West Valley Medical Center
West Valley Medical Center in Caldwell, ID publishes cash prices for 208 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Idaho median for 195 of 205 procedures and below it for 8. By typical cash price it ranks #22 of 22 Idaho hospitals and #6 of 6 hospitals in the Boise City, ID area, cheapest first. Click a procedure to compare it with other hospitals nearby.
1717 ARLINGTON AVENUE, CALDWELL, ID, 83605 Collected Sep 27, 2026 Source price file (208) 459-4641
Acute care hospital Emergency department CMS star rating 5 of 5 CCN 130014 · CMS hospital register
The price file shows no self-pay discount
For 458 of the 458 prices listed here, the cash price in West Valley Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named West Valley Medical Center in Caldwell, ID:
- Nov 28, 2023 Met requirements
- Apr 14, 2025 Met requirements
- May 9, 2025 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Idaho | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a | $883.04 | $883.04 | $66.02–$330.93 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP ART 1-2 LEVELS BIL | $883.04 | $883.04 | $281.69–$838.89 | 57% above | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS | $1,229.43 | $1,229.43 | $392.19–$1,167.96 | 183% above | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study | $1,229.43 | $1,229.43 | $401.74 | 183% above | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body | $3,568.17 | $3,568.17 | $848.52 | 150% above | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY | $3,568.17 | $3,568.17 | $1,138.25–$3,389.76 | 150% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST | $6,344.42 | $6,344.42 | $2,023.87–$6,027.20 | 380% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo | $1,650.81 | $1,650.81 | $401.74 | 17% below | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART W CN ART/GRAFTS | $1,650.81 | $1,650.81 | $526.61–$1,568.27 | 17% below | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium | $69.00 | $69.00 | $182.03 | 63% below | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO CN W QUAN CA | $69.00 | $69.00 | $22.01–$65.55 | 63% below | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PELVIS W/O CONT | $6,250.61 | $6,250.61 | $1,993.94–$5,938.08 | 237% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PELVIS W/CONT | $7,576.63 | $7,576.63 | $2,416.94–$7,197.80 | 235% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS W&WO CONT | $8,852.52 | $8,852.52 | $2,823.95–$8,409.89 | 291% above | — |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT | $3,788.32 | $3,788.32 | $1,208.47–$3,598.90 | 247% above | — |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT | $3,162.40 | $3,162.40 | $1,008.81–$3,004.28 | 252% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIFAC W/O CNT | $2,843.97 | $2,843.97 | $907.23–$2,701.77 | 240% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT | $2,252.93 | $2,252.93 | $718.68–$2,140.28 | 136% above | — |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONT | $4,734.87 | $4,734.87 | $1,510.42–$4,498.13 | 333% above | — |
| CT scan of the head without and with contrast CPT 70470 CT HD/BR W&W/O CONT | $5,677.04 | $5,677.04 | $1,810.98–$5,393.19 | 332% above | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST | $4,857.00 | $4,857.00 | $1,549.38–$4,614.15 | 468% above | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST | $4,377.21 | $4,377.21 | $1,396.33–$4,158.35 | 412% above | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $3,788.32 | $3,788.32 | $1,208.47–$3,598.90 | 243% above | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUP EXTRACRANIAL BIL | $2,078.59 | $2,078.59 | $663.07–$1,974.66 | 81% above | — |
| Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views | $256.41 | $256.41 | $182.03 | 2% above | — |
| Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 V | $256.41 | $256.41 | $81.79–$243.59 | 2% above | — |
| Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view | $256.41 | $256.41 | $182.03 | 19% above | — |
| Chest X-ray, single view CPT 71045 CHEST XRAY 1 V | $256.41 | $256.41 | $81.79–$243.59 | 19% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COM | $1,327.56 | $1,327.56 | $423.49–$1,261.18 | 201% above | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) | $824.73 | $824.73 | $245.18 | 142% above | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $824.73 | $824.73 | $263.09–$783.49 | 142% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY PERIPHL | $190.35 | $190.35 | $60.72–$180.83 | at median | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) | $190.35 | $190.35 | $182.03 | at median | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST | $3,173.30 | $3,173.30 | $1,012.28–$3,014.64 | 287% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST | $5,166.68 | $5,166.68 | $1,648.17–$4,908.35 | 373% above | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral | $601.39 | $601.39 | $263.00 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Other Outpatient | $601.39 | $601.39 | $101.41 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG CAD BI | $601.39 | $601.39 | $191.84–$571.32 | — | — |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUP LE ART BIL | $2,327.13 | $2,327.13 | $742.35–$2,210.77 | 153% above | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 DUP VEIN BIL | $2,078.59 | $2,078.59 | $663.07–$1,974.66 | 117% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc | $5,655.73 | $5,655.73 | $158.62–$1,429.19 | 211% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D COMP W CF DOP | $5,655.73 | $5,655.73 | $1,804.18–$5,372.94 | 211% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPA IMAG INCL GB | $2,483.29 | $2,483.29 | $792.17–$2,359.13 | 74% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present; | $2,483.29 | $2,483.29 | $848.52 | 74% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD | $1,215.31 | $1,215.31 | $387.68–$1,154.54 | 176% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LW JNT W&WO CONT | $3,159.79 | $3,159.79 | $1,007.97–$3,001.80 | 40% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT | $2,286.61 | $2,286.61 | $729.43–$2,172.28 | 43% above | — |
| MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) | $2,286.61 | $2,286.61 | $517.79 | 43% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONT | $3,541.03 | $3,541.03 | $1,129.59–$3,363.98 | 56% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences | $3,541.03 | $3,541.03 | $828.27 | 56% above | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $2,447.71 | $2,447.71 | $780.82–$2,325.32 | 44% above | — |
| MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material | $2,447.71 | $2,447.71 | $517.79 | 44% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONT | $3,709.41 | $3,709.41 | $1,183.30–$3,523.94 | 64% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences | $3,709.41 | $3,709.41 | $828.27 | 64% above | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT | $2,286.61 | $2,286.61 | $729.43–$2,172.28 | 35% above | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&W/O CONT | $3,057.81 | $3,057.81 | $975.44–$2,904.92 | 34% above | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT | $2,286.61 | $2,286.61 | $729.43–$2,172.28 | 34% above | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&W/O CONT | $3,541.03 | $3,541.03 | $1,129.59–$3,363.98 | 49% above | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT | $2,965.07 | $2,965.07 | $945.86–$2,816.82 | 75% above | — |
| MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences | $3,289.66 | $3,289.66 | $828.27 | 45% above | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&WO CONT | $3,289.66 | $3,289.66 | $1,049.40–$3,125.18 | 45% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT | $2,354.97 | $2,354.97 | $751.24–$2,237.22 | 44% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) | $2,354.97 | $2,354.97 | $517.79 | 44% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCRD SPECT R/S MULT | $4,777.10 | $4,777.10 | $1,523.89–$4,538.25 | 12% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat | $4,777.10 | $4,777.10 | $2,938.37 | 12% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD OR FU | $866.64 | $866.64 | $276.46–$823.31 | 100% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE | $1,215.31 | $1,215.31 | $387.68–$1,154.54 | 165% above | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRI | $1,056.65 | $1,056.65 | $337.07–$1,003.82 | 140% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMTR | $828.27 | $828.27 | $264.22–$786.86 | 93% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD | $828.27 | $828.27 | $264.22–$786.86 | 189% above | — |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR CAD BI | $303.34 | $303.34 | $96.77–$288.17 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Other Outpatient | $303.34 | $303.34 | $83.74 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed | $303.34 | $303.34 | $217.46 | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study | $1,147.78 | $1,147.78 | $401.74 | 124% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLW FUNC W/C&V | $1,147.78 | $1,147.78 | $366.14–$1,090.39 | 124% above | — |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $729.60 | $729.60 | $232.74–$693.12 | 65% above | — |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREG UT TRANSVAGINAL | $688.94 | $688.94 | $219.77–$654.49 | 56% above | — |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $1,466.91 | $1,466.91 | $467.94–$1,393.56 | 233% above | — |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CNTS | $1,039.20 | $1,039.20 | $331.50–$987.24 | 136% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD AND NECK | $816.83 | $816.83 | $260.57–$775.99 | 85% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study | $1,489.67 | $1,489.67 | $98.06–$365.88 | 174% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SNGL CONTRAST | $1,489.67 | $1,489.67 | $475.20–$1,415.19 | 174% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP VEIN UNI/LTD | $958.06 | $958.06 | $305.62–$910.16 | 67% above | — |
| X-ray of the abdomen, 1 view CPT 74018 ABD XR 1V | $256.41 | $256.41 | $81.79–$243.59 | 28% above | — |
| X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view | $256.41 | $256.41 | $182.03 | 28% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VIEWS | $821.45 | $821.45 | $262.04–$780.38 | 177% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination, spine, lumbosacral; 2 or 3 views | $821.45 | $821.45 | $245.18 | 177% above | — |
| X-ray of the lower back, 4 or more views CPT 72110 Radiologic examination, spine, lumbosacral; minimum of 4 views | $1,229.93 | $1,229.93 | $245.18 | 206% above | — |
| X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4 + VIEWS | $1,229.93 | $1,229.93 | $392.35–$1,168.43 | 206% above | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination, spine; thoracic, 2 views | $821.45 | $821.45 | $245.18 | 189% above | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS | $821.45 | $821.45 | $262.04–$780.38 | 189% above | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination, nasal bones, complete, minimum of 3 views | $708.18 | $708.18 | $182.03 | 121% above | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP | $708.18 | $708.18 | $225.91–$672.77 | 121% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radiologic examination, spine, cervical; 2 or 3 views | $821.45 | $821.45 | $182.03 | 214% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS | $821.45 | $821.45 | $262.04–$780.38 | 214% above | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic examination, pelvis; 1 or 2 views | $690.44 | $690.44 | $245.18 | 186% above | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS | $690.44 | $690.44 | $220.25–$655.92 | 186% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination, sacrum and coccyx, minimum of 2 views | $852.52 | $852.52 | $25.62–$180.95 | 241% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 + V | $852.52 | $852.52 | $271.95–$809.89 | 241% above | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Idaho | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT) | $126.07 | $126.07 | $5.30 | 376% above | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $126.07 | $126.07 | $40.22–$119.77 | 376% above | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT) Other Outpatient | $126.07 | $126.07 | $5.30 | 376% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $126.07 | $126.07 | $40.22–$119.77 | 291% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) Other Outpatient | $126.07 | $126.07 | $5.18 | 291% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) | $126.07 | $126.07 | $5.18 | 291% above | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $290.91 | $290.91 | $92.80–$276.36 | 34% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH | $35.72 | $35.72 | $11.39–$33.93 | 59% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Other Outpatient | $35.72 | $35.72 | $5.22 | 59% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each | $35.72 | $35.72 | $5.22 | 59% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody | $173.23 | $173.23 | $12.95 | 179% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP | $173.23 | $173.23 | $55.26–$164.57 | 179% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Other Outpatient | $173.23 | $173.23 | $12.95 | 179% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibodies (ANA); | $150.99 | $150.99 | $12.09 | 180% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUAL SCREEN | $150.99 | $150.99 | $48.17–$143.44 | 180% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibodies (ANA); Other Outpatient | $150.99 | $150.99 | $12.09 | 180% above | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP QT | $137.38 | $137.38 | $43.82–$130.51 | 18% below | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $498.84 | $498.84 | $159.13–$473.90 | 198% above | — |
| Basic metabolic panel (blood test) CPT 80048 BMP TOTAL CALCIUM | $248.05 | $248.05 | $79.13–$235.65 | 491% above | — |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium | $248.05 | $248.05 | $8.46 | 491% above | — |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium Other Outpatient | $248.05 | $248.05 | $8.46 | 491% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4 | $347.86 | $347.86 | $110.97–$330.47 | 47% above | — |
| Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) | $482.66 | $482.66 | $10.32 | 347% above | — |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $482.66 | $482.66 | $153.97–$458.53 | 347% above | — |
| Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) Other Outpatient | $482.66 | $482.66 | $10.32 | 347% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $188.72 | $188.72 | $60.20–$179.28 | 739% above | — |
| Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip) Other Outpatient | $91.01 | $91.01 | $3.93 | 259% above | — |
| Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip) | $91.01 | $91.01 | $3.93 | 259% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN | $91.01 | $91.01 | $29.03–$86.46 | 259% above | — |
| Blood lead test CPT 83655 LEAD URINE | $157.76 | $157.76 | $50.33–$149.87 | 184% above | — |
| Blood lead test CPT 83655 LEAD BLOOD | $251.46 | $251.46 | $80.22–$238.89 | 353% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin, chorionic (hCG); qualitative | $160.43 | $160.43 | $7.52 | 248% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM | $160.43 | $160.43 | $51.18–$152.41 | 248% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin, chorionic (hCG); qualitative Other Outpatient | $160.43 | $160.43 | $7.52 | 248% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO | $171.00 | $171.00 | $2.99 | 265% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $171.00 | $171.00 | $54.55–$162.45 | 265% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO Other Outpatient | $171.00 | $171.00 | $2.99 | 265% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein; | $222.47 | $222.47 | $5.18 | 411% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein; Other Outpatient | $222.47 | $222.47 | $5.18 | 411% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $222.47 | $222.47 | $70.97–$211.35 | 411% above | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE AMP PROB | $163.71 | $163.71 | $52.22–$155.52 | 1% below | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique Other Outpatient | $163.71 | $163.71 | $37.27 | 1% below | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique | $163.71 | $163.71 | $37.27 | 1% below | — |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Other Outpatient | $509.63 | $509.63 | $20.81 | 430% above | — |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QN | $509.63 | $509.63 | $162.57–$484.15 | 430% above | — |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 | $509.63 | $509.63 | $20.81 | 430% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125 | $509.63 | $509.63 | $20.81 | 437% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QN | $509.63 | $509.63 | $162.57–$484.15 | 437% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125 Other Outpatient | $509.63 | $509.63 | $20.81 | 437% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique | $51.04 | $51.04 | $51.31 | 46% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Other Outpatient | $51.04 | $51.04 | $51.31 | 46% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 DNA/RNA AMP | $51.04 | $51.04 | $16.28–$48.49 | 46% below | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other Outpatient | $229.89 | $229.89 | $35.09 | 101% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique | $229.89 | $229.89 | $35.09 | 101% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE | $229.89 | $229.89 | $73.33–$218.40 | 101% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) | $95.06 | $95.06 | $13.39 | 76% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) Other Outpatient | $95.06 | $95.06 | $13.39 | 76% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $95.06 | $95.06 | $30.32–$90.31 | 76% above | — |
| Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) Other Outpatient | $227.43 | $227.43 | $6.47 | 600% above | — |
| Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) | $227.43 | $227.43 | $6.47 | 600% above | — |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED | $227.43 | $227.43 | $72.55–$216.06 | 600% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8 Other Outpatient | $301.57 | $301.57 | $10.56 | 436% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $301.57 | $301.57 | $96.20–$286.49 | 436% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8 | $301.57 | $301.57 | $10.56 | 436% above | — |
| D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products, D-dimer; quantitative Other Outpatient | $337.07 | $337.07 | $10.18 | 260% above | — |
| D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products, D-dimer; quantitative | $337.07 | $337.07 | $10.18 | 260% above | — |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $337.07 | $337.07 | $107.53–$320.22 | 260% above | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S | $302.01 | $302.01 | $96.34–$286.91 | 220% above | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Other Outpatient | $302.01 | $302.01 | $22.23 | 220% above | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) | $302.01 | $302.01 | $22.23 | 220% above | — |
