Parkview Ortho Hospital
Parkview Ortho Hospital in Fort Wayne, IN publishes cash prices for 299 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 Indiana median for 146 of 297 procedures and below it for 133. By typical cash price it ranks #39 of 84 Indiana hospitals and #5 of 8 hospitals in the Fort Wayne, IN area, cheapest first. Select a procedure to compare it with other hospitals nearby.
11130 Parkview Circle Dr, Fort Wayne, IN 46845 Collected Oct 25, 2026 Source price file Check a bill from this hospital
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/WO CONTRAST | $942.50 | $1,885.00 | — | 31% below | 50% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W/WO CONTRAST | $942.50 | $1,885.00 | — | — | 50% |
| Abdominal X-ray, 2 views CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS | $296.00 | $592.00 | — | 10% above | 50% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS | $296.00 | $592.00 | — | — | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY-ANKLE MIN 3 VIEWS LT | $199.50 | $399.00 | — | 2% above | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY-ANKLE MIN 3 VIEWS RT | $199.50 | $399.00 | — | 2% above | 50% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY-ANKLE MIN 3 VIEWS LT | $199.50 | $399.00 | — | — | 50% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY-ANKLE MIN 3 VIEWS RT | $199.50 | $399.00 | — | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC U/S ANKLE/BRACHIAL INDEX | $599.00 | $1,198.00 | — | 63% above | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC U/S ANKLE/BRACHIAL INDEX | $599.00 | $1,198.00 | — | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT UPPER EXT W/O CONTRAST RT | $690.50 | $1,381.00 | — | 14% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT UPPER EXT W/O CONTRAST LT | $690.50 | $1,381.00 | — | 14% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT UPPER EXT W/O CONTRAST RT | $690.50 | $1,381.00 | — | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT UPPER EXT W/O CONTRAST LT | $690.50 | $1,381.00 | — | — | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC X-RAY EXAM ESOPHAGUS SINGLE CONT INC SCOUT FILMS STUDY | $483.50 | $967.00 | — | 4% above | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC X-RAY EXAM ESOPHAGUS SINGLE CONT INC SCOUT FILMS STUDY | $483.50 | $967.00 | — | — | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE RT | $449.50 | $899.00 | — | 4% above | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE LT | $449.50 | $899.00 | — | 4% above | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE RT | $449.50 | $899.00 | — | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE LT | $449.50 | $899.00 | — | — | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED LT | $360.00 | $720.00 | — | 11% above | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED RT | $360.00 | $720.00 | — | 11% above | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED RT | $360.00 | $720.00 | — | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED LT | $360.00 | $720.00 | — | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN & PELVIS | $1,985.00 | $3,970.00 | — | 5% above | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN & PELVIS | $1,985.00 | $3,970.00 | — | — | 50% |
| CT angiography (CTA) of the head CPT 70496 HC CTA-HEAD | $823.50 | $1,647.00 | — | 35% below | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CTA-HEAD | $823.50 | $1,647.00 | — | — | 50% |
| CT angiography (CTA) of the neck CPT 70498 HC CTA-NECK | $823.00 | $1,646.00 | — | 32% below | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA-NECK | $823.00 | $1,646.00 | — | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA-CHEST | $983.00 | $1,966.00 | — | 23% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA-CHEST | $983.00 | $1,966.00 | — | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART (COR/MORPH/CAL) | $858.50 | $1,717.00 | — | 2% above | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART (COR/MORPH/CAL) | $858.50 | $1,717.00 | — | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART W/O CON (CALC SCORE) | $297.00 | $594.00 | — | 59% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART W/O CON (CALC SCORE) | $297.00 | $594.00 | — | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST | $879.00 | $1,758.00 | — | 27% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELV/STONE W/O CONTR | $879.00 | $1,758.00 | — | 27% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST | $879.00 | $1,758.00 | — | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELV/STONE W/O CONTR | $879.00 | $1,758.00 | — | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELVIS W/CONTRAST | $1,470.00 | $2,940.00 | — | 15% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELVIS W/CONTRAST | $1,470.00 | $2,940.00 | — | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELVIS W/WO CONTRAST | $1,706.00 | $3,412.00 | — | at median | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELVIS W/WO CONTRAST | $1,706.00 | $3,412.00 | — | — | 50% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST | $812.00 | $1,624.00 | — | 24% below | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST | $812.00 | $1,624.00 | — | — | 50% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST | $671.50 | $1,343.00 | — | 21% below | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST | $671.50 | $1,343.00 | — | — | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SINUS WO CONTR | $411.50 | $823.00 | — | 51% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT FACE W/O CONTRAST | $536.50 | $1,073.00 | — | 36% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SINUS AXIALLY W/O CONTRAST | $536.50 | $1,073.00 | — | 36% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SINUS CORONALLY WO CONTRAST | $536.50 | $1,073.00 | — | 36% below | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SINUS WO CONTR | $411.50 | $823.00 | — | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SINUS CORONALLY WO CONTRAST | $536.50 | $1,073.00 | — | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT FACE W/O CONTRAST | $536.50 | $1,073.00 | — | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SINUS AXIALLY W/O CONTRAST | $536.50 | $1,073.00 | — | — | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD SCAN W/O CONTRAST | $541.00 | $1,082.00 | — | 29% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD ATTN ORBITS W/O CON | $541.00 | $1,082.00 | — | 29% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD ATTN IAC W/O CON | $541.00 | $1,082.00 | — | 29% below | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD ATTN IAC W/O CON | $541.00 | $1,082.00 | — | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD SCAN W/O CONTRAST | $541.00 | $1,082.00 | — | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD ATTN ORBITS W/O CON | $541.00 | $1,082.00 | — | — | 50% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD SCAN W/CONTRAST | $642.50 | $1,285.00 | — | 25% below | 50% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD SCAN W/CONTRAST | $642.50 | $1,285.00 | — | — | 50% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD ATTN ORBITS W/WO CON | $753.00 | $1,506.00 | — | 28% below | 50% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD SCAN W/WO CONTRAST | $753.00 | $1,506.00 | — | 28% below | 50% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD ATTN IAC W/WO CON | $753.00 | $1,506.00 | — | 28% below | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD ATTN IAC W/WO CON | $753.00 | $1,506.00 | — | — | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD ATTN ORBITS W/WO CON | $753.00 | $1,506.00 | — | — | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD SCAN W/WO CONTRAST | $753.00 | $1,506.00 | — | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE-STRGHT W/O CON | $723.50 | $1,447.00 | — | 18% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE-STRGHT W/O CON | $723.50 | $1,447.00 | — | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST | $571.00 | $1,142.00 | — | 31% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST | $571.00 | $1,142.00 | — | — | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONTRAST | $764.00 | $1,528.00 | — | 17% below | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/CONTRAST | $764.00 | $1,528.00 | — | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC U/S CAROTID DOPPLER BILATERAL | $902.50 | $1,805.00 | — | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC U/S CAROTID DOPPLER BILATERAL | $902.50 | $1,805.00 | — | — | 50% |
| Chest CT scan without and with contrast CPT 71270 HC CT CHEST W/WO CONTRAST | $1,004.00 | $2,008.00 | — | 8% below | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT CHEST W/WO CONTRAST | $1,004.00 | $2,008.00 | — | — | 50% |
| Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $215.50 | $431.00 | — | 5% above | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $215.50 | $431.00 | — | — | 50% |
| Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $163.00 | $326.00 | — | at median | 50% |
| Chest X-ray, single view inpatient CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $163.00 | $326.00 | — | — | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-RAY-CLAVICLE RT | $166.50 | $333.00 | — | 13% below | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-RAY-CLAVICLE LT | $166.50 | $333.00 | — | 13% below | 50% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-RAY-CLAVICLE LT | $166.50 | $333.00 | — | — | 50% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-RAY-CLAVICLE RT | $166.50 | $333.00 | — | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC U/S RETROPERITONEAL COMPLETE | $501.00 | $1,002.00 | — | at median | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC U/S RETROPERITONEAL COMPLETE | $501.00 | $1,002.00 | — | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA-BONE MINERAL ANALYSIS | $287.50 | $575.00 | — | 1% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA-BONE MINERAL ANALYSIS | $287.50 | $575.00 | — | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DEXA-BONE DENSITY PERIPHERAL | $150.50 | $301.00 | — | 4% above | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DEXA-BONE DENSITY PERIPHERAL | $150.50 | $301.00 | — | — | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC U/S MATERNITY LEVEL III INITIAL GESTATION | $840.50 | $1,681.00 | — | 49% above | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC U/S MATERNITY LEVEL III INITIAL GESTATION | $840.50 | $1,681.00 | — | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST W/O CONTRAST | $571.00 | $1,142.00 | — | 31% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST-HIGH RESOLUTION | $571.00 | $1,142.00 | — | 31% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST W/O CONTRAST | $571.00 | $1,142.00 | — | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST-HIGH RESOLUTION | $571.00 | $1,142.00 | — | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W/CONTRAST | $797.00 | $1,594.00 | — | 15% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W/CONTRAST | $797.00 | $1,594.00 | — | — | 50% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 HC U/S COLOR FLOW ART LOW EXT BIL | $974.00 | $1,948.00 | — | 4% above | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC U/S COLOR FLOW ART LOW EXT BIL | $974.00 | $1,948.00 | — | — | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HC U/S VENOUS IMAGING UP EXT BIL | $914.50 | $1,829.00 | — | 30% below | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HC U/S VENOUS IMAGING LWR EXT BIL | $914.50 | $1,829.00 | — | 30% below | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC U/S VENOUS IMAGING LWR EXT BIL | $914.50 | $1,829.00 | — | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC U/S VENOUS IMAGING UP EXT BIL | $914.50 | $1,829.00 | — | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC 2D&M-MODE W/SPCTRL & CF DPLR | $1,735.00 | $3,470.00 | — | 5% above | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC 2D&M-MODE W/SPCTRL & CF DPLR | $1,735.00 | $3,470.00 | — | — | 50% |
| Elbow X-ray, 2 views one side CPT 73070 HC X-RAY-ELBOW 2 VIEWS LT | $167.50 | $335.00 | — | 1% above | 50% |
| Elbow X-ray, 2 views one side CPT 73070 HC X-RAY-ELBOW 2 VIEWS RT | $167.50 | $335.00 | — | 1% above | 50% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-RAY-ELBOW 2 VIEWS RT | $167.50 | $335.00 | — | — | 50% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-RAY-ELBOW 2 VIEWS LT | $167.50 | $335.00 | — | — | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-RAY-ELBOW MIN 3 VIEWS LT | $208.00 | $416.00 | — | 19% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-RAY-ELBOW MIN 3 VIEWS RT | $208.00 | $416.00 | — | 19% below | 50% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-RAY-ELBOW MIN 3 VIEWS RT | $208.00 | $416.00 | — | — | 50% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-RAY-ELBOW MIN 3 VIEWS LT | $208.00 | $416.00 | — | — | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT IAC W/O CONTRAST | $633.00 | $1,266.00 | — | 26% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT W/O CONTRAST | $633.00 | $1,266.00 | — | 26% below | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT IAC W/O CONTRAST | $633.00 | $1,266.00 | — | — | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT W/O CONTRAST | $633.00 | $1,266.00 | — | — | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-RAY-FACIAL BONES 3+ VIEWS | $248.50 | $497.00 | — | 9% below | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-RAY-ZYGOMA 3+ VIEWS | $248.50 | $497.00 | — | 9% below | 50% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC X-RAY-ZYGOMA 3+ VIEWS | $248.50 | $497.00 | — | — | 50% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC X-RAY-FACIAL BONES 3+ VIEWS | $248.50 | $497.00 | — | — | 50% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-RAY-FOREARM 2 VIEWS LT | $163.50 | $327.00 | — | 11% below | 50% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-RAY-FOREARM 2 VIEWS RT | $163.50 | $327.00 | — | 11% below | 50% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-RAY-FOREARM 2 VIEWS RT | $163.50 | $327.00 | — | — | 50% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-RAY-FOREARM 2 VIEWS LT | $163.50 | $327.00 | — | — | 50% |
| Hand X-ray, 2 views both sides CPT 73120 HC X-RAY-HAND 1 VIEW BI | $241.50 | $483.00 | — | — | 50% |
| Hand X-ray, 2 views one side CPT 73120 HC X-RAY-HAND 2 VIEWS LT | $160.50 | $321.00 | — | 6% below | 50% |
| Hand X-ray, 2 views one side CPT 73120 HC X-RAY-HAND 2 VIEWS RT | $160.50 | $321.00 | — | 6% below | 50% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 HC X-RAY-HAND 1 VIEW BI | $241.50 | $483.00 | — | — | 50% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC X-RAY-HAND 2 VIEWS LT | $160.50 | $321.00 | — | — | 50% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC X-RAY-HAND 2 VIEWS RT | $160.50 | $321.00 | — | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY-OSCALCIS (HEEL) 2+ VIEWS LT | $177.00 | $354.00 | — | 17% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY-OSCALCIS (HEEL) 2+ VIEWS RT | $177.00 | $354.00 | — | 17% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY-OSCALCIS (HEEL) 2+ VIEWS LT | $177.00 | $354.00 | — | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY-OSCALCIS (HEEL) 2+ VIEWS RT | $177.00 | $354.00 | — | — | 50% |
