ Views	$288.89	$481.49	—	11% below	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Xr Hand, Lt, 3/+ Views	$288.89	$481.49	—	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Xr Hand, Rt, 3/+ Views	$288.89	$481.49	—	—	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee, Rt, 2V	$226.20	$377.00	—	17% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee, Lt, 2V	$226.20	$377.00	—	17% below	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Xr Knee, Lt, 2V	$226.20	$377.00	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Xr Knee, Rt, 2V	$226.20	$377.00	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr L-Spine, 2V	$331.45	$552.42	—	3% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr L-Spine Flex+Ext, 2V	$331.45	$552.42	—	3% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Xr L-Spine, 2V	$331.45	$552.42	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Xr L-Spine Flex+Ext, 2V	$331.45	$552.42	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 Xr L-Spine W/Obliq, 4V	$468.06	$780.10	—	at median	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Xr L-Spine W/Obliq, 4V	$468.06	$780.10	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr T-Spine, 2V	$293.39	$488.99	—	3% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Xr T-Spine, 2V	$293.39	$488.99	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones, 3+V	$288.89	$481.49	—	1% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Xr Nasal Bones, 3+V	$288.89	$481.49	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr C-Spine, 3V	$232.91	$388.19	—	30% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr C-Spine Flex+Ext Views Only	$232.91	$388.19	—	30% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Xr C-Spine, 3V	$232.91	$388.19	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Xr C-Spine Flex+Ext Views Only	$232.91	$388.19	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis, Leg Length/Standing	$251.94	$419.90	—	at median	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis, 1-2V	$251.94	$419.90	—	at median	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Xr Pelvis, Leg Length/Standing	$251.94	$419.90	—	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Xr Pelvis, 1-2V	$251.94	$419.90	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum & Coccyx, 2+V	$348.25	$580.41	—	17% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Xr Sacrum & Coccyx, 2+V	$348.25	$580.41	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 Acth(Adrenocorticotropic Hor)	$137.02	$228.36	—	4% above	40%
ACTH blood test inpatient CPT 82024 Acth(Adrenocorticotropic Hor)	$137.02	$228.36	—	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel	$167.90	$279.83	—	23% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel	$167.90	$279.83	—	—	40%
Aldosterone blood test CPT 82088 Aldosterone, Serum	$144.58	$240.97	—	3% above	40%
Aldosterone blood test inpatient CPT 82088 Aldosterone, Serum	$144.58	$240.97	—	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Crab Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Whitepin Tr	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hazel Nut Tree	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lettuce Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Barley Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Malt Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oat Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Baker's Yeast Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pork Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oyster Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Crab Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Chocolate Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Chicken	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Hormodendrum Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites-D.Farinae Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Asperg. Fumig Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Scallop Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Tuna Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg House Dust H2 Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Sesame Seed Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Maple (Box Elder) Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Cottonwood Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Russian Thistle Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Rhizopus Nigricans Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Mucor Racemosus Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Helminthosporium Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sheep Sorrel Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Giant Ragweed Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, English Plantain Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sycamore Tree Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Birch Tree Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, American Beech Tree Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Prerennial Rye Grass Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bent/Red Top Gr Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sw Vernal Grass Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, June/Kent Gr Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Clam Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cod/Perch Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Alternaria Alter Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Mites-D.Pterony Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Com/St Ragweed Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oak Tree Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Johnson Grass Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bermuda Grass Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Yellow Jack Ven Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Paper Wasp Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Walnut/Black Wn Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tomato Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Soybean	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Rice Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pistachio Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pecan Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Peanut Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Milk (Cow's) Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg White Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Corn Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Brazil Nut Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Almond Ige	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fusarium Moniliforme	$24.70	$41.16	—	6% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Botrytis Cinera	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cat Dander/Epi Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cottonwood Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Beef Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lamb Qrt Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Celery Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Elm Tree Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Halibut Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lobster Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Panel 15326	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Trichophyton Mentagro	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Perch Ocean Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Wh Faced Hornet Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Apple Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Trout (F204) Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Honeybee Venom Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Wheat Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Trichophyton Rubrum Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Banana Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Stachybotrys Chartarum/Ata Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Salmon Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg House Dust H1 Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tuna Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Coconut Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Potato Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Strawberry Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Mount Cedar Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grapefruit Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg White Mulberry Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Derm Farinae Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Kiwi Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Hazelnut Filbert Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg Yolk Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pea Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Penicillium Notatum Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Aspergillus Niger Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mugwort Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Carrot Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cocklebur Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pigweed Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cashew Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hickory/Pecan Tree	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sweet Gum Tree Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Willow Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Poplar/White Tree Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Red Maple Tree Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Shagbark Hickory Tr Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Penicillin G Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Alle Penicilloyl V Ige 703X	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, White Ash Tree Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Meadow Fescue Grass Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Epicocum P- Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Orchard Gr/Cocksfoot Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dog Dander Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hickory White	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Timothy Grass Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Alder	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Bipolaris	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Shrimp Ige	$26.38	$43.96	—	13% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Quest Allergen (86003X16)	$422.02	$703.36	—	1704% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Whitepin Tr	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fusarium Moniliforme	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Almond Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Brazil Nut Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Corn Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg White Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Milk (Cow's) Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Peanut Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pecan Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pistachio Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Rice Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Soybean	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tomato Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Walnut/Black Wn Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Paper Wasp Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Yellow Jack Ven Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bermuda Grass Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Johnson Grass Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oak Tree Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Com/St Ragweed Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Mites-D.Pterony Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Alternaria Alter Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cod/Perch Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Clam Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, June/Kent Gr Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sw Vernal Grass Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bent/Red Top Gr Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Prerennial Rye Grass Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, American Beech Tree Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Birch Tree Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sycamore Tree Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, English Plantain Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Giant Ragweed Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sheep Sorrel Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Helminthosporium Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Mucor Racemosus Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Rhizopus Nigricans Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Russian Thistle Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Cottonwood Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Maple (Box Elder) Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Sesame Seed Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg House Dust H2 Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Tuna Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Crab Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Scallop Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Asperg. Fumig Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites-D.Farinae Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Hormodendrum Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Chicken	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Chocolate Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Crab Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oyster Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pork Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Baker's Yeast Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oat Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Malt Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Barley Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lettuce Ige	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hazel Nut Tree	$24.70	$41.16	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Penicillin G Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Kiwi Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pea Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Banana Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Hazelnut Filbert Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg Yolk Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Apple Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cashew Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Derm Farinae Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alle Penicilloyl V Ige 703X	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Epicocum P- Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hickory White	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg White Mulberry Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Alder	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Bipolaris	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Botrytis Cinera	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Mount Cedar Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Carrot Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Coconut Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Trichophyton Mentagro	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg House Dust H1 Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Perch Ocean Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Willow Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lobster Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lamb Qrt Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cat Dander/Epi Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dog Dander Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hickory/Pecan Tree	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Shrimp Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Elm Tree Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Halibut Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Salmon Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex Panel 15326	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Timothy Grass Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Wh Faced Hornet Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cottonwood Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tuna Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Honeybee Venom Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Orchard Gr/Cocksfoot Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Wheat Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Meadow Fescue Grass Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, White Ash Tree Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Potato Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Celery Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Shagbark Hickory Tr Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Red Maple Tree Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stachybotrys Chartarum/Ata Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Poplar/White Tree Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Strawberry Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sweet Gum Tree Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grapefruit Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pigweed Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Trichophyton Rubrum Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cocklebur Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Trout (F204) Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mugwort Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Aspergillus Niger Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Penicillium Notatum Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Beef Ige	$26.38	$43.96	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Quest Allergen (86003X16)	$422.02	$703.36	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein	$59.21	$98.69	—	2% below	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Afp Serum (Afpe Group)	$59.51	$99.19	—	2% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein	$59.21	$98.69	—	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Afp Serum (Afpe Group)	$59.51	$99.19	—	—	40%
Ammonia blood test CPT 82140 Ammonia, Blood	$104.65	$174.41	—	91% above	40%
Ammonia blood test inpatient CPT 82140 Ammonia, Blood	$104.65	$174.41	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrull Peptide Ab,Igg	$61.16	$101.93	—	6% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrull Peptide Ab,Igg	$61.16	$101.93	—	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies	$24.15	$40.25	—	56% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen	$87.22	$145.36	—	58% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies	$24.15	$40.25	—	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody Screen	$87.22	$145.36	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture,Bacterial(Fac)	$11.48	$19.14	—	83% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Misc Culture	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Gardnerella Vaginalis Scrn Cul	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nose Culture	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture (Screen - )	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Ivtip	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Joint Fluid Culture Bacterial	$209.17	$348.62	—	217% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture,Bacterial(Fac)	$11.48	$19.14	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Gardnerella Vaginalis Scrn Cul	$209.17	$348.62	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture (Screen - )	$209.17	$348.62	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nose Culture	$209.17	$348.62	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Ivtip	$209.17	$348.62	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Misc Culture	$209.17	$348.62	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$209.17	$348.62	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Joint Fluid Culture Bacterial	$209.17	$348.62	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level Iv Path	$325.23	$542.05	—	60% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level Iv-M Path	$332.05	$553.42	—	63% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level Iv Path	$325.23	$542.05	—	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level Iv-M Path	$332.05	$553.42	—	—	40%
Blood culture for bacteria CPT 87040 Culture, Blood Aero & Anaero	$107.81	$179.69	—	15% above	40%
Blood culture for bacteria inpatient CPT 87040 Culture, Blood Aero & Anaero	$107.81	$179.69	—	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture(Fac)	$3.60	$6.00	—	77% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture (Hino)	$5.76	$9.60	—	64% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Vp Nationwide Childrens Hsop	$17.64	$29.40	—	11% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Cord Venipuncture	$19.88	$33.13	—	25% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$19.88	$33.13	—	25% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Med Onc Venipunture	$19.88	$33.13	—	25% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Mo Blpr Venipuncture	$20.71	$34.51	—	30% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture(Fac)	$3.60	$6.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture (Hino)	$5.76	$9.60	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Vp Nationwide Childrens Hsop	$17.64	$29.40	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Med Onc Venipunture	$19.88	$33.13	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$19.88	$33.13	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Cord Venipuncture	$19.88	$33.13	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Mo Blpr Venipuncture	$20.71	$34.51	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Arc Abo Type	$101.15	$168.59	—	70% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Charge	$105.20	$175.33	—	77% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Arc Abo Type	$101.15	$168.59	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Charge	$105.20	$175.33	—	—	40%
C-peptide blood test CPT 84681 C-Peptide,Serum	$73.85	$123.08	—	7% below	40%
C-peptide blood test inpatient CPT 84681 C-Peptide,Serum	$73.85	$123.08	—	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$70.01	$116.68	—	39% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$70.01	$116.68	—	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficle By Pcr	$335.20	$558.67	—	157% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium Difficle By Pcr	$335.20	$558.67	—	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 Ca19-9	$72.23	$120.38	—	1% below	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca19-9	$72.23	$120.38	—	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca-125 Serum	$163.75	$272.91	—	75% above	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Tumor Antigen	$175.67	$292.79	—	88% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca-125 Serum	$163.75	$272.91	—	—	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Tumor Antigen	$175.67	$292.79	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid-19/Sars-Cov-2 Rna	$350.97	$584.95	—	149% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid-19/Sars-Cov-2 Rna	$350.97	$584.95	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 Cea	$77.60	$129.34	—	11% below	40%
Carcinoembryonic antigen (CEA) test CPT 82378 Cea (Carcindembryonic Antigen	$81.22	$135.36	—	7% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea	$77.60	$129.34	—	—	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea (Carcindembryonic Antigen	$81.22	$135.36	—	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Ab,Igm Csf	$38.86	$64.76	—	33% below	40%
Chickenpox (varicella) immunity blood test CPT 86787 Q34972 Vzv Total, Igm Acif/Ifa	$55.64	$92.73	—	4% below	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab,Igm	$58.57	$97.62	—	1% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Immune Status Igg	$65.10	$108.50	—	13% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Ab,Igm Csf	$38.86	$64.76	—	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Q34972 Vzv Total, Igm Acif/Ifa	$55.64	$92.73	—	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab,Igm	$58.57	$97.62	—	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Immune Status Igg	$65.10	$108.50	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Amp Prob	$205.88	$343.14	—	123% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlmyd Trach Dna Probe	$263.43	$439.05	—	185% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Quest Chlam Trachomat Amp Prob	$270.48	$450.80	—	193% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia	$302.95	$504.91	—	228% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis Amp Prob	$205.88	$343.14	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlmyd Trach Dna Probe	$263.43	$439.05	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Quest Chlam Trachomat Amp Prob	$270.48	$450.80	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia	$302.95	$504.91	—	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Cholesterol Profile	$9.00	$15.00	—	83% below	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Cholesterol Profile	$9.00	$15.00	—	—	40%
Complete blood count (CBC) with differential CPT 85025 Cbc W/Diff	$10.96	$18.27	—	70% below	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W/Diff	$10.96	$18.27	—	—	40%
Complete blood count (CBC), no differential CPT 85027 Cbc: Automated Hemogram	$46.12	$76.86	—	36% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc: Automated Hemogram	$46.12	$76.86	—	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$12.67	$21.12	—	80% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$12.67	$21.12	—	—	40%
Cortisol blood test, total CPT 82533 Cortisol, Total	$100.45	$167.42	—	39% above	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol, Total	$100.45	$167.42	—	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab, Igg	$55.48	$92.46	—	19% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab Igg	$78.46	$130.76	—	14% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Blood, Cmv Negative	$78.46	$130.76	—	14% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab, Igg	$55.48	$92.46	—	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Blood, Cmv Negative	$78.46	$130.76	—	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab Igg	$78.46	$130.76	—	—	40%
D-dimer blood test (blood clot marker) CPT 85379 Quest Pitt D-Dimer, Quant	$145.08	$241.80	—	108% above	40%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, Quant	$145.08	$241.80	—	108% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, Quant	$145.08	$241.80	—	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Quest Pitt D-Dimer, Quant	$145.08	$241.80	—	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate	$78.90	$131.50	—	21% below	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dhea Sulfate	$78.90	$131.50	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines Screen, Serum	$129.45	$215.75	—	35% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturates Screen, Serum	$129.45	$215.75	—	35% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Screen, Serum	$129.45	$215.75	—	35% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates Screen, Serum	$129.45	$215.75	—	35% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepines Screen, Serum	$129.45	$215.75	—	35% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Screen, Serum	$129.45	$215.75	—	35% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine 11 Panel	$130.78	$217.97	—	37% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring, Phencyclidine	$157.06	$261.76	—	64% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Umbilical Cord Drug Panel 9	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Umbilical Cord 15 Drug Panel	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scr 9 Meconium Q30427X	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Tramadol	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Panel 9 Serum Q19733X	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Alcohol Serum Q19044X	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Monitor Alcohol	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethanol Urine	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine Screen Q4323	$163.91	$273.18	—	72% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturates Screen, Serum	$129.45	$215.75	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepines Screen, Serum	$129.45	$215.75	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines Screen, Serum	$129.45	$215.75	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates Screen, Serum	$129.45	$215.75	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cocaine Screen, Serum	$129.45	$215.75	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Screen, Serum	$129.45	$215.75	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine 11 Panel	$130.78	$217.97	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitoring, Phencyclidine	$157.06	$261.76	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine Screen Q4323	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Scr 9 Meconium Q30427X	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethanol Urine	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Monitor Alcohol	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Tramadol	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Umbilical Cord 15 Drug Panel	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Umbilical Cord Drug Panel 9	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Alcohol Serum Q19044X	$163.91	$273.18	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Panel 9 Serum Q19733X	$163.91	$273.18	—	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Viral Capsid Igg	$53.02	$88.36	—	18% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Capsid Anti Igm	$53.02	$88.36	—	18% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Ab Igg	$74.89	$124.82	—	15% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Vca Igm	$74.89	$124.82	—	15% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Capsid Anti Igm	$53.02	$88.36	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Viral Capsid Igg	$53.02	$88.36	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Vca Igm	$74.89	$124.82	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Ebv Vca Ab Igg	$74.89	$124.82	—	—	40%