| Estradiol blood test CPT 82670 ESTRADIOL TOTAL | $283.79 | $283.79 | $90.53–$269.60 | 111% above | — |
| Estradiol blood test CPT 82670 Estradiol; total Other Outpatient | $283.79 | $283.79 | $27.94 | 111% above | — |
| Estradiol blood test CPT 82670 Estradiol; total | $283.79 | $283.79 | $27.94 | 111% above | — |
| FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Other Outpatient | $274.36 | $274.36 | $18.58 | 162% above | — |
| FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) | $274.36 | $274.36 | $18.58 | 162% above | — |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $274.36 | $274.36 | $87.52–$260.64 | 162% above | — |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $238.64 | $238.64 | $13.63 | 250% above | — |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $238.64 | $238.64 | $76.13–$226.71 | 250% above | — |
| Ferritin blood test (iron stores) CPT 82728 Ferritin Other Outpatient | $238.64 | $238.64 | $13.63 | 250% above | — |
| Folate (folic acid) blood test CPT 82746 Folic acid; serum | $188.72 | $188.72 | $14.70 | 159% above | — |
| Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) SER | $188.72 | $188.72 | $60.20–$179.28 | 159% above | — |
| Folate (folic acid) blood test CPT 82746 Folic acid; serum Other Outpatient | $188.72 | $188.72 | $14.70 | 159% above | — |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free | $307.41 | $307.41 | $16.94 | 364% above | — |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $307.41 | $307.41 | $98.06–$292.04 | 364% above | — |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Other Outpatient | $307.41 | $307.41 | $16.94 | 364% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $131.46 | $131.46 | $41.94–$124.89 | 204% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Other Outpatient | $131.46 | $131.46 | $9.02 | 204% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free | $131.46 | $131.46 | $9.02 | 204% above | — |
| Free testosterone test CPT 84402 Testosterone; free | $121.94 | $121.94 | $25.47 | 42% above | — |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $121.94 | $121.94 | $38.90–$115.84 | 42% above | — |
| Free testosterone test CPT 84402 Testosterone; free Other Outpatient | $121.94 | $121.94 | $25.47 | 42% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GEN HEALTH PANEL | $242.01 | $242.01 | $77.20–$229.91 | 32% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) | $242.01 | $242.01 | $45.36 | 32% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR W GLUCOLA | $159.80 | $159.80 | $50.98–$151.81 | 471% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose; post glucose dose (includes glucose) Other Outpatient | $159.80 | $159.80 | $4.75 | 471% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose; post glucose dose (includes glucose) | $159.80 | $159.80 | $4.75 | 471% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Glucose; tolerance test (GTT), 3 specimens (includes glucose) | $255.44 | $255.44 | $12.87 | 256% above | — |
| Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS | $255.44 | $255.44 | $81.49–$242.67 | 256% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Glucose; tolerance test (GTT), 3 specimens (includes glucose) Other Outpatient | $255.44 | $255.44 | $12.87 | 256% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE | $229.19 | $229.19 | $73.11–$217.73 | 119% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique | $229.19 | $229.19 | $35.09 | 119% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique Other Outpatient | $229.19 | $229.19 | $35.09 | 119% above | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGA | $108.52 | $108.52 | $34.62–$103.09 | 6% above | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGM | $108.52 | $108.52 | $34.62–$103.09 | 6% above | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGG | $108.52 | $108.52 | $34.62–$103.09 | 6% above | — |
| H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient | $768.50 | $768.50 | $14.38 | 801% above | — |
| H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL | $768.50 | $768.50 | $245.15–$730.08 | 801% above | — |
| H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC | $768.50 | $768.50 | $14.38 | 801% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN | $614.80 | $614.80 | $196.12–$584.06 | 59% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Other Outpatient | $614.80 | $614.80 | $85.10 | 59% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed | $614.80 | $614.80 | $85.10 | 59% above | — |
| HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result Other Outpatient | $601.31 | $601.31 | $13.71 | 467% above | — |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 AB QUAL | $601.31 | $601.31 | $191.82–$571.24 | 467% above | — |
| HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result | $601.31 | $601.31 | $13.71 | 467% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC | $173.23 | $173.23 | $24.08 | 109% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient | $173.23 | $173.23 | $24.08 | 109% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1AG HIV-1/2AB SINGLE | $173.23 | $173.23 | $55.26–$164.57 | 109% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES POOL | $275.70 | $275.70 | $87.95–$261.92 | 206% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result | $275.70 | $275.70 | $35.09 | 206% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result Other Outpatient | $275.70 | $275.70 | $35.09 | 206% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C) | $307.41 | $307.41 | $9.71 | 615% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN | $307.41 | $307.41 | $98.06–$292.04 | 615% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C) Other Outpatient | $307.41 | $307.41 | $9.71 | 615% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb) Other Outpatient | $34.51 | $34.51 | $10.74 | 31% below | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb) | $34.51 | $34.51 | $10.74 | 31% below | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUAL | $34.51 | $34.51 | $11.01–$32.78 | 31% below | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient | $396.35 | $396.35 | $10.33 | 713% above | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B S AG EIA QL | $396.35 | $396.35 | $126.44–$376.53 | 713% above | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC | $396.35 | $396.35 | $10.33 | 713% above | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody; | $45.84 | $45.84 | $14.27 | 31% below | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB QUAL | $45.84 | $45.84 | $14.62–$43.55 | 31% below | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody; Other Outpatient | $45.84 | $45.84 | $14.27 | 31% below | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QN | $160.62 | $160.62 | $51.24–$152.59 | 27% below | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C DNA QN | $2,130.17 | $2,130.17 | $679.52–$2,023.66 | 874% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 Antibody; herpes simplex, type 1 Other Outpatient | $423.36 | $423.36 | $13.19 | 956% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB QL | $423.36 | $423.36 | $135.05–$402.19 | 956% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 Antibody; herpes simplex, type 1 | $423.36 | $423.36 | $13.19 | 956% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGM | $132.14 | $132.14 | $42.15–$125.53 | 96% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 Antibody; herpes simplex, type 2 | $132.14 | $132.14 | $19.35 | 96% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 Antibody; herpes simplex, type 2 Other Outpatient | $132.14 | $132.14 | $19.35 | 96% above | — |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE QN | $82.72 | $82.72 | $26.39–$78.58 | 3% above | — |
| Homocysteine blood test CPT 83090 Homocysteine | $82.72 | $82.72 | $15.48–$1,881.60 | 3% above | — |
| Homocysteine blood test CPT 83090 Homocysteine Other Outpatient | $82.72 | $82.72 | $17.92 | 3% above | — |
| Insulin blood test CPT 83525 INSULIN TOTAL | $211.00 | $211.00 | $67.31–$200.45 | 246% above | — |
| Insulin blood test CPT 83525 Insulin; total | $211.00 | $211.00 | $11.43 | 246% above | — |
| Insulin blood test CPT 83525 Insulin; total Other Outpatient | $211.00 | $211.00 | $11.43 | 246% above | — |
| Iron blood test (serum iron) CPT 83540 Iron | $103.82 | $103.82 | $6.47 | 230% above | — |
| Iron blood test (serum iron) CPT 83540 Iron Other Outpatient | $103.82 | $103.82 | $6.47 | 230% above | — |
| Iron blood test (serum iron) CPT 83540 IRON | $103.82 | $103.82 | $33.12–$98.63 | 230% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Other Outpatient | $95.74 | $95.74 | $8.74 | 120% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING | $95.74 | $95.74 | $30.54–$90.95 | 120% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity | $95.74 | $95.74 | $8.74 | 120% above | — |
| Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i Other Outpatient | $264.90 | $264.90 | $8.68 | 339% above | — |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $264.90 | $264.90 | $84.50–$251.65 | 339% above | — |
| Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i | $264.90 | $264.90 | $8.68 | 339% above | — |
| LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Other Outpatient | $254.15 | $254.15 | $18.52 | 210% above | — |
| LH (luteinizing hormone) test CPT 83002 LH | $254.15 | $254.15 | $81.07–$241.44 | 210% above | — |
| LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) | $254.15 | $254.15 | $18.52 | 210% above | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $235.95 | $235.95 | $6.89 | 279% above | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Other Outpatient | $235.95 | $235.95 | $6.89 | 279% above | — |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $235.95 | $235.95 | $75.27–$224.15 | 279% above | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $264.90 | $264.90 | $84.50–$251.65 | 471% above | — |
| Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani | $264.90 | $264.90 | $8.17 | 471% above | — |
| Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani Other Outpatient | $264.90 | $264.90 | $8.17 | 471% above | — |
| Lyme disease antibody test CPT 86618 Antibody; Borrelia burgdorferi (Lyme disease) | $170.56 | $170.56 | $17.03 | 109% above | — |
| Lyme disease antibody test CPT 86618 Antibody; Borrelia burgdorferi (Lyme disease) Other Outpatient | $170.56 | $170.56 | $17.03 | 109% above | — |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB QL | $170.56 | $170.56 | $54.41–$162.03 | 109% above | — |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $135.51 | $135.51 | $43.23–$128.73 | 207% above | — |
| Magnesium blood test CPT 83735 MAGNESIUM BLD | $146.29 | $146.29 | $46.67–$138.98 | 232% above | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $173.23 | $173.23 | $55.26–$164.57 | 201% above | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG | $173.23 | $173.23 | $55.26–$164.57 | 201% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening | $182.00 | $182.00 | $5.18 | 294% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE) | $182.00 | $182.00 | $58.06–$172.90 | 294% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening Other Outpatient | $182.00 | $182.00 | $5.18 | 294% above | — |
| Obstetric blood test panel CPT 80055 OB PANEL | $345.15 | $345.15 | $110.10–$327.89 | 55% above | — |
| Obstetric blood test panel CPT 80055 Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated Other Outpatient | $345.15 | $345.15 | $47.81 | 55% above | — |
| Obstetric blood test panel CPT 80055 Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated | $345.15 | $345.15 | $41.31–$5,020.05 | 55% above | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Other Outpatient | $347.86 | $347.86 | $18.39 | 324% above | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROS SPEC AG FREE | $347.86 | $347.86 | $110.97–$330.47 | 324% above | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free | $347.86 | $347.86 | $18.39 | 324% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA) TOTAL | $146.97 | $146.97 | $46.88–$139.62 | 63% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total | $146.97 | $146.97 | $18.39 | 63% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total Other Outpatient | $146.97 | $146.97 | $18.39 | 63% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAPDX TCSC NORSC TH | $124.71 | $124.71 | $39.78–$118.47 | 39% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision | $124.71 | $124.71 | $20.26 | 39% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision Other Outpatient | $124.71 | $124.71 | $20.26 | 39% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $439.51 | $439.51 | $140.20–$417.53 | 139% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone) Other Outpatient | $439.51 | $439.51 | $41.28 | 139% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone) | $439.51 | $439.51 | $41.28 | 139% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT); plasma or whole blood Other Outpatient | $201.54 | $201.54 | $6.01 | 322% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $201.54 | $201.54 | $64.29–$191.46 | 322% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT); plasma or whole blood | $201.54 | $201.54 | $5.19–$631.05 | 322% above | — |