| Knee X-ray, 3 views one side CPT 73562 HC X-RAY-KNEE THREE VIEWS LT | $208.00 | $416.00 | — | 9% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 HC X-RAY-KNEE THREE VIEWS RT | $208.00 | $416.00 | — | 9% below | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY-KNEE THREE VIEWS RT | $208.00 | $416.00 | — | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY-KNEE THREE VIEWS LT | $208.00 | $416.00 | — | — | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY-KNEE - 4 VWS OR MORE RT | $226.50 | $453.00 | — | 13% below | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY-KNEE - 4 VWS OR MORE LT | $226.50 | $453.00 | — | 13% below | 50% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY-KNEE - 4 VWS OR MORE RT | $226.50 | $453.00 | — | — | 50% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY-KNEE - 4 VWS OR MORE LT | $226.50 | $453.00 | — | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT LOWER EXT W/O CONTRAST LT | $574.00 | $1,148.00 | — | 27% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT LOWER EXT W/O CONTRAST RT | $574.00 | $1,148.00 | — | 27% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT LOWER EXT W/O CONTRAST RT | $574.00 | $1,148.00 | — | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT LOWER EXT W/O CONTRAST LT | $574.00 | $1,148.00 | — | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC U/S SOFT TISSUE ABDOMEN | $377.00 | $754.00 | — | 17% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC U/S ABDOMEN LIMITED | $459.00 | $918.00 | — | at median | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC U/S SOFT TISSUE ABDOMEN | $377.00 | $754.00 | — | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC U/S ABDOMEN LIMITED | $459.00 | $918.00 | — | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC U/S EXTR NON-VASC LMTD RT | $308.50 | $617.00 | — | 2% above | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC U/S EXTR NON-VASC LMTD LT | $308.50 | $617.00 | — | 2% above | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC U/S EXTR NON-VASC LMTD RT | $308.50 | $617.00 | — | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC U/S EXTR NON-VASC LMTD LT | $308.50 | $617.00 | — | — | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-RAY-TIBIA-FIBULA 2 VIEWS LT | $201.50 | $403.00 | — | 1% above | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-RAY-TIBIA-FIBULA 2 VIEWS RT | $201.50 | $403.00 | — | 1% above | 50% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-RAY-TIBIA-FIBULA 2 VIEWS LT | $201.50 | $403.00 | — | — | 50% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-RAY-TIBIA-FIBULA 2 VIEWS RT | $201.50 | $403.00 | — | — | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA-HEAD W/O CONTRAST | $807.00 | $1,614.00 | — | 28% below | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA-HEAD W/O CONTRAST | $807.00 | $1,614.00 | — | — | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST BILATERAL W/WO CON | $1,487.00 | $2,974.00 | — | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST BILATERAL W/WO CON | $1,487.00 | $2,974.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI HIP W/O CONTRAST | $561.50 | $1,123.00 | — | 45% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI-LOWER EXT JOINT W/O CON LT | $692.00 | $1,384.00 | — | 33% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI-LOWER EXT JOINT W/O CON RT | $692.00 | $1,384.00 | — | 33% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI-KNEE W/O CONTRAST LT | $692.00 | $1,384.00 | — | 33% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI-KNEE W/O CONTRAST RT | $692.00 | $1,384.00 | — | 33% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI HIP W/O CONTRAST | $561.50 | $1,123.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI-KNEE W/O CONTRAST RT | $692.00 | $1,384.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI-LOWER EXT JOINT W/O CON LT | $692.00 | $1,384.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI-LOWER EXT JOINT W/O CON RT | $692.00 | $1,384.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI-KNEE W/O CONTRAST LT | $692.00 | $1,384.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI-LOWER EXT JOINT W/WO CON L | $953.00 | $1,906.00 | — | 34% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI-LOWER EXT JOINT W/WO CON R | $953.00 | $1,906.00 | — | 34% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI-LOWER EXT JOINT W/WO CON L | $953.00 | $1,906.00 | — | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI-LOWER EXT JOINT W/WO CON R | $953.00 | $1,906.00 | — | — | 50% |
| MRI of the abdomen without contrast CPT 74181 HC MRI-MRCP | $515.50 | $1,031.00 | — | 52% below | 50% |
| MRI of the abdomen without contrast CPT 74181 HC MRI-ABDOMEN W/O CONTRAST | $868.00 | $1,736.00 | — | 19% below | 50% |
| MRI of the abdomen without contrast CPT 74181 HC MRI-ABDOMEN-MRCP W/O CONTRAST | $868.00 | $1,736.00 | — | 19% below | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-MRCP | $515.50 | $1,031.00 | — | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-ABDOMEN W/O CONTRAST | $868.00 | $1,736.00 | — | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-ABDOMEN-MRCP W/O CONTRAST | $868.00 | $1,736.00 | — | — | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI-ABDOMEN W/WO CONTRAST | $1,070.50 | $2,141.00 | — | 32% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI-ABDOMEN-MRCP W/WO CONTRAST | $1,070.50 | $2,141.00 | — | 32% below | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI-ABDOMEN W/WO CONTRAST | $1,070.50 | $2,141.00 | — | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI-ABDOMEN-MRCP W/WO CONTRAST | $1,070.50 | $2,141.00 | — | — | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI-CSF FLOW BRAIN W/O CONTRAST | $692.50 | $1,385.00 | — | 32% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI-BRAIN ATTN IAC WO CON | $692.50 | $1,385.00 | — | 32% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI-IAC W/O CON | $692.50 | $1,385.00 | — | 32% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI-BRAIN W/O CONTRAST | $692.50 | $1,385.00 | — | 32% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI-BRAIN & CSF FLOW STUDY W/O CONTRAST | $692.50 | $1,385.00 | — | 32% below | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-BRAIN ATTN IAC WO CON | $692.50 | $1,385.00 | — | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-BRAIN W/O CONTRAST | $692.50 | $1,385.00 | — | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-CSF FLOW BRAIN W/O CONTRAST | $692.50 | $1,385.00 | — | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-BRAIN & CSF FLOW STUDY W/O CONTRAST | $692.50 | $1,385.00 | — | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-IAC W/O CON | $692.50 | $1,385.00 | — | — | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN W/WO CONTRAST | $938.50 | $1,877.00 | — | 28% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI- IAC W/WO CON | $938.50 | $1,877.00 | — | 28% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN ATN PITUTRY W/WO CON | $938.50 | $1,877.00 | — | 28% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN ATTN IAC W/WO CON | $938.50 | $1,877.00 | — | 28% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN & CSF FLOW STUDY W/WO CONTRAST | $938.50 | $1,877.00 | — | 28% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN ATTN ORBITS W/WO CON | $938.50 | $1,877.00 | — | 28% below | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN ATTN ORBITS W/WO CON | $938.50 | $1,877.00 | — | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI- IAC W/WO CON | $938.50 | $1,877.00 | — | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN & CSF FLOW STUDY W/WO CONTRAST | $938.50 | $1,877.00 | — | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN ATTN IAC W/WO CON | $938.50 | $1,877.00 | — | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN ATN PITUTRY W/WO CON | $938.50 | $1,877.00 | — | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN W/WO CONTRAST | $938.50 | $1,877.00 | — | — | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-SPINE SURVEY LUM W/O CON | $248.00 | $496.00 | — | 76% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-PRE-VERTEBROPLASTY LUMBAR | $850.00 | $1,700.00 | — | 16% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-LUMBAR SPINE W/O CONTRAST | $850.00 | $1,700.00 | — | 16% below | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-SPINE SURVEY LUM W/O CON | $248.00 | $496.00 | — | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-LUMBAR SPINE W/O CONTRAST | $850.00 | $1,700.00 | — | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-PRE-VERTEBROPLASTY LUMBAR | $850.00 | $1,700.00 | — | — | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI-SPINE SURVEY LUM W/WO CON | $347.50 | $695.00 | — | 76% below | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI-LUMBAR SPINE W/WO CONTRAST | $1,034.50 | $2,069.00 | — | 29% below | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI-SPINE SURVEY LUM W/WO CON | $347.50 | $695.00 | — | — | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI-LUMBAR SPINE W/WO CONTRAST | $1,034.50 | $2,069.00 | — | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI-SPINE SURVEY THOR W/O CON | $275.50 | $551.00 | — | 73% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI-THORACIC SPINE W/O CON | $850.00 | $1,700.00 | — | 15% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI-SPINE SURVEY THOR W/O CON | $275.50 | $551.00 | — | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI-THORACIC SPINE W/O CON | $850.00 | $1,700.00 | — | — | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI-SPINE SURVEY CERV W/WO CON | $347.50 | $695.00 | — | 76% below | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI-CERVICAL SPINE W/WO CON | $1,388.00 | $2,776.00 | — | 5% below | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI-SPINE SURVEY CERV W/WO CON | $347.50 | $695.00 | — | — | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI-CERVICAL SPINE W/WO CON | $1,388.00 | $2,776.00 | — | — | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-SPINE SURVEY CERV W/O CON | $248.00 | $496.00 | — | 76% below | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-CERVICAL SPINE W/O CON | $786.00 | $1,572.00 | — | 25% below | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-CERV SPINE & CSF FLOW STUDY W/O CON | $786.00 | $1,572.00 | — | 25% below | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-SPINE SURVEY CERV W/O CON | $248.00 | $496.00 | — | — | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-CERVICAL SPINE W/O CON | $786.00 | $1,572.00 | — | — | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-CERV SPINE & CSF FLOW STUDY W/O CON | $786.00 | $1,572.00 | — | — | 50% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI-PELVIS W/WO CONTRAST | $1,106.00 | $2,212.00 | — | 24% below | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI-PELVIS W/WO CONTRAST | $1,106.00 | $2,212.00 | — | — | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI-PELVIS W/O CONTRAST | $764.50 | $1,529.00 | — | 27% below | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI-PELVIS W/O CONTRAST | $764.50 | $1,529.00 | — | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI-UPPER EXT JOINT W/O CON RT | $680.50 | $1,361.00 | — | 36% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI-UPPER EXT JOINT W/O CON LT | $680.50 | $1,361.00 | — | 36% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI-SHOULDER W/O CONTRAST LT | $680.50 | $1,361.00 | — | 36% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI-SHOULDER W/O CONTRAST RT | $680.50 | $1,361.00 | — | 36% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI-SHOULDER W/O CONTRAST RT | $680.50 | $1,361.00 | — | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI-UPPER EXT JOINT W/O CON LT | $680.50 | $1,361.00 | — | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI-SHOULDER W/O CONTRAST LT | $680.50 | $1,361.00 | — | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI-UPPER EXT JOINT W/O CON RT | $680.50 | $1,361.00 | — | — | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC X-RAY-CERVICAL SPINE MIN 4-5 VIEWS | $302.00 | $604.00 | — | 13% below | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC X-RAY-CERVICAL SPINE MIN 4-5 VIEWS | $302.00 | $604.00 | — | — | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK W/CONTRAST | $643.50 | $1,287.00 | — | 34% below | 50% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK W/CONTRAST | $643.50 | $1,287.00 | — | — | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK W/O CONTRAST | $545.00 | $1,090.00 | — | 35% below | 50% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT NECK W/O CONTRAST | $545.00 | $1,090.00 | — | — | 50% |
| Neck soft tissue X-ray CPT 70360 HC X-RAY-NECK (SOFT TISSUE) | $166.00 | $332.00 | — | 4% below | 50% |
| Neck soft tissue X-ray inpatient CPT 70360 HC X-RAY-NECK (SOFT TISSUE) | $166.00 | $332.00 | — | — | 50% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONTRAST | $594.00 | $1,188.00 | — | 29% below | 50% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O CONTRAST | $594.00 | $1,188.00 | — | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC U/S SOFT TISSUE PELVIS | $423.00 | $846.00 | — | 18% above | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC U/S PELVIC LIMITED | $423.00 | $846.00 | — | 18% above | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC U/S SOFT TISSUE PELVIS | $423.00 | $846.00 | — | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC U/S PELVIC LIMITED | $423.00 | $846.00 | — | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC U/S PELVIC | $453.00 | $906.00 | — | 2% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC U/S PELVIC | $453.00 | $906.00 | — | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC U/S MATERNITY > 14 WEEKS INITIAL GESTATION | $641.50 | $1,283.00 | — | 16% above | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC U/S MATERNITY > 14 WEEKS INITIAL GESTATION | $641.50 | $1,283.00 | — | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC U/S MATERNITY < 14 WEEKS INITIAL GESTATION | $616.00 | $1,232.00 | — | 20% above | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC U/S MATERNITY < 14 WEEKS INITIAL GESTATION | $616.00 | $1,232.00 | — | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC U/S MATERNITY LIMITED 1 OR MORE FETUS(S) | $512.50 | $1,025.00 | — | 34% above | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC U/S MATERNITY LIMITED 1 OR MORE FETUS(S) | $512.50 | $1,025.00 | — | — | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC X-RAY-RIBS 2 VIEWS UNILATERAL LT | $202.00 | $404.00 | — | 1% below | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC X-RAY-RIBS 2 VIEWS UNILATERAL RT | $202.00 | $404.00 | — | 1% below | 50% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-RAY-RIBS 2 VIEWS UNILATERAL RT | $202.00 | $404.00 | — | — | 50% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-RAY-RIBS 2 VIEWS UNILATERAL LT | $202.00 | $404.00 | — | — | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY-RIBS UNILAT W/PA CHEST L 3+ VIEWS | $245.50 | $491.00 | — | 1% above | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY-RIBS UNILAT W/PA CHEST R 3+ VIEWS | $245.50 | $491.00 | — | 1% above | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-RAY-RIBS UNILAT W/PA CHEST L 3+ VIEWS | $245.50 | $491.00 | — | — | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-RAY-RIBS UNILAT W/PA CHEST R 3+ VIEWS | $245.50 | $491.00 | — | — | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY-SHOULDER MIN 2 VIEWS RT | $209.00 | $418.00 | — | at median | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY-SHOULDER MIN 2 VIEWS LT | $209.00 | $418.00 | — | at median | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY-SHOULDER MIN 2 VIEWS LT | $209.00 | $418.00 | — | — | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY-SHOULDER MIN 2 VIEWS RT | $209.00 | $418.00 | — | — | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC X-RAY-PARANASAL SINUSES MIN 3 VIEWS | $274.50 | $549.00 | — | 3% below | 50% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC X-RAY-PARANASAL SINUSES MIN 3 VIEWS | $274.50 | $549.00 | — | — | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY-SKULL 3 OR LESS VIEWS | $203.00 | $406.00 | — | 13% below | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC X-RAY-SKULL 3 OR LESS VIEWS | $203.00 | $406.00 | — | — | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC X-RAY-REHAB ESOPHOGRAM | $461.00 | $922.00 | — | 27% above | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC X-RAY-REHAB ESOPHOGRAM | $461.00 | $922.00 | — | — | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC X-RAY-FEMUR 2 VIEWS LT | $207.50 | $415.00 | — | 3% above | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC X-RAY-FEMUR 2 VIEWS RT | $207.50 | $415.00 | — | 3% above | 50% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC X-RAY-FEMUR 2 VIEWS RT | $207.50 | $415.00 | — | — | 50% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC X-RAY-FEMUR 2 VIEWS LT | $207.50 | $415.00 | — | — | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONTRAST | $742.50 | $1,485.00 | — | 13% below | 50% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE W/O CONTRAST | $742.50 | $1,485.00 | — | — | 50% |