Estradiol blood test CPT 82670 Estradiol Serum, Total	$98.93	$164.89	—	12% below	40%
Estradiol blood test inpatient CPT 82670 Estradiol Serum, Total	$98.93	$164.89	—	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool	$69.48	$115.80	—	53% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool	$69.48	$115.80	—	—	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$71.74	$119.57	—	6% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$71.74	$119.57	—	—	40%
Fibrinogen blood test CPT 85384 Fibrinogen	$90.83	$151.38	—	102% above	40%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$90.83	$151.38	—	—	40%
Folate (folic acid) blood test CPT 82746 Folate	$62.11	$103.52	—	8% below	40%
Folate (folic acid) blood test inpatient CPT 82746 Folate	$62.11	$103.52	—	—	40%
Free T3 thyroid hormone test CPT 84481 Free T3	$68.18	$113.63	—	10% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 Free T3	$68.18	$113.63	—	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 Free (Profile)	$92.93	$154.89	—	119% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 Free	$93.61	$156.01	—	120% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T-4 Free (Profile)	$92.93	$154.89	—	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T-4 Free	$93.61	$156.01	—	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$95.79	$159.65	—	57% below	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel	$95.79	$159.65	—	—	40%
Glucose tolerance test, 3 samples CPT 82951 Lactose Tolerance Test	$26.02	$43.37	—	61% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Lactose Tolerance Test	$26.02	$43.37	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.Gonorrhoeae Dna Probe	$175.93	$293.21	—	89% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhea Amp Probe	$205.90	$343.16	—	122% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Probe	$208.36	$347.26	—	124% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Quest Neisser Gonorr Amp Probe	$270.48	$450.80	—	191% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.Gonorrhoeae Dna Probe	$175.93	$293.21	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhea Amp Probe	$205.90	$343.16	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Probe	$208.36	$347.26	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Quest Neisser Gonorr Amp Probe	$270.48	$450.80	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Qnt By Real-Time Pcr	$562.35	$937.25	—	57% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Qnt By Real-Time Pcr	$562.35	$937.25	—	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Pap Virus(Hpv) E6/E7	$146.62	$244.36	—	23% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Human Pap Virus(Hpv) E6/E7	$146.62	$244.36	—	—	40%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody:Prof	$60.88	$101.47	—	13% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody:Prof	$60.88	$101.47	—	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$74.48	$124.13	—	57% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$74.48	$124.13	—	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Rna Quantitative Pcr	$278.46	$464.10	—	45% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hcv Rna Quantitative Pcr	$278.46	$464.10	—	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Antibody:Herpes Simplex 1	$62.23	$103.71	—	5% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Antibody:Herpes Simplex 1	$62.23	$103.71	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Antibody;Herpes Simplex Ii	$97.82	$163.04	—	48% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv2 Igg Inhibition	$97.82	$163.04	—	48% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hsv2 Igg Inhibition	$97.82	$163.04	—	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Antibody;Herpes Simplex Ii	$97.82	$163.04	—	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp - (High Sensitive)	$85.15	$141.91	—	26% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Crp - (High Sensitive)	$85.15	$141.91	—	—	40%
Homocysteine blood test CPT 83090 Homocysteine	$68.23	$113.72	—	15% below	40%
Homocysteine blood test inpatient CPT 83090 Homocysteine	$68.23	$113.72	—	—	40%
Insulin blood test CPT 83525 Q-561 Assay Of Insulin	$23.11	$38.52	—	55% below	40%
Insulin blood test CPT 83525 Insulin Response 3Rd Spec	$40.19	$66.99	—	22% below	40%
Insulin blood test CPT 83525 Insulin Total	$40.19	$66.99	—	22% below	40%
Insulin blood test CPT 83525 Insulin Response 1St Spec	$40.19	$66.99	—	22% below	40%
Insulin blood test CPT 83525 Insulin Response 2Nd Spec	$40.19	$66.99	—	22% below	40%
Insulin blood test inpatient CPT 83525 Q-561 Assay Of Insulin	$23.11	$38.52	—	—	40%
Insulin blood test inpatient CPT 83525 Insulin Response 1St Spec	$40.19	$66.99	—	—	40%
Insulin blood test inpatient CPT 83525 Insulin Response 3Rd Spec	$40.19	$66.99	—	—	40%
Insulin blood test inpatient CPT 83525 Insulin Response 2Nd Spec	$40.19	$66.99	—	—	40%
Insulin blood test inpatient CPT 83525 Insulin Total	$40.19	$66.99	—	—	40%
Iron blood test (serum iron) CPT 83540 Iron	$36.75	$61.25	—	3% below	40%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$36.75	$61.25	—	—	40%
Iron-binding capacity (TIBC) test CPT 83550 Iron Profile	$10.49	$17.48	—	73% below	40%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$35.15	$58.58	—	10% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Profile	$10.49	$17.48	—	—	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$35.15	$58.58	—	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Spinal Fluid	$22.24	$37.07	—	19% below	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh, Serum	$36.71	$61.18	—	34% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh, Body Fluid	$36.75	$61.25	—	35% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh Spinal Fluid	$22.24	$37.07	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh, Serum	$36.71	$61.18	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh, Body Fluid	$36.75	$61.25	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$63.85	$106.42	—	10% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$63.85	$106.42	—	—	40%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$72.90	$121.50	—	20% above	40%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$72.90	$121.50	—	—	40%
Lyme disease antibody test CPT 86618 Lyme Ab Screen 6646	$51.38	$85.64	—	33% below	40%
Lyme disease antibody test inpatient CPT 86618 Lyme Ab Screen 6646	$51.38	$85.64	—	—	40%
Magnesium blood test CPT 83735 Magnesium	$40.24	$67.06	—	19% above	40%
Magnesium blood test CPT 83735 Magnesium,24Hr Urine	$40.24	$67.06	—	19% above	40%
Magnesium blood test CPT 83735 Ionized Magnesium	$40.24	$67.06	—	19% above	40%
Magnesium blood test CPT 83735 Magnesium Random Urine	$40.24	$67.06	—	19% above	40%
Magnesium blood test inpatient CPT 83735 Ionized Magnesium	$40.24	$67.06	—	—	40%
Magnesium blood test inpatient CPT 83735 Magnesium Random Urine	$40.24	$67.06	—	—	40%
Magnesium blood test inpatient CPT 83735 Magnesium	$40.24	$67.06	—	—	40%
Magnesium blood test inpatient CPT 83735 Magnesium,24Hr Urine	$40.24	$67.06	—	—	40%
Measles (rubeola) antibody test CPT 86765 Measles Rubeola Igg	$60.91	$101.51	—	7% above	40%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Ab,Igm	$70.13	$116.89	—	23% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Rubeola Igg	$60.91	$101.51	—	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Ab,Igm	$70.13	$116.89	—	—	40%
Mumps immunity blood test CPT 86735 Mumps Virus Antibody,Igm	$55.65	$92.75	—	5% below	40%
Mumps immunity blood test CPT 86735 Mumps Ab Igg	$71.35	$118.91	—	22% above	40%
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibody,Igm	$55.65	$92.75	—	—	40%
Mumps immunity blood test inpatient CPT 86735 Mumps Ab Igg	$71.35	$118.91	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free	$65.44	$109.07	—	21% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free	$65.44	$109.07	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostatic Specific Antigen Tot	$60.29	$100.49	—	24% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostatic Specific Antigen Tot	$60.29	$100.49	—	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q-58315 Pap Image Guide	$70.28	$117.14	—	28% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto Fluid Redo	$118.13	$196.88	—	21% above	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q-58315 Pap Image Guide	$70.28	$117.14	—	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath C/V Auto Fluid Redo	$118.13	$196.88	—	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone-Intactstat	$197.71	$329.52	—	40% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone-Intactstat	$197.71	$329.52	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt	$12.46	$20.76	—	67% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Aptt-Lupus Anticoagulant Prof	$38.10	$63.50	—	1% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Quest Pitt - Ptt Activated	$45.02	$75.04	—	20% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Aptt	$45.02	$75.04	—	20% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt	$12.46	$20.76	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Aptt-Lupus Anticoagulant Prof	$38.10	$63.50	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Quest Pitt - Ptt Activated	$45.02	$75.04	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Aptt	$45.02	$75.04	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus	$27.13	$45.21	—	24% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus	$27.13	$45.21	—	—	40%
Progesterone blood test CPT 84144 Progesterone	$42.18	$70.30	—	48% below	40%
Progesterone blood test CPT 84144 Progesterone, Serum	$68.00	$113.33	—	16% below	40%
Progesterone blood test inpatient CPT 84144 Progesterone	$42.18	$70.30	—	—	40%
Progesterone blood test inpatient CPT 84144 Progesterone, Serum	$68.00	$113.33	—	—	40%
Prolactin blood test CPT 84146 Prolactin, Serum	$68.65	$114.41	—	21% below	40%
Prolactin blood test CPT 84146 Prolactin, Send Out	$71.41	$119.01	—	18% below	40%
Prolactin blood test CPT 84146 Prolactin, Monomeric	$71.41	$119.01	—	18% below	40%
Prolactin blood test inpatient CPT 84146 Prolactin, Serum	$68.65	$114.41	—	—	40%
Prolactin blood test inpatient CPT 84146 Prolactin, Monomeric	$71.41	$119.01	—	—	40%
Prolactin blood test inpatient CPT 84146 Prolactin, Send Out	$71.41	$119.01	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Pt	$8.89	$14.82	—	63% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Quest Pitt - Pt	$10.48	$17.47	—	56% below	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Pt	$8.89	$14.82	—	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Quest Pitt - Pt	$10.48	$17.47	—	—	40%
Renin blood test CPT 84244 Renin	$62.39	$103.98	—	27% below	40%
Renin blood test inpatient CPT 84244 Renin	$62.39	$103.98	—	—	40%
Rh blood typing CPT 86901 Blood Rh	$23.17	$38.62	—	38% below	40%
Rh blood typing inpatient CPT 86901 Blood Rh	$23.17	$38.62	—	—	40%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Igg	$13.21	$22.01	—	60% below	40%
Rheumatoid factor (RF) test CPT 86431 Q- 90136 Rheumatoid Fctr Quant	$13.21	$22.01	—	60% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Q- 90136 Rheumatoid Fctr Quant	$13.21	$22.01	—	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Igg	$13.21	$22.01	—	—	40%
Rubella antibody test (immunity check) CPT 86762 Rubella Screen	$79.94	$133.24	—	63% above	40%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody	$112.13	$186.89	—	128% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Screen	$79.94	$133.24	—	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody	$112.13	$186.89	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedmentation Rate	$42.02	$70.04	—	11% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedmentation Rate	$42.02	$70.04	—	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Fert Semem Analysis	$189.14	$315.24	—	42% above	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Fert Semem Analysis	$189.14	$315.24	—	—	40%
Stool ova and parasites exam CPT 87177 Ova & Parasites, Conc & Id	$233.21	$388.68	—	488% above	40%
Stool ova and parasites exam inpatient CPT 87177 Ova & Parasites, Conc & Id	$233.21	$388.68	—	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screening(Fac)	$5.26	$8.76	—	82% below	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Screening(Fac)	$5.26	$8.76	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Serology	$49.00	$81.67	—	105% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Q-799 Treponema Pallidum (Rpr)	$49.00	$81.67	—	105% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 T. Pallidum (Vdrl) Csf	$52.34	$87.23	—	119% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr Serology	$49.00	$81.67	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Q-799 Treponema Pallidum (Rpr)	$49.00	$81.67	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 T. Pallidum (Vdrl) Csf	$52.34	$87.23	—	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon	$184.81	$308.02	—	58% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon	$184.81	$308.02	—	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone	$97.10	$161.84	—	5% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone	$97.10	$161.84	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Abs Tpo	$65.44	$109.06	—	1% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (Tpo)Antibx	$73.51	$122.52	—	13% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Lkm1 Quest #15038X	$73.51	$122.52	—	13% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Abs Tpo	$65.44	$109.06	—	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Lkm1 Quest #15038X	$73.51	$122.52	—	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (Tpo)Antibx	$73.51	$122.52	—	—	40%