| Progesterone blood test CPT 84144 Progesterone | $347.86 | $347.86 | $20.86 | 248% above | — |
| Progesterone blood test CPT 84144 PROGESTERONE | $347.86 | $347.86 | $110.97–$330.47 | 248% above | — |
| Progesterone blood test CPT 84144 Progesterone Other Outpatient | $347.86 | $347.86 | $20.86 | 248% above | — |
| Prolactin blood test CPT 84146 PROLACTIN | $248.73 | $248.73 | $79.34–$236.29 | 223% above | — |
| Prolactin blood test CPT 84146 Prolactin | $248.73 | $248.73 | $19.38 | 223% above | — |
| Prolactin blood test CPT 84146 Prolactin Other Outpatient | $248.73 | $248.73 | $19.38 | 223% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time; Other Outpatient | $185.37 | $185.37 | $4.29 | 638% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time; | $185.37 | $185.37 | $4.29 | 638% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $185.37 | $185.37 | $59.13–$176.10 | 638% above | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca Other Outpatient | $398.97 | $398.97 | $12.60 | 565% above | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca | $398.97 | $398.97 | $12.60 | 565% above | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR DOO MANUAL READ | $398.97 | $398.97 | $127.27–$379.02 | 565% above | — |
| Rheumatoid factor (RF) test CPT 86431 RA QN | $68.75 | $68.75 | $21.93–$65.31 | 130% above | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative | $68.75 | $68.75 | $5.67 | 130% above | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Other Outpatient | $68.75 | $68.75 | $5.67 | 130% above | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM | $89.66 | $89.66 | $28.60–$85.18 | 74% above | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB QUAL | $126.07 | $126.07 | $40.22–$119.77 | 144% above | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG | $173.23 | $173.23 | $55.26–$164.57 | 235% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated | $65.35 | $65.35 | $2.70 | 224% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated Other Outpatient | $65.35 | $65.35 | $2.70 | 224% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO | $65.35 | $65.35 | $20.85–$62.08 | 224% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o | $93.01 | $93.01 | $4.38 | 390% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o Other Outpatient | $93.01 | $93.01 | $4.38 | 390% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD SCN 3 SPEC | $93.01 | $93.01 | $29.67–$88.36 | 390% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLD CRC IA | $204.94 | $204.94 | $65.38–$194.69 | 189% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations Other Outpatient | $204.94 | $204.94 | $15.92 | 189% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations | $204.94 | $204.94 | $15.92 | 189% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF QUAL | $113.24 | $113.24 | $36.12–$107.58 | 303% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL | $122.02 | $122.02 | $38.92–$115.92 | 334% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GAMMA INTERFERON RESP | $375.00 | $375.00 | $119.63–$356.25 | 64% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon | $375.00 | $375.00 | $61.98 | 64% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon Other Outpatient | $375.00 | $375.00 | $61.98 | 64% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; total Other Outpatient | $409.86 | $409.86 | $25.81 | 256% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; total | $409.86 | $409.86 | $25.81 | 256% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $409.86 | $409.86 | $130.75–$389.37 | 256% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICRO AB | $138.19 | $138.19 | $44.08–$131.28 | 95% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID MICROSOMAL AB | $221.14 | $221.14 | $70.54–$210.08 | 212% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $252.81 | $252.81 | $80.65–$240.17 | 256% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH) Other Outpatient | $138.19 | $138.19 | $16.80 | 81% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $138.19 | $138.19 | $44.08–$131.28 | 81% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH) | $138.19 | $138.19 | $16.80 | 81% above | — |
| Uric acid blood test CPT 84550 URIC ACID BLD | $126.07 | $126.07 | $40.22–$119.77 | 410% above | — |
| Uric acid blood test CPT 84550 Uric acid; blood | $126.07 | $126.07 | $4.52 | 410% above | — |
| Uric acid blood test CPT 84550 Uric acid; blood Other Outpatient | $126.07 | $126.07 | $4.52 | 410% above | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w | $208.30 | $208.30 | $3.17 | 1223% above | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w Other Outpatient | $208.30 | $208.30 | $3.17 | 1223% above | — |
| Urinalysis with microscope exam, automated CPT 81001 UA W MICRO AUTO | $208.30 | $208.30 | $66.45–$197.88 | 1223% above | — |
| Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO | $86.93 | $86.93 | $27.73–$82.58 | 583% above | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w Other Outpatient | $86.93 | $86.93 | $2.25 | 583% above | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w | $86.93 | $86.93 | $2.25 | 583% above | — |
| Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine | $318.18 | $318.18 | $8.07 | 504% above | — |
| Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR | $318.18 | $318.18 | $101.50–$302.27 | 504% above | — |
| Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine Other Outpatient | $318.18 | $318.18 | $8.07 | 504% above | — |
| Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL BY DOO | $141.53 | $141.53 | $45.15–$134.45 | 272% above | — |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods | $141.53 | $141.53 | $8.61 | 272% above | — |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods Other Outpatient | $141.53 | $141.53 | $8.61 | 272% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Other Outpatient | $283.79 | $283.79 | $15.08 | 285% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); | $283.79 | $283.79 | $15.08 | 285% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $283.79 | $283.79 | $90.53–$269.60 | 285% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed | $175.00 | $175.00 | $29.60 | 109% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed Other Outpatient | $175.00 | $175.00 | $29.60 | 109% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D3 25-OH | $175.00 | $175.00 | $55.83–$166.25 | 109% above | — |
| Zinc blood test CPT 84630 Zinc Other Outpatient | $111.91 | $111.91 | $11.39 | 66% above | — |
| Zinc blood test CPT 84630 Zinc | $111.91 | $111.91 | $11.39 | 66% above | — |
| Zinc blood test CPT 84630 ZINC BLOOD | $111.91 | $111.91 | $35.70–$106.31 | 66% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (hCG); quantitative Other Outpatient | $111.22 | $111.22 | $15.05 | 36% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE | $111.22 | $111.22 | $35.48–$105.66 | 36% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (hCG); quantitative | $111.22 | $111.22 | $15.05 | 36% above | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Idaho | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion, elective, electrical conversion of arrhythmia; external | $4,618.53 | $4,618.53 | $125.50–$1,686.05 | 213% above | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL | $4,618.53 | $4,618.53 | $1,473.31–$4,387.60 | 213% above | — |
| Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including | $129,688.20 | $129,688.20 | $34,937.00 | 109% above | — |
| Catheter ablation for atrial fibrillation CPT 93656 COM EP REPO CTH TX AFIB | $129,688.20 | $129,688.20 | $41,370.54–$123,203.79 | 109% above | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Idaho | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $2,446.25 | $2,446.25 | $780.35–$2,323.94 | 147% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion, blood or blood components | $2,446.25 | $2,446.25 | $9,305.00 | 147% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INH TX AC AWY OBST | $281.96 | $281.96 | $89.95–$267.86 | 32% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MINS | $7,558.43 | $7,558.43 | $2,411.14–$7,180.51 | 227% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | $7,558.43 | $7,558.43 | $250.04–$2,298.86 | 227% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AW & DROWSY | $1,201.00 | $1,201.00 | $383.12–$1,140.95 | at median | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram (EEG); including recording awake and drowsy | $1,201.00 | $1,201.00 | $329.83–$1,399.23 | at median | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $619.40 | $619.40 | $5.44–$158.46 | 255% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $619.40 | $619.40 | $197.59–$588.43 | 255% above | — |
| Electroconvulsive therapy (ECT), one session CPT 90870 Electroconvulsive therapy (includes necessary monitoring) | $3,700.52 | $3,700.52 | $149.31–$1,388.54 | — | — |
| Electroconvulsive therapy (ECT), one session CPT 90870 ECT WITH MONITORING | $3,700.52 | $3,700.52 | $1,180.47–$3,515.49 | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LVL 1 EMER DEPT | $763.40 | $763.40 | $243.52–$725.23 | 285% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making | $1,123.92 | $1,123.92 | $1,184.00 | 217% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LVL 2 EMER DEPT | $1,123.92 | $1,123.92 | $358.53–$1,067.72 | 217% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making | $2,044.86 | $2,044.86 | $4,078.00 | 234% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LVL 3 EMER DEPT | $2,044.86 | $2,044.86 | $652.31–$1,942.62 | 234% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LVL 4 EMER DEPT | $3,556.55 | $3,556.55 | $1,134.54–$3,378.72 | 255% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making | $3,556.55 | $3,556.55 | $4,078.00 | 255% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making | $4,741.10 | $4,741.10 | $6,569.00 | 227% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LVL 5 EMER DEPT | $4,741.10 | $4,741.10 | $1,512.41–$4,504.05 | 227% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $2,213.57 | $2,213.57 | $706.13–$2,102.89 | 191% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation an | $2,213.57 | $2,213.57 | $30.81–$813.14 | 191% above | — |
| Group psychotherapy session CPT 90853 IOP PSY GRP (NOT FAMILY) | $319.77 | $319.77 | $118.31–$303.78 | 19% above | — |
| Group psychotherapy session CPT 90853 IOP CD GRP (NOT FAMILY) | $319.77 | $319.77 | $118.31–$303.78 | 19% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INIT UP TO 1HR | $661.57 | $661.57 | $211.04–$628.49 | 91% above | — |
| IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HOUR | $752.18 | $752.18 | $239.95–$714.57 | 56% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ | $587.73 | $587.73 | $187.49–$558.34 | 417% above | — |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NP | $721.00 | $721.00 | $230.00–$684.95 | 355% above | — |
| New patient office visit, about 30 minutes CPT 99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When us | $721.00 | $721.00 | $105.65 | 355% above | — |
| New patient office visit, about 45 minutes CPT 99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. Wh | $901.00 | $901.00 | $159.87 | 257% above | — |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NP | $901.00 | $901.00 | $287.42–$855.95 | 257% above | — |
| New patient office visit, about 60 minutes CPT 99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When u | $1,126.00 | $1,126.00 | $212.97 | 257% above | — |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NP | $1,126.00 | $1,126.00 | $359.19–$1,069.70 | 257% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 BASIC CARE NP | $462.00 | $462.00 | $147.38–$438.90 | 253% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT LEVEL 2 NP | $577.00 | $577.00 | $50.00 | 340% above | — |
| Occupational therapy evaluation, low complexity CPT 97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or | $343.40 | $343.40 | $92.60–$10,128.30 | 52% above | — |