| Toe X-ray, 2 or more views one side CPT 73660 HC X-RAY-TOE 2+ VIEWS RT | $110.50 | $221.00 | — | 28% below | 50% |
| Toe X-ray, 2 or more views one side CPT 73660 HC X-RAY-TOE 2+ VIEWS LT | $110.50 | $221.00 | — | 28% below | 50% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-RAY-TOE 2+ VIEWS RT | $110.50 | $221.00 | — | — | 50% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-RAY-TOE 2+ VIEWS LT | $110.50 | $221.00 | — | — | 50% |
| Transvaginal pelvic ultrasound CPT 76830 HC U/S TRANSVAGINAL NON-MATERNITY | $357.50 | $715.00 | — | 12% below | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC U/S TRANSVAGINAL NON-MATERNITY | $357.50 | $715.00 | — | — | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC U/S TRANSVAGINAL MATERNITY | $458.50 | $917.00 | — | 24% above | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC U/S TRANSVAGINAL MATERNITY | $458.50 | $917.00 | — | — | 50% |
| Ultrasound of the abdomen, complete CPT 76700 HC U/S ABDOMEN COMPLETE | $435.00 | $870.00 | — | 17% below | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC U/S ABDOMEN COMPLETE | $435.00 | $870.00 | — | — | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 HC U/S TESTICULAR | $423.00 | $846.00 | — | at median | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC U/S TESTICULAR | $423.00 | $846.00 | — | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC U/S NECK OR HEAD - SOFT TISSUE | $360.00 | $720.00 | — | 16% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC U/S THYROID | $450.00 | $900.00 | — | 6% above | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC U/S NECK OR HEAD - SOFT TISSUE | $360.00 | $720.00 | — | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC U/S THYROID | $450.00 | $900.00 | — | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-RAY UPPER GI SINGLE CONTRAST W/O KUB | $537.00 | $1,074.00 | — | 2% above | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-RAY UPPER GI SINGLE CONTRAST W/O KUB | $537.00 | $1,074.00 | — | — | 50% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-RAY-HUMERUS MIN 2 VIEWS LT | $199.50 | $399.00 | — | 4% above | 50% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-RAY-HUMERUS MIN 2 VIEWS RT | $199.50 | $399.00 | — | 4% above | 50% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-RAY-HUMERUS MIN 2 VIEWS RT | $199.50 | $399.00 | — | — | 50% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-RAY-HUMERUS MIN 2 VIEWS LT | $199.50 | $399.00 | — | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC U/S VENOUS IMAGING LOW EXT UNI | $634.50 | $1,269.00 | — | at median | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC U/S VENOUS IMAGING UP EXT UNI | $634.50 | $1,269.00 | — | at median | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC U/S VENOUS IMAGING LOW EXT UNI | $634.50 | $1,269.00 | — | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC U/S VENOUS IMAGING UP EXT UNI | $634.50 | $1,269.00 | — | — | 50% |
| Wrist X-ray, 2 views one side CPT 73100 HC X-RAY-WRIST 2 VIEWS RT | $157.50 | $315.00 | — | 1% above | 50% |
| Wrist X-ray, 2 views one side CPT 73100 HC X-RAY-WRIST 2 VIEWS LT | $157.50 | $315.00 | — | 1% above | 50% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-RAY-WRIST 2 VIEWS RT | $157.50 | $315.00 | — | — | 50% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-RAY-WRIST 2 VIEWS LT | $157.50 | $315.00 | — | — | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY-WRIST W/CARPAL SERIES RT | $177.00 | $354.00 | — | 31% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY-WRIST 3 VIEWS LT | $177.00 | $354.00 | — | 31% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY-WRIST W/CARPAL SERIES LT | $177.00 | $354.00 | — | 31% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY-CARPAL SERIES 3+ VIEWS LT | $177.00 | $354.00 | — | 31% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY-WRIST 3 VIEWS RT | $177.00 | $354.00 | — | 31% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY-CARPAL SERIES 3+ VIEWS RT | $177.00 | $354.00 | — | 31% below | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY-WRIST 3 VIEWS LT | $177.00 | $354.00 | — | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY-WRIST W/CARPAL SERIES LT | $177.00 | $354.00 | — | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY-CARPAL SERIES 3+ VIEWS RT | $177.00 | $354.00 | — | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY-WRIST 3 VIEWS RT | $177.00 | $354.00 | — | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY-WRIST W/CARPAL SERIES RT | $177.00 | $354.00 | — | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY-CARPAL SERIES 3+ VIEWS LT | $177.00 | $354.00 | — | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS LT | $207.50 | $415.00 | — | 22% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS RT | $207.50 | $415.00 | — | 22% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS LT | $207.50 | $415.00 | — | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS RT | $207.50 | $415.00 | — | — | 50% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $204.00 | $408.00 | — | 6% below | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $204.00 | $408.00 | — | — | 50% |
| X-ray of the ankle, 2 views both sides CPT 73600 HC X-RAY-ANKLE 1 VIEW BI | $252.50 | $505.00 | — | — | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY-ANKLE 2 VIEWS LT | $162.50 | $325.00 | — | 2% above | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY-ANKLE 2 VIEWS RT | $162.50 | $325.00 | — | 2% above | 50% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC X-RAY-ANKLE 1 VIEW BI | $252.50 | $505.00 | — | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY-ANKLE 2 VIEWS RT | $162.50 | $325.00 | — | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY-ANKLE 2 VIEWS LT | $162.50 | $325.00 | — | — | 50% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY-FINGER 2+ VIEWS RT | $110.50 | $221.00 | — | 31% below | 50% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY-FINGER 2+ VIEWS LT | $110.50 | $221.00 | — | 31% below | 50% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY-FINGER 2+ VIEWS LT | $110.50 | $221.00 | — | — | 50% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY-FINGER 2+ VIEWS RT | $110.50 | $221.00 | — | — | 50% |
| X-ray of the foot, 2 views both sides CPT 73620 HC X-RAY-FOOT 1 VIEW BI | $252.50 | $505.00 | — | — | 50% |
| X-ray of the foot, 2 views one side CPT 73620 HC X-RAY-FOOT 2 VIEWS RT | $170.00 | $340.00 | — | 4% above | 50% |
| X-ray of the foot, 2 views one side CPT 73620 HC X-RAY-FOOT 2 VIEWS LT | $170.00 | $340.00 | — | 4% above | 50% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 HC X-RAY-FOOT 1 VIEW BI | $252.50 | $505.00 | — | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY-FOOT 2 VIEWS RT | $170.00 | $340.00 | — | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY-FOOT 2 VIEWS LT | $170.00 | $340.00 | — | — | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY-FOOT 3 OR MORE VIEWS RT | $205.50 | $411.00 | — | 2% above | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY-FOOT 3 OR MORE VIEWS LT | $205.50 | $411.00 | — | 2% above | 50% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY-FOOT 3 OR MORE VIEWS LT | $205.50 | $411.00 | — | — | 50% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY-FOOT 3 OR MORE VIEWS RT | $205.50 | $411.00 | — | — | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY-HAND MIN 3 VIEWS RT | $200.00 | $400.00 | — | 1% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY-HAND MIN 3 VIEWS LT | $200.00 | $400.00 | — | 1% below | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY-HAND MIN 3 VIEWS RT | $200.00 | $400.00 | — | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY-HAND MIN 3 VIEWS LT | $200.00 | $400.00 | — | — | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY-KNEE SINGLE VIEW LT | $174.00 | $348.00 | — | 17% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY-KNEE SINGLE VIEW RT | $174.00 | $348.00 | — | 17% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY-KNEE TWO VIEWS RT | $174.00 | $348.00 | — | 17% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY-KNEE TWO VIEWS LT | $174.00 | $348.00 | — | 17% below | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY-KNEE TWO VIEWS RT | $174.00 | $348.00 | — | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY-KNEE TWO VIEWS LT | $174.00 | $348.00 | — | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY-KNEE SINGLE VIEW RT | $174.00 | $348.00 | — | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY-KNEE SINGLE VIEW LT | $174.00 | $348.00 | — | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY-LS SPINE 2 OR 3 VIEWS | $246.00 | $492.00 | — | 2% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY-LS SPINE FLEX & EXT ONLY | $246.00 | $492.00 | — | 2% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY-LS SPINE 2 OR 3 VIEWS | $246.00 | $492.00 | — | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY-LS SPINE FLEX & EXT ONLY | $246.00 | $492.00 | — | — | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY-LS SPINE MIN 4 VIEWS | $325.50 | $651.00 | — | 6% below | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-RAY-LS SPINE MIN 4 VIEWS | $325.50 | $651.00 | — | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY-THORACIC SPINE 2 VIEWS | $224.00 | $448.00 | — | 4% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-RAY-THORACIC SPINE 2 VIEWS | $224.00 | $448.00 | — | — | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY-NASAL BONES 3+ VIEWS | $208.50 | $417.00 | — | 3% above | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-RAY-NASAL BONES 3+ VIEWS | $208.50 | $417.00 | — | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-RAY-CERV SPINE-FLEX & EXT 2-3 VIEWS | $217.50 | $435.00 | — | 13% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-RAY-CERV SPINE 2 OR 3 VIEWS | $217.50 | $435.00 | — | 13% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC X-RAY-CERV SPINE 2 OR 3 VIEWS | $217.50 | $435.00 | — | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC X-RAY-CERV SPINE-FLEX & EXT 2-3 VIEWS | $217.50 | $435.00 | — | — | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY-PELVIS 1 OR 2 VIEWS | $201.50 | $403.00 | — | 3% above | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY-PELVIS RADIUM 1-2 VIEWS | $201.50 | $403.00 | — | 3% above | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY-PELVIS 1 OR 2 VIEWS | $201.50 | $403.00 | — | — | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY-PELVIS RADIUM 1-2 VIEWS | $201.50 | $403.00 | — | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY-SACRUM / COCCYX 2+ VIEWS | $208.00 | $416.00 | — | 5% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-RAY-SACRUM / COCCYX 2+ VIEWS | $208.00 | $416.00 | — | — | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC ACTH | $196.50 | $393.00 | — | 21% below | 50% |
| ACTH blood test inpatient CPT 82024 HC ACTH | $196.50 | $393.00 | — | — | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT (SGPT) | $28.00 | $56.00 | — | 2% above | 50% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT (SGPT) | $28.00 | $56.00 | — | — | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST (SGOT) | $29.00 | $58.00 | — | at median | 50% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST (SGOT) | $29.00 | $58.00 | — | — | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL | $356.00 | $712.00 | — | 13% above | 50% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL | $356.00 | $712.00 | — | — | 50% |
| Albumin blood test CPT 82040 HC 9510-ALBUMIN | $21.00 | $42.00 | — | 8% below | 50% |
| Albumin blood test CPT 82040 HC ALBUMIN | $21.00 | $42.00 | — | 8% below | 50% |
| Albumin blood test inpatient CPT 82040 HC 9510-ALBUMIN | $21.00 | $42.00 | — | — | 50% |
| Albumin blood test inpatient CPT 82040 HC ALBUMIN | $21.00 | $42.00 | — | — | 50% |
| Aldosterone blood test CPT 82088 HC ALDOSTERONE SERUM | $215.00 | $430.00 | — | 4% above | 50% |
| Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE SERUM | $215.00 | $430.00 | — | — | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE TOTAL | $32.00 | $64.00 | — | at median | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC PHOSPHATASE ALK | $32.00 | $64.00 | — | at median | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC APBS- ALK PHOS BONE SPECIFIC | $32.00 | $64.00 | — | at median | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC APBS- ALK PHOS BONE SPECIFIC | $32.00 | $64.00 | — | — | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE TOTAL | $32.00 | $64.00 | — | — | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC PHOSPHATASE ALK | $32.00 | $64.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ASGE ASPERGILLUS IGE PANEL | $8.50 | $17.00 | — | 56% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RAGWEED WESTERN IGE | $46.08 | $92.15 | — | 140% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RUSSIAN THISTLE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CUCUMBER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RICE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SESAME SEED IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RHIZOPUS NIGRICANS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RAGWEED GIANT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG POTATO IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PORK IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PIGWEED IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PECAN NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PECAN HICKORY TREE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PEANUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PEACH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PEA IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG P.NOTATUM IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GRAPE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ORANGE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG REDTOP BENTGRASS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ONION IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HAZEL NUT TREE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG OAT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MUSTARD SEED IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG OAK IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MACADAMIA NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MUGWORT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ISOCYANATE HDI IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MUCOR RACEMOSUS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MILK IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MARSH ELDER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MAPLE RED IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HORSE EPITHELIAL IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG LOBSTER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG JOHNSON GRASS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG LETTUCE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG JUNE KENTUCKY BLUE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG LAMBS QRTR WEED IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MALT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG LACTALBUMIN ALPHA IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ASPERGILLUS NIGER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG KOCHIA FIREBUSH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PEAR IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HOUSE DUST GREER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG YELLOW JACKET IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HAZEL NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PINEAPPLE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GLUTEN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG YELLOW FACED HORNET IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GARLIC IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SWEET POTATO IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ENGLISH PLANTAIN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CHEESE CHEDDAR IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WHITE FACED HORNET IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ELM IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CHICKEN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CHOCOLATE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CLAM IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COCKLEBUR IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CODFISH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CORN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COTTONWOOD IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CRAB IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG D.FARINAE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG D.PTERON IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG EGG YOLK IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WHEY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG THYME IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC LATEX ALLERGEN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SCALLOP IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SAGE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RAGWEED SHORT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WATERMELON IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PISTACHIO NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RED DYE #4 IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PINE NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MEADOW FESCUE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ORCHARD GRASS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RYE GRASS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG TIMOTHY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG A.FUMIGATUS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ALTERNARIA IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RASPBERRY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PENICILLIN V IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AGMS1 - MAPLE SUGAR TREE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PENICILLIN G IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG NETTLE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PARSLEY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PAPRIKA IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG PAPER WASP IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG OYSTER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG OREGANO IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MULBERRY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG NUTMEG IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BEECH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BIRCH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BOX ELDER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG C.HERBARUM IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MT JUNIPER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MACKEREL IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GOOSE FEATHERS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BELL PEPPER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WHEAT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG EGGPLANT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WALNUT TREE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BLACKBERRY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WALNUT NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG MUSHROOM IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG TURKEY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CINNAMON IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG TUNA IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BROCCOLI IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG TOMATO IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COFFEE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SYCAMORE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG KIWI IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG STRAWBERRY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SOYBEAN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SHRIMP IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COTTON SEED IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SHEEP SORREL IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COW DANDER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG SALMON IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CRANBERRY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG RYE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COCONUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG YEAST BAKERS-BREWERS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CELERY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG DUCK FEATHERS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WILLOW IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG FIRE ANT (INVICTA) | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WHITE PINE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WHITE ASH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ISOCYANATE TDI IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ISOCYANATE MDI IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GUINEA PIG EPITH IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HONEYBEE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG LEMON IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HELMINTHOS POR HALODES IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BLUEBERRY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HALIBUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GREEN BEAN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GINGER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG FLOUNDER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BAHIA GRASS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG EGG WHOLE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BLUE MUSSEL IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG EGG WHITE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG GRAPEFRUIT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG DOG DANDER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG DILL IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CEDAR IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BRAZIL NUT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BEAN RED KIDNEY IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BLACK PEPPER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CABBAGE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BASIL IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BEAN WHITE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG AMOXICILLIN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG AVOCADO IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BEEF (FOOD) IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BERMUDA GRASS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BARLEY (FOOD) IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CAND.ALBICANS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CARROT IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CASEIN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CASHEW IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BUMBLEBEE IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG BANANA (FOOD) IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CAT DANDER IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG APPLE (FOOD) IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CHICKEN FEATHERS IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG ALMOND (FOOD) IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG COCKROACH GERMAN IGE | $51.50 | $103.00 | — | 168% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG WORMWOOD SAGEBRUSH IGE | $54.00 | $108.00 | — | 181% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG VIRGINIA LIVE OAK IGE | $54.00 | $108.00 | — | 181% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC CURVULARIA SPICIFERA / BIPOLARIS IGE | $54.00 | $108.00 | — | 181% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG CORN-MAIZE IGE | $54.00 | $108.00 | — | 181% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC AG HOUSE DUT-HOLL IGE | $54.00 | $108.00 | — | 181% above | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ASGE ASPERGILLUS IGE PANEL | $8.50 | $17.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RAGWEED WESTERN IGE | $46.08 | $92.15 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BERMUDA GRASS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC LATEX ALLERGEN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RED DYE #4 IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AGMS1 - MAPLE SUGAR TREE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PAPRIKA IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MT JUNIPER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG LEMON IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GREEN BEAN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GRAPEFRUIT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CEDAR IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CABBAGE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG AVOCADO IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG EGGPLANT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MUSHROOM IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BROCCOLI IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG KIWI IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COW DANDER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COCONUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SESAME SEED IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG REDTOP BENTGRASS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MUSTARD SEED IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ISOCYANATE HDI IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ASPERGILLUS NIGER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG YELLOW JACKET IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG YELLOW FACED HORNET IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WHITE FACED HORNET IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG THYME IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SCALLOP IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SAGE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RAGWEED SHORT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PISTACHIO NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PINE NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PENICILLIN V IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PENICILLIN G IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PARSLEY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PAPER WASP IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG OYSTER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG OREGANO IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG NUTMEG IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MACKEREL IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ISOCYANATE TDI IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ISOCYANATE MDI IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HONEYBEE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HELMINTHOS POR HALODES IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HALIBUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GINGER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG FLOUNDER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG EGG WHOLE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG EGG WHITE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG DOG DANDER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG DILL IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BRAZIL NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BLACK PEPPER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BASIL IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG AMOXICILLIN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BEEF (FOOD) IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BARLEY (FOOD) IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BANANA (FOOD) IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG APPLE (FOOD) IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ALMOND (FOOD) IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG YEAST BAKERS-BREWERS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WILLOW IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WHITE PINE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WHITE ASH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WHEAT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WALNUT TREE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WALNUT NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG TURKEY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG TUNA IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG TOMATO IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SYCAMORE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG STRAWBERRY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SOYBEAN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SHRIMP IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SHEEP SORREL IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SALMON IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RYE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RUSSIAN THISTLE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RICE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RHIZOPUS NIGRICANS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RAGWEED GIANT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG POTATO IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PORK IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PIGWEED IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PECAN NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PECAN HICKORY TREE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PEANUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PEACH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PEA IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG P.NOTATUM IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ORANGE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ONION IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG OAT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG OAK IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MUGWORT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MUCOR RACEMOSUS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MILK IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MARSH ELDER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MAPLE RED IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG LOBSTER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG LETTUCE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG LAMBS QRTR WEED IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG LACTALBUMIN ALPHA IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG KOCHIA FIREBUSH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HOUSE DUST GREER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HAZEL NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GLUTEN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GARLIC IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ENGLISH PLANTAIN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ELM IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG EGG YOLK IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG D.PTERON IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG D.FARINAE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CRAB IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COTTONWOOD IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CORN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CODFISH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COCKLEBUR IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CLAM IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CHOCOLATE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CHICKEN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CHEESE CHEDDAR IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CELERY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CASHEW IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CASEIN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CARROT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CAND.ALBICANS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG C.HERBARUM IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BOX ELDER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BIRCH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BEECH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ALTERNARIA IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG A.FUMIGATUS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG TIMOTHY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RYE GRASS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG ORCHARD GRASS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MEADOW FESCUE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG JUNE KENTUCKY BLUE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG JOHNSON GRASS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HORSE EPITHELIAL IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GOOSE FEATHERS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG FIRE ANT (INVICTA) | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG DUCK FEATHERS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COCKROACH GERMAN IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CHICKEN FEATHERS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CAT DANDER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BUMBLEBEE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WHEY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BAHIA GRASS IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG SWEET POTATO IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PINEAPPLE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG PEAR IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MALT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MACADAMIA NUT IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HAZEL NUT TREE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GRAPE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CUCUMBER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CRANBERRY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COTTON SEED IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG COFFEE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CINNAMON IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BLACKBERRY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BELL PEPPER IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BEAN WHITE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BEAN RED KIDNEY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BLUE MUSSEL IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG BLUEBERRY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG GUINEA PIG EPITH IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG MULBERRY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG NETTLE IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG RASPBERRY IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WATERMELON IGE | $51.50 | $103.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG WORMWOOD SAGEBRUSH IGE | $54.00 | $108.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG CORN-MAIZE IGE | $54.00 | $108.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC CURVULARIA SPICIFERA / BIPOLARIS IGE | $54.00 | $108.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG VIRGINIA LIVE OAK IGE | $54.00 | $108.00 | — | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC AG HOUSE DUT-HOLL IGE | $54.00 | $108.00 | — | — | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC SAFP-MATERNAL SERUM AFP | $132.00 | $264.00 | — | 29% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA FETOPROTEIN - TM | $132.00 | $264.00 | — | 29% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC QUADS - QDAFP QUAD SCREEN AFP | $132.00 | $264.00 | — | 29% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC PENT SCREEN-ALPHAFETOPROTEIN | $132.00 | $264.00 | — | 29% above | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC PENT SCREEN-ALPHAFETOPROTEIN | $132.00 | $264.00 | — | — | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC QUADS - QDAFP QUAD SCREEN AFP | $132.00 | $264.00 | — | — | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA FETOPROTEIN - TM | $132.00 | $264.00 | — | — | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC SAFP-MATERNAL SERUM AFP | $132.00 | $264.00 | — | — | 50% |
| Ammonia blood test CPT 82140 HC AMMONIA BLOOD | $125.00 | $250.00 | — | 4% above | 50% |
| Ammonia blood test inpatient CPT 82140 HC AMMONIA BLOOD | $125.00 | $250.00 | — | — | 50% |
| Amylase blood test CPT 82150 HC AMYLASE URINE | $42.00 | $84.00 | — | 19% below | 50% |
| Amylase blood test CPT 82150 HC AMYLASE FLUID | $42.00 | $84.00 | — | 19% below | 50% |
| Amylase blood test CPT 82150 HC AMYLASE BLOOD | $42.00 | $84.00 | — | 19% below | 50% |
| Amylase blood test inpatient CPT 82150 HC AMYLASE BLOOD | $42.00 | $84.00 | — | — | 50% |
| Amylase blood test inpatient CPT 82150 HC AMYLASE URINE | $42.00 | $84.00 | — | — | 50% |
| Amylase blood test inpatient CPT 82150 HC AMYLASE FLUID | $42.00 | $84.00 | — | — | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRIC PEPTIDE | $52.00 | $104.00 | — | 1% below | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRIC PEPTIDE | $52.00 | $104.00 | — | — | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA SCREEN | $45.50 | $91.00 | — | 24% below | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA SCREEN | $45.50 | $91.00 | — | — | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC B-TYPE NATRIURETIC PEPTIDE BNP | $176.00 | $352.00 | — | 3% above | 50% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC B-TYPE NATRIURETIC PEPTIDE BNP | $176.00 | $352.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE GU - FEMALE | $128.00 | $256.00 | — | 37% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE GU - MALE | $128.00 | $256.00 | — | 37% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE RESPIRATORY | $128.00 | $256.00 | — | 37% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE NOSE | $128.00 | $256.00 | — | 37% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE CSF | $128.00 | $256.00 | — | 37% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE MISC. | $128.00 | $256.00 | — | 37% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULT ENVIRONMENTAL | $134.50 | $269.00 | — | 44% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE GU - FEMALE | $128.00 | $256.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE NOSE | $128.00 | $256.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE CSF | $128.00 | $256.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE RESPIRATORY | $128.00 | $256.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE MISC. | $128.00 | $256.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE GU - MALE | $128.00 | $256.00 | — | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULT ENVIRONMENTAL | $134.50 | $269.00 | — | — | 50% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $53.00 | $106.00 | — | 32% below | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $53.00 | $106.00 | — | — | 50% |
| Bilirubin blood test, total CPT 82247 HC FLUID BILI TOTAL | $26.50 | $53.00 | — | 23% below | 50% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL | $26.50 | $53.00 | — | 23% below | 50% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL | $26.50 | $53.00 | — | — | 50% |
| Bilirubin blood test, total inpatient CPT 82247 HC FLUID BILI TOTAL | $26.50 | $53.00 | — | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC G&M SURG PATH-LEVEL IV PROSTATE NEEDLE BIOPSY ANY METHOD | $340.00 | $680.00 | — | 31% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC G&M SURG PATH-LEVEL IV | $340.00 | $680.00 | — | 31% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC G&M SURG PATH-LEVEL IV PROSTATE NEEDLE BIOPSY ANY METHOD | $340.00 | $680.00 | — | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC G&M SURG PATH-LEVEL IV | $340.00 | $680.00 | — | — | 50% |
| Blood culture for bacteria CPT 87040 HC CULTURE BLOOD | $130.50 | $261.00 | — | at median | 50% |
| Blood culture for bacteria inpatient CPT 87040 HC CULTURE BLOOD | $130.50 | $261.00 | — | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE | $11.00 | $22.00 | — | 34% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE | $11.00 | $22.00 | — | — | 50% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE POST PRAN | $27.00 | $54.00 | — | 1% above | 50% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE | $27.00 | $54.00 | — | 1% above | 50% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE - GEM POCT | $27.00 | $54.00 | — | 1% above | 50% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE I-STAT | $27.00 | $54.00 | — | 1% above | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE I-STAT | $27.00 | $54.00 | — | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE | $27.00 | $54.00 | — | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE - GEM POCT | $27.00 | $54.00 | — | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE POST PRAN | $27.00 | $54.00 | — | — | 50% |
| Blood lead test CPT 83655 HC LEAD BLOOD | $80.50 | $161.00 | — | 13% above | 50% |
| Blood lead test CPT 83655 HC LEAD WHOLE BLOOD | $80.50 | $161.00 | — | 13% above | 50% |
| Blood lead test CPT 83655 HC 9327-HEAVY METAL LEAD | $80.50 | $161.00 | — | 13% above | 50% |
| Blood lead test CPT 83655 HC LEAD PANEL-LEAD | $80.50 | $161.00 | — | 13% above | 50% |
| Blood lead test inpatient CPT 83655 HC LEAD WHOLE BLOOD | $80.50 | $161.00 | — | — | 50% |
| Blood lead test inpatient CPT 83655 HC 9327-HEAVY METAL LEAD | $80.50 | $161.00 | — | — | 50% |
| Blood lead test inpatient CPT 83655 HC LEAD PANEL-LEAD | $80.50 | $161.00 | — | — | 50% |
| Blood lead test inpatient CPT 83655 HC LEAD BLOOD | $80.50 | $161.00 | — | — | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUALITATIVE - SERUM | $60.00 | $120.00 | — | 18% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUALITATIVE - SERUM | $60.00 | $120.00 | — | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO | $59.50 | $119.00 | — | 21% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO | $59.50 | $119.00 | — | — | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ISTC8 -IBUNW-BUN | $24.00 | $48.00 | — | 2% above | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 HC B.U.N. | $24.00 | $48.00 | — | 2% above | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 HC FLUID BUN | $24.00 | $48.00 | — | 2% above | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC FLUID BUN | $24.00 | $48.00 | — | — | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC B.U.N. | $24.00 | $48.00 | — | — | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ISTC8 -IBUNW-BUN | $24.00 | $48.00 | — | — | 50% |
| C-peptide blood test CPT 84681 HC C-PEPTIDE | $112.00 | $224.00 | — | 18% below | 50% |
| C-peptide blood test inpatient CPT 84681 HC C-PEPTIDE | $112.00 | $224.00 | — | — | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC QUANTITATIVE CRP | $95.50 | $191.00 | — | 39% above | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC QUANTITATIVE CRP | $95.50 | $191.00 | — | — | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE DNA | $135.50 | $271.00 | — | 2% above | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC CDFE2 ENDO C DIFF AMPLIFIED PROBE | $135.50 | $271.00 | — | 2% above | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE DNA | $135.50 | $271.00 | — | — | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CDFE2 ENDO C DIFF AMPLIFIED PROBE | $135.50 | $271.00 | — | — | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19-9 | $149.50 | $299.00 | — | 3% above | 50% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19-9 | $149.50 | $299.00 | — | — | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC CA 125 | $163.00 | $326.00 | — | at median | 50% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CA 125 | $163.00 | $326.00 | — | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVL1 COVID-19, PCR | $108.50 | $217.00 | — | 3% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 CORONA VIRUS CEPHEID | $187.50 | $375.00 | — | 77% above | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVL1 COVID-19, PCR | $108.50 | $217.00 | — | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 CORONA VIRUS CEPHEID | $187.50 | $375.00 | — | — | 50% |
| Calcium blood test, total CPT 82310 HC CALCIUM TOTAL | $24.00 | $48.00 | — | 9% below | 50% |
| Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL | $24.00 | $48.00 | — | — | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA | $114.50 | $229.00 | — | 5% below | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC FCEA - FLUID CEA | $114.50 | $229.00 | — | 5% below | 50% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA | $114.50 | $229.00 | — | — | 50% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC FCEA - FLUID CEA | $114.50 | $229.00 | — | — | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC ANTI-V. ZOSTER | $122.50 | $245.00 | — | 26% above | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER IGM | $122.50 | $245.00 | — | 26% above | 50% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER IGM | $122.50 | $245.00 | — | — | 50% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTI-V. ZOSTER | $122.50 | $245.00 | — | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA RNA PROBE | $82.50 | $165.00 | — | 15% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CTRNA - SS CHLAMYDIA TRACHOMATIS RNA | $82.50 | $165.00 | — | 15% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA RNA PROBE | $82.50 | $165.00 | — | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CTRNA - SS CHLAMYDIA TRACHOMATIS RNA | $82.50 | $165.00 | — | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE | $78.50 | $157.00 | — | 25% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC NMR LIPIDS | $82.50 | $165.00 | — | 21% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE | $78.50 | $157.00 | — | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC NMR LIPIDS | $82.50 | $165.00 | — | — | 50% |
| Complete blood count (CBC) with differential CPT 85025 HC HEMAGRAM/AUTO DIFFERENTIAL | $39.00 | $78.00 | — | 6% below | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC HEMAGRAM/AUTO DIFFERENTIAL | $39.00 | $78.00 | — | — | 50% |
| Complete blood count (CBC), no differential CPT 85027 HC HEMAGRAM W/PLATELETS | $29.50 | $59.00 | — | at median | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMAGRAM W/PLATELETS | $29.50 | $59.00 | — | — | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $74.50 | $149.00 | — | 16% below | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $74.50 | $149.00 | — | — | 50% |
| Cortisol blood test, total CPT 82533 HC CORTISOL 8 A.M. | $118.50 | $237.00 | — | 26% above | 50% |
| Cortisol blood test, total CPT 82533 HC CORTISOL 4 P.M. | $118.50 | $237.00 | — | 26% above | 50% |
| Cortisol blood test, total CPT 82533 HC CORTISOL RANDOM | $118.50 | $237.00 | — | 26% above | 50% |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL RANDOM | $118.50 | $237.00 | — | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL 8 A.M. | $118.50 | $237.00 | — | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL 4 P.M. | $118.50 | $237.00 | — | — | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 HC C K | $51.50 | $103.00 | — | 33% above | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 HC CKISO TOTAL CK | $51.50 | $103.00 | — | 33% above | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CKISO TOTAL CK | $51.50 | $103.00 | — | — | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC C K | $51.50 | $103.00 | — | — | 50% |
| Creatinine blood test CPT 82565 HC CREATININE | $28.00 | $56.00 | — | 3% below | 50% |
| Creatinine blood test CPT 82565 HC ISTC8 - ICREW - CREATININE | $28.00 | $56.00 | — | 3% below | 50% |
| Creatinine blood test inpatient CPT 82565 HC ISTC8 - ICREW - CREATININE | $28.00 | $56.00 | — | — | 50% |
| Creatinine blood test inpatient CPT 82565 HC CREATININE | $28.00 | $56.00 | — | — | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC CYTOMEGALOVIRUS IGG | $94.50 | $189.00 | — | 19% above | 50% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CYTOMEGALOVIRUS IGG | $94.50 | $189.00 | — | — | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER QUANTITATIVE | $128.00 | $256.00 | — | 5% above | 50% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER QUANTITATIVE | $128.00 | $256.00 | — | — | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA-S | $117.00 | $234.00 | — | 20% below | 50% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA-S | $117.00 | $234.00 | — | — | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC UMBILICAL CORD DRUG SCREEN | $113.00 | $226.00 | — | 1% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DAS9 - 9 PANEL SERUM DRUG SCREEN | $113.00 | $226.00 | — | 1% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN MULTIDRUG IA | $113.00 | $226.00 | — | 1% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN PRESUMPTIVE, ANY NUMBER OF DRUGS | $119.00 | $238.00 | — | 4% above | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN MULTIDRUG IA | $113.00 | $226.00 | — | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DAS9 - 9 PANEL SERUM DRUG SCREEN | $113.00 | $226.00 | — | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC UMBILICAL CORD DRUG SCREEN | $113.00 | $226.00 | — | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN PRESUMPTIVE, ANY NUMBER OF DRUGS | $119.00 | $238.00 | — | — | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES | $35.00 | $70.00 | — | 46% below | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ISTC8 - ILYTESW- ELECTROLYTES | $35.00 | $70.00 | — | 46% below | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ISTC8 - ILYTESW- ELECTROLYTES | $35.00 | $70.00 | — | — | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES | $35.00 | $70.00 | — | — | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC E-B VIRUS ANTIBODY IGM | $82.00 | $164.00 | — | 1% above | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC E-B VIRUS ANTIBODY IGG | $82.00 | $164.00 | — | 1% above | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC E-B VIRUS ANTIBODY IGG | $82.00 | $164.00 | — | — | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC E-B VIRUS ANTIBODY IGM | $82.00 | $164.00 | — | — | 50% |
| Estradiol blood test CPT 82670 HC ESTRADIOL S | $147.00 | $294.00 | — | 14% above | 50% |
| Estradiol blood test inpatient CPT 82670 HC ESTRADIOL S | $147.00 | $294.00 | — | — | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC FSH | $106.00 | $212.00 | — | 17% below | 50% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH | $106.00 | $212.00 | — | — | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CAPF CALPROTECTIN FECAL | $56.00 | $112.00 | — | 69% below | 50% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CAPF CALPROTECTIN FECAL | $56.00 | $112.00 | — | — | 50% |
| Ferritin blood test (iron stores) CPT 82728 HC THEVF: BILLING FERRITIN | $114.50 | $229.00 | — | 44% above | 50% |
| Ferritin blood test (iron stores) CPT 82728 HC FERRITIN | $126.50 | $253.00 | — | 59% above | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC THEVF: BILLING FERRITIN | $114.50 | $229.00 | — | — | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN | $126.50 | $253.00 | — | — | 50% |
| Fibrinogen blood test CPT 85384 HC TEG FIBRINOGEN ACTIVITY | $70.00 | $140.00 | — | 17% above | 50% |
| Fibrinogen blood test CPT 85384 HC FIBRINOGEN LEVEL ACTIVITY | $70.00 | $140.00 | — | 17% above | 50% |
| Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN LEVEL ACTIVITY | $70.00 | $140.00 | — | — | 50% |
| Fibrinogen blood test inpatient CPT 85384 HC TEG FIBRINOGEN ACTIVITY | $70.00 | $140.00 | — | — | 50% |
| Folate (folic acid) blood test CPT 82746 HC FOLIC ACID | $103.00 | $206.00 | — | 34% above | 50% |
| Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID | $103.00 | $206.00 | — | — | 50% |
| Free T3 thyroid hormone test CPT 84481 HC T3 FREE | $103.00 | $206.00 | — | 22% below | 50% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC T3 FREE | $103.00 | $206.00 | — | — | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T 4 FREE | $74.50 | $149.00 | — | 8% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 FREE DIALYSIS | $74.50 | $149.00 | — | 8% below | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 FREE DIALYSIS | $74.50 | $149.00 | — | — | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T 4 FREE | $74.50 | $149.00 | — | — | 50% |
| Free testosterone test CPT 84402 HC TSFR-FREE TESTOSTERONE | $68.50 | $137.00 | — | 18% below | 50% |
| Free testosterone test CPT 84402 HC TESMS-TESTOSTERON FREE LCMS-MS | $68.50 | $137.00 | — | 18% below | 50% |
| Free testosterone test inpatient CPT 84402 HC TSFR-FREE TESTOSTERONE | $68.50 | $137.00 | — | — | 50% |
| Free testosterone test inpatient CPT 84402 HC TESMS-TESTOSTERON FREE LCMS-MS | $68.50 | $137.00 | — | — | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC G.G.T.P. | $29.00 | $58.00 | — | 11% below | 50% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC G.G.T.P. | $29.00 | $58.00 | — | — | 50% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL | $207.50 | $415.00 | — | 32% below | 50% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL | $207.50 | $415.00 | — | — | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE 2 HOUR POST DOSE | $43.00 | $86.00 | — | 5% above | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE 1HR POST 50GMS GLUCOSE | $43.00 | $86.00 | — | 5% above | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE 2 HOUR POST DOSE | $43.00 | $86.00 | — | — | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE 1HR POST 50GMS GLUCOSE | $43.00 | $86.00 | — | — | 50% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOL-FIRST 3 SPECIMENS | $75.50 | $151.00 | — | 2% above | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOL-FIRST 3 SPECIMENS | $75.50 | $151.00 | — | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NGRNA - SS NEISSERIA GONORRHOEAE RNA | $98.50 | $197.00 | — | 1% above | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC GONORRHEA RNA PROBE | $98.50 | $197.00 | — | 1% above | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC GONORRHEA RNA PROBE | $98.50 | $197.00 | — | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NGRNA - SS NEISSERIA GONORRHOEAE RNA | $98.50 | $197.00 | — | — | 50% |
| H. pylori stool antigen test CPT 87338 HC H. PYLORI AG STOOL | $137.50 | $275.00 | — | 5% above | 50% |
| H. pylori stool antigen test inpatient CPT 87338 HC H. PYLORI AG STOOL | $137.50 | $275.00 | — | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HC RTPCR -HIV-1 RNA QN RT BY PCR | $393.00 | $786.00 | — | 11% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HC RTPCR -HIV-1 RNA QN RT BY PCR | $393.00 | $786.00 | — | — | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV 1&2 ANTIBODY | $77.00 | $154.00 | — | 29% above | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV 1&2 ANTIBODY | $77.00 | $154.00 | — | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C POC | $28.00 | $56.00 | — | 57% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GHCF GLYCOHGB CONFIRM CONFIRM | $60.00 | $120.00 | — | 8% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HGB | $60.00 | $120.00 | — | 8% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C POC | $28.00 | $56.00 | — | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GHCF GLYCOHGB CONFIRM CONFIRM | $60.00 | $120.00 | — | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HGB | $60.00 | $120.00 | — | — | 50% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN POC | $20.00 | $40.00 | — | 9% above | 50% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN | $25.00 | $50.00 | — | 36% above | 50% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN POC | $20.00 | $40.00 | — | — | 50% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN | $25.00 | $50.00 | — | — | 50% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE AB TOTAL | $98.50 | $197.00 | — | 47% above | 50% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE AB TOTAL | $98.50 | $197.00 | — | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEP B SURFACE AB | $109.50 | $219.00 | — | 67% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEP B SURFACE AB | $109.50 | $219.00 | — | — | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SURF AG | $63.00 | $126.00 | — | 3% above | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SURF AG | $63.00 | $126.00 | — | — | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C IGG | $126.50 | $253.00 | — | 27% above | 50% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C IGG | $126.50 | $253.00 | — | — | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC HPCQN -HCQNC HEP C RNA PCR | $252.00 | $504.00 | — | 13% above | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HPCQN -HCQNC HEP C RNA PCR | $252.00 | $504.00 | — | — | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HSV1-IGG ANTIBODIES | $100.00 | $200.00 | — | 97% above | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HSVT - HSVT1 HSV 1 IGM TITER | $100.00 | $200.00 | — | 97% above | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSVT - HSVT1 HSV 1 IGM TITER | $100.00 | $200.00 | — | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV1-IGG ANTIBODIES | $100.00 | $200.00 | — | — | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HSV2-IGG ANTIBODIES | $100.00 | $200.00 | — | 38% above | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HSVT- HSVT2 HSV 2 IGM TITER | $100.00 | $200.00 | — | 38% above | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV2-IGG ANTIBODIES | $100.00 | $200.00 | — | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSVT- HSVT2 HSV 2 IGM TITER | $100.00 | $200.00 | — | — | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC HSCRP - HIGH SENSITIVITY CRP | $102.00 | $204.00 | — | 38% above | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC ULTRASENSITIVE CRP | $102.00 | $204.00 | — | 38% above | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC HSCRP - HIGH SENSITIVITY CRP | $102.00 | $204.00 | — | — | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC ULTRASENSITIVE CRP | $102.00 | $204.00 | — | — | 50% |
| Homocysteine blood test CPT 83090 HC SERUM HOMOCYSTEINE | $129.00 | $258.00 | — | 1% below | 50% |
| Homocysteine blood test CPT 83090 HC VTN HOMOCYSTEINE | $129.00 | $258.00 | — | 1% below | 50% |
| Homocysteine blood test inpatient CPT 83090 HC VTN HOMOCYSTEINE | $129.00 | $258.00 | — | — | 50% |
| Homocysteine blood test inpatient CPT 83090 HC SERUM HOMOCYSTEINE | $129.00 | $258.00 | — | — | 50% |
| Insulin blood test CPT 83525 HC INSULIN TOLERANCE-EACH SPECIMN | $63.50 | $127.00 | — | 11% below | 50% |
| Insulin blood test CPT 83525 HC INSULIN LEVEL TOTAL | $63.50 | $127.00 | — | 11% below | 50% |
| Insulin blood test inpatient CPT 83525 HC INSULIN TOLERANCE-EACH SPECIMN | $63.50 | $127.00 | — | — | 50% |
| Insulin blood test inpatient CPT 83525 HC INSULIN LEVEL TOTAL | $63.50 | $127.00 | — | — | 50% |
| Iron blood test (serum iron) CPT 83540 HC IRON | $49.50 | $99.00 | — | 3% above | 50% |
| Iron blood test (serum iron) inpatient CPT 83540 HC IRON | $49.50 | $99.00 | — | — | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 HC TOTAL IRON BINDING CAPACITY | $45.50 | $91.00 | — | 3% above | 50% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC TOTAL IRON BINDING CAPACITY | $45.50 | $91.00 | — | — | 50% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $58.00 | $116.00 | — | 43% below | 50% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $58.00 | $116.00 | — | — | 50% |
| LH (luteinizing hormone) test CPT 83002 HC LH | $147.00 | $294.00 | — | 4% above | 50% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC LH | $147.00 | $294.00 | — | — | 50% |
| Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID - GEM POCT | $104.00 | $208.00 | — | 16% above | 50% |
| Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID I-STAT | $104.00 | $208.00 | — | 16% above | 50% |
| Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID | $104.00 | $208.00 | — | 16% above | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID | $104.00 | $208.00 | — | — | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID I-STAT | $104.00 | $208.00 | — | — | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID - GEM POCT | $104.00 | $208.00 | — | — | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LD | $44.50 | $89.00 | — | 4% above | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH FLUID | $44.50 | $89.00 | — | 4% above | 50% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH FLUID | $44.50 | $89.00 | — | — | 50% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LD | $44.50 | $89.00 | — | — | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE FLUID | $96.50 | $193.00 | — | 9% above | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE | $103.50 | $207.00 | — | 17% above | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE FLUID | $96.50 | $193.00 | — | — | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE | $103.50 | $207.00 | — | — | 50% |
| Liver function blood test panel CPT 80076 HC LIVER PROFILE | $44.50 | $89.00 | — | 53% below | 50% |
| Liver function blood test panel inpatient CPT 80076 HC LIVER PROFILE | $44.50 | $89.00 | — | — | 50% |
| Lyme disease antibody test CPT 86618 HC LYME SCREEN IGG/IGM | $173.50 | $347.00 | — | 41% above | 50% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME SCREEN IGG/IGM | $173.50 | $347.00 | — | — | 50% |
| Magnesium blood test CPT 83735 HC MAGBR- RBC MAGNESIUM | $75.50 | $151.00 | — | 59% above | 50% |
| Magnesium blood test CPT 83735 HC MAGNESIUM | $80.00 | $160.00 | — | 68% above | 50% |
| Magnesium blood test inpatient CPT 83735 HC MAGBR- RBC MAGNESIUM | $75.50 | $151.00 | — | — | 50% |
| Magnesium blood test inpatient CPT 83735 HC MAGNESIUM | $80.00 | $160.00 | — | — | 50% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG AB | $106.00 | $212.00 | — | 35% above | 50% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGM | $106.00 | $212.00 | — | 35% above | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGM | $106.00 | $212.00 | — | — | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG AB | $106.00 | $212.00 | — | — | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC MONOSCREEN | $109.00 | $218.00 | — | 40% above | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONOSCREEN | $109.00 | $218.00 | — | — | 50% |
| Mumps immunity blood test CPT 86735 HC MUMPS IGM ANTIBODIES | $107.50 | $215.00 | — | 41% above | 50% |
| Mumps immunity blood test CPT 86735 HC MUMPS IGG | $107.50 | $215.00 | — | 41% above | 50% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS IGM ANTIBODIES | $107.50 | $215.00 | — | — | 50% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS IGG | $107.50 | $215.00 | — | — | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSFT - PSA FREE | $50.50 | $101.00 | — | 27% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PHIDX - PHI12 PSA FREE | $50.50 | $101.00 | — | 27% below | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSFT - PSA FREE | $50.50 | $101.00 | — | — | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PHIDX - PHI12 PSA FREE | $50.50 | $101.00 | — | — | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA-PROSTATE-SPECIFIC ANTIGEN | $88.00 | $176.00 | — | 10% above | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSAP - PSA POST PROSTATECTOMY | $88.00 | $176.00 | — | 10% above | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSAP - PSA POST PROSTATECTOMY | $88.00 | $176.00 | — | — | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA-PROSTATE-SPECIFIC ANTIGEN | $88.00 | $176.00 | — | — | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC INTRA OPERATIVE INTACT PTH | $197.50 | $395.00 | — | 3% above | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC INTACT PTH | $197.50 | $395.00 | — | 3% above | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC INTRA OPERATIVE INTACT PTH | $197.50 | $395.00 | — | — | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC INTACT PTH | $197.50 | $395.00 | — | — | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC VWIL6-APTT VWILL PANEL | $51.50 | $103.00 | — | 3% above | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC LUPT5-PTT/LA SCREEN LA EVAL | $51.50 | $103.00 | — | 3% above | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT | $64.00 | $128.00 | — | 28% above | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC VWIL6-APTT VWILL PANEL | $51.50 | $103.00 | — | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC LUPT5-PTT/LA SCREEN LA EVAL | $51.50 | $103.00 | — | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT | $64.00 | $128.00 | — | — | 50% |
| Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHOROUS | $28.50 | $57.00 | — | 1% below | 50% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHOROUS | $28.50 | $57.00 | — | — | 50% |
| Potassium blood test CPT 84132 HC POTASSIUM I-STAT | $28.50 | $57.00 | — | at median | 50% |
| Potassium blood test CPT 84132 HC POTASSIUM BLOOD | $28.50 | $57.00 | — | at median | 50% |
| Potassium blood test CPT 84132 HC POTASSIUM - GEM POCT | $28.50 | $57.00 | — | at median | 50% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM I-STAT | $28.50 | $57.00 | — | — | 50% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM BLOOD | $28.50 | $57.00 | — | — | 50% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM - GEM POCT | $28.50 | $57.00 | — | — | 50% |
| Progesterone blood test CPT 84144 HC PROGESTERONE | $142.00 | $284.00 | — | 3% above | 50% |
| Progesterone blood test inpatient CPT 84144 HC PROGESTERONE | $142.00 | $284.00 | — | — | 50% |
| Prolactin blood test CPT 84146 HC PROLACTIN | $102.50 | $205.00 | — | 2% above | 50% |
| Prolactin blood test inpatient CPT 84146 HC PROLACTIN | $102.50 | $205.00 | — | — | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $27.50 | $55.00 | — | 4% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME POCT | $27.50 | $55.00 | — | 4% above | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $27.50 | $55.00 | — | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME POCT | $27.50 | $55.00 | — | — | 50% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG SCREEN TEST POC | $50.00 | $100.00 | — | 50% below | 50% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG SCREEN TEST POC | $50.00 | $100.00 | — | — | 50% |
| Renin blood test CPT 84244 HC RENIN ACTIVITY | $116.50 | $233.00 | — | 5% above | 50% |
| Renin blood test inpatient CPT 84244 HC RENIN ACTIVITY | $116.50 | $233.00 | — | — | 50% |
| Rh blood typing CPT 86901 HC RHDD-RHDDA RHD DISCREPANCY - D ANTIGEN | $10.50 | $21.00 | — | 73% below | 50% |
| Rh blood typing CPT 86901 HC RH | $41.50 | $83.00 | — | 7% above | 50% |
| Rh blood typing inpatient CPT 86901 HC RHDD-RHDDA RHD DISCREPANCY - D ANTIGEN | $10.50 | $21.00 | — | — | 50% |
| Rh blood typing inpatient CPT 86901 HC RH | $41.50 | $83.00 | — | — | 50% |
| Rheumatoid factor (RF) test CPT 86431 HC RF QUANT | $23.50 | $47.00 | — | 52% below | 50% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC RF QUANT | $23.50 | $47.00 | — | — | 50% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA IGM | $89.00 | $178.00 | — | 34% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA SCREEN | $89.00 | $178.00 | — | 34% above | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA SCREEN | $89.00 | $178.00 | — | — | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA IGM | $89.00 | $178.00 | — | — | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SED RATE AUTOMATED | $36.50 | $73.00 | — | 6% below | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SED RATE AUTOMATED | $36.50 | $73.00 | — | — | 50% |
| Sodium blood test CPT 84295 HC SODIUM BLOOD | $44.00 | $88.00 | — | 20% above | 50% |
| Sodium blood test CPT 84295 HC SODIUM - GEM POCT | $44.00 | $88.00 | — | 20% above | 50% |
| Sodium blood test CPT 84295 HC SODIUM I-STAT | $44.00 | $88.00 | — | 20% above | 50% |
| Sodium blood test inpatient CPT 84295 HC SODIUM - GEM POCT | $44.00 | $88.00 | — | — | 50% |
| Sodium blood test inpatient CPT 84295 HC SODIUM BLOOD | $44.00 | $88.00 | — | — | 50% |
| Sodium blood test inpatient CPT 84295 HC SODIUM I-STAT | $44.00 | $88.00 | — | — | 50% |
| Stool ova and parasites exam CPT 87177 HC OPCPS - OPDS OVA PARASITE DIRECT SMEAR | $48.50 | $97.00 | — | at median | 50% |
| Stool ova and parasites exam inpatient CPT 87177 HC OPCPS - OPDS OVA PARASITE DIRECT SMEAR | $48.50 | $97.00 | — | — | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD (FECAL) SCREEN | $37.50 | $75.00 | — | 4% above | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD (FECAL) SCREEN | $37.50 | $75.00 | — | — | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC FIT OCCULT BLOOD IA DIAG | $42.50 | $85.00 | — | 18% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC FIT OCCULT BLOOD IA SCRN | $72.50 | $145.00 | — | 40% above | 50% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC FIT OCCULT BLOOD IA DIAG | $42.50 | $85.00 | — | — | 50% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC FIT OCCULT BLOOD IA SCRN | $72.50 | $145.00 | — | — | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC FTA/ABS | $98.50 | $197.00 | — | 46% above | 50% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC FTA/ABS | $98.50 | $197.00 | — | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC VDRL CSF QUAL | $41.00 | $82.00 | — | 1% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RPR BLOOD QUAL | $41.00 | $82.00 | — | 1% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC RPR BLOOD QUAL | $41.00 | $82.00 | — | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC VDRL CSF QUAL | $41.00 | $82.00 | — | — | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL | $165.00 | $330.00 | — | 39% above | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC TESMS-TESTOSTERON TOTL LCMS-MS | $165.00 | $330.00 | — | 39% above | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESMS-TESTOSTERON TOTL LCMS-MS | $165.00 | $330.00 | — | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL | $165.00 | $330.00 | — | — | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC CUPN1- MICROSOMAL AB | $78.00 | $156.00 | — | 16% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC LIVER-KIDNEY IGG MICROSOMAL | $78.00 | $156.00 | — | 16% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC ANTI-MICROSOMAL ANTIBODIES | $78.00 | $156.00 | — | 16% below | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC ANTI-MICROSOMAL ANTIBODIES | $78.00 | $156.00 | — | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC LIVER-KIDNEY IGG MICROSOMAL | $78.00 | $156.00 | — | — | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC CUPN1- MICROSOMAL AB | $78.00 | $156.00 | — | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THY STIM HORMONE | $92.50 | $185.00 | — | 13% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC CUPN1- TSH | $92.50 | $185.00 | — | 13% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC CUPN1- TSH | $92.50 | $185.00 | — | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THY STIM HORMONE | $92.50 | $185.00 | — | — | 50% |
| Total IgE blood test CPT 82785 HC IGE-QUANT | $80.50 | $161.00 | — | 7% above | 50% |
| Total IgE blood test inpatient CPT 82785 HC IGE-QUANT | $80.50 | $161.00 | — | — | 50% |
| Total cholesterol blood test CPT 82465 HC FLUID CHOLESTEROL | $34.00 | $68.00 | — | 11% above | 50% |
| Total cholesterol blood test CPT 82465 HC LIPOPROTEIN ELEPHR CHOLESTEROL | $34.00 | $68.00 | — | 11% above | 50% |
| Total cholesterol blood test CPT 82465 HC CHOLESTEROL | $34.00 | $68.00 | — | 11% above | 50% |
| Total cholesterol blood test inpatient CPT 82465 HC LIPOPROTEIN ELEPHR CHOLESTEROL | $34.00 | $68.00 | — | — | 50% |
| Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL | $34.00 | $68.00 | — | — | 50% |
| Total cholesterol blood test inpatient CPT 82465 HC FLUID CHOLESTEROL | $34.00 | $68.00 | — | — | 50% |
| Total thyroxine (T4) blood test CPT 84436 HC T-4 TOTAL | $47.50 | $95.00 | — | at median | 50% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC T-4 TOTAL | $47.50 | $95.00 | — | — | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 HC T-3 TOTAL | $125.00 | $250.00 | — | 3% above | 50% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T-3 TOTAL | $125.00 | $250.00 | — | — | 50% |
| Transferrin blood test CPT 84466 HC TRANSFERRIN | $69.50 | $139.00 | — | 18% below | 50% |
| Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN | $69.50 | $139.00 | — | — | 50% |
| Trichomonas test (NAAT) CPT 87661 HC SSTRI - T VAGINALIS SURE SWAB | $99.00 | $198.00 | — | 4% above | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC SSTRI - T VAGINALIS SURE SWAB | $99.00 | $198.00 | — | — | 50% |
| Triglycerides blood test CPT 84478 HC LIPOPROTEIN ELEPHR TRIGLYCERID | $37.00 | $74.00 | — | 3% above | 50% |
| Triglycerides blood test CPT 84478 HC TRIGLYCERIDES | $37.00 | $74.00 | — | 3% above | 50% |
| Triglycerides blood test CPT 84478 HC TRIGLYCERIDE FLUID | $37.00 | $74.00 | — | 3% above | 50% |
| Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES | $37.00 | $74.00 | — | — | 50% |
| Triglycerides blood test inpatient CPT 84478 HC LIPOPROTEIN ELEPHR TRIGLYCERID | $37.00 | $74.00 | — | — | 50% |
| Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDE FLUID | $37.00 | $74.00 | — | — | 50% |
| Troponin test, quantitative CPT 84484 HC TROPT - TROPONIN T | $157.00 | $314.00 | — | 30% above | 50% |
| Troponin test, quantitative inpatient CPT 84484 HC TROPT - TROPONIN T | $157.00 | $314.00 | — | — | 50% |
| Uric acid blood test CPT 84550 HC URIC ACID | $34.00 | $68.00 | — | 29% below | 50% |
| Uric acid blood test inpatient CPT 84550 HC URIC ACID | $34.00 | $68.00 | — | — | 50% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS (WITH MICRO) | $43.50 | $87.00 | — | 4% above | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS (WITH MICRO) | $43.50 | $87.00 | — | — | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC UROBILINOGEN | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC PROTEIN URINE RANDOM | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC KETONE URINE | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC GLUCOSE URINE RAN | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC SPEC GRAVITY URINE | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC PH URINE | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC POCT AUTOM URINALYSIS WO MICRO | $25.50 | $51.00 | — | 4% above | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC KETONE URINE | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC SPEC GRAVITY URINE | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC GLUCOSE URINE RAN | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC PROTEIN URINE RANDOM | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC POCT AUTOM URINALYSIS WO MICRO | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC UROBILINOGEN | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS | $25.50 | $51.00 | — | — | 50% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIPSTICK | $10.00 | $20.00 | — | 36% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 HC BILE URINE | $10.00 | $20.00 | — | 36% below | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC BILE URINE | $10.00 | $20.00 | — | — | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIPSTICK | $10.00 | $20.00 | — | — | 50% |
| Urine culture for bacteria, with colony count CPT 87086 HC CULTURE URINE | $43.00 | $86.00 | — | 2% below | 50% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE URINE | $43.00 | $86.00 | — | — | 50% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN 24-HR URINE | $25.50 | $51.00 | — | 26% below | 50% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN RANDOM URINE | $32.00 | $64.00 | — | 8% below | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN 24-HR URINE | $25.50 | $51.00 | — | — | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN RANDOM URINE | $32.00 | $64.00 | — | — | 50% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY POC | $55.50 | $111.00 | — | 3% above | 50% |