Total IgE blood test CPT 82785 Ig-E	$100.60	$167.67	—	62% above	40%
Total IgE blood test CPT 82785 Immunoglobulin E	$100.60	$167.67	—	62% above	40%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E	$100.60	$167.67	—	—	40%
Total IgE blood test inpatient CPT 82785 Ig-E	$100.60	$167.67	—	—	40%
Total thyroxine (T4) blood test CPT 84436 Q-7020 Assay Of Tot Thyroxine	$13.89	$23.15	—	67% below	40%
Total thyroxine (T4) blood test CPT 84436 T-4 Thyroxine	$43.06	$71.76	—	3% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 Q-7020 Assay Of Tot Thyroxine	$13.89	$23.15	—	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T-4 Thyroxine	$43.06	$71.76	—	—	40%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3),Total	$62.11	$103.52	—	3% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3),Total	$62.11	$103.52	—	—	40%
Transferrin blood test CPT 84466 Transferrin,Serum	$62.11	$103.52	—	16% below	40%
Transferrin blood test inpatient CPT 84466 Transferrin,Serum	$62.11	$103.52	—	—	40%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vag Rna Pap	$146.62	$244.36	—	70% above	40%
Trichomonas test (NAAT) CPT 87661 Trichomonas Probe	$305.39	$508.98	—	253% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vag Rna Pap	$146.62	$244.36	—	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Probe	$305.39	$508.98	—	—	40%
Troponin test, quantitative CPT 84484 Cardiac Troponin	$90.08	$150.13	—	7% above	40%
Troponin test, quantitative inpatient CPT 84484 Cardiac Troponin	$90.08	$150.13	—	—	40%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis	$33.51	$55.85	—	24% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis	$33.51	$55.85	—	—	40%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis, Nonauto W/Scope	$4.82	$8.04	—	74% below	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis, Nonauto W/Scope	$4.82	$8.04	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Nonauto W/O Scope	$4.18	$6.96	—	74% below	40%
Urinalysis without microscope exam, manual CPT 81002 Urine Specific Gravity	$23.45	$39.08	—	45% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Nonauto W/O Scope	$4.18	$6.96	—	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Specific Gravity	$23.45	$39.08	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$56.70	$94.50	—	at median	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$56.70	$94.50	—	—	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy(Fac)	$10.33	$17.22	—	79% below	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy	$15.29	$25.48	—	69% below	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$18.79	$31.32	—	61% below	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Vis Clr Compar	$19.49	$32.48	—	60% below	40%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test, Urine	$30.91	$51.51	—	36% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy(Fac)	$10.33	$17.22	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy	$15.29	$25.48	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test	$18.79	$31.32	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Vis Clr Compar	$19.49	$32.48	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test, Urine	$30.91	$51.51	—	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12	$88.36	$147.26	—	19% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B-12	$88.36	$147.26	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D	$21.00	$35.00	—	78% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D,25-Hydroxy	$76.81	$128.02	—	19% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D	$21.00	$35.00	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D,25-Hydroxy	$76.81	$128.02	—	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D,1,25-Dihydroxy	$136.59	$227.65	—	11% below	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D,1,25-Dihydroxy	$136.59	$227.65	—	—	40%
Zinc blood test CPT 84630 Zinc	$40.41	$67.35	—	21% below	40%
Zinc blood test inpatient CPT 84630 Zinc	$40.41	$67.35	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Quantatative Hcg	$139.09	$231.81	—	106% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant (Afpe Group)	$139.09	$231.81	—	106% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Tumor Marker	$143.47	$239.12	—	112% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Quant (Afpe Group)	$139.09	$231.81	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Quantatative Hcg	$139.09	$231.81	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Hcg Tumor Marker	$143.47	$239.12	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 Sinus Endo W/Balloon Dil Maxil	$4,221.50	$7,035.84	—	78% below	40%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 Sinus Endo W/Balloon Dil Maxil	$4,221.50	$7,035.84	—	—	40%
Botox injections for chronic migraine CPT 64615 Chemodenerv Musc Migraine	$143.67	$239.45	—	74% below	40%
Botox injections for chronic migraine inpatient CPT 64615 Chemodenerv Musc Migraine	$143.67	$239.45	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Mam Breast Bx 1 Les Stero Lt	$2,118.49	$3,530.81	—	47% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Mam Bx 1St Lesion Stero (Rt)	$2,118.49	$3,530.81	—	47% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 Mam Breast Bx 1 Les Stero Lt	$2,118.49	$3,530.81	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 Mam Bx 1St Lesion Stero (Rt)	$2,118.49	$3,530.81	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Cl Tx Dstl Fib Fx Wo Manip	$214.28	$357.14	—	43% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Clsd Treat Frac Fib Lt W/O Man	$826.04	$1,376.73	—	119% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Clsd Treat Frac Fib Rt W/O Man	$826.04	$1,376.73	—	119% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Cl Tx Dstl Fib Fx Wo Manip	$214.28	$357.14	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Clsd Treat Frac Fib Rt W/O Man	$826.04	$1,376.73	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Clsd Treat Frac Fib Lt W/O Man	$826.04	$1,376.73	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Treat Metatarsal Fracture	$125.77	$209.62	—	65% below	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Metatarsal Fx	$746.24	$1,243.73	—	105% above	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Cl Tx Metatarsal Fx; Wo Manip	$1,068.25	$1,780.42	—	194% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Treat Metatarsal Fracture	$125.77	$209.62	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed Metatarsal Fx	$746.24	$1,243.73	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Cl Tx Metatarsal Fx; Wo Manip	$1,068.25	$1,780.42	—	—	40%
Cardiac catheterization with coronary angiogram CPT 93458 Cath Plcmt W/ Lhc And Lv	$10,888.43	$18,147.39	—	9% below	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Cath Plcmt W/ Lhc And Lv	$10,888.43	$18,147.39	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion-Electrical Elect	$2,825.34	$4,708.90	—	37% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$2,825.34	$4,708.90	—	37% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$2,825.34	$4,708.90	—	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion-Electrical Elect	$2,825.34	$4,708.90	—	—	40%
Catheter ablation for atrial fibrillation CPT 93656 Tx Atrial Fib Pulm Vein Isol	$22,442.47	$37,404.12	—	34% below	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Tx Atrial Fib Pulm Vein Isol	$22,442.47	$37,404.12	—	—	40%
Cervical biopsy CPT 57500 Cervical Bx(Fac)	$323.95	$539.92	—	81% below	40%
Cervical biopsy inpatient CPT 57500 Cervical Bx(Fac)	$323.95	$539.92	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Newborn Circumcision(Fac)	$1,009.97	$1,683.28	—	43% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision (Bedside Nursery)	$7,073.77	$11,789.62	—	300% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Newborn Circumcision(Fac)	$1,009.97	$1,683.28	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision (Bedside Nursery)	$7,073.77	$11,789.62	—	—	40%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision Neonate	$1,932.55	$3,220.91	—	3% below	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision Neonate	$1,932.55	$3,220.91	—	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cls Tx Dist Radius/Ulna Fx;Wo	$99.00	$165.00	—	76% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cltx Dstl Rad Fx/Epi Sep Wo M	$1,068.25	$1,780.42	—	161% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Distal End Radius Fx	$1,138.10	$1,896.84	—	178% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cls Tx Dist Radius/Ulna Fx;Wo	$99.00	$165.00	—	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cltx Dstl Rad Fx/Epi Sep Wo M	$1,068.25	$1,780.42	—	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed Distal End Radius Fx	$1,138.10	$1,896.84	—	—	40%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Cerv Colp Leep W Bx	$1,686.52	$2,810.86	—	56% below	40%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 Cerv Colp Leep W Bx	$1,686.52	$2,810.86	—	—	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colpscopy Cx W/Bx Cx/Endocx	$158.48	$264.14	—	83% below	40%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colpscopy Cx W/Bx Cx/Endocx	$158.48	$264.14	—	—	40%
Coronary stent placement, one artery CPT 92928 Perc N-Des W/Ang 1 Art/Br	$18,454.30	$30,757.16	—	43% above	40%
Coronary stent placement, one artery inpatient CPT 92928 Perc N-Des W/Ang 1 Art/Br	$18,454.30	$30,757.16	—	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy/Endoscopy	$326.39	$543.99	—	84% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy/Endoscopy	$326.39	$543.99	—	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct Premlg Lesion 1St	$102.43	$170.72	—	49% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct Premlg Lesion 1St	$102.43	$170.72	—	—	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Tympanostomy W/Vent Tube Local	$282.79	$471.32	—	79% below	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Tympanostomy W/Vent Tube Local	$282.79	$471.32	—	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax Uni	$32.45	$54.09	—	79% below	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal Impacted Ear Wax Uni	$378.40	$630.66	—	145% above	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Rem Impacted Ear Wax Uni (50)	$567.59	$945.99	—	267% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax Uni	$32.45	$54.09	—	—	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal Impacted Ear Wax Uni	$378.40	$630.66	—	—	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Rem Impacted Ear Wax Uni (50)	$567.59	$945.99	—	—	40%
Earwax removal with instruments, one ear CPT 69210 Cerumen Removal,1 Or Both Ears	$39.73	$66.22	—	74% below	40%
Earwax removal with instruments, one ear CPT 69210 Cerumen Rmvl 1/Both Ears	$106.15	$176.92	—	31% below	40%
Earwax removal with instruments, one ear CPT 69210 Obs Rem Impacted Ear Wax Uni	$136.63	$227.72	—	12% below	40%
Earwax removal with instruments, one ear one side CPT 69210 Rem Impcted Cerumen, Unilat	$502.18	$836.96	—	225% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Cerumen Removal,1 Or Both Ears	$39.73	$66.22	—	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Cerumen Rmvl 1/Both Ears	$106.15	$176.92	—	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Obs Rem Impacted Ear Wax Uni	$136.63	$227.72	—	—	40%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Rem Impcted Cerumen, Unilat	$502.18	$836.96	—	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial (Biopsy) Wo Cerv D	$96.33	$160.55	—	75% below	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Obs Biopsy Of Uterus Lining	$633.08	$1,055.13	—	65% above	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial (Biopsy) Wo Cerv D	$96.33	$160.55	—	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Obs Biopsy Of Uterus Lining	$633.08	$1,055.13	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Inj Proc Hysterosalpingiophy	$431.38	$718.96	—	13% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Xr Catheter For Hysterography	$431.38	$718.96	—	13% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Catheter For Hysterography	$431.38	$718.96	—	13% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Fert Hysterosalpingogram	$431.38	$718.96	—	13% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Catheter For Hysterography	$431.38	$718.96	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Xr Catheter For Hysterography	$431.38	$718.96	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Inj Proc Hysterosalpingiophy	$431.38	$718.96	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Fert Hysterosalpingogram	$431.38	$718.96	—	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy W/Endometrial Bx	$1,370.77	$2,284.62	—	86% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hysteroscopy W/Endometrial Bx	$1,370.77	$2,284.62	—	—	40%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Iud Device	$32.40	$54.00	—	94% below	40%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion Iud Device	$32.40	$54.00	—	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Skin Abscess Simple	$102.43	$170.72	—	74% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Skin Abscess,Simple	$900.94	$1,501.57	—	133% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Usg Abscess Drain Sub Q	$1,009.05	$1,681.75	—	160% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Ir Usg Abscess Drain Sub Q	$1,009.05	$1,681.75	—	160% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abcess Simple	$1,009.05	$1,681.75	—	160% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Of Abscess; Single	$1,009.05	$1,681.75	—	160% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Skin Abscess Simple	$102.43	$170.72	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Skin Abscess,Simple	$900.94	$1,501.57	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Of Abscess; Single	$1,009.05	$1,681.75	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Usg Abscess Drain Sub Q	$1,009.05	$1,681.75	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Ir Usg Abscess Drain Sub Q	$1,009.05	$1,681.75	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D Abcess Simple	$1,009.05	$1,681.75	—	—	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Anes Groin Incision	$886.49	$1,477.49	—	92% below	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Cu Groin Incision	$1,300.19	$2,166.99	—	88% below	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Fac Groin Incision	$1,950.29	$3,250.49	—	82% below	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Anes Groin Incision	$886.49	$1,477.49	—	—	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Cu Groin Incision	$1,300.19	$2,166.99	—	—	