| Occupational therapy evaluation, low complexity CPT 97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or Other Outpatient | $343.40 | $343.40 | $96.46 | 52% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination Other Outpatient | $353.84 | $353.84 | $94.00 | 53% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination | $353.84 | $353.84 | $90.24–$9,870.00 | 53% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st | $353.84 | $353.84 | $90.24–$9,870.00 | 76% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st Other Outpatient | $353.84 | $353.84 | $94.00 | 76% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o | $353.84 | $353.84 | $90.24–$9,870.00 | 57% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o Other Outpatient | $353.84 | $353.84 | $94.00 | 57% above | — |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 minutes with patient | $846.56 | $846.56 | $141.23–$413.04 | 145% above | — |
| Psychotherapy session, 60 minutes CPT 90837 INDIV SESSION 60MIN | $846.56 | $846.56 | $270.05–$804.23 | 145% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes | $171.48 | $171.48 | $12.51–$74.34 | 390% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKECESS 3-10 MIN | $171.48 | $171.48 | $54.70–$162.91 | 390% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 EST | $1,126.00 | $1,126.00 | $50.00 | 314% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision makin | $1,126.00 | $1,126.00 | $174.09 | 314% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making | $721.00 | $721.00 | $86.12 | 428% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 EST | $721.00 | $721.00 | $50.00 | 428% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 EST | $901.00 | $901.00 | $287.42–$855.95 | 348% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision m | $901.00 | $901.00 | $122.69 | 348% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 EST | $577.00 | $577.00 | $50.00 | 550% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision mak | $577.00 | $577.00 | $53.44 | 550% above | — |
| Speech and language evaluation CPT 92523 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language) Other Outpatient | $578.02 | $578.02 | $218.45 | 47% above | — |
| Speech and language evaluation CPT 92523 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language) | $578.02 | $578.02 | $203.15–$22,937.25 | 47% above | — |
| Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual Other Outpatient | $480.93 | $480.93 | $73.39 | 153% above | — |
| Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual | $480.93 | $480.93 | $70.45–$7,705.95 | 153% above | — |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $453.85 | $453.85 | $144.78–$431.16 | 88% above | — |
| Spirometry (breathing test) CPT 94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation | $453.85 | $453.85 | $23.76–$404.67 | 88% above | — |
| Spirometry before and after a bronchodilator CPT 94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration | $816.19 | $816.19 | $34.74–$813.14 | 59% above | — |
| Spirometry before and after a bronchodilator CPT 94060 BRONCH EV SPIR PRE/POST | $816.19 | $816.19 | $260.36–$775.38 | 59% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, therapeutic (separate procedure) | $493.27 | $493.27 | $77.41–$330.93 | 101% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEB | $493.27 | $493.27 | $157.35–$468.61 | 101% above | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Idaho | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX LIVE VAC SQ | $801.49 | $801.49 | $255.68–$761.42 | 228% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella virus vaccine (VAR), live, for subcutaneous use | $801.49 | $801.49 | $380.14 | 228% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use Other Outpatient | $42.70 | $42.70 | — | 19% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use | $42.70 | $42.70 | $38.31 | 19% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRI 0.5 ML PF IM | $42.70 | $42.70 | $13.62–$40.57 | 19% above | — |
| Hepatitis A vaccine, adult dose CPT 90632 HAVRIX ADULT 1 ML VAC IM | $341.96 | $341.96 | $109.09–$324.86 | 214% above | — |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A vaccine (HepA), adult dosage, for intramuscular use | $341.96 | $341.96 | $121.65 | 214% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use | $135.85 | $135.85 | $124.00 | 32% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use Other Outpatient | $135.85 | $135.85 | — | 32% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX ADLT 10MCG IM | $135.85 | $135.85 | $43.34–$129.06 | 32% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF IM | $183.75 | $183.75 | $58.62–$174.56 | 27% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use Other Outpatient | $183.75 | $183.75 | — | 27% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use | $183.75 | $183.75 | $161.96 | 27% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC LIVE SQ | $249.45 | $249.45 | $50.00 | 58% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use | $249.45 | $249.45 | $193.28 | 58% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO VAC IM | $794.03 | $794.03 | $253.30–$754.33 | 199% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use | $794.03 | $794.03 | $497.34 | 199% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use Other Outpatient | $272.91 | $272.91 | — | 83% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use | $272.91 | $272.91 | $220.23 | 83% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 VAC IMSQ | $272.91 | $272.91 | $87.06–$259.26 | 83% above | — |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine, for intramuscular use | $1,417.67 | $1,417.67 | $520.11 | 239% above | — |
| Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VAC IM | $1,417.67 | $1,417.67 | $452.24–$1,346.79 | 239% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC VAC >= 7 YRS IM | $185.27 | $185.27 | $50.00 | 139% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use | $185.27 | $185.27 | $63.94 | 139% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use | $155.01 | $155.01 | $65.14 | 106% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL VAC >= 7 YRS IM | $155.01 | $155.01 | $50.00 | 106% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid) | $267.88 | $267.88 | $17.79–$182.50 | 365% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN SGL | $267.88 | $267.88 | $85.45–$254.49 | 365% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDTL | $187.68 | $187.68 | $59.87–$178.30 | 421% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition | $187.68 | $187.68 | $12.96–$30.96 | 421% above | — |