| Urine pregnancy test, read by color change CPT 81025 HC - HCG URINE PREG TO QUEST | $55.50 | $111.00 | — | 3% above | 50% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREG BY COLOR COMPARISON | $55.50 | $111.00 | — | 3% above | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY POC | $55.50 | $111.00 | — | — | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC - HCG URINE PREG TO QUEST | $55.50 | $111.00 | — | — | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREG BY COLOR COMPARISON | $55.50 | $111.00 | — | — | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B12 | $105.00 | $210.00 | — | 42% above | 50% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B12 | $105.00 | $210.00 | — | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY | $141.50 | $283.00 | — | 5% above | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY | $141.50 | $283.00 | — | — | 50% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC 1 25 DIHYRDOXY VITAMIN D | $223.50 | $447.00 | — | 25% above | 50% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC 1 25 DIHYRDOXY VITAMIN D | $223.50 | $447.00 | — | — | 50% |
| Zinc blood test CPT 84630 HC ZNCR - ZINC RBC | $57.00 | $114.00 | — | 31% below | 50% |
| Zinc blood test CPT 84630 HC ZINC | $57.00 | $114.00 | — | 31% below | 50% |
| Zinc blood test inpatient CPT 84630 HC ZNCR - ZINC RBC | $57.00 | $114.00 | — | — | 50% |
| Zinc blood test inpatient CPT 84630 HC ZINC | $57.00 | $114.00 | — | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC PENT SCREEN-HCG | $80.50 | $161.00 | — | 1% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG TUMOR MARKER | $80.50 | $161.00 | — | 1% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC QUADS - QDHCG QUAD SCREEN HCG | $80.50 | $161.00 | — | 1% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUANTITATIVE - SERUM | $80.50 | $161.00 | — | 1% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG TUMOR MARKER | $80.50 | $161.00 | — | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC PENT SCREEN-HCG | $80.50 | $161.00 | — | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC QUADS - QDHCG QUAD SCREEN HCG | $80.50 | $161.00 | — | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUANTITATIVE - SERUM | $80.50 | $161.00 | — | — | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 HC CHEMODENERVATION FACIAL OR CERVICAL SPINE | $673.00 | $1,346.00 | — | 4% above | 50% |
| Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERVATION FACIAL OR CERVICAL SPINE | $673.00 | $1,346.00 | — | — | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STRTCTC | $1,797.00 | $3,594.00 | — | 28% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STRTCTC | $1,797.00 | $3,594.00 | — | — | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRICAL | $2,364.00 | $4,728.00 | — | 68% above | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRICAL | $2,364.00 | $4,728.00 | — | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJ HYSTEROSALPINGOGRAM | $292.50 | $585.00 | — | 2% above | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJ SONOHYSTEROGRAPHY | $292.50 | $585.00 | — | 2% above | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJ SONOHYSTEROGRAPHY | $292.50 | $585.00 | — | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJ HYSTEROSALPINGOGRAM | $292.50 | $585.00 | — | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS/ASP/INJ MAJ JNT | $383.00 | $766.00 | — | 7% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC CT ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $383.00 | $766.00 | — | 7% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC CT ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $383.00 | $766.00 | — | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS/ASP/INJ MAJ JNT | $383.00 | $766.00 | — | — | 50% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT DEVICE | $1,975.50 | $3,951.00 | — | 5% above | 50% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERT DRUG IMPLANT DEVICE | $1,975.50 | $3,951.00 | — | — | 50% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING | $1,968.00 | $3,936.00 | — | 42% above | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING | $1,968.00 | $3,936.00 | — | — | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE/LUMBAR/DIAG | $1,941.00 | $3,882.00 | — | 89% above | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE/LUMBAR/DIAG | $1,941.00 | $3,882.00 | — | — | 50% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W/ IMAGING CT | $3,140.50 | $6,281.00 | — | 187% above | 50% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W/ IMAGING | $3,140.50 | $6,281.00 | — | 187% above | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W/ IMAGING CT | $3,140.50 | $6,281.00 | — | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W/ IMAGING | $3,140.50 | $6,281.00 | — | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST PLCMNT DEV 1ST LESION US IMAG | $1,763.50 | $3,527.00 | — | 24% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST PLCMNT DEV 1ST LESION US IMAG | $1,763.50 | $3,527.00 | — | — | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION | $1,223.50 | $2,447.00 | — | 36% above | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION | $1,223.50 | $2,447.00 | — | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC DRUG AEROSOL | $126.00 | $252.00 | — | 12% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC METERED DOSE INHALER | $126.00 | $252.00 | — | 12% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INTRAPULMONARY PERCUSSIVE THERAPY W/AEROSOL | $126.00 | $252.00 | — | 12% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC DRUG AEROSOL | $126.00 | $252.00 | — | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC METERED DOSE INHALER | $126.00 | $252.00 | — | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INTRAPULMONARY PERCUSSIVE THERAPY W/AEROSOL | $126.00 | $252.00 | — | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUS INIT 16-60 MIN | $980.50 | $1,961.00 | — | 45% above | 50% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INFUS INIT 16-60 MIN | $980.50 | $1,961.00 | — | — | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC BASIC COMPRHNSV AUDIOMETRY-AUD | $364.00 | $728.00 | — | 89% above | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC BASIC COMPRHNSV AUDIOMETRY-AUD | $364.00 | $728.00 | — | — | 50% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE & DROWSY | $719.00 | $1,438.00 | — | 5% above | 50% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE & DROWSY | $719.00 | $1,438.00 | — | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM | $203.50 | $407.00 | — | 1% above | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM | $203.50 | $407.00 | — | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INF HYD INIT 31-60 MINS | $439.00 | $878.00 | — | 20% above | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INF HYD INIT 31-60 MINS | $439.00 | $878.00 | — | — | 50% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INF THER INIT 16-60 MINS | $504.50 | $1,009.00 | — | 25% above | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INF THER INIT 16-60 MINS | $504.50 | $1,009.00 | — | — | 50% |
| IV push of a medicine, first drug CPT 96374 HC IV PUSH INITIAL | $285.50 | $571.00 | — | 35% above | 50% |
| IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INITIAL | $285.50 | $571.00 | — | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC SQ/IM INJECTION | $145.00 | $290.00 | — | 38% above | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC SQ/IM INJECTION | $145.00 | $290.00 | — | — | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPEUTIC PHLEBOTOMY | $437.50 | $875.00 | — | 108% above | 50% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPEUTIC PHLEBOTOMY | $437.50 | $875.00 | — | — | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBQ SUSR | $409.26 | $818.53 | — | at median | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBQ SUSR | $409.26 | $818.53 | — | — | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH,PERTUS(ACEL),TET,POL (PF) 15 LF-48 MCG- 5 LF UNIT/0.5ML IM SUSP | $150.98 | $301.95 | — | 3% above | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH,PERTUS(ACEL),TET,POL (PF) 15 LF-48 MCG- 5 LF UNIT/0.5ML IM SUSP | $150.98 | $301.95 | — | — | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SUSP | $92.19 | $184.38 | — | 12% above | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | $99.83 | $199.66 | — | 21% above | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SUSP | $92.19 | $184.38 | — | — | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | $99.83 | $199.66 | — | — | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG | $165.26 | $330.53 | — | 13% below | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG | $165.26 | $330.53 | — | — | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACC TS2024-25 6MOS UP(PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG | $29.05 | $58.10 | — | 26% below | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACC TS2024-25 6MOS UP(PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG | $29.05 | $58.10 | — | — | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG | $630.84 | $1,261.69 | — | at median | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP | $1,062.82 | $2,125.64 | — | 68% above | 50% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG | $630.84 | $1,261.69 | — | — | 50% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP | $1,062.82 | $2,125.64 | — | — | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VACCINE (PF) 720 ELISA UNIT- 20 MCG/ML IM SYRG | $238.59 | $477.18 | — | at median | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A AND B VACCINE (PF) 720 ELISA UNIT- 20 MCG/ML IM SYRG | $238.59 | $477.18 | — | — | 50% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG | $170.44 | $340.88 | — | at median | 50% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG | $170.44 | $340.88 | — | — | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG | $127.36 | $254.73 | — | 49% above | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG | $127.36 | $254.73 | — | — | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | $193.83 | $387.66 | — | 10% above | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP | $249.58 | $499.17 | — | 42% above | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | $193.83 | $387.66 | — | — | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP | $249.58 | $499.17 | — | — | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG | $296.22 | $592.43 | — | 1% below | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG | $296.22 | $592.43 | — | — | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG | $89.82 | $179.63 | — | 23% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP | $95.62 | $191.24 | — | 31% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG | $89.82 | $179.63 | — | — | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP | $95.62 | $191.24 | — | — | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR | $61.05 | $122.10 | — | 25% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR | $61.05 | $122.10 | — | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC TS2024-25(65YR UP)-PF 180 MCG/0.5 ML IM SYRG | $66.09 | $132.18 | — | 63% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC TS2024-25(65YR UP)-PF 180 MCG/0.5 ML IM SYRG | $66.09 | $132.18 | — | — | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBQ SOLR | $213.00 | $426.00 | — | 17% below | 50% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBQ SOLR | $213.00 | $426.00 | — | — | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT | $497.23 | $994.46 | — | 42% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENIN C,Y,W-135 VAC,1 OF 2(PF) 5 MCG X 3/ 0.5 ML (FINAL) IM SOLR | $544.94 | $1,089.87 | — | 56% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT | $497.23 | $994.46 | — | — | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENIN C,Y,W-135 VAC,1 OF 2(PF) 5 MCG X 3/ 0.5 ML (FINAL) IM SOLR | $544.94 | $1,089.87 | — | — | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG | $387.95 | $775.90 | — | at median | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG | $387.95 | $775.90 | — | — | 50% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $466.48 | $932.96 | — | at median | 50% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $466.48 | $932.96 | — | — | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $532.20 | $1,064.39 | — | 15% below | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $532.20 | $1,064.39 | — | — | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG | $268.66 | $537.33 | — | 27% above | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG | $268.66 | $537.33 | — | — | 50% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP | $907.72 | $1,815.43 | — | 632% above | 50% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP | $907.72 | $1,815.43 | — | — | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML IM SYRG | $1,135.24 | $2,270.47 | — | at median | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML IM SYRG | $1,135.24 | $2,270.47 | — | — | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG | $1,135.24 | $2,270.47 | — | at median | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG | $1,135.24 | $2,270.47 | — | — | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR | $588.40 | $1,176.79 | — | 3% below | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR | $588.40 | $1,176.79 | — | — | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE S.O. | $1,309.92 | $2,619.84 | — | 64% above | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR | $1,309.92 | $2,619.84 | — | 64% above | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR | $1,309.92 | $2,619.84 | — | — | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE S.O. | $1,309.92 | $2,619.84 | — | — | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR | $390.28 | $780.57 | — | at median | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR | $422.96 | $845.92 | — | 8% above | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR | $390.28 | $780.57 | — | — | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR | $422.96 | $845.92 | — | — | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG | $159.04 | $318.09 | — | 39% above | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG | $159.04 | $318.09 | — | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG S.O. | $156.00 | $311.99 | — | 27% above | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG | $160.60 | $321.20 | — | 31% above | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG S.O. | $156.00 | $311.99 | — | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG | $160.60 | $321.20 | — | — | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG | $325.62 | $651.24 | — | at median | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG | $325.62 | $651.24 | — | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN- 1 VAC | $83.50 | $167.00 | — | 36% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN- 1 VAC | $83.50 | $167.00 | — | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUN ADMIN EA ADD | $65.00 | $130.00 | — | 64% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUN ADMIN EA ADD | $65.00 | $130.00 | — | — | 50% |
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.