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Fac Groin Incision	$1,950.29	$3,250.49	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath/Ligament	$143.67	$239.45	—	58% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Ir Inj Tendon Sheath/Ligament	$966.26	$1,610.44	—	185% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Tendon Sheath Inject	$2,060.33	$3,433.88	—	507% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Tendon Sheath/Ligament	$143.67	$239.45	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Ir Inj Tendon Sheath/Ligament	$966.26	$1,610.44	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Tendon Sheath Inject	$2,060.33	$3,433.88	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 Obs Drain/Inj Maj Jt Bilateral	$2,090.82	$3,484.70	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Major Jt Inj/Bursa	$143.67	$239.45	—	79% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inj Joint/Bursa W/O Us	$351.82	$586.36	—	49% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Obs Drain/Inj Maj Joint	$1,393.89	$2,323.15	—	100% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Injection-Steroid-Joint-Rt	$1,393.89	$2,323.15	—	100% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Xr Asp Inj Major Jnt Bursa Rt	$1,393.89	$2,323.15	—	100% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Injection-Steroid-Joint-Lt	$1,393.89	$2,323.15	—	100% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Ir Drain/Inj Maj Joint Left	$1,393.89	$2,323.15	—	100% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Ir Drain/Inj Maj Joint Right	$1,393.89	$2,323.15	—	100% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 Obs Drain/Inj Maj Jt Bilateral	$2,090.82	$3,484.70	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Major Jt Inj/Bursa	$143.67	$239.45	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/Inj Joint/Bursa W/O Us	$351.82	$586.36	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Obs Drain/Inj Maj Joint	$1,393.89	$2,323.15	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Ir Drain/Inj Maj Joint Left	$1,393.89	$2,323.15	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Injection-Steroid-Joint-Lt	$1,393.89	$2,323.15	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Injection-Steroid-Joint-Rt	$1,393.89	$2,323.15	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Xr Asp Inj Major Jnt Bursa Rt	$1,393.89	$2,323.15	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Ir Drain/Inj Maj Joint Right	$1,393.89	$2,323.15	—	—	40%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert Nonbio Drug Del Impl	$61.82	$103.03	—	84% below	40%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert Nonbio Drug Del Impl	$61.82	$103.03	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Inter Joint Bursa	$73.87	$123.11	—	88% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj/Aspir Jt/Bursa,Interm	$143.67	$239.45	—	77% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Ir Drain/Inj Interm Jnt/Bursa	$1,296.87	$2,161.45	—	110% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Drain/Inj Interm Jnt/Bursa Rt	$311.03	$518.39	—	50% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Drain/Inj Interm Jnt/Bursa Lt	$311.03	$518.39	—	50% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Lt	$1,393.89	$2,323.15	—	126% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Rt	$1,393.89	$2,323.15	—	126% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Inter Joint Bursa	$73.87	$123.11	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj/Aspir Jt/Bursa,Interm	$143.67	$239.45	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Ir Drain/Inj Interm Jnt/Bursa	$1,296.87	$2,161.45	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Drain/Inj Interm Jnt/Bursa Rt	$311.03	$518.39	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Drain/Inj Interm Jnt/Bursa Lt	$311.03	$518.39	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Rt	$1,393.89	$2,323.15	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Lt	$1,393.89	$2,323.15	—	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Inj/Aspir Small Jt	$143.67	$239.45	—	71% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inject Sm Joint Bursa Ff	$1,314.12	$2,190.20	—	166% above	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Ir Drainage Of Small Joint	$1,419.13	$2,365.22	—	188% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Inj/Aspir Small Jt	$143.67	$239.45	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inject Sm Joint Bursa Ff	$1,314.12	$2,190.20	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Ir Drainage Of Small Joint	$1,419.13	$2,365.22	—	—	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Posterior Caps-Yag	$288.04	$480.07	—	80% below	40%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Posterior Caps-Yag	$288.04	$480.07	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Rpr Lac Intm Sc/Axil/Trnk<2.5	$182.33	$303.89	—	66% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd Wnd Repair S/A/T/Ext	$601.48	$1,002.46	—	13% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Suture Layrd2.5-Less S,N,T.Ext	$699.30	$1,165.50	—	31% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Rpr Lac Intm Sc/Axil/Trnk<2.5	$182.33	$303.89	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd Wnd Repair S/A/T/Ext	$601.48	$1,002.46	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Suture Layrd2.5-Less S,N,T.Ext	$699.30	$1,165.50	—	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 P/P Njx Intrlaminar Lmbr/Sac	$2,308.62	$3,847.70	—	13% above	40%
Lower-back epidural injection, with imaging guidance CPT 62323 Or Njx Intrlaminar Lmbr/Sac	$2,308.62	$3,847.70	—	13% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Or Njx Intrlaminar Lmbr/Sac	$2,308.62	$3,847.70	—	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 P/P Njx Intrlaminar Lmbr/Sac	$2,308.62	$3,847.70	—	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 P/P Nerve Block Inj, Lum/Sacr	$2,196.77	$3,661.29	—	35% above	40%
Lower-back epidural injection, without imaging guidance CPT 62322 Nm Njx Int-Lam Lmbr/Sac W/O Im	$2,804.03	$4,673.39	—	73% above	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 P/P Nerve Block Inj, Lum/Sacr	$2,196.77	$3,661.29	—	—	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Nm Njx Int-Lam Lmbr/Sac W/O Im	$2,804.03	$4,673.39	—	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Bgn Les T/A/L 0.5 Or <	$336.32	$560.54	—	75% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Bgn Les T/A/L 0.5 Or <	$336.32	$560.54	—	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Bgn Les F/E/Ey/N/L 0.5<	$336.32	$560.54	—	75% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Bgn Les F/E/Ey/N/L 0.5<	$336.32	$560.54	—	—	40%
Nail removal (partial or complete), one nail CPT 11730 Removal Of Nail Plate	$102.43	$170.72	—	68% below	40%
Nail removal (partial or complete), one nail CPT 11730 Rmvl Nail Plate Initial	$278.61	$464.35	—	13% below	40%
Nail removal (partial or complete), one nail CPT 11730 Removal Nail Plate/Simple	$833.87	$1,389.78	—	162% above	40%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Single	$933.93	$1,556.55	—	193% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Of Nail Plate	$102.43	$170.72	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Rmvl Nail Plate Initial	$278.61	$464.35	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Nail Plate/Simple	$833.87	$1,389.78	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Single	$933.93	$1,556.55	—	—	40%
Occipital nerve block (injection for headaches) CPT 64405 Greater Occiptal Nerve Inj	$143.67	$239.45	—	82% below	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Greater Occiptal Nerve Inj	$143.67	$239.45	—	—	40%
Pacemaker implant (dual chamber) CPT 33208 Dual Chamber Pacer Ins	$12,242.96	$20,404.94	—	21% below	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 Dual Chamber Pacer Ins	$12,242.96	$20,404.94	—	—	40%
Paracentesis with imaging guidance CPT 49083 2W Abd Paracentesis W/Imag	$1,282.70	$2,137.83	—	26% below	40%
Paracentesis with imaging guidance CPT 49083 Us Guided Paracentesis W S&I	$1,308.71	$2,181.18	—	25% below	40%
Paracentesis with imaging guidance CPT 49083 Ir Abd Paracentesis W/Imag	$1,308.71	$2,181.18	—	25% below	40%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Imaging	$1,308.71	$2,181.18	—	25% below	40%
Paracentesis with imaging guidance CPT 49083 Oncb Abd Paracentesis W/Imag	$1,308.71	$2,181.18	—	25% below	40%
Paracentesis with imaging guidance CPT 49083 Ir Paracentesis Us Guided W S&	$1,308.71	$2,181.18	—	25% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 2W Abd Paracentesis W/Imag	$1,282.70	$2,137.83	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 Oncb Abd Paracentesis W/Imag	$1,308.71	$2,181.18	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 Ir Abd Paracentesis W/Imag	$1,308.71	$2,181.18	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Imaging	$1,308.71	$2,181.18	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 Ir Paracentesis Us Guided W S&	$1,308.71	$2,181.18	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 Us Guided Paracentesis W S&I	$1,308.71	$2,181.18	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Of Nail Bed	$182.33	$303.89	—	77% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Nail Bed	$2,411.60	$4,019.34	—	210% above	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 P/P Excision Nail	$2,411.60	$4,019.34	—	210% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Of Nail Bed	$182.33	$303.89	—	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 P/P Excision Nail	$2,411.60	$4,019.34	—	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Nail Bed	$2,411.60	$4,019.34	—	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Ir Ct Destroy Lumbar+Sac F Jnt	$3,932.35	$6,553.92	—	18% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Ir Ct Destroy Lumbar+Sac F Jnt	$3,932.35	$6,553.92	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body	$182.33	$303.89	—	73% below	40%
Removal of a foreign object under the skin, simple CPT 10120 Rmvl Foreign Body	$447.97	$746.61	—	33% below	40%
Removal of a foreign object under the skin, simple CPT 10120 Ir Incis&Fb Rem Subcut	$1,501.84	$2,503.06	—	124% above	40%
Removal of a foreign object under the skin, simple CPT 10120 Incis&Fb Rem Subcut	$1,501.84	$2,503.06	—	124% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body	$182.33	$303.89	—	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Rmvl Foreign Body	$447.97	$746.61	—	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Ir Incis&Fb Rem Subcut	$1,501.84	$2,503.06	—	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incis&Fb Rem Subcut	$1,501.84	$2,503.06	—	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Ir Fragmnt Of Kidney Stone	$11,390.76	$18,984.60	—	14% above	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Ir Fragmnt Of Kidney Stone	$11,390.76	$18,984.60	—	—	40%
Short arm cast (elbow to hand) CPT 29075 Applicat Forearm Cast(Fac)	$136.76	$227.93	—	55% below	40%
Short arm cast (elbow to hand) CPT 29075 Apply Short Arm Cast	$746.24	$1,243.73	—	148% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Applicat Forearm Cast(Fac)	$136.76	$227.93	—	—	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Apply Short Arm Cast	$746.24	$1,243.73	—	—	40%
Short arm splint (forearm and hand) CPT 29125 Applicat Forearm Splint(Fac)	$61.82	$103.03	—	79% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Splinting Short Arm - Lt	$586.67	$977.79	—	102% above	40%
Short arm splint (forearm and hand) one side CPT 29125 Splinting Short Arm - Rt	$586.67	$977.79	—	102% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 Applicat Forearm Splint(Fac)	$61.82	$103.03	—	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Splinting Short Arm - Lt	$586.67	$977.79	—	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Splinting Short Arm - Rt	$586.67	$977.79	—	—	40%
Short leg cast (below the knee) CPT 29405 Applicat Short Leg Cast(Fac)	$136.76	$227.93	—	64% below	40%
Short leg cast (below the knee) CPT 29405 Short Leg Serial Casting	$313.66	$522.76	—	18% below	40%
Short leg cast (below the knee) CPT 29405 Obs Apply Short Leg Cast	$313.66	$522.76	—	18% below	40%
Short leg cast (below the knee) inpatient CPT 29405 Applicat Short Leg Cast(Fac)	$136.76	$227.93	—	—	40%
Short leg cast (below the knee) inpatient CPT 29405 Short Leg Serial Casting	$313.66	$522.76	—	—	40%
Short leg cast (below the knee) inpatient CPT 29405 Obs Apply Short Leg Cast	$313.66	$522.76	—	—	40%
Short leg splint (calf to foot) CPT 29515 Applic Short Leg Splint	$78.15	$130.25	—	73% below	40%
Short leg splint (calf to foot) one side CPT 29515 Apply Short Leg Splint Lt	$226.35	$377.25	—	23% below	40%
Short leg splint (calf to foot) one side CPT 29515 Short Leg Splint Procedure Rt	$586.67	$977.79	—	99% above	40%
Short leg splint (calf to foot) one side CPT 29515 Short Leg Splint Procedure Lt	$586.67	$977.79	—	99% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 Applic Short Leg Splint	$78.15	$130.25	—	—	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 Apply Short Leg Splint Lt	$226.35	$377.25	—	—	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 Short Leg Splint Procedure Lt	$586.67	$977.79	—	—	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 Short Leg Splint Procedure Rt	$586.67	$977.79	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Gen/Trnk 2.5Cm/<	$74.34	$123.90	—	77% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr Superfic Wnds 2.5Cm Or <	$102.43	$170.72	—	69% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr Sprfcl Wnd 2.5<	$229.75	$382.91	—	30% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Gen/Trnk 2.5/Less	$699.30	$1,165.50	—	112% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Clab Srep S/N/A/G/Tr/E;2.5Cm/<	$966.82	$1,611.36	—	193% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Gen/Trnk 2.5Cm/<	$74.34	$123.90	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr Superfic Wnds 2.5Cm Or <	$102.43	$170.72	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr Sprfcl Wnd 2.5<	$229.75	$382.91	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Gen/Trnk 2.5/Less	$699.30	$1,165.50	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Clab Srep S/N/A/G/Tr/E;2.5Cm/<	$966.82	$1,611.36	—	—	40%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx; Single Lesion	$102.43	$170.72	—	77% below	40%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion	$900.31	$1,500.51	—	102% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx; Single Lesion	$102.43	$170.72	—	—	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Single Lesion	$900.31	$1,500.51	—	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Mal Les T/A/L 0.5<	$336.32	$560.54	—	75% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc Mal Les T/A/L 0.5<	$336.32	$560.54	—	—	40%
Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags 1-15 Les	$102.43	$170.72	—	65% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 Rem Skin Tags 1-15 Les	$102.43	$170.72	—	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Belpre Lumbar Puncture Dx	$1,814.44	$3,024.06	—	69% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx L-Spine Punct W/O Fluoro	$2,032.18	$3,386.97	—	90% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Ir Dx L-Spine Punct W/O Fluoro	$3,055.37	$5,092.28	—	185% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 4W Dx L-Spine Punct W/O Fluoro	$3,055.37	$5,092.28	—	185% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Obs Dx L-Spine Punct W/O Fluor	$3,055.37	$5,092.28	—	185% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 3N Dx L-Spine Punct W/O Fluoro	$3,055.37	$5,092.28	—	185% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Belpre Lumbar Puncture Dx	$1,814.44	$3,024.06	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Dx L-Spine Punct W/O Fluoro	$2,032.18	$3,386.97	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 4W Dx L-Spine Punct W/O Fluoro	$3,055.37	$5,092.28	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Ir Dx L-Spine Punct W/O Fluoro	$3,055.37	$5,092.28	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 3N Dx L-Spine Punct W/O Fluoro	$3,055.37	$5,092.28	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Obs Dx L-Spine Punct W/O Fluor	$3,055.37	$5,092.28	—	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr Superfic Wnds 2.6-7.5Cm	$102.43	$170.72	—	71% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr S/N/Ax/Gen/Trnk2.6-7.5Cm	$254.89	$424.82	—	28% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Gen/Trnk 2.6-7.5	$699.30	$1,165.50	—	98% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rpr Superfic Wnds 2.6-7.5Cm	$102.43	$170.72	—	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rpr S/N/Ax/Gen/Trnk2.6-7.5Cm	$254.89	$424.82	—	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair Gen/Trnk 2.6-7.5	$699.30	$1,165.50	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr Superfic Wnd F/E/Ey/N/L 2.	$102.43	$170.72	—	68% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr Sprfcl Wnd F/E/Ey/N/L 2.5<	$248.63	$414.38	—	22% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair F/E/N/L/M 2.5/Less	$699.30	$1,165.50	—	120% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr Superfic Wnd F/E/Ey/N/L 2.	$102.43	$170.72	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr Sprfcl Wnd F/E/Ey/N/L 2.5<	$248.63	$414.38	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair F/E/N/L/M 2.5/Less	$699.30	$1,165.50	—	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tan Bx Of Skin; Single Lesion	$102.43	$170.72	—	66% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Les	$652.85	$1,088.09	—	116% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tan Bx Of Skin; Single Lesion	$102.43	$170.72	—	—	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bx Skin Single Les	$652.85	$1,088.09	—	—	40%
Thoracentesis with imaging guidance CPT 32555 Aspirate Pleura W/Imaging-Fac	$2,575.18	$4,291.96	—	48% above	40%
Thoracentesis with imaging guidance CPT 32555 4W Aspirate Pleura W Image	$2,961.46	$4,935.76	—	70% above	40%
Thoracentesis with imaging guidance CPT 32555 P/P Aspirate Pleura W/Imaging	$2,961.46	$4,935.76	—	70% above	40%
Thoracentesis with imaging guidance CPT 32555 Ir Thoracentesis Us Guided S&I	$2,961.46	$4,935.76	—	70% above	40%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Us Guided S&I	$2,961.46	$4,935.76	—	70% above	40%
Thoracentesis with imaging guidance CPT 32555 Ir Aspirate Pleura W Image	$2,961.46	$4,935.76	—	70% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate Pleura W/Imaging-Fac	$2,575.18	$4,291.96	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 P/P Aspirate Pleura W/Imaging	$2,961.46	$4,935.76	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Us Guided S&I	$2,961.46	$4,935.76	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 Ir Thoracentesis Us Guided S&I	$2,961.46	$4,935.76	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 4W Aspirate Pleura W Image	$2,961.46	$4,935.76	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 Ir Aspirate Pleura W Image	$2,961.46	$4,935.76	—	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt 1-2 Musc Grp	$143.67	$239.45	—	79% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Ir Inj Trigger Point 1/2 Muscl	$1,030.37	$1,717.29	—	48% above	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trig Pt 1-2 Musc Ff	$1,393.89	$2,323.15	—	100% above	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Sngl/Mlt Trigger 1-2 Musff	$1,393.89	$2,323.15	—	100% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Pt 1-2 Musc Grp	$143.67	$239.45	—	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Ir Inj Trigger Point 1/2 Muscl	$1,030.37	$1,717.29	—	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Sngl/Mlt Trigger 1-2 Musff	$1,393.89	$2,323.15	—	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trig Pt 1-2 Musc Ff	$1,393.89	$2,323.15	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast 1St Lesion Us Imag	$2,118.49	$3,530.81	—	36% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast 1St Lesion Us Imag	$2,118.49	$3,530.81	—	—	40%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy,Unilat Or Bilat(Fac)	$1,009.97	$1,683.28	—	—	40%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 Vasectomy,Unilat Or Bilat(Fac)	$1,009.97	$1,683.28	—	—	40%
Vein ablation, radiofrequency, first vein CPT 36475 Cath Endoven Rfa Therapy 1St V	$7,313.26	$12,188.76	—	12% above	40%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Cath Endoven Rfa Therapy 1St V	$7,313.26	$12,188.76	—	—	40%
Wart removal, up to 14 warts CPT 17110 Destruct Bgn Lesion 1-14(Fac)	$102.30	$170.50	—	67% below	40%
Wart removal, up to 14 warts CPT 17110 Destruct B9 Lesion 1-14	$301.42	$502.37	—	4% below	40%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct Bgn Lesion 1-14(Fac)	$102.30	$170.50	—	—	40%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct B9 Lesion 1-14	$301.42	$502.37	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin/Tissue	$204.47	$340.78	—	74% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Epi/Dem First 20Sqcm	$1,502.55	$2,504.25	—	93% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Clab Dbrdmt Subq Tis 1St 20Cm	$1,801.36	$3,002.27	—	131% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Skin	$1,842.61	$3,071.01	—	136% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Obs Debride Epi/Dem 1St 20Sqcm	$2,119.00	$3,531.67	—	172% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin/Tissue	$204.47	$340.78	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Epi/Dem First 20Sqcm	$1,502.55	$2,504.25	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Clab Dbrdmt Subq Tis 1St 20Cm	$1,801.36	$3,002.27	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Skin	$1,842.61	$3,071.01	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Obs Debride Epi/Dem 1St 20Sqcm	$2,119.00	$3,531.67	—	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Mo Transfusion Blood Compont	$2,355.56	$3,925.94	—	112% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood Or Component	$2,355.56	$3,925.94	—	112% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Mo Transfusion Blood Compont	$2,355.56	$3,925.94	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood Or Component	$2,355.56	$3,925.94	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment	$84.00	$140.00	—	52% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi/Via Vent/Initial	$313.48	$522.47	—	79% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi/Initial	$313.48	$522.47	—	79% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hhn/Initial	$313.48	$522.47	—	79% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb First Tx	$313.48	$522.47	—	79% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi/Via Vent/Sub	$313.48	$522.47	—	79% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hhn/Sub	$313.48	$522.47	—	79% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment	$84.00	$140.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi/Initial	$313.48	$522.47	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi/Via Vent/Initial	$313.48	$522.47	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hhn/Sub	$313.48	$522.47	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hhn/Initial	$313.48	$522.47	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ippb First Tx	$313.48	$522.47	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi/Via Vent/Sub	$313.48	$522.47	—	—	40%
Chemotherapy IV infusion, first hour CPT 96413 Iv Chemo 16-90 Min,Initial	$1,178.36	$1,963.94	—	54% above	40%
Chemotherapy IV infusion, first hour CPT 96413 Ivt Chemo Iv Infusion 1 Hr	$1,178.36	$1,963.94	—	54% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Iv Chemo 16-90 Min,Initial	$1,178.36	$1,963.94	—	—	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Ivt Chemo Iv Infusion 1 Hr	$1,178.36	$1,963.94	—	—	40%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Np-Complete Eye Exam	$67.25	$112.09	—	74% below	40%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 Np-Complete Eye Exam	$67.25	$112.09	—	—	40%
Comprehensive eye exam, returning patient CPT 92014 Est Pt Complete Eye Exm	$67.25	$112.09	—	71% below	40%
Comprehensive eye exam, returning patient inpatient CPT 92014 Est Pt Complete Eye Exm	$67.25	$112.09	—	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Audiologic Eval Level Ii	$243.86	$406.44	—	7% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Audiologic Eval Level Ii	$243.86	$406.44	—	—	40%
Critical care, first 30 to 74 minutes CPT 99291 Ed Critical Care/30-74 Min	$3,853.06	$6,421.77	—	31% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Ed Critical Care/30-74 Min	$3,853.06	$6,421.77	—	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake	$770.21	$1,283.68	—	19% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg Awake	$770.21	$1,283.68	—	—	40%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram Complete	$31.23	$52.05	—	88% below	40%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Electrocardiogram Complete	$31.23	$52.05	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg, 12+ Leads, Tracing Only	$127.17	$211.95	—	31% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg, 12+ Leads, Tracing Only	$127.17	$211.95	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Fac Ed Level 1	$251.72	$419.53	—	19% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Ob/Ed Fac Level 1	$280.22	$467.03	—	10% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Fac Ed Level 1	$251.72	$419.53	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Ob/Ed Fac Level 1	$280.22	$467.03	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Fac Ed Level 2	$475.37	$792.29	—	7% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Ob/Ed Fac Level 2	$475.37	$792.29	—	7% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Fac Ed Level 2	$475.37	$792.29	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Ob/Ed Fac Level 2	$475.37	$792.29	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Fac Ed Level 3	$678.33	$1,130.55	—	20% below	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Ob/Ed Fac Level 3	$752.27	$1,253.78	—	11% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Fac Ed Level 3	$678.33	$1,130.55	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Ob/Ed Fac Level 3	$752.27	$1,253.78	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Ob/Ed Fac Level 4	$1,202.63	$2,004.38	—	9% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Fac Ed Level 4	$1,202.63	$2,004.38	—	9% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Fac Ed Level 4	$1,202.63	$2,004.38	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Ob/Ed Fac Level 4	$1,202.63	$2,004.38	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Fac Ed Level 5	$1,778.11	$2,963.51	—	2% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Ob/Ed Fac Level 5	$1,778.11	$2,963.51	—	2% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Ob/Ed Fac Level 5	$1,778.11	$2,963.51	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Fac Ed Level 5	$1,778.11	$2,963.51	—	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Card. Rehab.	$1,047.41	$1,745.69	—	17% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Pharmacology Stress Test Ekg	$1,047.41	$1,745.69	—	17% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Ekg Monitoring	$1,047.41	$1,745.69	—	17% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Card. Rehab.	$1,047.41	$1,745.69	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Ekg Monitoring	$1,047.41	$1,745.69	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Pharmacology Stress Test Ekg	$1,047.41	$1,745.69	—	—	40%
Eye exam, returning patient, intermediate CPT 92012 Est Pt Intermediate Eye Exam	$67.25	$112.09	—	78% below	40%
Eye exam, returning patient, intermediate inpatient CPT 92012 Est Pt Intermediate Eye Exam	$67.25	$112.09	—	—	40%
Family therapy with the patient, 50 minutes CPT 90847 Family/Couple Therapy	$77.75	$129.58	—	74% below	40%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy With Patient	$151.57	$252.61	—	49% below	40%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy W/Patient	$151.57	$252.61	—	49% below	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family/Couple Therapy	$77.75	$129.58	—	—	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy With Patient	$151.57	$252.61	—	—	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy W/Patient	$151.57	$252.61	—	—	40%
Family therapy without the patient, 50 minutes CPT 90846 Family Psytx W/O Patient	$81.64	$136.07	—	74% below	40%
Family therapy without the patient, 50 minutes CPT 90846 Family Therapy W/O Patient	$151.57	$252.61	—	51% below	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psytx W/O Patient	$81.64	$136.07	—	—	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Therapy W/O Patient	$151.57	$252.61	—	—	40%
Group psychotherapy session CPT 90853 Group Therapy	$146.72	$244.54	—	14% below	40%
Group psychotherapy session inpatient CPT 90853 Group Therapy	$146.72	$244.54	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration 31-90 Min(Fac)	$108.66	$181.10	—	74% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration 31-90 Minutes	$128.48	$214.13	—	69% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Ivt Iv Hydration 31-90 Min	$372.70	$621.17	—	11% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration 31-60 Min	$372.70	$621.17	—	11% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Ob/Ed Iv Hyrdat 31-90 Mins	$372.70	$621.17	—	11% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Inf Hyd Initial Er 1St Hr	$372.70	$621.17	—	11% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Hydration 31-90 Min(Fac)	$108.66	$181.10	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Hydration 31-90 Minutes	$128.48	$214.13	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Ivt Iv Hydration 31-90 Min	$372.70	$621.17	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Hydration 31-60 Min	$372.70	$621.17	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Inf Hyd Initial Er 1St Hr	$372.70	$621.17	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Ob/Ed Iv Hyrdat 31-90 Mins	$372.70	$621.17	—	—	40%
IV infusion of a medicine, first hour CPT 96365 Iv Therapy 16-90 Min(Fac)	$108.66	$181.10	—	75% below	40%
IV infusion of a medicine, first hour CPT 96365 Iv Therapy 16-90 Min	$442.15	$736.91	—	2% above	40%
IV infusion of a medicine, first hour CPT 96365 Belpre Iv Therapy 16-90 Min	$459.43	$765.71	—	6% above	40%
IV infusion of a medicine, first hour CPT 96365 Clab Iv Therapy 16-90 Min	$514.55	$857.58	—	19% above	40%
IV infusion of a medicine, first hour CPT 96365 Ivt Iv Infusion-Obs 16-90 Min	$514.55	$857.58	—	19% above	40%
IV infusion of a medicine, first hour CPT 96365 Ivt Iv Therapy 16-90 Min	$514.55	$857.58	—	19% above	40%
IV infusion of a medicine, first hour CPT 96365 Thr/Prph/Dia Iv Inf Init=<1H	$514.55	$857.58	—	19% above	40%
IV infusion of a medicine, first hour CPT 96365 Ob/Ed Iv Therapy 16-90 Min	$514.55	$857.58	—	19% above	40%
IV infusion of a medicine, first hour CPT 96365 Iv Infusion First Hour	$514.55	$857.58	—	19% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Iv Therapy 16-90 Min(Fac)	$108.66	$181.10	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Iv Therapy 16-90 Min	$442.15	$736.91	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Belpre Iv Therapy 16-90 Min	$459.43	$765.71	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Clab Iv Therapy 16-90 Min	$514.55	$857.58	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Thr/Prph/Dia Iv Inf Init=<1H	$514.55	$857.58	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Ob/Ed Iv Therapy 16-90 Min	$514.55	$857.58	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Ivt Iv Therapy 16-90 Min	$514.55	$857.58	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Ivt Iv Infusion-Obs 16-90 Min	$514.55	$857.58	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Iv Infusion First Hour	$514.55	$857.58	—	—	40%
IV push of a medicine, first drug CPT 96374 Iv Inject Seq Each Drug	$39.98	$66.64	—	84% below	40%
IV push of a medicine, first drug CPT 96374 Ther/Proph Dian Inj Ia	$108.66	$181.10	—	58% below	40%
IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj,Iv Push	$108.66	$181.10	—	58% below	40%
IV push of a medicine, first drug CPT 96374 Iv Push	$128.48	$214.13	—	50% below	40%
IV push of a medicine, first drug CPT 96374 Iv Push Initial Medication	$282.66	$471.10	—	10% above	40%
IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj Iv Push	$320.74	$534.57	—	25% above	40%
IV push of a medicine, first drug CPT 96374 Ivt Ivp Outpt Initial	$320.74	$534.57	—	25% above	40%
IV push of a medicine, first drug CPT 96374 Iv Injection	$320.74	$534.57	—	25% above	40%
IV push of a medicine, first drug CPT 96374 Ob/Ed Iv Injection	$320.74	$534.57	—	25% above	40%
IV push of a medicine, first drug CPT 96374 Ther/Diag Inj Iv Push (59)	$393.94	$656.57	—	54% above	40%
IV push of a medicine, first drug inpatient CPT 96374 Iv Inject Seq Each Drug	$39.98	$66.64	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph Dian Inj Ia	$108.66	$181.10	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj,Iv Push	$108.66	$181.10	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Iv Push	$128.48	$214.13	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Iv Push Initial Medication	$282.66	$471.10	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ivt Ivp Outpt Initial	$320.74	$534.57	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ob/Ed Iv Injection	$320.74	$534.57	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj Iv Push	$320.74	$534.57	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Iv Injection	$320.74	$534.57	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Diag Inj Iv Push (59)	$393.94	$656.57	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im(Fac)	$34.69	$57.81	—	75% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 3 West Sq/Im Inj	$136.82	$228.04	—	3% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ivt Sq/Im Outpatient	$141.89	$236.49	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im	$158.93	$264.88	—	12% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Sq/Im Outpatient	$158.93	$264.88	—	12% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Nm Im/Sq Injection	$158.93	$264.88	—	12% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Im Subcutaneous Injection	$158.93	$264.88	—	12% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ob/Ed Sq/Im Injection	$158.93	$264.88	—	12% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im(Fac)	$34.69	$57.81	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 3 West Sq/Im Inj	$136.82	$228.04	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ivt Sq/Im Outpatient	$141.89	$236.49	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Nm Im/Sq Injection	$158.93	$264.88	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection Sq/Im Outpatient	$158.93	$264.88	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Im Subcutaneous Injection	$158.93	$264.88	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ob/Ed Sq/Im Injection	$158.93	$264.88	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im	$158.93	$264.88	—	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Evaluation	$74.05	$123.41	—	76% below	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Eval	$246.75	$411.25	—	21% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Evaluation	$74.05	$123.41	—	—	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Eval	$246.75	$411.25	—	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nrv Cond Test 7-8 Studies	$2,142.97	$3,571.62	—	55% above	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nrv Cond Test 7-8 Studies	$2,142.97	$3,571.62	—	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 At Neuromuscular Re-Ed 1/4 Hr	$127.73	$212.88	—	17% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromusclar Re-Ed Every 1/4Hr	$127.73	$212.88	—	17% above	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromusclar Re-Ed Every 1/4Hr	$127.73	$212.88	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 At Neuromuscular Re-Ed 1/4 Hr	$127.73	$212.88	—	—	40%
New patient office visit, about 45 minutes CPT 99204 Ov New Pt Level Iv	$205.40	$342.33	—	69% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 Ov New Pt Level Iv	$205.40	$342.33	—	—	40%
New patient office visit, about 60 minutes CPT 99205 Ov New Pt Level V	$257.26	$428.76	—	49% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 Ov New Pt Level V	$257.26	$428.76	—	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Ov New Pt Level Ii	$115.69	$192.82	—	14% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Ov New Pt Level Ii	$115.69	$192.82	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 At Manual Therapy 1/4 Hr	$114.85	$191.41	—	4% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 At Manual Therapy 1/4 Hr	$114.85	$191.41	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 At Ther Exercise 1/4 Hr*	$121.90	$203.16	—	3% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 At Ther Exercise 1/4 Hr	$121.90	$203.16	—	3% above	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 At Ther Exercise 1/4 Hr*	$121.90	$203.16	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 At Ther Exercise 1/4 Hr	$121.90	$203.16	—	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 Prev Visit New Age 18-39	$51.00	$85.00	—	57% below	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Prev Visit New Age 18-39	$51.00	$85.00	—	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 Prev Visit, New Pt 40-64 Yrs	$69.00	$115.00	—	53% below	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Prev Visit, New Pt 40-64 Yrs	$69.00	$115.00	—	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 Prev Visit Est Pt 18-39(Fac)	$37.20	$62.00	—	70% below	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Prev Visit Est Pt 18-39(Fac)	$37.20	$62.00	—	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 Prev Visit, Est Pt, 40-64 Yrs	$37.20	$62.00	—	70% below	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Prev Visit, Est Pt, 40-64 Yrs	$37.20	$62.00	—	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 Prev Visit, Est Pt, 65+ Yrs	$37.20	$62.00	—	71% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Prev Visit, Est Pt, 65+ Yrs	$37.20	$62.00	—	—	40%
Psychiatric evaluation with medical services CPT 90792 Psych Diag Eval W/Med Srvcs	$74.05	$123.41	—	79% below	40%
Psychiatric evaluation with medical services CPT 90792 Psych Diag Eval W/Med Services	$246.75	$411.25	—	30% below	40%
Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diag Eval W/Med Srvcs	$74.05	$123.41	—	—	40%
Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diag Eval W/Med Services	$246.75	$411.25	—	—	40%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psycl Tst Eval Phys/Qhp 1St	$78.92	$131.54	—	81% below	40%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psycl Tst Eval Phys/Qhp 1St	$78.92	$131.54	—	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psytx Crisis Initial 60 Min	$77.75	$129.58	—	75% below	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psytx Crisis Initial 60 Min	$77.75	$129.58	—	—	40%
Psychotherapy session, 30 minutes CPT 90832 Psytx Pt&/Family 30 Minutes	$74.05	$123.41	—	61% below	40%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy 30 Min	$185.98	$309.96	—	2% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psytx Pt&/Family 30 Minutes	$74.05	$123.41	—	—	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy 30 Min	$185.98	$309.96	—	—	40%
Psychotherapy session, 45 minutes CPT 90834 Psytx Pt&/Family 45 Minutes	$74.05	$123.41	—	72% below	40%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy 45 Min	$246.75	$411.25	—	8% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psytx Pt&/Family 45 Minutes	$74.05	$123.41	—	—	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy 45 Min	$246.75	$411.25	—	—	40%
Psychotherapy session, 60 minutes CPT 90837 Psytx Pt&/Family 60 Minutes	$74.05	$123.41	—	76% below	40%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy 60 Min	$246.75	$411.25	—	21% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx Pt&/Family 60 Minutes	$74.05	$123.41	—	—	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy 60 Min	$246.75	$411.25	—	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Couns 3-10 Mins(Fac)	$19.38	$32.30	—	56% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behav Chng Smoking 3-10 Min	$30.26	$50.43	—	31% below	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Couns 3-10 Mins(Fac)	$19.38	$32.30	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behav Chng Smoking 3-10 Min	$30.26	$50.43	—	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Ov Est Pt Level V	$226.10	$376.84	—	34% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Ov Est Pt Level V	$226.10	$376.84	—	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Ov Est Pt Level Iii	$139.97	$233.29	—	21% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Ov Est Pt Level Iii	$139.97	$233.29	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Ov Est Pt Level Iv	$131.72	$219.53	—	4% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Ov Est Pt Level Iv	$131.72	$219.53	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Ov Est Pt Level Ii	$106.67	$177.79	—	6% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Ov Est Pt Level Ii	$106.67	$177.79	—	—	40%
Spirometry (breathing test) CPT 94010 Pulm Function Spirometry	$519.68	$866.14	—	68% above	40%
Spirometry (breathing test) inpatient CPT 94010 Pulm Function Spirometry	$519.68	$866.14	—	—	40%
Spirometry before and after a bronchodilator CPT 94060 Pulm Func Test C Bron	$861.71	$1,436.19	—	51% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulm Func Test C Bron	$861.71	$1,436.19	—	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 At Functional Training 1/4 Hr	$132.41	$220.69	—	8% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 Activities Therapy Ind. Q 15	$132.41	$220.69	—	8% above	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 At Functional Training 1/4 Hr	$132.41	$220.69	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Activities Therapy Ind. Q 15	$132.41	$220.69	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Mo Phlebotomy Theraputic	$309.75	$516.25	—	31% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Theraputic	$309.75	$516.25	—	31% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Theraputic	$309.75	$516.25	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Mo Phlebotomy Theraputic	$309.75	$516.25	—	—	40%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 Executive Stress Test	$683.03	$1,138.38	—	13% below	40%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Executive Stress Test	$683.03	$1,138.38	—	—	40%
Visual field test, extended CPT 92083 Visual Field Examination(S)	$64.18	$106.97	—	58% below	40%
Visual field test, extended inpatient CPT 92083 Visual Field Examination(S)	$64.18	$106.97	—	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Iiv Adjuvant Vaccine Im	$82.96	$138.26	—	9% above	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Iiv Adjuvant Vaccine Im	$82.96	$138.26	—	—	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Moderna Cov2 50 Mcg/0.5Ml Im	$154.54	$257.57	—	25% below	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Moderna Cov2 50 Mcg/0.5Ml Im	$154.54	$257.57	—	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Sarscv2 Vac 30Mcg Trs-Suc Im	$219.56	$365.94	—	34% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Sarscv2 Vac 30Mcg Trs-Suc Im	$219.56	$365.94	—	—	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella(Chicken Pox) Sc(Fac)	$217.72	$362.87	—	42% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella(Chicken Pox) Sc(Fac)	$217.72	$362.87	—	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Dtap-Ipv Vacc 4-6 Yr Im(Vfc)	$12.75	$21.25	—	90% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Dtap-Ipv Vacc 4-6 Yr Im(Fac)	$85.28	$142.14	—	34% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Dtap-Ipv Vacc 4-6 Yr Im(Vfc)	$12.75	$21.25	—	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Dtap-Ipv Vacc 4-6 Yr Im(Fac)	$85.28	$142.14	—	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Dtap Vacc <7 Yrs Im(Vfc)	$12.75	$21.25	—	80% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Dtap Vacc <7 Yrs Im(Fac)	$40.15	$66.92	—	38% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Infanrix Dtap Vaccine	$45.62	$76.04	—	30% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Dtap Vacc <7 Yrs Im(Vfc)	$12.75	$21.25	—	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Dtap Vacc <7 Yrs Im(Fac)	$40.15	$66.92	—	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Infanrix Dtap Vaccine	$45.62	$76.04	—	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Dtap-Hep B- Ipv Vacc Im(Fac)	$132.13	$220.21	—	32% below	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Dtap-Hep B- Ipv Vacc Im(Fac)	$132.13	$220.21	—	—	40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Pentacel Vacc Im	$134.51	$224.19	—	15% below	40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pentacel Vacc Im	$134.51	$224.19	—	—	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 Dtap-Ipv-Hib-Hepb Vaccine Im	$30.00	$50.00	—	91% below	40%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 Dtap-Ipv-Hib-Hepb Vaccine Im	$30.00	$50.00	—	—	40%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 Riv3(Flublok)Vacc No Prsrv Im	$117.59	$195.99	—	36% below	40%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 Riv3(Flublok)Vacc No Prsrv Im	$117.59	$195.99	—	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vacc Ts25-26 45 Mcg/0.5 Ml	$31.52	$52.54	—	31% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Split 3Yrs Or > Im No Pres	$31.52	$52.54	—	31% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone Trivalent 2024-25	$31.52	$52.54	—	31% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vacc 25-26 180 Mcg/0.5 Ml	$103.39	$172.31	—	126% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone Trivalent 2024-25	$31.52	$52.54	—	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Split 3Yrs Or > Im No Pres	$31.52	$52.54	—	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vacc Ts25-26 45 Mcg/0.5 Ml	$31.52	$52.54	—	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vacc 25-26 180 Mcg/0.5 Ml	$103.39	$172.31	—	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv Vaccine Non Valent Im	$383.99	$639.99	—	26% below	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Hpv Vaccine Non Valent Im	$383.99	$639.99	—	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hep A/Hep B Vacc,Adult Im	$174.81	$291.35	—	43% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Twinrix 20 Mcg Pfs Im Hepa/B	$202.22	$337.04	—	34% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hep A/Hep B Vacc,Adult Im	$174.81	$291.35	—	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Twinrix 20 Mcg Pfs Im Hepa/B	$202.22	$337.04	—	—	40%
Hepatitis A vaccine, adult dose CPT 90632 Hep A Vaccine, Adult Im(Fac)	$114.80	$191.33	—	41% below	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hep A Vaccine, Adult Im(Fac)	$114.80	$191.33	—	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hep A Vacc, Pediatric 2 Doses	$12.75	$21.25	—	86% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hep A Vacc,Pediatric 2 Doses	$54.16	$90.27	—	40% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hep A Vacc, Pediatric 2 Doses	$12.75	$21.25	—	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hep A Vacc,Pediatric 2 Doses	$54.16	$90.27	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hep B Vaccine, Adult Im	$99.12	$165.20	—	36% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine 20 Mcg/1Ml	$115.79	$192.98	—	26% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hep B Vaccine, Adult Im	$99.12	$165.20	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine 20 Mcg/1Ml	$115.79	$192.98	—	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Hepb Vacc 2/4 Dose Adult Im	$112.69	$187.81	—	48% below	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Hepb Vacc 2/4 Dose Adult Im	$112.69	$187.81	—	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hep B Vacc, Ped/Adol 3 Dose Im	$39.73	$66.21	—	34% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hep B Vacc, Ped/Adol 3 Dose Im	$39.73	$66.21	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Hib 3 Dose Im (Vf)	$12.75	$21.25	—	82% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Hib 3 Dose Im(Fac)	$40.00	$66.66	—	43% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Pedvaxhib Vaccine	$47.50	$79.17	—	32% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Hib 3 Dose Im (Vf)	$12.75	$21.25	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Hib 3 Dose Im(Fac)	$40.00	$66.66	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Pedvaxhib Vaccine	$47.50	$79.17	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib 4 Dose Schedule(Vf)	$12.75	$21.25	—	58% below	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib 4 Dose Schedule(Fac)	$27.32	$45.54	—	11% below	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hib 4 Dose Schedule(Vf)	$12.75	$21.25	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hib 4 Dose Schedule(Fac)	$27.32	$45.54	—	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone Iiv No Pres High Dose	$103.39	$172.31	—	at median	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Iiv Pf High Dose 0.7Ml Im	$103.39	$172.31	—	at median	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone Hi-Dose Triv 2024-25	$103.39	$172.31	—	at median	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Iiv Pf High Dose 0.7Ml Im	$103.39	$172.31	—	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone Iiv No Pres High Dose	$103.39	$172.31	—	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone Hi-Dose Triv 2024-25	$103.39	$172.31	—	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr Vaccine Live, Sc(Fac)	$125.72	$209.53	—	40% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr Ii	$152.25	$253.75	—	27% below	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr Vaccine Live, Sc(Fac)	$125.72	$209.53	—	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr Ii	$152.25	$253.75	—	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Mmrv Proquad Vacc Sc(Fac)	$360.35	$600.58	—	30% below	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Mmrv Proquad Vacc Sc(Fac)	$360.35	$600.58	—	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Conj Vaccine Im	$118.25	$197.09	—	63% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Vaccine Im(Fac)	$205.93	$343.22	—	35% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo Vaccine	$252.44	$420.73	—	20% below	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Conj Vaccine Im	$118.25	$197.09	—	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Vaccine Im(Fac)	$205.93	$343.22	—	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menveo Vaccine	$252.44	$420.73	—	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Menb Rp W/Omv Vaccine Im	$287.60	$479.34	—	48% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Bexsero 0.5Ml Syringe	$359.05	$598.42	—	35% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Menb Rp W/Omv Vaccine Im	$287.60	$479.34	—	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Bexsero 0.5Ml Syringe	$359.05	$598.42	—	—	40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 Flumist Vacc,Live,Intranasal	$12.75	$21.25	—	68% below	40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 Flumist Vacc,Live,Intranasal	$12.75	$21.25	—	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumoccoccal Vac, 13 Val Im	$324.13	$540.22	—	26% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Prevnar 13 Im	$363.36	$605.60	—	17% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumoccoccal Vac, 13 Val Im	$324.13	$540.22	—	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Prevnar 13 Im	$363.36	$605.60	—	—	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pcv15 Vaccine Im	$289.78	$482.97	—	21% above	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 Pcv15 Vaccine Im	$289.78	$482.97	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal Conjugate Pcv20	$432.92	$721.54	—	35% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal Conjugate Pcv20	$432.92	$721.54	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Ppsv23 Vacc 2Yrs+ Subq/Im	$168.89	$281.49	—	39% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine(Vfc)	$168.89	$281.49	—	39% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococc Polysac 23Val Im	$187.97	$313.29	—	32% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Ppsv23 Vacc 2Yrs+ Subq/Im	$168.89	$281.49	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine(Vfc)	$168.89	$281.49	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococc Polysac 23Val Im	$187.97	$313.29	—	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus, Ipv Sc/Im(Vfc)	$12.75	$21.25	—	80% below	40%
Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus Ipv Sc/Im	$68.26	$113.77	—	7% above	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus, Ipv Sc/Im(Vfc)	$12.75	$21.25	—	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus Ipv Sc/Im	$68.26	$113.77	—	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Rsv Monoc Antb Seasn 1 Ml Im	$481.14	$801.90	—	54% below	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Rsv Monoc Antb Seasn 1 Ml Im	$481.14	$801.90	—	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Rsv Monoc Antb Seasn .5Ml Im	$481.14	$801.90	—	64% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Rsv Monoc Antb Seasn .5Ml Im	$481.14	$801.90	—	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Abrysvo Rsv Vacc 120Mcg/.5Ml	$354.57	$590.95	—	51% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Abrysvo Rsv Vacc 120Mcg/.5Ml	$354.57	$590.95	—	—	40%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Arexvy Rsv Vacc .5Ml	$354.57	$590.95	—	at median	40%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 Arexvy Rsv Vacc .5Ml	$354.57	$590.95	—	—	40%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine 2.5Iu/Ml Kit Im	$664.57	$1,107.62	—	30% below	40%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine 2.5Iu/Ml Kit Im	$664.57	$1,107.62	—	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus Vacc 2 Dose Oral	$117.94	$196.56	—	55% below	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus Vacc 2 Dose Oral	$117.94	$196.56	—	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus Vacc 3 Dose, Oral	$135.53	$225.88	—	at median	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus Vacc 3 Dose, Oral	$135.53	$225.88	—	—	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingles Vacc Recombinant Im	$243.10	$405.17	—	52% below	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Shingles Vacc Recombinant Im	$243.10	$405.17	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Vacc No Presv >/= 7 Yr Im	$20.87	$34.78	—	77% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria&Tetanustox 0.5Mlinj	$59.17	$98.61	—	34% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Vacc No Presv >/=7 Im(Fac)	$91.52	$152.53	—	2% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Vacc No Presv >/= 7 Yr Im	$20.87	$34.78	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Diphtheria&Tetanustox 0.5Mlinj	$59.17	$98.61	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Vacc No Presv >/=7 Im(Fac)	$91.52	$152.53	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vacc >7 Im(Vfc)	$12.75	$21.25	—	88% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vacc >/=7 Yr Im	$60.81	$101.35	—	45% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vaccine > 7 Im	$63.85	$106.42	—	42% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vacc >7 Im(Fac)	$67.41	$112.35	—	39% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet/Dip/Pertuss 0.5Ml >7Yr	$77.67	$129.45	—	30% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vacc >7 Im(Vfc)	$12.75	$21.25	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vacc >/=7 Yr Im	$60.81	$101.35	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vaccine > 7 Im	$63.85	$106.42	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vacc >7 Im(Fac)	$67.41	$112.35	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet/Dip/Pertuss 0.5Ml >7Yr	$77.67	$129.45	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Immunization(Fac)	$34.69	$57.81	—	15% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin	$41.02	$68.36	—	1% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Obs Immunization Admin	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Tetanus Vaccine Admin	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Ivt Immunization Admin	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Tetanus Administration	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Rabies Administration	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Meningococcal Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Hepatitis A Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Tet&Diptheria Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Shingles Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Polio Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Acthib Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Rabies Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Scc Admin Mmr Vac	$141.89	$236.49	—	249% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Immunization(Fac)	$34.69	$57.81	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin	$41.02	$68.36	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Obs Immunization Admin	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Hepatitis A Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Tetanus Vaccine Admin	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Shingles Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Meningococcal Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Rabies Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Rabies Administration	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Polio Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Mmr Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Tetanus Administration	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Tet&Diptheria Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Scc Admin Acthib Vac	$141.89	$236.49	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Ivt Immunization Admin	$141.89	$236.49	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immunization, Each Addl	$14.86	$24.76	—	57% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Scc Admin Vac Each Add	$40.16	$66.93	—	15% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vacc Admin Additional	$40.16	$66.93	—	15% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin Each Add	$41.02	$68.36	—	18% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Immunization, Each Addl	$14.86	$24.76	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Scc Admin Vac Each Add	$40.16	$66.93	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vacc Admin Additional	$40.16	$66.93	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Admin Each Add	$41.02	$68.36	—	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://HospitalPriceDisclosure.com/Download.aspx?pi=WrIdhNNIFG4M*__*3EC7cPFcg*-*